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Sample records for trial comparing traditional

  1. A Randomized Controlled Trial Comparing the Letter Project Advance Directive to Traditional Advance Directive.

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S; Neri, Eric; Kraemer, Helena

    2017-09-01

    Simpler alternatives to traditional advance directives that are easy to understand and available in multiple formats and can be initiated by patients and families will help facilitate advance care planning. The goal of this study was to compare the acceptability of the letter advance directive (LAD) to the traditional advance directive (TAD) of the state of California. A web-based, randomized controlled trial was conducted, in which the participants were randomized to one of two types of advance directives (ADs): the LAD (intervention) or the TAD (control). Primary outcomes were participant ratings of the ease, value, and their level of comfort in the AD document they completed. A total of 400 participants completed the study, with 216 randomized to the LAD and 184 to the TAD by a computerized algorithm. Overall, participants preferred the LAD to the TAD (success rate difference [SRD] = 0.46, 95th percentile confidence interval [CI]: 0.36-0.56, p advance directive to be a better alternative to the traditional advance directive form.

  2. Active learning on the ward: outcomes from a comparative trial with traditional methods.

    Science.gov (United States)

    Melo Prado, Hegla; Hannois Falbo, Gilliatt; Rodrigues Falbo, Ana; Natal Figueirôa, José

    2011-03-01

    Academic activity during internship is essentially practical and ward rounds are traditionally considered the cornerstone of clinical education. However, the efficacy and effectiveness of ward rounds for learning purposes have been under-investigated and it is necessary to assess alternative educational paradigms for this activity. This study aimed to compare the educational effectiveness of ward rounds conducted with two different learning methodologies. Student subjects were first tested on 30 true/false questions to assess their initial degree of knowledge on pneumonia and diarrhoea. Afterwards, they attended ward rounds conducted using an active and a traditional learning methodology. The participants were submitted to a second test 48hours later in order to assess knowledge acquisition and were asked to answer two questions about self-directed learning and their opinions on the two learning methodologies used. Seventy-two medical students taking part in a paediatric clinic rotation were enrolled. The active methodology proved to be more effective than the traditional methodology for the three outcomes considered: knowledge acquisition (33 students [45.8%] versus 21 students [29.2%]; p=0.03); self-directed learning (38 students [52.8%] versus 11 students [15.3%]; pmethods (61 students [84.7%] versus 38 students [52.8%]; ptraditional methodology in a ward-based context. This study seems to be valuable in terms of the new evidence it demonstrates on learning methodologies in the context of the ward round. © Blackwell Publishing Ltd 2011.

  3. A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain

    Directory of Open Access Journals (Sweden)

    Tamara J. Somers

    2016-01-01

    Full Text Available Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N=30 to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad. This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p’s < 0.05. These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.

  4. A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Watson, Angus J M; Bruhn, Hanne; MacLeod, Kathleen; McDonald, Alison; McPherson, Gladys; Kilonzo, Mary; Norrie, John; Loudon, Malcolm A; McCormack, Kirsty; Buckley, Brian; Brown, Steven; Curran, Finlay; Jayne, David; Rajagopal, Ramesh; Cook, Jonathan A

    2014-11-11

    Current interventions for haemorrhoidal disease include traditional haemorrhoidectomy (TH) and stapled haemorrhoidopexy (SH) surgery. However, uncertainty remains as to how they compare from a clinical, quality of life (QoL) and economic perspective. The study is therefore designed to determine whether SH is more effective and more cost-effective, compared with TH. eTHoS (either Traditional Haemorrhoidectomy or Stapled Haemorrhoidopexy for Haemorrhoidal Disease) is a pragmatic, multicentre, randomised controlled trial. Currently, 29 secondary care centres are open to recruitment. Patients, aged 18 year or older, with circumferential haemorrhoids grade II to IV, are eligible to take part. The primary clinical and economic outcomes are QoL profile (area under the curve derived from the EuroQol Group's 5 Dimension Health Status Questionnaire (EQ-5D) at all assessment points) and incremental cost per quality adjusted life year (QALY) based on the responses to the EQ-5D at 24 months. The secondary outcomes include a comparison of the SF-36 scores, pain and symptoms sub-domains, disease recurrence, complication rates and direct and indirect costs to the National Health Service (NHS). A sample size of n =338 per group has been calculated to provide 90% power to detect a difference in the mean area under the curve (AUC) of 0.25 standard deviations derived from EQ-5D score measurements, with a two-sided significance level of 5%. Allowing for non-response, 400 participants will be randomised per group. Randomisation will utilise a minimisation algorithm that incorporates centre, grade of haemorrhoidal disease, baseline EQ-5D score and gender. Blinding of participants and outcome assessors is not attempted. This is one of the largest trials of its kind. In the United Kingdom alone, 29,000 operations for haemorrhoidal disease are done annually. The trial is therefore designed to give robust evidence on which clinicians and health service managers can base management decisions

  5. A better way to teach knot tying: a randomized controlled trial comparing the kinesthetic and traditional methods.

    Science.gov (United States)

    Huang, Emily; Chern, Hueylan; O'Sullivan, Patricia; Cook, Brian; McDonald, Erik; Palmer, Barnard; Liu, Terrence; Kim, Edward

    2014-10-01

    Knot tying is a fundamental and crucial surgical skill. We developed a kinesthetic pedagogical approach that increases precision and economy of motion by explicitly teaching suture-handling maneuvers and studied its effects on novice performance. Seventy-four first-year medical students were randomized to learn knot tying via either the traditional or the novel "kinesthetic" method. After 1 week of independent practice, students were videotaped performing 4 tying tasks. Three raters scored deidentified videos using a validated visual analog scale. The groups were compared using analysis of covariance with practice knots as a covariate and visual analog scale score (range, 0 to 100) as the dependent variable. Partial eta-square was calculated to indicate effect size. Overall rater reliability was .92. The kinesthetic group scored significantly higher than the traditional group for individual tasks and overall, controlling for practice (all P kinesthetic overall mean was 64.15 (standard deviation = 16.72) vs traditional 46.31 (standard deviation = 16.20; P kinesthetic suture handling substantively improved performance on knot tying. We believe this effect can be extrapolated to more complex surgical skills. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Randomized Controlled Trial Comparing Smartphone Assisted Versus Traditional Guided Self-Help for Adults with Binge Eating

    Science.gov (United States)

    Hildebrandt, Tom; Michaelides, Andreas; Mackinnon, Dianna; Greif, Rebecca; DeBar, Lynn; Sysko, Robyn

    2017-01-01

    Objective Guided self-help treatments based on cognitive-behavior therapy (CBT-GSH) are efficacious for binge eating. With limited availability of CBT-GSH in the community, mobile technology offers a means to increase use of these interventions. The purpose of this study was to test the initial efficacy of Noom Monitor, a smartphone application designed to facilitate CBT-GSH (CBT-GSH+Noom), on study retention, adherence, and eating disorder symptoms compared to traditional CBT-GSH. Method Sixty-six men and women with DSM-5 binge eating disorder (BED) or bulimia nervosa (BN) were randomized to receive 8 sessions of CBT-GSH + Noom (n = 33) or CBT-GSH (n = 33) over 12 weeks. Primary symptom outcomes were Eating Disorder Examination objective bulimic episodes (OBEs), subjective bulimic episodes (SBEs), and compensatory behaviors. Assessments were collected at 0, 4, 8, 12, 24, and 36 weeks. Behavioral outcomes were modeled using zero-inflated negative-binomial latent growth curve models with intent-to-treat. Results There was a significant effect of treatment on change in OBEs (β =−0.84, 95%CI = −1.49, −0.19) favoring CBT-GSH + Noom. Remission rates were not statistically different between treatments for OBEs (βlogit =−0.73, 95%CI = −1.86, 3.27; CBT-GSH + Noom = 17/27, 63.0% vs. CBT-GSH 11/27, 40.7%, NNT = 4.5), but CBT-GSH + Noom participants reported greater meal and snack adherence and regular meal adherence mediated treatment effects on OBEs. The treatments did not differ at the 6-month follow-up. Discussion Smartphone applications for the treatment binge eating appear to have advantages for adherence, a critical component of treatment dissemination. PMID:28960384

  7. Randomized controlled trial comparing smartphone assisted versus traditional guided self-help for adults with binge eating.

    Science.gov (United States)

    Hildebrandt, Tom; Michaelides, Andreas; Mackinnon, Dianna; Greif, Rebecca; DeBar, Lynn; Sysko, Robyn

    2017-11-01

    Guided self-help treatments based on cognitive-behavior therapy (CBT-GSH) are efficacious for binge eating. With limited availability of CBT-GSH in the community, mobile technology offers a means to increase use of these interventions. The purpose of this study was to test the initial efficacy of Noom Monitor, a smartphone application designed to facilitate CBT-GSH (CBT-GSH + Noom), on study retention, adherence, and eating disorder symptoms compared to traditional CBT-GSH. Sixty-six men and women with DSM-5 binge-eating disorder (BED) or bulimia nervosa (BN) were randomized to receive eight sessions of CBT-GSH + Noom (n = 33) or CBT-GSH (n = 33) over 12 weeks. Primary symptom outcomes were eating disorder examination objective bulimic episodes (OBEs), subjective bulimic episodes (SBEs), and compensatory behaviors. Assessments were collected at 0, 4, 8, 12, 24, and 36 weeks. Behavioral outcomes were modeled using zero-inflated negative-binomial latent growth curve models with intent-to-treat. There was a significant effect of treatment on change in OBEs (β = -0.84, 95% CI = -1.49, -0.19) favoring CBT-GSH + Noom. Remission rates were not statistically different between treatments for OBEs (β logit  = -0.73, 95% CI = -1.86, 3.27; CBT-GSH-Noom = 17/27, 63.0% vs. CBT-GSH 11/27, 40.7%, NNT = 4.5), but CBT-GSH-Noom participants reported greater meal and snack adherence and regular meal adherence mediated treatment effects on OBEs. The treatments did not differ at the 6-month follow-up. Smartphone applications for the treatment binge eating appear to have advantages for adherence, a critical component of treatment dissemination. © 2017 Wiley Periodicals, Inc.

  8. The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial

    Science.gov (United States)

    Thow, Megan; Ferguson, Stuart G

    2016-01-01

    Background Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-reach populations), cost effectiveness, and usability. However, to date, no studies have examined how participants recruited via social media progress through a study compared with those recruited using more traditional recruitment strategies. Objectives (1) Examine whether visiting the study website prior to being contacted by researchers creates self-screened participants who are more likely to progress through all study phases (eligible, enrolled, completed); (2) compare conversion percentages and cost effectiveness of each recruitment method at each study phase; and, (3) compare demographic and smoking characteristics of participants recruited through each strategy to determine if they attract similar samples. Methods Participants recruited to a smoking cessation clinical trial were grouped by how they had become aware of the study: via social media (Facebook) or traditional media (eg, newspaper, flyers, radio, word of mouth). Groups were compared based on throughput data (conversion percentages and cost) as well as demographic and smoking characteristics. Results Visiting the study website did not result in individuals who were more likely to be eligible for (P=.24), enroll in (P=.20), or complete (P=.25) the study. While using social media was more cost effective than traditional methods when we examined earlier endpoints of the recruitment process (cost to obtain a screened respondent: AUD $22.73 vs $29.35; cost to obtain an eligible respondent: $37.56 vs $44.77), it was

  9. The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial.

    Science.gov (United States)

    Frandsen, Mai; Thow, Megan; Ferguson, Stuart G

    2016-08-10

    Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-reach populations), cost effectiveness, and usability. However, to date, no studies have examined how participants recruited via social media progress through a study compared with those recruited using more traditional recruitment strategies. (1) Examine whether visiting the study website prior to being contacted by researchers creates self-screened participants who are more likely to progress through all study phases (eligible, enrolled, completed); (2) compare conversion percentages and cost effectiveness of each recruitment method at each study phase; and, (3) compare demographic and smoking characteristics of participants recruited through each strategy to determine if they attract similar samples. Participants recruited to a smoking cessation clinical trial were grouped by how they had become aware of the study: via social media (Facebook) or traditional media (eg, newspaper, flyers, radio, word of mouth). Groups were compared based on throughput data (conversion percentages and cost) as well as demographic and smoking characteristics. Visiting the study website did not result in individuals who were more likely to be eligible for (P=.24), enroll in (P=.20), or complete (P=.25) the study. While using social media was more cost effective than traditional methods when we examined earlier endpoints of the recruitment process (cost to obtain a screened respondent: AUD $22.73 vs $29.35; cost to obtain an eligible respondent: $37.56 vs $44.77), it was less cost effective in later endpoints

  10. Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: a randomized crossover feeding trial.

    Science.gov (United States)

    Santiago-Torres, Margarita; Kratz, Mario; Lampe, Johanna W; Tapsoba, Jean De Dieu; Breymeyer, Kara L; Levy, Lisa; Villaseñor, Adriana; Wang, Ching-Yun; Song, Xiaoling; Neuhouser, Marian L

    2016-02-01

    Mexican immigrants are disproportionally affected by diet-related risk of metabolic dysfunction. Whether adhering to a traditional Mexican diet or adopting a US diet contributes to metabolic changes associated with future risk of type 2 diabetes and other chronic diseases has not been investigated. The purpose of this study was to test in a randomized crossover feeding trial the metabolic responses to a Mexican diet compared with a commonly consumed US diet. First- and second-generation healthy women of Mexican descent (n = 53) were randomly assigned in a crossover design to consume a Mexican or US diet for 24 d each, separated by a 28-d washout period. Diets were eucaloric and similar in macronutrient composition. The metabolic responses to diets were assessed by measuring fasting serum concentrations of glucose, insulin, insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), adiponectin, C-reactive protein (CRP), and interleukin 6 (IL-6), as well as the homeostasis model assessment of insulin resistance (HOMA-IR) at the beginning and end of each period. Linear mixed models tested the intervention effect on the biomarkers, while adjusting for diet sequence, feeding period, baseline and washout biomarker concentrations, age, acculturation, and BMI. Compared with the US diet, the Mexican diet reduced insulin by 14% [geometric means (95% CIs): 9.3 (8.3, 10.3) compared with 8.0 (7.2, 8.9) μU/mL; P = 0.02], HOMA-IR by 15% [2.0 (1.8, 2.3) compared with 1.7 (1.6, 2.0); P = 0.02], and IGFBP-3 by 6% (mean ± SEM: 2420 ± 29 compared with 2299 ± 29 ng/mL; P diet. Compared with the commonly consumed US diet, the traditional Mexican diet modestly improved insulin sensitivity under conditions of weight stability in healthy women of Mexican descent, while having no impact on biomarkers of inflammation. This trial was registered at clinicaltrials.gov as NCT01369173. © 2016 American Society for Nutrition.

  11. The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program.

    Science.gov (United States)

    Terry, Paul E; Fowles, Jinnet Briggs; Xi, Min; Harvey, Lisa

    2011-01-01

    PURPOSE. This study compares a traditional worksite-based health promotion program with an activated consumer program and a control program DESIGN. Group randomized controlled trial with 18-month intervention. SETTING. Two large Midwestern companies. SUBJECTS. Three hundred and twenty employees (51% response). INTERVENTION. The traditional health promotion intervention offered population-level campaigns on physical activity, nutrition, and stress management. The activated consumer intervention included population-level campaigns for evaluating health information, choosing a health benefits plan, and understanding the risks of not taking medications as prescribed. The personal development intervention (control group) offered information on hobbies. The interventions also offered individual-level coaching for high risk individuals in both active intervention groups. MEASURES. Health risk status, general health status, consumer activation, productivity, and the ability to evaluate health information. ANALYSIS. Multivariate analyses controlled for baseline differences among the study groups. RESULTS. At the population level, compared with baseline performance, the traditional health promotion intervention improved health risk status, consumer activation, and the ability to recognize reliable health websites. Compared with baseline performance, the activated consumer intervention improved consumer activation, productivity, and the ability to recognize reliable health websites. At the population level, however, only the activated consumer intervention improved any outcome more than the control group did; that outcome was consumer activation. At the individual level for high risk individuals, both traditional health coaching and activated consumer coaching positively affected health risk status and consumer activation. In addition, both coaching interventions improved participant ability to recognize a reliable health website. Consumer activation coaching also

  12. Just-in-time consent: The ethical case for an alternative to traditional informed consent in randomized trials comparing an experimental intervention with usual care.

    Science.gov (United States)

    Vickers, Andrew J; Young-Afat, Danny A; Ehdaie, Behfar; Kim, Scott Yh

    2018-02-01

    Informed consent for randomized trials often causes significant and persistent anxiety, distress and confusion to patients. Where an experimental treatment is compared to a standard care control, much of this burden is potentially avoidable in the control group. We propose a "just-in-time" consent in which consent discussions take place in two stages: an initial consent to research from all participants and a later specific consent to randomized treatment only from those assigned to the experimental intervention. All patients are first approached and informed about research procedures, such as questionnaires or tests. They are also informed that they might be randomly selected to receive an experimental treatment and that, if selected, they can learn more about the treatment and decide whether or not to accept it at that time. After randomization, control patients undergo standard clinical consent whereas patients randomized to the experimental procedure undergo a second consent discussion. Analysis would be by intent-to-treat, which protects the trial from selection bias, although not from poor acceptance of experimental treatment. The advantages of just-in-time consent stem from the fact that only patients randomized to the experimental treatment are subject to a discussion of that intervention. We hypothesize that this will reduce much of the patient's burden associated with the consent process, such as decisional anxiety, confusion and information overload. We recommend well-controlled studies to compare just-in-time and traditional consent, with endpoints to include characteristics of participants, distress and anxiety and participants' understanding of research procedures.

  13. Comparability of prostate trials

    DEFF Research Database (Denmark)

    Suciu, S; Sylvester, R; Iversen, P

    1993-01-01

    The present overview of advanced prostate cancer required the identification of randomized clinical trials studying the question of maximal androgen blockade versus the classic castration therapy. The heterogeneity of the trials concerned the type of castration (surgical or chemical) and the type...... of antiandrogen (flutamide, Anandron, or cyproterone acetate) added to castration. This paper reviews the different types of heterogeneity that might exist among trials that are involved in the overview: study design, randomization procedure, treatment evaluation, statistical evaluation, and data maturity....... In order to overcome these various types of heterogeneity and to compare like with like, the treatment comparison should be stratified a posteriori by question (i.e., type of castration or type of anti-androgen studied) and by study. In this way, one may draw valid conclusions. Of course, those trials...

  14. A randomized control trial comparing use of a novel electrocardiogram simulator with traditional teaching in the acquisition of electrocardiogram interpretation skill.

    Science.gov (United States)

    Fent, Graham; Gosai, Jivendra; Purva, Makani

    2016-01-01

    Accurate interpretation of the electrocardiogram (ECG) remains an essential skill for medical students and junior doctors. While many techniques for teaching ECG interpretation are described, no single method has been shown to be superior. This randomized control trial is the first to investigate whether teaching ECG interpretation using a computer simulator program or traditional teaching leads to improved scores in a test of ECG interpretation among medical students and postgraduate doctors immediately after and 3months following teaching. Participants' opinions of the program were assessed using a questionnaire. There were no differences in ECG interpretation test scores immediately after or 3months after teaching in the lecture or simulator groups. At present therefore, there is insufficient evidence to suggest that ECG simulator programs are superior to traditional teaching. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. A pragmatic multicentre randomised controlled trial comparing stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease: the eTHoS study.

    Science.gov (United States)

    Watson, Angus Jm; Cook, Jonathan; Hudson, Jemma; Kilonzo, Mary; Wood, Jessica; Bruhn, Hanne; Brown, Steven; Buckley, Brian; Curran, Finlay; Jayne, David; Loudon, Malcolm; Rajagopal, Ramesh; McDonald, Alison; Norrie, John

    2017-11-01

    Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remains as to which of these surgical procedures is the most clinically effective and cost-effective. The aim of this study was to compare the clinical effectiveness and cost-effectiveness of SH with that of TH. A large, open two-arm parallel-group pragmatic multicentre randomised controlled trial involving 32 UK hospitals and a within-trial cost-benefit analysis. A discrete choice experiment was conducted to estimate benefits (willingness to pay). Patients with grades II-IV haemorrhoids who had not previously undergone SH or TH were included in the study. Participants were randomised to receive either SH or TH. Randomisation was minimised at 1 : 1, in accordance with baseline EuroQol-5 Dimensions, three-level version (EQ-5D-3L) score, haemorrhoid grade, sex and centre, via an automated system. The primary outcome was area under the quality-of-life curve measured using the EQ-5D-3L descriptive system over 24 months, and the primary economic outcome was the incremental cost-effectiveness ratio. Secondary outcomes included disease-specific quality of life, recurrence, complications, further interventions and costs. Between January 2011 and August 2014, 777 patients were randomised (389 to receive SH and 388 to receive TH). There were 774 participants included in the analysis as a result of one post-randomisation exclusion in the SH arm and two in the TH arm. SH was less painful than TH in the short term. Surgical complications were similar in both arms. EQ-5D-3L score was higher for the SH arm in the first 6 weeks after surgery, but

  16. A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: The two-person CPR study.

    Science.gov (United States)

    Roppolo, Lynn P; Heymann, Rahm; Pepe, Paul; Wagner, James; Commons, Bradford; Miller, Ronna; Allen, Emilie; Horne, Leyla; Wainscott, Michael P; Idris, Ahamed H

    2011-03-01

    The primary purpose of this study was to compare two, shorter, self-directed methods of cardiopulmonary resuscitation (CPR) education for healthcare professionals (HCP) to traditional training with a focus on the trainee's ability to perform two-person CPR. First-year medical students with either no prior CPR for HCP experience or prior training greater than 5 years were randomized to complete one of three courses: 1) HeartCode BLS System, 2) BLS Anytime, or 3) Traditional training. Only data from the adult CPR skills testing station was reviewed via video recording by certified CPR instructors and the Laerdal PC Skill Reporter software program (Laerdal Medical, Stavanger, Norway). There were 180 first-year medical students who met inclusion criteria: 68 were HeartCode BLS System, 53 BLS Anytime group, and 59 traditional group Regarding two-person CPR, 57 (84%) of Heartcode BLS students and 43 (81%) of BLS Anytime students were able to initiate the switch compared to 39 (66%) of traditional course students (p = 0.04). There were no significant differences in the quality of chest compressions or ventilations between the three groups. There was a trend for a much higher CPR skills testing pass rate for the traditional course students. However, failure to "clear to analyze or shock" while using the AED was the most common reason for failure in all groups. The self-directed learning groups not only had a high level of success in initiating the "switch" to two-person CPR, but were not significantly different from students who completed traditional training. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  17. The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial

    OpenAIRE

    Frandsen, Mai; Thow, Megan; Ferguson, Stuart G

    2016-01-01

    Background Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-re...

  18. Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym.

    Science.gov (United States)

    Bustamante Valles, Karla; Montes, Sandra; Madrigal, Maria de Jesus; Burciaga, Adan; Martínez, María Elena; Johnson, Michelle J

    2016-09-15

    Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the

  19. Comparative Economic Analysis of Beekeeping Using Traditional ...

    African Journals Online (AJOL)

    The study was carried out in Tabora and Katavi regions in the miombo woodlands of Tanzania. The overall objective of the study was to undertake a comparative economic analysis of beekeeping using improved or traditional beehives. Data were collected from 198 beekeepers that were randomly selected from a sampling ...

  20. Comparability of prostate trials

    DEFF Research Database (Denmark)

    Suciu, S; Sylvester, R; Iversen, P

    1993-01-01

    The present overview of advanced prostate cancer required the identification of randomized clinical trials studying the question of maximal androgen blockade versus the classic castration therapy. The heterogeneity of the trials concerned the type of castration (surgical or chemical) and the type...

  1. A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal.

    Science.gov (United States)

    Mantovani, Edoardo; Arduino, Paolo Giacomo; Schierano, Gianmario; Ferrero, Luca; Gallesio, Giorgia; Mozzati, Marco; Russo, Andrea; Scully, Crispian; Carossa, Stefano

    2014-10-01

    The surgical removal of mandibular third molars is frequently accompanied by significant postsurgical sequelae, and different protocols have been described to decrease such adverse events. The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during mandibular third molar removal. A single-center, randomized, split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral mandibular third molar teeth. Each patient was treated, at the same appointment, using bur removal on 1 side of the mandible and a piezoelectric device on the contralateral side. The primary outcomes reported were postoperative pain, objective orofacial swelling, and surgical duration; secondary outcomes were gender, age, and possible adverse events. Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup, and categorical variables were analyzed by χ(2) test. The study sample consisted of 100 otherwise healthy patients. The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur (conventional) removal, reaching statistical difference after 4 days (P = .043). The clinical value of orofacial swelling at day 7, normalized to baseline, was lower in the piezosurgery group (P piezosurgery group (P piezosurgery for lower third molar tooth removal. This study also compared surgeons with different degrees of experience. It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. [Comparison of the effectiveness and cost of treatment with humid environment as compared to traditional cure. Clinical trial on primary care patients with venous leg ulcers and pressure ulcers].

    Science.gov (United States)

    Capillas Pérez, R; Cabré Aguilar, V; Gil Colomé, A M; Gaitano García, A; Torra i Bou, J E

    2000-01-01

    The discovery of moist environment dressings as alternatives to the traditional treatments based on exposing wounds to air, opened new expectations for the care and treatment of chronic wounds. Over the years, these expectations have led to the availability of new moist environment dressings which have made it possible to improve the care provided to patients suffering this kind of wounds, as well as providing important reasons to weigh in terms of cost-benefit-effectiveness at the time of selecting which type of treatment should be employed. The lack of comparative analysis among traditional treatments and moist environment treatments for chronic wounds among patients receiving primary health care led the authors to perform an analysis comparing these aforementioned options of treatment on patients suffering venous leg ulcers or pressure ulcers. The authors designed a Randomized Clinical Trial involving patients receiving ambulatory care in order to compare the effectiveness and cost-benefit of traditional versus moist environment dressing during the treatment of patients suffering stage II or III pressure ulcers or venous leg ulcers. In this trial, variables related to effectiveness of both treatments, as well as their costs were analyzed. 70 wounds were included in this Randomized Clinical Trial, 41 were venous leg ulcers of which 21 received a moist environment treatment while 20 received traditional cure, the other 29 wounds were pressure ulcers of which 15 received moist environment dressings treatment and 14 received traditional dressings. No statistically significant differences were found among the defining variables for these lesions in either group under treatment. In the venous leg ulcer study group, the authors conclusions were an average of 18.13 days, 16.33 treatment sessions and a cost of 10,616 pesetas to heal one square centimeter of the initial surface area of a wound on patients treated with traditional treatment compared to an average of 18

  3. Traditional Chinese and Thai medicine in a comparative perspective.

    Science.gov (United States)

    He, Ke

    2015-12-01

    The work presented in this paper compares traditional Chinese medicine and traditional Thai medicine, expounding on origins, academic thinking, theoretical system, diagnostic method and modern development. Based on a secondary analysis of available literature, the paper concentrates on two crucial historical developments: (1) the response to, and consequences of, the impact of the Western medicine; and (2) the revival of traditional medicine in these two countries and its prospects. From a comparative perspective, the analysis has led to the conclusion that the rise and fall of traditional medicine is an issue closely related with social and political issues; and the development of traditional medicines requires national policy and financial support from governments, human resource development, the improvement of service quality, and the dissemination of traditional medicine knowledge to the public. In addition, this paper also suggests deepening exchanges and cooperation between China and Thailand, strengthening cooperation between traditional medicine and medical tourism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. A Comparative Analysis of Charter Schools and Traditional Public Schools

    Science.gov (United States)

    Smith, Jodi Renee Abbott

    2014-01-01

    The focus of this descriptive research study was to compare charter and traditional public schools on the academic knowledge of fifth grade students as measured by Arizona's Instrument to Measure Standards (AIMS) in a suburb of a large southwestern city. This analysis also compared charter and traditional public schools on AYP status. It was…

  5. Comfrey root: from tradition to modern clinical trials.

    Science.gov (United States)

    Staiger, Christiane

    2013-02-01

    Comfrey (Symphytum officinale L.) has been used over many centuries as a medicinal plant. In particular, the use of the root has a longstanding tradition. Today, several randomised controlled trials have demonstrated the efficacy and safety. Comfrey root extract has been used for the topical treatment of painful muscle and joint complaints. It is clinically proven to relieve pain, inflammation and swelling of muscles and joints in the case of degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents, also in children aged 3 years and older. This paper provides information on clinical trials, non-interventional studies and further literature published on comfrey root till date.

  6. Mobile Learning vs. Traditional Classroom Lessons: A Comparative Study

    Science.gov (United States)

    Furió, D.; Juan, M.-C.; Seguí, I.; Vivó, R.

    2015-01-01

    Different methods can be used for learning, and they can be compared in several aspects, especially those related to learning outcomes. In this paper, we present a study in order to compare the learning effectiveness and satisfaction of children using an iPhone game for learning the water cycle vs. the traditional classroom lesson. The iPhone game…

  7. Comparing Traditional and Crowdsourcing Methods for Pretesting Survey Questions

    Directory of Open Access Journals (Sweden)

    Jennifer Edgar

    2016-10-01

    Full Text Available Cognitive interviewing is a common method used to evaluate survey questions. This study compares traditional cognitive interviewing methods with crowdsourcing, or “tapping into the collective intelligence of the public to complete a task.” Crowdsourcing may provide researchers with access to a diverse pool of potential participants in a very timely and cost-efficient way. Exploratory work found that crowdsourcing participants, with self-administered data collection, may be a viable alternative, or addition, to traditional pretesting methods. Using three crowdsourcing designs (TryMyUI, Amazon Mechanical Turk, and Facebook, we compared the participant characteristics, costs, and quantity and quality of data with traditional laboratory-based cognitive interviews. Results suggest that crowdsourcing and self-administered protocols may be a viable way to collect survey pretesting information, as participants were able to complete the tasks and provide useful information; however, complex tasks may require the skills of an interviewer to administer unscripted probes.

  8. Comparative study of oven and traditionally roasted suya : an ...

    African Journals Online (AJOL)

    Comparative study of oven and traditionally roasted suya: an indigenous Nigerian meat. M C Okafor, H U Nwanjo, G O Oze. Abstract. No Abstract. Animal Production Research Avancees Vol. 3 (2) 2007: pp. 131-136. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  9. Comparing gender discrimination and inequality in indie and traditional publishing.

    Science.gov (United States)

    Weinberg, Dana B; Kapelner, Adam

    2018-01-01

    In traditional publishing, female authors' titles command nearly half (45%) the price of male authors' and are underrepresented in more prestigious genres, and books are published by publishing houses, which determined whose books get published, subject classification, and retail price. In the last decade, the growth of digital technologies and sales platforms have enabled unprecedented numbers of authors to bypass publishers to publish and sell books. The rise of indie publishing (aka self-publishing) reflects the growth of the "gig" economy, where the influence of firms has diminished and workers are exposed more directly to external markets. Encompassing the traditional and the gig economy, the book industry illuminates how the gig economy may disrupt, replicate, or transform the gender discrimination mechanisms and inequality found in the traditional economy. In a natural experiment spanning from 2002 to 2012 and including over two million book titles, we compare discrimination mechanisms and inequality in indie and traditional publishing. We find that indie publishing, though more egalitarian, largely replicates traditional publishing's gender discrimination patterns, showing an unequal distribution of male and female authors by genre (allocative discrimination), devaluation of genres written predominantly by female authors (valuative discrimination), and lower prices within genres for books by female authors (within-job discrimination). However, these discrimination mechanisms are associated with far less price inequality in indie, only 7%, in large part due to the smaller and lower range of prices in indie publishing compared to traditional publishing. We conclude that, with greater freedom, workers in the gig economy may be inclined to greater equality but will largely replicate existing labor market segmentation and the lower valuation of female-typical work and of female workers. Nonetheless, price setting for work may be more similar for workers in the

  10. Comparative analysis of traditional and alternative energy sources

    Directory of Open Access Journals (Sweden)

    Adriana Csikósová

    2008-11-01

    Full Text Available The presented thesis with designation of Comparing analysis of traditional and alternative energy resources includes, on basisof theoretical information source, research in firm, internal data, trends in company development and market, descriptionof the problem and its application. Theoretical information source is dedicated to the traditional and alternative energy resources,reserves of it, trends in using and development, the balance of it in the world, EU and in Slovakia as well. Analysis of the thesisis reflecting profile of the company and the thermal pump market evaluation using General Electric method. While the companyis implementing, except other products, the thermal pumps on geothermal energy base and surround energy base (air, the missionof the comparing analysis is to compare traditional energy resources with thermal pump from the ecological, utility and economic sideof it. The results of the comparing analysis are resumed in to the SWOT analysis. The part of the thesis includes he questionnaire offerfor effectiveness improvement and customer satisfaction analysis, and expected possibilities of alternative energy resources assistance(benefits from the government and EU funds.

  11. Comparing the effectiveness of virtual and traditional forestry field tours

    OpenAIRE

    Easley, Elissa C.; Fletcher, Richard A.; Jensen, Edward C.; Rickenbach, Mark

    2002-01-01

    Virtual tours are among the many new Internet-based tools with potential applications in natural resource education. While technology exists to create virtual tour Web sites, little is understood about how they meet educational objectives and whether they can be complementary alternatives for traditional field tours. The Sustainable Forestry Partnership and the Forestry Media Center at Oregon State University created parallel virtual and field tours to compare these teaching techniques. Both ...

  12. Can we compare SMS marketing to traditional marketing communications?

    OpenAIRE

    Roozen, Irene; Genin, Emile

    2008-01-01

    Nowadays most companies acknowledge the importance of SMS marketing in reaching and interacting with their customers (Kavassalis et al. 2003; Dickinger et al. 2004; Tsang, Ho & Liang 2004; Sharl, Dickinger & Murphy 2005; Muk 2007). However, there is much discussion in the press regarding the effectiveness when it comes to SMS marketing. Are customers willing to accept, reading and using SMS messages: how effective is SMS marketing compared to traditional marketing communications? The goal of ...

  13. Transition, tradition, and nostalgia; postsocialist transformations in a comparative framework.

    Science.gov (United States)

    Hann, Chris

    2012-12-01

    The concepts of transition and tradition have not been the object of much original theoretical work in recent Anglophone socio-cultural anthropology. The term transition has been applied loosely to the demise of socialist regimes in Eastern Europe and their replacement by market economies and more pluralist forms of government. However, these objectives have proved elusive and most anthropologists therefore speak of open-ended "transformation processes" rather than a linear shift to capitalist democracy. Use of the concept of tradition has been much influenced by the work of historians on the "invention of tradition". This paper explores how societies, in particular elite groups, construct different types of tradition in the wake of historical caesurae. Paying particular attention to the concept of nostalgia, it compares perceptions of the past in Britain, where social change has been largely gradual, with those in empires and states which experienced sharp political discontinuities in the twentieth century. To explain and understand nostalgia for socialism in large sections of the population in many postsocialist states, it is necessary to investigate not only economic and social mobility and related material factors but also factors pertaining to identity, especially collective identities.

  14. Low back pain : a comparative study on the value of core training versus traditional strengthening exercises

    OpenAIRE

    Schembri, Laura; Fenech, Pauline; Sacco, Mark

    2014-01-01

    This randomised controlled trial (RCT) employed a pre-test/post-test design to compare the effects of core training (Pilates method) and traditional back exercises on a population with low back pain (LBP). Therapeutic intervention related to the Pilates method has recently become popular, but there is little evidence to prove it works. In this study, 120 individuals with LBP were allocated to three different groups. Group A was the control group, Group B was given modifie...

  15. Is it too early to move to full electronic PROM data collection?: A randomized controlled trial comparing PROM's after hallux valgus captured by e-mail, traditional mail and telephone.

    Science.gov (United States)

    Palmen, Leonieke N; Schrier, Joost C M; Scholten, Ruben; Jansen, Justus H W; Koëter, Sander

    2016-03-01

    Patient reported outcome measures (PROM's) after hallux valgus surgery are used to rate the effectiveness as perceived by the patient. The interpretability of these PROM's is highly dependent on participation rate. Data capture method may be an important factor contributing to the response rate. We investigated the effect on response rate of traditional paper mail, telephone and e-mail PROM's after hallux valgus surgery. All consecutive patients operated between January and September 2013, were identified. Included patients were randomized by envelope in three groups: traditional pen and paper mail, e-mail and telephone. They were asked to fill in a FFI and EQ-5D. Two weeks later non-responders were sent a reminder. Of the 73 included patients, 25 were approached by mail, 24 by e-mail and 24 patients by telephone. The response rate on traditional mail was highest (88%), while response on e-mail was lowest (33%). Response rate on telephone was also high (79%). Response rate on traditional mail and telephone was significantly higher (pmail. Though electronic data collection has enormous potential, this study shows that e-mail yields unacceptable low response rates. It is too early to replace traditional pen-and-paper PROM's by electronic questionnaires. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Traditional and modern cohabitation in Latin America: A comparative typology

    Directory of Open Access Journals (Sweden)

    Maira Covre-Sussai

    2015-05-01

    Full Text Available Background: The existence of cohabitation is a historical feature of nuptiality in Latin America. Traditionally, cohabitation was common in less developed regions, among the lower social classes. But today its occurrence is increasing and in social groups and regions in which it was not common. The features of this latter type of cohabitation remain unclear. Objective: We differentiate types of cohabitation in Latin America on the basis of relationship context at its outset and its outcomes in terms of childbearing. The comparability of these types over countries is attested, as well as their evolution over time and the educational and age profiles of cohabitants. Methods: Demographic and Health Survey data for the 1980s, 1990s, and 2000s for up to eight countries are analyzed by means of Multiple Group Latent Class Analysis. Results: Three types of cohabitation are found. The traditional type includes young and lower-educated women who start to cohabit during adolescence. They have more children at younger ages. The remaining two types of cohabitation included higher-educated women and are considered modern. The innovative type groups women from all age groups, with fewer children born at a higher age and never as a single woman. Blended cohabitation refers to older women, who could negotiate a marriage, but do not. They start to cohabit during adulthood, but always after single pregnancy. Conclusions: The persistence of historical trends is attested. Traditional cohabitation is related to socioeconomic deprivation and prevails in Central American and Caribbean countries.However, two modern types of cohabitation are emerging in the region. They are concentrated in the South and related to women's independence.

  17. Sasang Constitutional Medicine and Traditional Chinese Medicine: A Comparative Overview

    Directory of Open Access Journals (Sweden)

    Junghee Yoo

    2012-01-01

    Full Text Available Sasang constitutional medicine (SCM is a holistic typological constitution medicine which balances psychological, social, and physical aspects of an individual to achieve wellness and increase longevity. SCM has the qualities of preventative medicine, as it emphasizes daily health management based on constitutionally differentiated regimens and self-cultivation of the mind and body. This review's goal is to establish a fundamental understanding of SCM and to provide a foundation for further study. It compares the similarities and differences of philosophical origins, perspectives on the mind (heart, typological systems, pathology, and therapeutics between SCM and traditional Chinese medicine (TCM. TCM is based on the Taoist view of the universe and humanity. The health and longevity of an individual depends on a harmonious relationship with the universe. On the other hand, SCM is based on the Confucian view of the universe and humanity. SCM focuses on the influence of human affairs on the psyche, physiology, and pathology.

  18. [Methodological quality evaluation of randomized controlled trials for traditional Chinese medicines for treatment of sub-health].

    Science.gov (United States)

    Zhao, Jun; Liao, Xing; Zhao, Hui; Li, Zhi-Geng; Wang, Nan-Yue; Wang, Li-Min

    2016-11-01

    To evaluate the methodological quality of the randomized controlled trials(RCTs) for traditional Chinese medicines for treatment of sub-health, in order to provide a scientific basis for the improvement of clinical trials and systematic review. Such databases as CNKI, CBM, VIP, Wanfang, EMbase, Medline, Clinical Trials, Web of Science and Cochrane Library were searched for RCTS for traditional Chinese medicines for treatment of sub-health between the time of establishment and February 29, 2016. Cochrane Handbook 5.1 was used to screen literatures and extract data, and CONSORT statement and CONSORT for traditional Chinese medicine statement were adopted as the basis for quality evaluation. Among the 72 RCTs included in this study, 67 (93.05%) trials described the inter-group baseline data comparability, 39(54.17%) trials described the unified diagnostic criteria, 28(38.89%) trials described the unified standards of efficacy, 4 (5.55%) trials mentioned the multi-center study, 19(26.38%) trials disclosed the random distribution method, 6(8.33%) trials used the random distribution concealment, 15(20.83%) trials adopted the method of blindness, 3(4.17%) study reported the sample size estimation in details, 5 (6.94%) trials showed a sample size of more than two hundred, 19(26.38%) trials reported the number of withdrawal, defluxion cases and those lost to follow-up, but only 2 trials adopted the ITT analysis,10(13.89%) trials reported the follow-up results, none of the trial reported the test registration and the test protocol, 48(66.7%) trials reported all of the indicators of expected outcomes, 26(36.11%) trials reported the adverse reactions and adverse events, and 4(5.56%) trials reported patient compliance. The overall quality of these randomized controlled trials for traditional Chinese medicines for treatment of sub-health is low, with methodological defects in different degrees. Therefore, it is still necessary to emphasize the correct application of principles

  19. Operational auditing versus traditional method: A comparative investigation

    Directory of Open Access Journals (Sweden)

    Reza Tehrani

    2013-06-01

    Full Text Available Operational auditing is one of the management consultancy services whose significance is on the rise day by day. This approach is, clearly, a systematic and methodical process used to evaluate economic savings of financial processes in organizations and the results of the evaluations are reported to interested people along with some comments to improve operational processes. Accordingly, it appears that the proper employment of the existing rationale in operational auditing can be a significant step towards the improvement of financial efficiency in Iranian public and private banking sector. This paper studies the effects of operational auditing on the improvement of economic saving of financial processes in Iranian private banks compared with traditional approaches where the operations are based on financial statements. The population of this survey includes 15 private and public Iranian banks and the proposed study selects 78 branches, randomly. The Cronbach alpha was used to test the reliability a questionnaire employed to collect the needed data in this study. The results obtained by SPSS Software indicated that the reliability of the instrumentsanged between 0.752 and 0.867, suggesting an acceptable level of the reliability for the questionnaire. Besides, content validity was used to confirm the validity of the instrument. The results of the study indicated that the operational auditing as a useful approach influencing the financial efficiency of public and private banks has significantly transformed the traditional thinking in the field of management auditing. The operational auditing has a number of significant advantages including a better method of controlling financial operations within Iranian banks, efficient planning in the future, facilitating efficient, appropriate, and accurate management decision making, and sound evaluation of managers’ financial operations.

  20. Regulating traditional justice in South Africa: a comparative analysis ...

    African Journals Online (AJOL)

    Without a reconsideration of the issues, the Bill will still be met with criticism even from those it is meant to regulate, and could potentially result in various constitutional challenges and litigations. KEYWORDS: Traditional Courts Bill; traditional justice systems; customary law; ascertainment; legal representation; hierarchy of ...

  1. Comparison of ultrasonic shears and traditional suture ligature for vaginal hysterectomy: randomized controlled trial.

    Science.gov (United States)

    Fitz-Gerald, Alison Louise; Tan, Jason; Chan, Kok-Weng; Polyakov, Alex; Edwards, Geoff N; Najjar, Haider; Tsaltas, Jim; Vollenhoven, Beverley

    2013-01-01

    To compare operating time, intraoperative blood loss, postoperative analgesia, and length of hospital stay using ultrasonic shears vs traditional suture ligature in vaginal hysterectomy. Randomized controlled trial (Canadian Task Force classification I). Gynecology units within a single health network, university hospital. Forty women requiring vaginal hysterectomy because of benign disease. Vaginal hysterectomy performed using either ultrasonically activated shears (USS) or traditional suture ligatures. Twenty-one patients were randomized to the USS arm, and 19 patients to the traditional suture ligature arm. Patient characteristics were comparable. Mean (SD) hysterectomy time and was similar in both the USS and traditional arms, 28.66 (4.0) minutes vs 32.37 (3.18) minutes (p = .47), as was total operating time, 97.38 (8.9) minutes vs 91.63 (7.69) minutes (p = .63). Operative blood loss was significantly decreased in the USS group: 62.63 (12.46) mL vs 136.05 (21.54) mL (p = .006). There was, however, no significant change in hemoglobin concentration between the 2 groups: 19.53 (1.79) g/L vs -16.72 (2.5) g/L. There was no significant difference in mean oxycodone use: 9.29 (2.66) mg vs 8.06 (3.19) mg (p = .77). Length of hospital stay was similar in both groups: 58.98 (3.27) hours vs 60.05 (6.48) hours (p = .88). There was no significant difference in overall complication rates between the groups. Although the Harmonic scalpel system, compared with the traditional suture ligation method, seems to be a safe alternative for securing the pedicles in vaginal hysterectomy, it offers no benefit insofar as operative time, reduction in clinically significant blood loss, and analgesic requirements. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  2. Comparative Study of the Effectiveness of Three Learning Environments: Hyper-Realistic Virtual Simulations, Traditional Schematic Simulations and Traditional Laboratory

    Science.gov (United States)

    Martinez, Guadalupe; Naranjo, Francisco L.; Perez, Angel L.; Suero, Maria Isabel; Pardo, Pedro J.

    2011-01-01

    This study compared the educational effects of computer simulations developed in a hyper-realistic virtual environment with the educational effects of either traditional schematic simulations or a traditional optics laboratory. The virtual environment was constructed on the basis of Java applets complemented with a photorealistic visual output.…

  3. A COMPARATIVE ANALISYS ON THE TRADITIONAL FOOD PRODUCTS IN EU

    Directory of Open Access Journals (Sweden)

    Teodora Mihaela Tarcza

    2016-12-01

    Full Text Available This paper is intent on highlighting the differences between traditional food products registered in every member state of the EU. The legislative system protecting the 'peculiar, endemic', food products was first introduced in the EU in 1992 and it was implemented in the then - member states.The countries that adhered to the EU in the following years underwent a preparation phase in terms of legislation in order to educate the producers and consumers regarding these regulations.Therefore, some countries have a history of over twenty years in recognizing and registering traditional food products(TFP, whereas newly - entered EU member states have an experience of less than ten years.This can be one of the many reasons underlying the significant discrepancy in the number of traditional food products registered in every EU member state.Throughout the paper we intend to analyse and highlight the number of traditional food products registered in the European Union’ s database– DOORdatabase– by every EU member state, and also provide an overview of their status in the EU.Moreover, throughout the paper we will answer questions such as„ Why does France have 255 traditional food products registered, whereas countries like Romania and Bulgaria only 4 ? “aiming to justify these differences but also present the evolution of the supply of traditional food products over time.To achieve the objectives of our research, we have covered vast literature and we have processed a series of secondary data that were put at our disposal by the databases of the European Commission, the agricultural sector.The results of our research are interesting, and the graphs will help better visualize and understand the status of the supply of traditional food products from a quantitative point of view countrywide.The identified elements as influencing factors in the quantitative supply of traditional food products and their grouping in a series of criteria tantamount to

  4. Using Facebook ads with traditional paper mailings to recruit adolescent girls for a clinical trial.

    Science.gov (United States)

    Schwinn, Traci; Hopkins, Jessica; Schinke, Steven P; Liu, Xiang

    2017-02-01

    Clinical trials require sufficient samples recruited within limited time and budget constraints. Trials with minors are additionally burdened by the requirement for youth assent and parental permission. This paper details the use of Facebook ads and traditional paper mailings to enroll 797 adolescent girls for a longitudinal, web-based, drug abuse prevention trial. Data on sample representativeness and retention are also provided. Facebook ads appeared on the pages of females aged 13 or 14years who reside in the U.S. Ads linked girls to a recruitment website. Girls who wanted more information submitted contact information and were mailed information packets to their homes containing, among other things, youth assent and parent permission forms. Returned forms were verified for accuracy and validity. The Facebook ad campaign reached 2,267,848 girls and had a unique click-through rate of 3.0%. The campaign cost $41,202.37 with an average cost of $51.70 per enrolled girl. Information packets were mailed to 1,873 girls. Approximately one-half of girls returned the forms, and 797 girls were enrolled. The Facebook campaign's success varied by ad type, month, and day of the week. Baseline data revealed comparability to national data on demographic and substance use variables. Results suggest that Facebook ads provide a useful initial point of access to unparalleled numbers of adolescents. Clinical trials may benefit from a two-fold recruitment strategy that uses online ads to attract interested adolescents followed by traditional recruitment methods to communicate detailed information to adolescents and parents. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Using Facebook ads with traditional paper mailings to recruit adolescent girls for a clinical trial

    Science.gov (United States)

    Schwinn, Traci; Hopkins, Jessica; Schinke, Steven P; Liu, Xiang

    2016-01-01

    Introduction Clinical trials require sufficient samples recruited within limited time and budget constraints. Trials with minors are additionally burdened by the requirement for youth assent and parental permission. This paper details the use of Facebook ads and traditional paper mailings to enroll 797 adolescent girls for a longitudinal, web-based, drug abuse prevention trial. Data on sample representativeness and retention are also provided. Methods Facebook ads appeared on the pages of females aged 13 or 14 years who reside in the U.S. Ads linked girls to a recruitment website. Girls who wanted more information submitted contact information and were mailed information packets to their homes containing, among other things, youth assent and parent permission forms. Returned forms were verified for accuracy and validity. Results The Facebook ad campaign reached 2,267,848 girls and had a unique click-through rate of 3.0%. The campaign cost $41,202.37 with an average cost of $51.70 per enrolled girl. Information packets were mailed to 1,873 girls. Approximately one-half of girls returned the forms, and 797 girls were enrolled. The Facebook campaign's success varied by ad type, month, and day of the week. Baseline data revealed comparability to national data on demographic and substance use variables. Conclusions Results suggest that Facebook ads provide a useful initial point of access to unparalleled numbers of adolescents. Clinical trials may benefit from a two-fold recruitment strategy that uses online ads to attract interested adolescents followed by traditional recruitment methods to communicate detailed information to adolescents and parents. PMID:27835860

  6. traditional and modern art in nigeria: a comparative analysis

    African Journals Online (AJOL)

    Modern art on the other hand is referred to as a marriage of the old tradition with the new artistic expression in terms of materials, techniques and tools by the college-trained artists. The current state of the arts in Nigeria is examined and suggestions are made for the reconstruction and revitalization of the art profession, and ...

  7. Prospective registration, bias risk and outcome-reporting bias in randomised clinical trials of traditional Chinese medicine

    DEFF Research Database (Denmark)

    Liu, Jian-Ping; Han, Mei; Li, Xin-Xue

    2013-01-01

    Clinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in registries with their subsequent publications.......Clinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in registries with their subsequent publications....

  8. Comparative advantage between traditional and smart navigation systems

    Science.gov (United States)

    Shin, Jeongkyu; Kim, Pan-Jun; Kim, Seunghwan

    2013-03-01

    The smart navigation system that refers to real-time traffic data is believed to be superior to traditional navigation systems. To verify this belief, we created an agent-based traffic model and examined the effect of changing market share of the traditional shortest-travel-time algorithm based navigation and the smart navigation system. We tested our model on the grid and actual metropolitan road network structures. The result reveals that the traditional navigation system have better performance than the smart one as the market share of the smart navigation system exceeds a critical value, which is contrary to conventional expectation. We suggest that the superiority inversion between agent groups is strongly related to the traffic weight function form, and is general. We also found that the relationship of market share, traffic flow density and travel time is determined by the combination of congestion avoidance behavior of the smartly navigated agents and the inefficiency of shortest-travel-time based navigated agents. Our results can be interpreted with the minority game and extended to the diverse topics of opinion dynamics. This work was supported by the Original Technology Research Program for Brain Science through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology(No. 2010-0018847).

  9. Tradition

    DEFF Research Database (Denmark)

    Otto, Ton

    2016-01-01

    : beliefs, practices, institutions, and also things. In this sense, the meaning of the term in social research is very close to its usage in common language and is not always theoretically well developed (see Shils, 1971: 123). But the concept of tradition has also been central to major theoretical debates...... on the nature of social change, especially in connection with the notion of modernity. Here tradition is linked to various forms of agency as a factor of both stability and intentional change....

  10. Comparing alternative and traditional dissemination metrics in medical education.

    Science.gov (United States)

    Amath, Aysah; Ambacher, Kristin; Leddy, John J; Wood, Timothy J; Ramnanan, Christopher J

    2017-09-01

    The impact of academic scholarship has traditionally been measured using citation-based metrics. However, citations may not be the only measure of impact. In recent years, other platforms (e.g. Twitter) have provided new tools for promoting scholarship to both academic and non-academic audiences. Alternative metrics (altmetrics) can capture non-traditional dissemination data such as attention generated on social media platforms. The aims of this exploratory study were to characterise the relationships among altmetrics, access counts and citations in an international and pre-eminent medical education journal, and to clarify the roles of these metrics in assessing the impact of medical education academic scholarship. A database study was performed (September 2015) for all papers published in Medical Education in 2012 (n = 236) and 2013 (n = 246). Citation, altmetric and access (HTML views and PDF downloads) data were obtained from Scopus, the Altmetric Bookmarklet tool and the journal Medical Education, respectively. Pearson coefficients (r-values) between metrics of interest were then determined. Twitter and Mendeley (an academic bibliography tool) were the only altmetric-tracked platforms frequently (> 50%) utilised in the dissemination of articles. Altmetric scores (composite measures of all online attention) were driven by Twitter mentions. For short and full-length articles in 2012 and 2013, both access counts and citation counts were most strongly correlated with one another, as well as with Mendeley downloads. By comparison, Twitter metrics and altmetric scores demonstrated weak to moderate correlations with both access and citation counts. Whereas most altmetrics showed limited correlations with readership (access counts) and impact (citations), Mendeley downloads correlated strongly with both readership and impact indices for articles published in the journal Medical Education and may therefore have potential use that is complementary to that of citations in

  11. Origins and Traditions in Comparative Education: Challenging Some Assumptions

    Science.gov (United States)

    Manzon, Maria

    2018-01-01

    This article questions some of our assumptions about the history of comparative education. It explores new scholarship on key actors and ways of knowing in the field. Building on the theory of the social constructedness of the field of comparative education, the paper elucidates how power shapes our scholarly histories and identities.

  12. Investigation into the Individualized Treatment of Traditional Chinese Medicine through a Series of N-of-1 Trials

    Science.gov (United States)

    Yang, Peilan; Wang, Jie; Wu, Yingen; Zi, Suna; Tang, Jie; Wang, Zhenwei

    2018-01-01

    Purpose To compare the efficacy of individualized herbal decoction with standard decoction for patients with stable bronchiectasis through N-of-1 trials. Methods We conducted a single center N-of-1 trials in 17 patients with stable bronchiectasis. Each N-of-1 trial contains three cycles. Each cycle is divided into two 4-week intervention including individualized decoction and fixed decoction (control). The primary outcome was patient self-reported symptoms scores on a 1–7 point Likert scale. Secondary outcomes were 24-hour sputum volume and CAT scores. Results Among 14 completed trials, five showed that the individualized decoction was statistically better than the control decoction on symptom scores (P traditional Chinese medicine individual diagnosis and treatment. PMID:29552084

  13. Comparing New School Effects in Charter and Traditional Public Schools

    Science.gov (United States)

    Kelly, Andrew P.; Loveless, Tom

    2012-01-01

    This study investigates whether student achievement varies during the institutional life span of charter schools by comparing them to new public schools. The results show that there is little evidence that new public schools struggle with initial start-up issues to the same extent as new charter schools. Even after controlling for school…

  14. Comparative study of the effectiveness of three learning environments: Hyper-realistic virtual simulations, traditional schematic simulations and traditional laboratory

    Directory of Open Access Journals (Sweden)

    Maria Isabel Suero

    2011-10-01

    Full Text Available This study compared the educational effects of computer simulations developed in a hyper-realistic virtual environment with the educational effects of either traditional schematic simulations or a traditional optics laboratory. The virtual environment was constructed on the basis of Java applets complemented with a photorealistic visual output. This new virtual environment concept, which we call hyper-realistic, transcends basic schematic simulation; it provides the user with a more realistic perception of a physical phenomenon being simulated. We compared the learning achievements of three equivalent, homogeneous groups of undergraduates—an experimental group who used only the hyper-realistic virtual laboratory, a first control group who used a schematic simulation, and a second control group who used the traditional laboratory. The three groups received the same theoretical preparation and carried out equivalent practicals in their respective learning environments. The topic chosen for the experiment was optical aberrations. An analysis of variance applied to the data of the study demonstrated a statistically significant difference (p value <0.05 between the three groups. The learning achievements attained by the group using the hyper-realistic virtual environment were 6.1 percentage points higher than those for the group using the traditional schematic simulations and 9.5 percentage points higher than those for the group using the traditional laboratory.

  15. Comparing interactive videodisc training effectiveness to traditional training methods

    International Nuclear Information System (INIS)

    Kenworthy, N.W.

    1987-01-01

    Videodisc skills training programs developed by Industrial Training Corporation are being used and evaluated by major industrial facilities. In one such study, interactive videodisc training programs were compared to videotape and instructor-based training to determine the effectiveness of videodisc in terms of performance, training time and trainee attitudes. Results showed that when initial training was done using the interactive videodisc system, trainee performance was superior to the performance of trainees using videotape, and approximately equal to the performance of those trained by an instructor. When each method was used in follow-up training, interactive videodisc was definitely the most effective. Results also indicate that training time can be reduced using interactive videodisc. Attitudes of both trainees and instructors toward the interactive videodisc training were positive

  16. Comparative emissions from Pakistani coals and traditional coals

    Energy Technology Data Exchange (ETDEWEB)

    Du, Y X [Guangzhou Medical College (China). Dept. of Hygiene; Huang, L F [Guangzhou Health and Anti-epidemic Station (China)

    1994-12-31

    Briquette coal has been widely used for domestic cooking and heating in many Chinese cites over the last two decades. To determine whether burning briquette coal contributes significantly to indoor air pollution, a study was performed in cities-of Southern China in which the measured levels of SO{sub 2}, NO{sub x}, TSP, SD, B(a)P in the kitchens of coal burning families were compared with levels obtained in families using gas. Significantly higher contentions of these pollutants, whose peaks correlated with daily cooking episodes, were detected in coal burning families. The levels of TSP and B(a)P were further found to be dependent on cooking methods, with deep frying and stir-frying of meat generating the most indoor TSP and B(a)P. Briquette coal burning was found to be the source of B(a)P contamination in food. A higher incidence of chronic pharyngitis as well as a suppressed salivary bacteriolytic enzyme activity were found in children of coal burning families. Epidemiologic and laboratory studies also show a close association between coal burning and the incidence of lung cancer in females. (author)

  17. COMPARISON OF THE SHAKE WEIGHT® MODALITY EXERCISES WHEN COMPARED TO TRADITIONAL DUMBBELLS

    Directory of Open Access Journals (Sweden)

    Jordan M. Glenn

    2012-12-01

    Full Text Available Individuals are continuously looking for faster, more efficient methods with which to develop physical fitness. This has led to the development of products and programs marketed towards increasing physical fitness in minimal time. The Shake Weight® (SW has been advertised to increase muscular strength among other factors in less time than traditional weightlifting. The purpose of this study was to compare the electromyographic (EMG muscle activity of the SW to a traditional dumbbell (DB performing the same exercises. Twelve men (22.9 ± 1.6 years and 13 women (23.0 ± 1.9 years volunteered to participate in this study. Subjects performed the chest shake (CS, biceps shake (BS, and triceps shake (TS using the SW and DW. Maximal voluntary isometric contractions (MVIC were exhibited for all muscles. EMG activity was recorded for the pectoralis major (PM, triceps brachii (TB, biceps brachii (BB, anterior deltoid (AD, trapezius (TR, and rectus abdominus (RA and compared to detect differences between modalities. EMG activity for each muscle group was reported as a percentage of each subject's individual MVIC. A repeated measures ANOVA revealed no significant differences between the SW and DB modalities during each exercise for all muscles except the BB (p < 0.05. During the CS exercise muscle activity was significantly greater for DB in the BB muscle when compared to the SW mode (50.8 ± 28.9%; 35.8 ± 30.8%. The SW did not have any advantage over the DB for any exercise, nor for any muscle group. Further, no muscle group during any of the SW trials exhibited an MVIC over 60%, the level necessary to increase muscular strength

  18. Effectiveness of traditional bone setting in chronic neck pain: randomized clinical trial.

    Science.gov (United States)

    Zaproudina, Nina; Hänninen, Osmo O P; Airaksinen, Olavi

    2007-01-01

    This study evaluates the effectiveness of traditional bone setting (TBS) in chronic neck pain (cNP) compared with conventional physiotherapy (PT) and massage (M). This was a randomized clinical trial. Working-aged employed subjects with cNP (n = 105; 37 men and 68 women; mean age, 41.5 years) were randomized into TBS, PT, and M groups. Follow-up times were 1, 6, and 12 months after the treatments. Neck pain intensity (visual analog scale), perceived disability (Neck Disability Index [NDI]), and neck spine mobility measurements were used as outcomes. Global assessment was evaluated by the subjects (scale from -1 to +10). Data were analyzed using time (pre and post) by group (TBS, PT and M), 2- way analysis of variance for repeated measures. Neck pain decreased and NDI scores improved in all groups 1 month after the treatment (P better after TBS. Neck spine mobility in rotation movements tended to improve significantly better and the frons-knee distance improved more after TBS. One year later, both NDI and neck pain were significantly better after TBS than in reference groups. A significant improvement was reported by 40% to 45.5% of subjects in the PT and M groups and by 68.6% in the TBS group. Bone setters' ability to communicate and to interact with patients was evaluated significantly higher. In the TBS group, the number of sick days was minimal as was the use of painkillers during 1-year follow-up compared to that in the reference groups. Traditional bone setting, which is a soft manual mobilization technique focusing on the muscles, joints, and ligaments, appears to be effective in cNP. Two thirds of subjects experienced it as beneficial, and it seems to be able to improve disability and pain in patients with cNP. Subjective and partially objective benefits of TBS were found in those patients more than after other interventions, and the effects lasted at least for 1 year.

  19. Bridging the gap: how traditional healers interact with their patients. A comparative study in Cameroon.

    NARCIS (Netherlands)

    Labhardt, N.D.; Aboa, S.M.; Manga, E.; Bensing, J.M.; Langewitz, W.

    2010-01-01

    Objective: To compare traditional healers (TH) and Cameroonian representatives of Western medicine (Western providers (WP)) in terms of patient characteristics and communication patterns during the consultation in rural Cameroon. Methods: A facility-based comparative study was conducted. Seven TH

  20. Parental Involvement in the Musical Education of Violin Students: Suzuki and "Traditional" Approaches Compared

    Science.gov (United States)

    Bugeja, Clare

    2009-01-01

    This article investigates parental involvement in the musical education of violin students and the changing role of the parents' across the learning process. Two contexts were compared, one emphasising the Suzuki methodology and the other a "traditional" approach. Students learning "traditionally" are typically taught note reading from the…

  1. Game-based versus traditional case-based learning: comparing effectiveness in stroke continuing medical education.

    Science.gov (United States)

    Telner, Deanna; Bujas-Bobanovic, Maja; Chan, David; Chester, Bob; Marlow, Bernard; Meuser, James; Rothman, Arthur; Harvey, Bart

    2010-09-01

    To evaluate family physicians' enjoyment of and knowledge gained from game-based learning, compared with traditional case-based learning, in a continuing medical education (CME) event on stroke prevention and management. An equivalence trial to determine if game-based learning was as effective as case-based learning in terms of attained knowledge levels. Game questions and small group cases were developed. Participants were randomized to either a game-based or a case-based group and took part in the event. Ontario provincial family medicine conference. Thirty-two family physicians and 3 senior family medicine residents attending the conference. Participation in either a game-based or a case-based CME learning group. Scores on 40-item immediate and 3-month posttests of knowledge and a satisfaction survey. Results from knowledge testing immediately after the event and 3 months later showed no significant difference in scoring between groups. Participants in the game-based group reported higher levels of satisfaction with the learning experience. Games provide a novel way of organizing CME events. They might provide more group interaction and discussion, as well as improve recruitment to CME events. They might also provide a forum for interdisciplinary CME. Using games in future CME events appears to be a promising approach to facilitate participant learning.

  2. Screening asymptomatic patients with diabetes for unknown coronary artery disease: Does it reduce risk? An open-label randomized trial comparing a strategy based on exercise testing aimed at revascularization with management based on pharmacological/behavioural treatment of traditional risk factors. DADDY-D Trial (Does coronary Atherosclerosis Deserve to be Diagnosed and treated early in Diabetics?

    Directory of Open Access Journals (Sweden)

    Romano Stefania

    2009-12-01

    Full Text Available Abstract Background Coronary artery disease is the leading cause of morbidity and mortality in patients with type 2 diabetes. Screening for asymptomatic coronary artery disease with treatment by means of revascularization seems to be an appealing option for prevention. The utility of such a strategy has never been challenged in a randomized trial. Methods/Design In the present study a cohort of diabetic patients without any symptoms and without known coronary artery disease will be screened at two diabetes outpatients services. Those with intermediate or high risk (equal or greater than 10% according to the Italian risk chart will be asked to participate and enrolled. They will be seen and followed in order to provide the best adherence to medical therapy. Half of the patients will be randomized to undergo an exercise tolerance testing while the other group will continue to be regularly seen at diabetes outpatients services. Best medical/behavioral therapy will be offered to both groups. Those patients with a positive exercise tolerance testing will be studied by coronary angiography and treated according to the severity of coronary lesions by percutaneous stenting or surgery. The objective of the study is to evaluate the efficacy of the screening strategy aimed at revascularization. A cost-effectiveness analysis will be performed at the end of the follow up. Discussion The study will provide useful information about prevention and treatment of diabetic patients at high risk of coronary events. It will be made clearer if detection of silent coronary artery disease has to be recommended and followed by treatment. Given the simplicity of the study protocol, it will be easily transferable to the real world. Trial registration (ClinicalTrials.gov: NCT00547872

  3. Forensic Accounting and Auditing: Compared and Contrasted to Traditional Accounting and Auditing

    Science.gov (United States)

    Gray, Dahli

    2008-01-01

    Forensic versus traditional accounting and auditing are compared and contrasted. Evidence gathering is detailed. Forensic science and fraud symptoms are explained. Criminalists, expert testimony and corporate governance are presented.

  4. Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene.

    Science.gov (United States)

    López Martín, M Beatriz; Erice Calvo-Sotelo, Alejo

    To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Screening asymptomatic patients with diabetes for unknown coronary artery disease: does it reduce risk? An open-label randomized trial comparing a strategy based on exercise testing aimed at revascularization with management based on pharmacological/behavioural treatment of traditional risk factors. DADDY-D Trial (Does coronary Atherosclerosis Deserve to be Diagnosed and treated early in Diabetics?).

    Science.gov (United States)

    Turrini, Fabrizio; Messora, Roberto; Giovanardi, Paolo; Tondi, Stefano; Magnavacchi, Paolo; Cavani, Rita; Tosoni, Giandomenico; Cappelli, Carlo; Pellegrini, Elisa; Romano, Stefania; Baldini, Augusto; Zennaro, Romeo Giulietto; Bondi, Marco

    2009-12-23

    Coronary artery disease is the leading cause of morbidity and mortality in patients with type 2 diabetes. Screening for asymptomatic coronary artery disease with treatment by means of revascularization seems to be an appealing option for prevention. The utility of such a strategy has never been challenged in a randomized trial. In the present study a cohort of diabetic patients without any symptoms and without known coronary artery disease will be screened at two diabetes outpatients services. Those with intermediate or high risk (equal or greater than 10% according to the Italian risk chart) will be asked to participate and enrolled. They will be seen and followed in order to provide the best adherence to medical therapy. Half of the patients will be randomized to undergo an exercise tolerance testing while the other group will continue to be regularly seen at diabetes outpatients services. Best medical/behavioral therapy will be offered to both groups. Those patients with a positive exercise tolerance testing will be studied by coronary angiography and treated according to the severity of coronary lesions by percutaneous stenting or surgery.The objective of the study is to evaluate the efficacy of the screening strategy aimed at revascularization. A cost-effectiveness analysis will be performed at the end of the follow up. The study will provide useful information about prevention and treatment of diabetic patients at high risk of coronary events. It will be made clearer if detection of silent coronary artery disease has to be recommended and followed by treatment. Given the simplicity of the study protocol, it will be easily transferable to the real world. (ClinicalTrials.gov): NCT00547872.

  6. A Randomized Controlled Trial of Simulation-Based Teaching versus Traditional Instruction in Medicine: A Pilot Study among Clinical Medical Students

    Science.gov (United States)

    Gordon, James A.; Shaffer, David W.; Raemer, Daniel B.; Pawlowski, John; Hurford, William E.; Cooper, Jeffrey B.

    2006-01-01

    Objective: To compare simulator-based teaching with traditional instruction among clinical medical students. Methods: Randomized controlled trial with written pre-post testing. Third-year medical students (n = 38) received either a myocardial infarction (MI) simulation followed by a reactive airways disease (RAD) lecture, or a RAD simulation…

  7. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2015-02-01

    Full Text Available AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii. METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined. All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii. RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was 5.8% (PCONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  8. A Comparative Analysis of Activity-Based Costing and Traditional Costing

    OpenAIRE

    Derya Eren Akyol; Gonca Tuncel; G. Mirac Bayhan

    2007-01-01

    Activity-Based Costing (ABC) which has become an important aspect of manufacturing/service organizations can be defined as a methodology that measures the cost and performance of activities, resources and cost objects. It can be considered as an alternative paradigm to traditional cost-based accounting systems. The objective of this paper is to illustrate an application of ABC method and to compare the results of ABC with traditional costing methods. The results of the application highlight t...

  9. Blended Learning and Sense of Community: A Comparative Analysis with Traditional and Fully Online Graduate Courses

    Directory of Open Access Journals (Sweden)

    Fred Rovai and Hope Jordan

    2004-08-01

    Full Text Available Blended learning is a hybrid of classroom and online learning that includes some of the conveniences of online courses without the complete loss of face-to-face contact. The present study used a causal-comparative design to examine the relationship of sense of community between traditional classroom, blended, and fully online higher education learning environments. Evidence is provided to suggest that blended courses produce a stronger sense of community among students than either traditional or fully online courses.

  10. Comparative trials in registration files of cardiovascular drugs : Comparator drugs and dosing schemes.

    NARCIS (Netherlands)

    Wieringa, NF; Vos, R; de Graeff, PA

    Registration files of 13 cardiovascular drugs were analysed with respect to the number of double-blind phase-III clinical trials, the use of placebo and active comparator drugs and their dosing schemes. Half of the 146 double-blind trials used active comparator drugs. The majority of files included

  11. Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial.

    Science.gov (United States)

    Høyer, Ellen; Jahnsen, Reidun; Stanghelle, Johan Kvalvik; Strand, Liv Inger

    2012-01-01

    Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.

  12. Clinical trial of osteoarthritis jamu formula compare to piroxicam

    Directory of Open Access Journals (Sweden)

    Danang Ardiyanto

    2016-12-01

    is a lack of evidence of its efficacy and safety. The objectives of study were to investigate the efficacy and safety of  a traditional formula for OA. Methods: Design of the study was a randomized clinical trial (RCT involved 123 patients (subjects for 28 days intervention. This study was conducted between March - December 2014 with 30 physicians were participated at 20 regencies in Indonesia. The variables measured were VAS score, PGAP functional status assessment (FSA, and Short Form (SF-36 to assess jamu efficacy in comparison to piroxicam. To evaluate the safety of jamu formula using values of SGOT, SGPT, BUN, and creatinine. Result: The jamu formula administration effects can reduce VAS significantly  (p<0.05  if it was compared to baseline. FSA score of jamu formula group was decreased significantly (p=0.000 when compared to the start of intervention. Short Form (SF-36 of jamu formula group were significantly improved when compared with baseline value. The result of the three parameters between jamu group and piroxicam group should not significantly different. There was no difference in those parameters between both groups (p>0.05. In biological parameters, SGPT, SGOT, BUN, and creatinine level, showed normal range in both groups. Conclusion: This study showed that the efficacy and safety of jamu formula was clinically comparable to piroxicam after 28 days of treatment. Keywords: efficacy, safety, RCT, jamu formula  

  13. [Comparative analysis between origin of cooked traditional Chinese medicine powder and modern formula granules].

    Science.gov (United States)

    Li, Rui; Zhai, Hua-Qiang; Tian, Wei-Lan; Hou, Ji-Ru; Jin, Shi-Yuan; Wang, Yong-Yan

    2016-03-01

    In this study, the origin and causes of cooked traditional Chinese medicine powder were reviewed, and a comprehensive analysis was made for the time background of modern traditional Chinese medicine formula granules and the future development trend, in order to provide reference for application and promotion of traditional Chinese medicine formula granules. By reference to ancient medical books of previous dynasties, a system review was conducted for infancy, formation, maturity and transition of cooked traditional Chinese medicine powder, and a comprehensive analysis was made for the six factors of cooked traditional Chinese medicine powder's maturity in the Song Dynasty. Efforts were made to collect domestic and foreign research literatures of modern formula granules, understand the detailed development, and conduct an objective analysis of the current clinical application of modern formula granules. According to the comparative analysis for the application characteristics of cooked traditional Chinese medicine powder and modern formula granules, ①the popularity of cooked traditional Chinese medicine powder in the Song Dynasty has six factors: soaring numbers of medical students and medical practitioners, high medical expenses due to huge army, rapid population growth, frequent epidemics and increasing diseases, and insufficient finances of central and local governments. ②On the basis of clinical application characteristics of traditional Chinese medicine formula granules, traditional Chinese medicine formula granules contain extracted and concentrated effective components, which guarantee the curative effect, meet modern people's demands for "quick, simple and convenience" traditional Chinese medicine decoctions, show a relatively high cost performance; however, formula granules are restricted by their varieties and lack unified quality control standards, and single-extract formula granules have not synergy and attenuation effects of combined traditional

  14. Comparative Study of Powdered Ginger Drink Processed by Different Method:Traditional and using Evaporation Machine

    Science.gov (United States)

    Apriyana, Wuri; Taufika Rosyida, Vita; Nur Hayati, Septi; Darsih, Cici; Dewi Poeloengasih, Crescentiana

    2017-12-01

    Ginger drink is one of the traditional beverage that became one of the products of interest by consumers in Indonesia. This drink is believed to have excellent properties for the health of the body. In this study, we have compared the moisture content, ash content, metal content and the identified compound of product which processed with traditional technique and using an evaporator machine. The results show that both of products fulfilled some parameters of the Indonesian National Standard for the traditional powdered drink. GC-MS analysis data showed the identified compound of both product. The major of hydrocarbon groups that influenced the flavor such as zingiberene, camphene, beta-phelladrine, beta-sesquepelladrine, curcumene, and beta-bisabolene were found higher in ginger drink powder treated with a machine than those processed traditionally.

  15. Comparative environmental law and orientalism : reading beyond the 'text' of traditional knowledge protection

    OpenAIRE

    Vermeylen, Saskia Anna Filip

    2015-01-01

    This article uses traditional knowledge as a case study to address multiple discussions in the field of comparative law. First, it addresses the theoretical challenge of the role of comparative law as a critical research tool in the development of environmental law. Second, within the context of transnational legal processes, it questions the extent to which comparative law as a method can further the relationship between different levels of law making by distinct legal actors. It is timely t...

  16. Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial.

    Science.gov (United States)

    Michalsen, Andreas; Bock, Silke; Lüdtke, Rainer; Rampp, Thomas; Baecker, Marcus; Bachmann, Jürgen; Langhorst, Jost; Musial, Frauke; Dobos, Gustav J

    2009-06-01

    We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/- 8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a control group (n = 26). Verum patients were treated with a single application of wet cupping, and control patients with a single local application of heat within the region overlying the trapezius muscle. Patients were followed up on day 7 after treatment. The primary outcome, severity of CTS symptoms (VAS), was reduced from 61.5 +/- 20.5 to 24.6 +/- 22.7 mm at day 7 in the cupping group and from 67.1 +/- 20.2 to 51.7 +/- 23.9 mm in the control group [group difference -24.5mm (95%CI -36.1; -2.9, P cupping therapy may be effective in relieving the pain and other symptoms related to CTS. The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified. The results of a randomized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented. Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome.

  17. Comparative analysis of profitability of honey production using traditional and box hives.

    Science.gov (United States)

    Al-Ghamdi, Ahmed A; Adgaba, Nuru; Herab, Ahmed H; Ansari, Mohammad J

    2017-07-01

    Information on the profitability and productivity of box hives is important to encourage beekeepers to adopt the technology. However, comparative analysis of profitability and productivity of box and traditional hives is not adequately available. The study was carried out on 182 beekeepers using cross sectional survey and employing a random sampling technique. The data were analyzed using descriptive statistics, analysis of variance (ANOVA), the Cobb-Douglas (CD) production function and partial budgeting. The CD production function revealed that supplementary bee feeds, labor and medication were statistically significant for both box and traditional hives. Generally, labor for bee management, supplementary feeding, and medication led to productivity differences of approximately 42.83%, 7.52%, and 5.34%, respectively, between box and traditional hives. The study indicated that productivity of box hives were 72% higher than traditional hives. The average net incomes of beekeepers using box and traditional hives were 33,699.7 SR/annum and 16,461.4 SR/annum respectively. The incremental net benefit of box hives over traditional hives was nearly double. Our study results clearly showed the importance of adoption of box hives for better productivity of the beekeeping subsector.

  18. Comparative analysis of profitability of honey production using traditional and box hives

    Directory of Open Access Journals (Sweden)

    Ahmed A. Al-Ghamdi

    2017-07-01

    Full Text Available Information on the profitability and productivity of box hives is important to encourage beekeepers to adopt the technology. However, comparative analysis of profitability and productivity of box and traditional hives is not adequately available. The study was carried out on 182 beekeepers using cross sectional survey and employing a random sampling technique. The data were analyzed using descriptive statistics, analysis of variance (ANOVA, the Cobb-Douglas (CD production function and partial budgeting. The CD production function revealed that supplementary bee feeds, labor and medication were statistically significant for both box and traditional hives. Generally, labor for bee management, supplementary feeding, and medication led to productivity differences of approximately 42.83%, 7.52%, and 5.34%, respectively, between box and traditional hives. The study indicated that productivity of box hives were 72% higher than traditional hives. The average net incomes of beekeepers using box and traditional hives were 33,699.7 SR/annum and 16,461.4 SR/annum respectively. The incremental net benefit of box hives over traditional hives was nearly double. Our study results clearly showed the importance of adoption of box hives for better productivity of the beekeeping subsector.

  19. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial

    DEFF Research Database (Denmark)

    Rafiq, Sulman; Steinbrüchel, Daniel Andreas; Wanscher, Michael Jaeger

    2014-01-01

    BACKGROUND: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. METHODS: Open-label, prospective...

  20. Handcrafted Vacuum-Assisted Device for Skin Ulcers Treatment Versus Traditional Therapy, Randomized Controlled Trial.

    Science.gov (United States)

    Gonzalez, Israel Gonzalez; Angel, Medina Andrade Luis; Baez, Maria Valeria Jimenez; Ruiz Flores, Brenda; de Los Angeles Martinez Ferretiz, Maria; Woolf, Stephanny Vanestty; López, Israel; Sandoval-Jurado, Luis; Pat-Espadas, Fany Guadalupe; Cruz, Alan Alejandro Reyes; Delgado, Arsenio Torres

    2017-02-01

    Chronic lower limb ulcers constitute a public health problem, with important socioeconomic implications and high attention cost. This trial evaluates handcrafted vacuum-assisted therapy versus traditional treatment effectiveness for lower limbs ulcers. It was a prospective randomized clinical trial conducted over 144 patients with lower limbs ulcers. Patients were randomized into two groups of 72 patients: Experimental group were treated with debridement, cure and a handcrafted vacuum-assisted device that was changed every 72 h. Control group was treated with debridement and cure with soap every 24 h. Ulcers were evaluated every 72 h and on 10th day. The presence of systemic inflammatory response, pain, granulation tissue and viability for discharge was registered and analyzed . After exclusion of 18 patients, 126 were included, 65.1% were men with an average of 58 years. Sole region ulcer by diabetic foot was the more frequent in both groups (73%). Leukocytes count, systemic inflammatory response and pain were significantly lower in experimental group (p ulcers. This system would benefit patients favoring earlier infection control, faster granulation tissue appearance and earlier discharge. Clinical trials registered in https://www.clinicaltrials.gov/ Number NCT02512159.

  1. Adminsitrator Perception of Management Skills Comparing Traditionally and Alternatively Certified Teachers

    Science.gov (United States)

    Ring, Candi Lynn

    2016-01-01

    Within the scientific literature there has been no examination of teacher preparation regarding classroom and behavior management skills comparing educators who obtained traditional teacher certification through a university-based education program and those who obtained alternative certification. Consequently, the goal of this study was to assess…

  2. Blended versus Traditional Course Delivery: Comparing Students' Motivation, Learning Outcomes, and Preferences

    Science.gov (United States)

    Tseng, Hungwei; Walsh, Eamonn Joseph, Jr.

    2016-01-01

    This study sought to compare and assess students' experiences and perceptions in a blended and a traditional course, as well as their level of learning motivation, level of learning outcomes and skills, and learning achievement. Two instructors who were teaching 1 section of an undergraduate English literacy course using the face-to-face format…

  3. A Comparative Meta-Analysis of 5E and Traditional Approaches in Turkey

    Science.gov (United States)

    Anil, Özgür; Batdi, Veli

    2015-01-01

    The aim of this study is to compare the 5E learning model with traditional learning methods in terms of their effect on students' academic achievement, retention and attitude scores. In this context, the meta-analytic method known as the "analysis of analyses" was used and a review undertaken of the studies and theses (N = 14) executed…

  4. ChargeOut! : discounted cash flow compared with traditional machine-rate analysis

    Science.gov (United States)

    Ted Bilek

    2008-01-01

    ChargeOut!, a discounted cash-flow methodology in spreadsheet format for analyzing machine costs, is compared with traditional machine-rate methodologies. Four machine-rate models are compared and a common data set representative of logging skidders’ costs is used to illustrate the differences between ChargeOut! and the machine-rate methods. The study found that the...

  5. Comparative effects of traditional Chinese and Western migraine medicines in an animal model of nociceptive trigeminovascular activation.

    Science.gov (United States)

    Zhao, Yonglie; Martins-Oliveira, Margarida; Akerman, Simon; Goadsby, Peter J

    2017-01-01

    Background Migraine is a highly prevalent and disabling disorder of the brain with limited therapeutic options, particularly for preventive treatment. There is a need to identify novel targets and test their potential efficacy in relevant preclinical migraine models. Traditional Chinese medicines have been used for millennia and may offer avenues for exploration. Methods We evaluated two traditional Chinese medicines, gastrodin and ligustrazine, and compared them to two Western approaches with propranolol and levetiracetam, one effective and one ineffective, in an established in vivo rodent model of nociceptive durovascular trigeminal activation. Results Intravenous gastrodin (30 and 100 mg/kg) significantly inhibited nociceptive dural-evoked neuronal firing in the trigeminocervical complex. Ligustrazine (10 mg/kg) and propranolol (3 mg/kg) also significantly inhibited dural-evoked trigeminocervical complex responses, although the timing of responses of ligustrazine does not match its pharmacokinetic profile. Levetiracetam had no effects on trigeminovascular responses. Conclusion Our data suggest gastrodin has potential as an anti-migraine treatment, whereas ligustrazine seems less promising. Interestingly, in line with clinical trial data, propranolol was effective and levetiracetam not. Exploration of the mechanisms and modelling effects of Chinese traditional therapies offers novel route for drug discovery in migraine.

  6. Cross-National Prevalence of Traditional Bullying, Traditional Victimization, Cyberbullying and Cyber-Victimization: Comparing Single-Item and Multiple-Item Approaches of Measurement

    Science.gov (United States)

    Yanagida, Takuya; Gradinger, Petra; Strohmeier, Dagmar; Solomontos-Kountouri, Olga; Trip, Simona; Bora, Carmen

    2016-01-01

    Many large-scale cross-national studies rely on a single-item measurement when comparing prevalence rates of traditional bullying, traditional victimization, cyberbullying, and cyber-victimization between countries. However, the reliability and validity of single-item measurement approaches are highly problematic and might be biased. Data from…

  7. Traditional knowledge on medicinal plant of the Karen in northern Thailand: a comparative study.

    Science.gov (United States)

    Tangjitman, Kornkanok; Wongsawad, Chalobol; Winijchaiyanan, Piyawan; Sukkho, Treetip; Kamwong, Kaweesin; Pongamornkul, Wittaya; Trisonthi, Chusie

    2013-10-28

    We studied traditional medicinal plant knowledge among the Karen in northern Thailand. To compare traditional medicinal knowledge in 14 Karen villages in northern Thailand and determine culturally important medicinal plant species in each Karen village. We interviewed 14 key informants and 438 non-specialist informants about their traditional knowledge of medicinal plants. We tested normality of the data and correlations with distance to the nearest city using Kolmogorov-Smirnov tests and Spearman's rank correlation coefficient. Cluster analysis and cultural importance index (CI) were calculated for the similarity of medicinal plant used and culturally importance medicinal plant species among Karen villages respectively. In total 379 medicinal plant species were used. Number of medicinal plants used positively correlate with distance to the nearest city. Relatively low similarities of medicinal plant species and different CI values for species among the different areas were found. Traditional medicinal plants still play an important role in medicinal practice of the Karen. Local environments, availability of medicinal plant and distance between Karen villages and the nearest city affect the amount of traditional medicinal knowledge in each Karen village. The medicinal plants in this study with high CI values might give some useful leads for further biomedical research. © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2016-01-01

    The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Clinical Trial Of Glimepiride Compared With Glibenclamide For ...

    African Journals Online (AJOL)

    Objective: The study was undertaken to compare the efficacy and safety of Glimepiride against Glibenclamide in the management of patients with type 2 DM in Jos, Nigeria. Study design: An open, randomised controlled trial. Setting: Diabetes Clinic of the Jos University Teaching Hospital, Jos, Nigeria. Subjects: Seventy four ...

  10. A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety ...

    African Journals Online (AJOL)

    A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety and Cost Effectiveness of Lornoxicam with Diclofenac Sodium in Patients of Osteoarthritis Knee. ... All patients were assessed with visual analogue scale and 100 meter walking test before starting of therapy, at 15 days and at 1, 2 and 3 months of therapy.

  11. Traditional massage of newborns in Nepal: implications for trials of improved practice.

    Science.gov (United States)

    Mullany, Luke C; Darmstadt, Gary L; Khatry, Subarna K; Tielsch, James M

    2005-04-01

    Mustard oil massage of newborns is an integral component of traditional care practices in many communities. Recent evidence suggests that this practice may have detrimental effects, particularly for preterm infants or for those whose skin barrier function is otherwise sub-optimal. Other natural oils such as sunflower, sesame or safflower seed oil may have a beneficial impact on newborn health and survival. Little is known, however, about cultural and other factors related to the acceptance and uptake of alternative, more beneficial oils for massage of the newborn. A questionnaire concerning the usage and reasons for application of mustard and other oils to newborn skin was administered to the caretakers of 8580 newborns in Sarlahi district of rural Nepal. Four focus group discussions among representative groups were conducted to describe the perceived benefits of oil massage and the factors involved in the decision to apply oil. The potential for the introduction of alternative natural oils was explored. Approximately 99 per cent of newborns were massaged at least once with mustard oil in the 2 weeks after birth, and 80 per cent were massaged at least twice daily. Promotion of strength, maintenance of health, and provision of warmth were the most commonly cited reasons for application of mustard oil. Focus group discussion participants noted that smell, oiliness, mode of pre-massage preparation, and perceived absorptive potential on the skin are important contextual factors involved in the practice. Caretakers are willing to consider adaptation of established traditions for the promotion of positive health outcomes if essential contextual criteria are met. An understanding of cultural, social, and economic factors that shape the context of traditional healthcare practices is essential to the design and implementation of intervention trials examining the relative efficacy of application of oils in reducing neonatal mortality and morbidity.

  12. Comparative Analysis of Automatic Exudate Detection between Machine Learning and Traditional Approaches

    Science.gov (United States)

    Sopharak, Akara; Uyyanonvara, Bunyarit; Barman, Sarah; Williamson, Thomas

    To prevent blindness from diabetic retinopathy, periodic screening and early diagnosis are neccessary. Due to lack of expert ophthalmologists in rural area, automated early exudate (one of visible sign of diabetic retinopathy) detection could help to reduce the number of blindness in diabetic patients. Traditional automatic exudate detection methods are based on specific parameter configuration, while the machine learning approaches which seems more flexible may be computationally high cost. A comparative analysis of traditional and machine learning of exudates detection, namely, mathematical morphology, fuzzy c-means clustering, naive Bayesian classifier, Support Vector Machine and Nearest Neighbor classifier are presented. Detected exudates are validated with expert ophthalmologists' hand-drawn ground-truths. The sensitivity, specificity, precision, accuracy and time complexity of each method are also compared.

  13. [Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

    Science.gov (United States)

    Alonso, E; Rubio, A; March, J C; Danet, A

    2011-01-01

    The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  14. The Traditional Chinese Medicine and Relevant Treatment for the Efficacy and Safety of Atopic Dermatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Shi, Zhao-feng; Song, Tie-bing; Xie, Juan; Yan, Yi-quan

    2017-01-01

    Background Atopic dermatitis (AD) has become a common skin disease that requires systematic and comprehensive treatment to achieve adequate clinical control. Traditional Chinese medicines and related treatments have shown clinical effects for AD in many studies. But the systematic reviews and meta-analyses for them are lacking. Objective The systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were conducted to evaluate the efficacy and safety of traditional Chinese medicines and related treatments for AD treatment. Methods Randomized controlled trials (RCTs) were searched based on standardized searching rules in eight medical databases from the inception up to December 2016 and a total of 24 articles with 1,618 patients were enrolled in this meta-analysis. Results The results revealed that traditional Chinese medicines and related treatments did not show statistical differences in clinical effectiveness, SCORAD amelioration, and SSRI amelioration for AD treatment compared with control group. However, EASI amelioration of traditional Chinese medicines and related treatments for AD was superior to control group. Conclusion We need to make conclusion cautiously for the efficacy and safety of traditional Chinese medicine and related treatment on AD therapy. More standard, multicenter, double-blind randomized controlled trials (RCTs) of traditional Chinese medicine and related treatment for AD were required to be conducted for more clinical evidences providing in the future. PMID:28713436

  15. A Comparative Study of the Traditional Houses Kaili and Bugis-Makassar in Indonesia

    Science.gov (United States)

    Suharto, M. F.; Kawet, R. S. S. I.; Tumanduk, M. S. S. S.

    2018-02-01

    In this study, I compared the physical elements of two Indonesian traditional houses between a Kaili tribe (Central Sulawesi) and a Bugis-Makassar tribe (South Sulawesi). If we viewed of the name, meaning and function from both traditional houses have similarities, namely the Souraja/Saoraja house (House of the King), however, observed more detail the physical elements of architecture also show the differences. The spatial, physical and stylistic systems (N. John Habraken’s theory) were applied to analyze their differences and the similarities of the physical elements of architecture on those two traditional houses. The results of the analysis identified that the physical elements of architecture such as the orientation, the function and distribution of rooms (the spatial system), the constructions and materials of floor, wall and roof (the physical system) and the opening types of the door and window as well as ornaments used showed similarities. Meanwhile the physical elements of architecture such as the arrangement of columns, form and spatial pattern as well as the placement of the stairs (the spatial system), the constructions and materials of foundation, column and beam (the physical system) as well as the form of the roof and façade found differences of both traditional houses.

  16. Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial.

    Science.gov (United States)

    Watson, Angus J M; Hudson, Jemma; Wood, Jessica; Kilonzo, Mary; Brown, Steven R; McDonald, Alison; Norrie, John; Bruhn, Hanne; Cook, Jonathan A

    2016-11-12

    Two commonly performed surgical interventions are available for severe (grade II-IV) haemorrhoids; traditional excisional surgery and stapled haemorrhoidopexy. Uncertainty exists as to which is most effective. The eTHoS trial was designed to establish the clinical effectiveness and cost-effectiveness of stapled haemorrhoidopexy compared with traditional excisional surgery. The eTHoS trial was a large, open-label, multicentre, parallel-group, pragmatic randomised controlled trial done in adult participants (aged 18 years or older) referred to hospital for surgical treatment for grade II-IV haemorrhoids. Participants were randomly assigned (1:1) to receive either traditional excisional surgery or stapled haemorrhoidopexy. Randomisation was minimised according to baseline EuroQol 5 dimensions 3 level score (EQ-5D-3L), haemorrhoid grade, sex, and centre with an automated system to stapled haemorrhoidopexy or traditional excisional surgery. The primary outcome was area under the quality of life curve (AUC) measured with the EQ-5D-3L descriptive system over 24 months, assessed according to the randomised groups. The primary outcome measure was analysed using linear regression with adjustment for the minimisation variables. This trial is registered with the ISRCTN registry, number ISRCTN80061723. Between Jan 13, 2011, and Aug 1, 2014, 777 patients were randomised (389 to receive stapled haemorrhoidopexy and 388 to receive traditional excisional surgery). Stapled haemorrhoidopexy was less painful than traditional excisional surgery in the short term and surgical complication rates were similar between groups. The EQ-5D-3L AUC score was higher in the traditional excisional surgery group than the stapled haemorrhoidopexy group over 24 months; mean difference -0·073 (95% CI -0·140 to -0·006; p=0·0342). EQ-5D-3L was higher for stapled haemorrhoidopexy in the first 6 weeks after surgery, the traditional excisional surgery group had significantly better quality of life

  17. Comparative Study on the Education System of Traditional Medicine in China, Japan, Korea, and Taiwan.

    Science.gov (United States)

    Park, Yu Lee; Huang, Ching Wen; Sasaki, Yui; Ko, Youme; Park, Sunju; Ko, Seong-Gyu

    2016-01-01

    China, Japan, Korea, and Taiwan have developed modernized education systems in traditional medicine. This study aims to provide an overview of the education systems in these countries and compare them. Data were collected through the websites of government agencies, universities, and relevant organizations. These countries have systemically developed basic medical education (BME), postgraduate medical education (PGME), and continuing medical education (CME) in traditional medicine. BME is provided at colleges of traditional medicine at the undergraduate level and graduate levels. The length of education at the undergraduate level is five, six, and seven years in China, Korea, and Taiwan, respectively; the length at the graduate level is four years in Korea and five years in Taiwan. A seven- or eight-year program combining undergraduate and graduate courses is unique to China. In Japan, unlike in other countries, there are two distinct education systems-one is comprised of courses on traditional medicine included in the curriculum for Western medical doctors, and the other is a three- or four-year undergraduate program for practitioners including acupuncturists and moxibustionists. PGME in Korea consists of one-year internship and three-year residency programs which are optional; however, in China and Taiwan, internship is required for the national licensing examination and further training is in the process of standardization. The required credits for maintenance of CME are eight per year in Korea, 25 per year in China, and 180 over six years in Taiwan. The design of the educational systems in these countries can provide useful information for the development of education in traditional medicine around the world. Copyright © 2016. Published by Elsevier Inc.

  18. Test person operated 2-Alternative Forced Choice Audiometry compared to traditional audiometry

    DEFF Research Database (Denmark)

    Schmidt, Jesper Hvass; Brandt, Christian; Christensen-Dalsgaard, Jakob

      Background: With a newly developed technique, hearing thresholds can be estimated with a system operated by the test persons themselves. This technique is based on the 2 Alternative Forced Choice paradigm known from the psychoacoustic research theory. Test persons can operate the system very......-likelihood and up-down methods has proven effective and reliable even under suboptimal test settings. In non-optimal testing conditions i.e. as a part of a hearing conservation programme the headphone Sennheiser HDA-200 has been used as it contains hearing protection. This test-method has been validated......-retest studies of 2AFC audiometry are comparable to test-retest results known from traditional audiometry under standard clinical settings.   Conclusions 2 Alternative Forced Choice audiometry can be a reliable alternative to traditional audiometry especially under certain circumstances, where it can...

  19. The Use of Computer Simulation to Compare Student performance in Traditional versus Distance Learning Environments

    Directory of Open Access Journals (Sweden)

    Retta Guy

    2015-06-01

    Full Text Available Simulations have been shown to be an effective tool in traditional learning environments; however, as distance learning grows in popularity, the need to examine simulation effectiveness in this environment has become paramount. A casual-comparative design was chosen for this study to determine whether students using a computer-based instructional simulation in hybrid and fully online environments learned better than traditional classroom learners. The study spans a period of 6 years beginning fall 2008 through spring 2014. The population studied was 281 undergraduate business students self-enrolled in a 200-level microcomputer application course. The overall results support previous studies in that computer simulations are most effective when used as a supplement to face-to-face lectures and in hybrid environments.

  20. Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial.

    Science.gov (United States)

    Bellussi, F; Alcamisi, L; Guizzardi, G; Parma, D; Pilu, G

    2018-03-13

    To investigate the usefulness of visual biofeedback using transperineal ultrasound to improve coached pushing during the active second stage of labor in nulliparous women. This was a randomized controlled trial of low-risk nulliparous women in the active second stage of labor. Patients were allocated to either coached pushing aided by visual demonstration on transperineal ultrasound of the progress of the fetal head (sonographic coaching) or traditional coaching. Patients in both groups were coached by an obstetrician for the first 20 min of the active second stage of labor and, subsequently, the labor was supervised by a midwife. Primary outcomes were duration of the active second stage and increase in the angle of progression at the end of the coaching process. Secondary outcomes included the incidence of operative delivery and complications of labor. Forty women were recruited into the study. Those who received sonographic coaching had a shorter active phase of the second stage (30 min (interquartile range (IQR), 24-42 min) vs 45 min (IQR, 39-55 min); P = 0.01) and a greater increase in the angle of progression (13.5° (IQR, 9-20°) vs 5° (IQR, 3-9.5°); P = 0.01) in the first 20 min of the active second stage of labor than did those who had traditional coaching. No differences were found in the secondary outcomes between the two groups. Our preliminary data suggest that transperineal ultrasound may be a useful adjunct to coached pushing during the active second stage of labor. Further studies are required to confirm these findings and better define the benefits of this approach. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

  1. Decision on performing interim analysis for comparative clinical trials.

    Science.gov (United States)

    Pak, Kyongsun; Jacobus, Susanna; Uno, Hajime

    2017-09-01

    In randomized-controlled trials, interim analyses are often planned for possible early trial termination to claim superiority or futility of a new therapy. While unblinding is necessary to conduct the formal interim analysis in blinded studies, blinded data also have information about the potential treatment difference between the groups. We developed a blinded data monitoring tool that enables investigators to predict whether they observe such an unblinded interim analysis results that supports early termination of the trial. Investigators may skip some of the planned interim analyses if an early termination is unlikely. We specifically focused on blinded, randomized-controlled studies to compare binary endpoints of a new treatment with a control. Assuming one interim analysis is planned for early termination for superiority or futility, we conducted extensive simulation studies to assess the impact of the implementation of our tool on the size, power, expected number of interim analyses, and bias in the treatment effect. The numerical study showed the proposed monitoring tool does not affect size or power, but dramatically reduces the expected number of interim analyses when the effect of the treatment difference is small. The tool serves as a useful reference when interpreting the summary of the blinded data throughout the course of the trial, without losing integrity of the study. This tool could potentially save the study resources and budget by avoiding unnecessary interim analyses.

  2. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial

    Science.gov (United States)

    Farris, Coreen; Fischhoff, Baruch; Rosengart, Matthew R; Angus, Derek C; Yealy, Donald M; Wallace, David J; Barnato, Amber E

    2017-01-01

    education arm completed the trial. Of these, 64/100 (64%) and 58/100 (58%), respectively, completed reassessment at six months. The mean age was 40 (SD 8.9), 283 (96%) were trained in emergency medicine, and 207 (70%) were ATLS (advanced trauma life support) certified. Physicians exposed to the game under-triaged fewer severely injured patients than those exposed to didactic education (316/596 (0.53) v 377/592 (0.64), estimated difference 0.11, 95% confidence interval 0.05 to 0.16; P<0.001). Cognitive load did not influence under-triage (161/308 (0.53) v 155/288 (0.54) in the game arm; 197/300 (0.66) v 180/292 (0.62) in the traditional educational apps arm; P=0.66). At six months, physicians exposed to the game remained less likely to under-triage patients (146/256 (0.57) v 172/232 (0.74), estimated difference 0.17, 0.09 to 0.25; P<0.001). No physician reported side effects. The sample might not reflect all emergency medicine physicians, and a small set of cases was used to assess performance. Conclusions Compared with apps based on traditional didactic education, exposure of physicians to a theoretically grounded video game improved triage decision making in a validated virtual simulation. Though the observed effect was large, the wide confidence intervals include the possibility of a small benefit, and the real world efficacy of this intervention remains uncertain. Trial registration clinicaltrials.gov; NCT02857348 (initial study)/NCT03138304 (follow-up). PMID:29233854

  3. Experimental tests on winter cereal: Sod seeding compared to minimum tillage and traditional plowing

    Directory of Open Access Journals (Sweden)

    Antoniotto Guidobono Cavalchini

    2013-09-01

    Full Text Available Compared to traditional plowing and minimum tillage, the sod seeding technique has been tested in order to evaluate the differences in energy consumption, labor and machinery requirement and CO2 emission reduction. The experiments were conducted on winter cereal seeding in a Po valley farm in October 2011. The tests were carried out as follows: wheat variety seeding, over corn and alfalfa crops, in large plots with three repetitions for each thesis. They included: sod seeding anticipated by round up weeding in the case of the plots over alfalfa; traditional plowing at 35 cm followed by rotary tillage and combined seeding (seeder plus rotary tiller; minimum tillage based on ripping at the same depth (35 cm and combined seeder ( seeder plus rotary tiller. The following farm operations - fertilizer, and other agrochemical distributionshave been the same in all the considered theses. The results, statistically significant (P<0.001 in terms of yields, highlighted slight differences: the best data in the case of the traditional plowing both in the case of wheat crop over corn and alfalfa (84.43 and 6.75 t/ha; slightly lower yields for the sod seeding (6.23 and 79.9 t/ha for corn and alfalfa respectively; lower in the case of minimum tillage (5.87; 79.77 t/ha in the two situations. Huge differences in energy and oil consumption have been recorded: in the case of succession to corn 61.47; 35.31; 4.27 kg oil/ha respectively for, traditional plowing, minimum tillage and sod seeding; in the case of alfalfa 61.2; 50.96; 5.14 kg oil/ha respectively for traditional plowing, minimum tillage and sod seeding. The innovative technique, highlighted huge energy saving with an oil consumption equal to 92% and 89% (P<0.001 of what happens in traditional plowing and minimum tillage. Large differences concern labor and machine productivity. These parameters together with oil consumption and machine size [power (kW and weight (t] lead to even greater differences in

  4. Cost-effectiveness of home telemedical cardiotocography compared with traditional outpatient monitoring.

    Science.gov (United States)

    Tõrõk, M; Kovács, F; Doszpod, J

    2000-01-01

    We compared the cost of passive sensor telemedical non-stress cardiotocography performed at home and the same test performed by traditional equipment in an outpatient clinic in the Budapest area. The costs were calculated using two years' registered budget data from the home monitoring service in Budapest and the outpatient clinic of the department of obstetrics and gynaecology at the Haynal Imre University of Health Sciences. The traditional test at the university outpatient clinic cost 3652 forint for the health-care and 1000 forint in additional expenses for the patient (travel and time off work). This means that the total cost for each test in the clinic was 4652 forint. The cost of home telemedical cardiotocography was 1500 forint per test, but each test took 2.1 times as long. For a more realistic comparison between the two methods, we adjusted the cost to take account of the extra length of time that home monitoring required. The adjusted cost for home care was 3150 forint, some 32% lower than in the clinic. Passive sensor telemedical non-stress cardiotocography at home was therefore less expensive than the same test performed in the traditional way in an outpatient clinic.

  5. Comparative Analysis of Phenolic Content and Anti oxidative Activities of Eight Malaysian Traditional Vegetables

    International Nuclear Information System (INIS)

    Nur Huda-Faujan; Zulaikha Abdul Rahim; Maryam Mohamed Rehan; Faujan Ahmad

    2015-01-01

    Vegetables have been believed to exhibit antioxidant activities due to its phenolic content. Thus, this study was carried out to determine the total phenolic content of water and ethanolic extracts of Malaysian traditional vegetables and assess their antioxidant activities. Eight samples of Malaysian traditional vegetables were dried and extracted its phenolic compounds using water and ethanolic solvent. Total phenolic content of the extracts were compared and evaluated using Folin-Ciocalteu and Prussian Blue reagent. The antioxidant activity were assessed using ferric thiocyanate assay and DPPH free radical scavenging assays. Results found that total phenolic content of water extracts ranged from 7.08 to 14.76 mg GAE (Folin-Ciocalteu assay) and 3.50 to 7.82 mg GAE (Prussian Blue assay). However, the content of phenolic of ethanolic extracts ranged from 5.21 to 15.86 mg GAE (Folin-Ciocalteu assay), and 1.84 to 11.54 mg GAE (Prussian Blue assay). The highest antioxidant activity was observed in water extracts of Etlingera elatior (75.6 %) and ethanolic extracts of Sauropus androgynus (78.1 %). Results also found that the best half maximal inhibitory concentration or IC 50 were demonstrated by water and ethanolic extracts of Sauropus androgynus which demonstrated 0.077 mg/mL and 0.078 mg/ mL, respectively. Hence, this study obtained that most of the Malaysian traditional vegetables have a potential source of natural antioxidant. (author)

  6. COMPARATIVE FEASIBILITY ANALYSIS OF MODERN AND TRADITIONAL SYSTEM OF BROILER CHICKEN FARM BUSINESS

    Directory of Open Access Journals (Sweden)

    Firda Rachma Amalia

    2015-05-01

    Full Text Available Feasibility study is a study assessing a project to be undertaken in the future. This research aimed to analyze whether the broiler business by partnership pattern at Prospek Mitra Lestari (PML was feasible to be continued. This research analyzed two models of cage that is traditional cage (open with a scale of 10,000  and modern cage (close with a scale 14.500 and decided whether they were financially feasible or not. In addition, this research aimed to compare between traditional cage and modern cage with estimation for one year (six harvest times and to analyze which cage had better feasibility in order to provide recommendations or suggestions to the breeders or young breeders. Sensitivity analysis was based on current input and output data from breeder in 2012. The feasibility study of chicken broiler farm cage partnership with traditional and modern cage with the next ten year estimation showed that the modern cage was better than the traditional cage. It can be seen from the values of NPV, IRR, PP, B/C, GPM and ROI. Sensitivity analysis shows that traditional cage is more sensitive to price changes than modern cage. It is shown in the traditional cage with the capacity of 10,000 produces smaller values, indicating that is it is sensitive to cost increase by 2% and to selling price decline of chicken by 1,7%. The recommendations from this study include inputs to farmers in selecting a modern cage since it is more feasible than the traditional cage for long periods of time, while the traditional cage is more viable than the modern cage if the farmer wants a shorter investment timeKeywords: Feasibility studies, Broiler, modern and Traditional cageABSTRAKKelayakan merupakan studi  menilai proyek yang akan dikerjakan di masa mendatang. Penelitian ini bertujuan untuk menganalisisis apakah usaha ayam broiler dengan pola kemitraan pada Prospek Mitra Lestari (PML layak untuk diteruskan. Penelitian ini menganalisisis dua model kandang tradisional

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

    NARCIS (Netherlands)

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

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

  8. Telerehabilitation Versus Traditional Care Following Total Hip Replacement: A Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Nelson, Mark; Bourke, Michael; Crossley, Kay; Russell, Trevor

    2017-03-02

    Total hip replacement (THR) is the gold standard treatment for severe hip osteoarthritis. Effectiveness of physical rehabilitation for THR patients following discharge from hospital is supported by evidence; however, barriers such as geographical location and transport can limit access to appropriate health care. One solution to this issue is using an alternative model of care using telerehabilitation technology to deliver rehabilitation programs directly into patients' homes. A telerehabilitation model may also have potential health care cost savings for health care providers. This study aims to determine if a telerehabilitation model of care delivered remotely is as effective as face-to-face rehabilitation in the THR population and cost effective for health care providers and patients. A total of 70 people undergoing THR will be recruited to participate in a randomized, single-blind, controlled noninferiority clinical trial. The trial will compare a technology-based THR rehabilitation program to in-person care. On discharge from hospital, participants randomized to the in-person group will receive usual care, defined as a paper home exercise program (HEP) targeting strengthening exercises for quadriceps, hip abductors, extensors, and flexors; they will be advised to perform their HEP 3 times per day. At 2, 4, and 6 weeks postoperatively, they will receive a 30-minute in-person physiotherapy session with a focus on gait retraining and reviewing and progressing their HEP. The telerehabilitation protocol will involve a program similar in content to the in-person rehabilitation program, except delivery will be directly into the homes of the participants via telerehabilitation technology on an iPad. Outcomes will be evaluated preoperatively, day of discharge from in-patient physiotherapy, 6 weeks and 6 months postoperatively. The primary outcome will be the quality of life subscale of the hip disability and osteoarthritis outcome score, measured at 6 weeks. Both

  9. Comparing the efficacy of multimedia modules with traditional textbooks for learning introductory physics content

    Science.gov (United States)

    Stelzer, Timothy; Gladding, Gary; Mestre, José P.; Brookes, David T.

    2009-02-01

    We compared the efficacy of multimedia learning modules with traditional textbooks for the first few topics of a calculus-based introductory electricity and magnetism course. Students were randomly assigned to three groups. One group received the multimedia learning module presentations, and the other two received the presentations via written text. All students were then tested on their learning immediately following the presentations as well as 2weeks later. The students receiving the multimedia learning modules performed significantly better on both tests than the students experiencing the text-based presentations.

  10. Teaching Traditions in Science Education in Switzerland, Sweden and France: A Comparative Analysis of Three Curricula

    Science.gov (United States)

    Marty, Laurence; Venturini, Patrice; Almqvist, Jonas

    2018-01-01

    Classroom actions rely, among other things, on teaching habits and traditions. Previous research has clarified three different teaching traditions in science education: the academic tradition builds on the idea that simply the products and methods of science are worth teaching; the applied tradition focuses on students' ability to use scientific…

  11. Academic satisfaction among traditional and problem based learning medical students. A comparative study.

    Science.gov (United States)

    Albarrak, Ahmed I; Mohammed, Rafiuddin; Abalhassan, Mohammed F; Almutairi, Nasser K

    2013-11-01

    To evaluate the academic satisfaction and importance among traditional learning (TL) and problem based learning (PBL) medical students, and to further evaluate the areas of concern in the academic education from the student's point of view. A cross sectional study was conducted at the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from May to June 2012. The survey questionnaires were self-administered and consisted of mainly 6 sections: teaching, learning, supervision, course organization, information technology (IT) facilities, and development of skills. A total of 92 TL (males: 66 [71.7%]; females: 26 [28.3%]), and 108 PBL (males: 84 [77.8%]; females: 24 [22.1%]), with a mean age of 21.3 +/- 1.3 (TL), and 20.7 +/- 1.0 (PBL) were included in the study. The overall satisfaction rate was higher in the PBL students when compared with TL students in: teaching (84.7%/60.3%); learning (81.4%/64.5%); supervision (80%/51.5%); course organization (69.3%/46.9%); IT facilities (74.0%/58.9%); and development of skills (79.1%/53.9%). There was statistical significance difference in academic satisfaction comparing both groups of students (pdisadvantages of the traditional system. The PBL was potentially considered a successful method in enhancing medical education.

  12. Comparative study of combustion product emissions of Pakistani coal briquettes and traditional Pakistani domestic fuels

    International Nuclear Information System (INIS)

    Wachter, E.A.; Gammage, R.B.; Haas, J.W. III; Wilson, D.L.; DePriest, J.C.; Wade, J.; Ahmad, N.; Sibtain, F.; Zahid Raza, M.

    1992-10-01

    A comparative emissions study was conducted on combustion products of various solid domestic cooking fuels; the objective was to compare relative levels of organic and inorganic toxic emissions from traditional Pakistani fuels (wood, wood charcoal, and dried animal dung) with manufactured low-rank coal briquettes (Lakhra and Sor- Range coals) under conditions simulating domestic cooking. A small combustion shed 12 m 3 internal volume, air exchange rate 14 h -1 was used to simulate south Asian cooking rooms. 200-g charges of the various fuels were ignited in an Angethi stove located inside the shed, then combusted to completion; effluents from this combustion were monitored as a function of time. Measurements were made of respirable particulates, volatile and semi-volatile organics, CO, SO 2 , and NO x . Overall it appears that emissions from coal briquettes containing combustion amendments (slaked lime, clay, and potassium nitrate oxidizer) are no greater than emissions from traditional fuels, and in some cases are significantly lower; generally, emissions are highest for all fuels in the early stages of combustion

  13. Promoting dental hygiene to children: comparing traditional and interactive media following threat appeals.

    Science.gov (United States)

    Panic, Katarina; Cauberghe, Veroline; De Pelsmacker, Patrick

    2014-01-01

    Until now, social marketing campaigns mainly targeted children using traditional media. However, little is known about the effectiveness of computer games to communicate health-related information to children. This study compares the impact of an interactive game as a medium to provide health information and improve children's dietary habits to the impact of more traditional media. Using a 2 × 3 between-subject factorial design with 190 children (7-9 years old), this study investigates the effect of threat messages (weak vs. strong) concerning dental hygiene on behavioral outcome (snack choice), and how this effect is moderated by the type of medium used to communicate subsequent health information after the threat appeal (computer game, information brochure, narrative story). Results show a positive significant effect of perceived threat on children's adaptive behavior. However, this effect only remains significant when afterwards children are exposed to a narrative health-related story. When children play a game or read a brochure, they need to devote more attention to process this content, distracting them from the original threat message. In sum, when a threat message is followed by additional health information, the medium through which this information is presented influences the effectiveness of the preceding threat message.

  14. Sensory and Quality Evaluation of Traditional Compared with Power Ultrasound Processed Corn (Zea Mays) Tortilla Chips.

    Science.gov (United States)

    Janve, Bhaskar; Yang, Wade; Sims, Charles

    2015-06-01

    Power ultrasound reduces the traditional corn steeping time from 18 to 1.5 h during tortilla chips dough (masa) processing. This study sought to examine consumer (n = 99) acceptability and quality of tortilla chips made from the masa by traditional compared with ultrasonic methods. Overall appearance, flavor, and texture acceptability scores were evaluated using a 9-point hedonic scale. The baked chips (process intermediate) before and after frying (finished product) were analyzed using a texture analyzer and machine vision. The texture values were determined using the 3-point bend test using breaking force gradient (BFG), peak breaking force (PBF), and breaking distance (BD). The fracturing properties determined by the crisp fracture support rig using fracture force gradient (FFG), peak fracture force (PFF), and fracture distance (FD). The machine vision evaluated the total surface area, lightness (L), color difference (ΔE), Hue (°h), and Chroma (C*). The results were evaluated by analysis of variance and means were separated using Tukey's test. Machine vision values of L, °h, were higher (P power ultrasound as potential tortilla chips processing aid. © 2015 Institute of Food Technologists®

  15. Catch me if you can: Comparing ballast water sampling skids to traditional net sampling

    Science.gov (United States)

    Bradie, Johanna; Gianoli, Claudio; Linley, Robert Dallas; Schillak, Lothar; Schneider, Gerd; Stehouwer, Peter; Bailey, Sarah

    2018-03-01

    With the recent ratification of the International Convention for the Control and Management of Ships' Ballast Water and Sediments, 2004, it will soon be necessary to assess ships for compliance with ballast water discharge standards. Sampling skids that allow the efficient collection of ballast water samples in a compact space have been developed for this purpose. We ran 22 trials on board the RV Meteor from June 4-15, 2015 to evaluate the performance of three ballast water sampling devices (traditional plankton net, Triton sampling skid, SGS sampling skid) for three organism size classes: ≥ 50 μm, ≥ 10 μm to Natural sea water was run through the ballast water system and untreated samples were collected using paired sampling devices. Collected samples were analyzed in parallel by multiple analysts using several different analytic methods to quantify organism concentrations. To determine whether there were differences in the number of viable organisms collected across sampling devices, results were standardized and statistically treated to filter out other sources of variability, resulting in an outcome variable representing the mean difference in measurements that can be attributed to sampling devices. These results were tested for significance using pairwise Tukey contrasts. Differences in organism concentrations were found in 50% of comparisons between sampling skids and the plankton net for ≥ 50 μm, and ≥ 10 μm to < 50 μm size classes, with net samples containing either higher or lower densities. There were no differences for < 10 μm organisms. Future work will be required to explicitly examine the potential effects of flow velocity, sampling duration, sampled volume, and organism concentrations on sampling device performance.

  16. Comparative analysis to determine asphalt density and content, using nuclear and traditional methods

    International Nuclear Information System (INIS)

    Margffoy S, F.R.; Robayo S, A.M.

    1989-01-01

    Quality control for flex pavement construction in Colombia for asphaltic mix, as well as for granular and granular sub base layers is made by means of methods that does not guarantee the quality of the job, due to the difficult execution of tests, which impede more to be done or due to inherent problems of the test process. Thanks to the inherent characteristics and advantages of nuclear techniques, those become the optimal alternative to this quality control job. The present research project has been developed with the objective of justifying the use of new technologies applied to road construction; making a comparative analysis between traditional methods used in our country and nuclear techniques that have been using in United States with great success in quality control in road construction

  17. Comparing responses to horticultural-based and traditional activities in dementia care programs.

    Science.gov (United States)

    Jarrott, Shannon E; Gigliotti, Christina M

    2010-12-01

    Engaging persons with dementia in meaningful activities supports well-being; however, care staff are challenged to implement age- and ability-appropriate activities in a group setting. We compared a randomly assigned treatment group, who received horticultural therapy-based (HT-based) programming to a comparison group, who engaged in traditional activities (TA) programming, on engagement and affect. Horticultural therapy-based programming was implemented twice weekly at 4 treatment sites for 6 weeks, while regular TA were observed at comparison sites. Results revealed no differences between groups on affective domains. Levels of adaptive behavior differed between the groups, with the treatment group demonstrating higher levels of active, passive, and other engagement and the comparison group demonstrating higher levels of self-engagement. Our results highlight the value of HT-based programs and the importance of simultaneously capturing participants' affective and behavioral responses. Theoretical and practical considerations about the facilitation of and context in which the programming occurs are discussed.

  18. A randomized trial comparing treatments for varicose veins.

    Science.gov (United States)

    Brittenden, Julie; Cotton, Seonaidh C; Elders, Andrew; Ramsay, Craig R; Norrie, John; Burr, Jennifer; Campbell, Bruce; Bachoo, Paul; Chetter, Ian; Gough, Michael; Earnshaw, Jonothan; Lees, Tim; Scott, Julian; Baker, Sara A; Francis, Jill; Tassie, Emma; Scotland, Graham; Wileman, Samantha; Campbell, Marion K

    2014-09-25

    Ultrasound-guided foam sclerotherapy and endovenous laser ablation are widely used alternatives to surgery for the treatment of varicose veins, but their comparative effectiveness and safety remain uncertain. In a randomized trial involving 798 participants with primary varicose veins at 11 centers in the United Kingdom, we compared the outcomes of foam, laser, and surgical treatments. Primary outcomes at 6 months were disease-specific quality of life and generic quality of life, as measured on several scales. Secondary outcomes included complications and measures of clinical success. After adjustment for baseline scores and other covariates, the mean disease-specific quality of life was slightly worse after treatment with foam than after surgery (P=0.006) but was similar in the laser and surgery groups. There were no significant differences between the surgery group and the foam or the laser group in measures of generic quality of life. The frequency of procedural complications was similar in the foam group (6%) and the surgery group (7%) but was lower in the laser group (1%) than in the surgery group (Pdisease-specific quality of life in the foam group than in the surgery group. All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; Current Controlled Trials number, ISRCTN51995477.).

  19. Comparative analysis of medicinal plants used in traditional medicine in Italy and Tunisia

    Directory of Open Access Journals (Sweden)

    Ghedira Kamel

    2009-10-01

    Full Text Available Abstract Background Italy and Tunisia (Africa for the Romans, facing each other on the opposite sides of the Mediterranean Sea, have been historically linked since the ancient times. Over the centuries both countries were mutually dominated so the vestiges and traces of a mutual influence are still present. The aim of the present study is to conduct a comparative analysis of the medicinal species present in the respective Floras in order to explore potential analogies and differences in popular phytotherapy that have come out from those reciprocal exchanges having taken place over the centuries Methods The comparative analysis based on the respective floras of both countries takes into consideration the bulk of medicinal species mutually present in Italy and Tunisia, but it focuses on the species growing in areas which are similar in climate. The medicinal uses of these species are considered in accordance with the ethnobotanical literature. Results A list of 153 medicinal species belonging to 60 families, present in both floras and used in traditional medicine, was drawn. A considerable convergence in therapeutic uses of many species emerged from these data. Conclusion This comparative analysis strengthens the firm belief that ethno-botanical findings represent not only an important shared heritage, developed over the centuries, but also a considerable mass of data that should be exploited in order to provide new and useful knowledge.

  20. Comparative study of radon concentration in selected modern and traditional building at Kenyatta University

    International Nuclear Information System (INIS)

    Chege, W.M.; Rathore, I.V.S.; Chhabra, S.C.; Mustapha, A.O.

    2010-01-01

    Radon is leading source of radiation exposure to the public and increases risk of cancer (UNSCEAR, 2000). There is general lack of data on indoor radon in Kenya especially on building design-traditional versus modern. In rural Kenya traditional mud huts coexist with modern stone building. Indoor radon found to vary widely in Kenya: Mustapha et al (2002): 5-1200 Bqm3, Maina et al (2004): 5-704 Bqm3. None of previous works indicates radon variation with building design. The aim of the current study is to compare radon concentrations in coexisting stone buildings and mud huts. Such data would be useful in formulation of policies regarding housing, as part of radon data base in Kenya Experimental Techniques Characteristic of selected buildings: Traditional Huts: Single roomed, Wall made of wood and plastered using mud, bare floor and no ceiling, grass-thatched or mud plastered, doors and windows remained open during the sampling period. Modern Buildings: (Classes used to represent modern building). Those made of natural stone, wooden floor, ceiling, doors and windows remained shut during the sampling period. Measurement of Radon Concentration Radon sampling was done using Charcoal canisters (EPA type). They were activated, and then exposed simultaneously at sampling sites for 48 hours. Analysis and data acquisition was done using NaI(Tl) gamma-ray spectrometer. Radon concentration was calculated based on gamma rays emitted by 214Pb (295 and 352 keV) and 214Bi (609 keV). 13 Results and Discussion Radon levels were higher in classrooms and significantly high in huts. Mean (Bqm-3 ) Minimum (Bqm-3 ) Maximum (Bqm-3 ). Traditional huts had 170.3 15.6 30.2 315.4 while modern buildings had 193 ±19.3 115.76 257.2. There were higher levels in classroom despite lower levels of 226Ra (50.18 Bqkg-1) in natural stone. Possible source of high concentrations: - radon seeping in through floor boards building up over time as building more closed up - Radon concentration was more varied

  1. A comparative ecophysiology of ecolly (vitis vinifera l.) under the traditional independent long-stem pruning and crawled cordon training

    International Nuclear Information System (INIS)

    Nan, L.; Zhao, X.; Liu, L.; Wang, H.; Li, H.

    2014-01-01

    The aim of this study was to compare the ecophysiology character of Ecolly grape (Vitis vinifera L.) with the new technology-single crawled cordon training (SCCT) and traditional method-independent long-stem pruning (ILSP). The connections among net photosynthesis rate (Pn), transpiration rate (Tr), instantaneous water utilization efficiency (WUEi), stomatal conductance (Cs) and intercellular CO/sub 2/ concentration (Ci) were always mutual and inextricable in the trial. The leaves in every stage had the highest Pn respectively when growing under the light irradiance of the different period. The ILSP showed a lower total photosynthetic capacity than the SCCT. There was the total semblable Tr for two pruning plants, but lower Tr in ILSP at the every position of the prior stage and riping stage (PS and RS) excluding the growing stage (GS). The WUEi declined because of the net CO/sub 2/ assimilation saturated and the transpiration constantly fleetly increased before the photosynthetic active radiation (PAR) increased to 600 meu mol m/sup -2/ s/sup -1/. The increased WUEis from the first to the second stage deduced that stomatal closure at high irradiance reduced more Tr than Pn, while the values decreased again in the last stage indicated that stomatal opening at low irradiance added more Tr than Pn. These results suggested that it may be possible technology to change trellises in order to obtain better ecophysiology character in this study. The growth variability of vine may be affected by a particular training style. (author)

  2. Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.

    Science.gov (United States)

    Trish, Erin; Ginsburg, Paul; Gascue, Laura; Joyce, Geoffrey

    2017-09-01

    Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans. Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all MA and commercial enrollees with a large national health insurer operating in both markets, as well as a 20% sample of TM beneficiaries. Enrollment in an MA plan. Mean reimbursement paid to physicians, laboratories, and durable medical equipment suppliers for MA and commercial enrollees relative to TM rates for 11 Healthcare Common Procedure Coding Systems (HCPCS) codes spanning 7 sites of care. The sample consisted of 144 million claims. Physician reimbursement in MA was more strongly tied to TM rates than commercial prices, although MA plans tended to pay physicians less than TM. For a mid-level office visit with an established patient (Current Procedural Terminology [CPT] code 99213), the mean MA price was 96.9% (95% CI, 96.7%-97.2%) of TM. Across the common physician services we evaluated, mean MA reimbursement ranged from 91.3% of TM for cataract removal in an ambulatory surgery center (CPT 66984; 95% CI, 90.7%-91.9%) to 102.3% of TM for complex evaluation and management of a patient in the emergency department (CPT 99285; 95% CI, 102.1%-102.6%). However, for laboratory services and durable medical equipment, where commercial prices are lower than TM rates, MA plans take advantage of these lower commercial prices, ranging from 67.4% for a walker

  3. A New Measure of Traditional Values Across Cultures: China and Russia Compared

    Directory of Open Access Journals (Sweden)

    Robert J. Taormina

    2016-10-01

    Full Text Available A new measure of adherence to traditional values was created with the objective of facilitating research within and across cultures and nations. The measure was tested in China (N = 321 and Russia (N = 314 and factor analysis of the data revealed two subscales named Personal Traditional Values (10 items and Public Traditional Values (6 items. Empirical psychometric testing of the overall 16-item measure and the two subscales strongly supported the validity and reliability of all three measures. Means comparisons conducted to assess how well the measures could be used for cross-cultural comparisons revealed the Russians somewhat more than the Chinese living by traditional values overall, both nations about equal on living according to traditional values in their personal lives, and the Russians significantly more inclined to abide by traditional values in public. Also tested were several social and psychological variables as theoretical predictors of living by traditional values, and Life Satisfaction was tested as a possible correlate of living according to traditional values. Regression analyses on the combined data confirmed that Family Emotional Support, Conscientiousness, Collectivism, and Age were all significant positive predictors of living by traditional values. Additional regressions also found some unique predictors for each nation. These findings and the results of the parametric tests support the use of the new scales for measuring traditional values both within and across cultures.

  4. Increased Gamma Brainwave Amplitude Compared to Control in Three Different Meditation Traditions.

    Directory of Open Access Journals (Sweden)

    Claire Braboszcz

    Full Text Available Despite decades of research, effects of different types of meditation on electroencephalographic (EEG activity are still being defined. We compared practitioners of three different meditation traditions (Vipassana, Himalayan Yoga and Isha Shoonya with a control group during a meditative and instructed mind-wandering (IMW block. All meditators showed higher parieto-occipital 60-110 Hz gamma amplitude than control subjects as a trait effect observed during meditation and when considering meditation and IMW periods together. Moreover, this gamma power was positively correlated with participants meditation experience. Independent component analysis was used to show that gamma activity did not originate in eye or muscle artifacts. In addition, we observed higher 7-11 Hz alpha activity in the Vipassana group compared to all the other groups during both meditation and instructed mind wandering and lower 10-11 Hz activity in the Himalayan yoga group during meditation only. We showed that meditation practice is correlated to changes in the EEG gamma frequency range that are common to a variety of meditation practices.

  5. A Pilot Randomized, Single Blind, Placebo-Controlled Trial of Traditional Acupuncture for Vasomotor Symptoms and Mechanistic Pathways of Menopause

    Science.gov (United States)

    Painovich, Jeannette M.; Shufelt, Chrisandra L.; Azziz, Ricardo; Yang, Yuching; Goodarzi, Mark O.; Braunstein, Glenn D.; Karlan, Beth Y.; Stewart, Paul M.; Merz, C. Noel Bairey

    2011-01-01

    Objective To conduct a pilot study for feasibility of planning a definitive clinical trial comparing traditional acupuncture (TA) to sham acupuncture (SA) and waiting control (WC) on menopause related vasomotor symptoms (VMS), quality of life (QOL), and the hypothalamic-pituitary-adrenal (HPA) axis in peri and post-menopausal women. Methods Thirty-three peri and post-menopausal women with at least 7 VMS daily were randomized to TA, SA or WC. The TA and SA groups were given three treatments per week for 12 weeks. Outcomes included the number and severity of VMS, MENQOL questionnaire, Beck Depression Inventory, Spielberg State-Trait Anxiety Instrument, Pittsburgh Quality Sleep Index, 24 hour urine cortisol and metabolites, and ACTH stimulation testing. Results Both TA and SA groups demonstrated improved VMS trends compared to WC (Δ −3.5±3.00 vs. −4.1±3.79 vs. −1.2±2.4, respectively, p=.20), and significantly improved MENQOL vasomotor scores (Δ − 1.5±2.02 vs. −1.8±1.52 vs. 0.3±0.64, respectively, p=.04). There were no psychosocial group differences. Exit 24-hour urinary measures were lower in the TA vs the SA or WC in total cortisol metabolites (4,658.9±1,670.9 vs 7,735.8±3,747.9 vs 5,166.0±2,234.5, p=0.03, respectively) and DHEA (41.4±27.46, 161.2±222.77, 252.4±385.40, respectively, p=0.05). The ACTH stimulation cortisol response data also trended in the hypothesized direction (p=0.17). Conclusion Both TA and SA reduce VMS frequency and severity and improve VMS-related quality of life compared to WC; however, TA alone may impact the HPA axis. This association is viewed as preliminary and hypothesis-generating and should be explored in a large clinical trial. PMID:21968279

  6. [Academic discussion of adverse reaction of clinical trials of new traditional Chinese medicines and relevant influencing factors].

    Science.gov (United States)

    Wang, Wen-ping; Yu, Ming; Wang, Li; Jiang, Xi-ren; Li, Xiao-bin; Wang, Hua-wei; Cao, Ying; Liu, Kai; Huang, Lu-qi

    2015-01-01

    Data of clinical trial projects involved by clinical trial institutions certified by the State Food and Drug Administration from 2002 to November 2012 were collected to summarize adverse reactions in project summary/statistical reports, analyze the rate of adverse reactions of clinical trials of new traditional Chinese medicines and relevant influencing factors, and increase the awareness of the safety of new traditional Chinese medicines. A total of 73 050 cases in 209 projects of 14 specialties were collected, including 49 689 cases in the new traditional Chinese medicine group and 271 adverse reaction cases, with an incidence rate of adverse reactions at 0.55%. The adverse reaction rate in 3 months 0.63% for injection > 0.50% for oral. In the administration of only the test drug, the adverse reaction rate of patches was the highest (2.68%), whereas that of aerosols and suppositories was lowest (0). In the combined administration of the test drug and the simulation agent, the adverse reaction rate of external test patch + capsule was the highest (3.38%), whereas that of capsule + oral liquid, pills + granules, tablets + oral liquid, tablets + pills, tablet + capsule was the lowest (0). In the administration of only the test drug, the adverse reaction rate was 0.47%; In the combined administration with simulation agent (drug volume increase), the adverse reaction rate was 0.74%. Different doses caused adverse reaction different rates; The adverse reaction rate of drugs with whole-course dose between 1 100-1 200 g was the highest (3.36%), that for whole-course doses of 500-600, 900-1 000, 1 400-1 500, 1 600-1 700, 1 800-1 900 g was the lowest (0). In conclusion, the adverse reaction rate of new traditional Chinese medicines was still up to 0.55%, with the adverse reaction rate between 0.47% and 0.72% over the 11 years, without significant difference in each year. The adverse reaction rate was closely related to course of treatment, approach of administration

  7. Comparative Proteomic Profiling and Biomarker Identification of Traditional Chinese Medicine-Based HIV/AIDS Syndromes.

    Science.gov (United States)

    Wen, Li; Liu, Ye-Fang; Jiang, Cen; Zeng, Shao-Qian; Su, Yue; Wu, Wen-Jun; Liu, Xi-Yang; Wang, Jian; Liu, Ying; Su, Chen; Li, Bai-Xue; Feng, Quan-Sheng

    2018-03-08

    Given the challenges in exploring lifelong therapy with little side effect for human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) cases, there is increasing interest in developing traditional Chinese medicine (TCM) treatments based on specific TCM syndrome. However, there are few objective and biological evidences for classification and diagnosis of HIV/AIDS TCM syndromes to date. In this study, iTRAQ-2DLC-MS/MS coupled with bioinformatics were firstly employed for comparative proteomic profiling of top popular TCM syndromes of HIV/AIDS: accumulation of heat-toxicity (AHT) and Yang deficiency of spleen and kidney (YDSK). It was found that for the two TCM syndromes, the identified differential expressed proteins (DEPs) as well as their biological function distributions and participation in signaling pathways were significantly different, providing biological evidence for the classification of HIV/AIDS TCM syndromes. Furthermore, the TCM syndrome-specific DEPs were confirmed as biomarkers based on western blot analyses, including FN1, GPX3, KRT10 for AHT and RBP4, ApoE, KNG1 for YDSK. These biomarkers also biologically linked with the specific TCM syndrome closely. Thus the clinical and biological basis for differentiation and diagnosis of HIV/AIDs TCM syndromes were provided for the first time, providing more opportunities for stable exertion and better application of TCM efficacy and superiority in HIV/AIDS treatment.

  8. Traditional Chinese Medicine and Constitutional Medicine in China, Japan and Korea: A Comparative Study.

    Science.gov (United States)

    Yu, Wenjun; Ma, Mingyue; Chen, Xuemei; Min, Jiayu; Li, Lingru; Zheng, Yanfei; Li, Yingshuai; Wang, Ji; Wang, Qi

    2017-01-01

    Traditional Chinese medicine (TCM), Japanese-Chinese medicine, and Korean Sasang constitutional medicine have common origins. However, the constitutional medicines of China, Japan, and Korea differ because of the influence of geographical culture, social environment, national practices, and other factors. This paper aimed to compare the constitutional medicines of China, Japan, and Korea in terms of theoretical origin, constitutional classification, constitution and pathogenesis, clinical applications and basic studies that were conducted. The constitutional theories of the three countries are all derived from the Canon of Internal Medicine or Treatise on Febrile and Miscellaneous Diseases of Ancient China. However, the three countries have different constitutional classifications and criteria. Medical sciences in the three countries focus on the clinical applications of constitutional theory. They all agree that different pathogenic laws that guide the treatment of diseases govern different constitutions; thus, patients with different constitutions are treated differently. The three countries also differ in terms of drug formulations and medication. Japanese medicine is prescribed only based on constitution. Korean medicine is based on treatment, in which drugs cannot be mixed. TCM synthesize the treatment model of constitution differentiation, disease differentiation and syndrome differentiation with the treatment thought of treating disease according to three categories of etiologic factors, which reflect the constitution as the characteristic of individual precision treatment. In conclusion, constitutional medicines of China, Japan, and Korea have the same theoretical origin, but differ in constitutional classification, clinical application of constitutional theory on the treatment of diseases, drug formulations and medication.

  9. Color electron microprobe cathodoluminescence of Bishunpur meteorite compared with the traditional optical microscopy method

    Directory of Open Access Journals (Sweden)

    Amanda Araujo Tosi

    Full Text Available Abstract Cathodoluminescence (CL imaging is an outstanding method for sub classification of Unequilibrated Ordinary Chondrites (UOC - petrological type 3. CL can be obtained by several electron beam apparatuses. The traditional method uses an electron gun coupled to an optical microscope (OM. Although many scanning electron microscopes (SEM and electron microprobes (EPMA have been equipped with a cathodoluminescence, this technique was not fully explored. Images obtained by the two methods differ due to a different kind of signal acquisition. While in the CL-OM optical photography true colors are obtained, in the CL-EPMA the results are grayscale monochromatic electronic signals. L-RGB filters were used in the CL-EPMA analysis in order to obtain color data. The aim of this work is to compare cathodoluminescence data obtained from both techniques, optical microscope and electron microprobe, on the Bishunpur meteorite classified as LL 3.1 chondrite. The present study allows concluding that 20 KeV and 7 nA is the best analytical condition at EPMA in order to test the equivalence between CL-EPMA and CL-OM colour results. Moreover, the color index revealed to be a method for aiding the study of the thermal metamorphism, but it is not definitive for the meteorite classification.

  10. Comparative survey of PAHs incidence in Portuguese traditional meat and blood sausages.

    Science.gov (United States)

    Roseiro, L C; Gomes, A; Patarata, L; Santos, C

    2012-06-01

    Sixteen polycyclic aromatic hydrocarbons (PAHs) in representative traditional sausages produced in "Trás-os-Montes" and "Alentejo", were determined. Light PAHs represented similar overall contents in both regions and showed close decreasing order patterns (ACY, PHE, FLR and NAP), irrespective of the product type considered. Amongst the carcinogenic/mutagenic PAHs analyzed (PAH8), both regions also had greater contents associated to BaA and CHR, with slightly higher values for the former compound in "Alentejo" and, oppositely, for the later in "Trás-os-Montes". However, their quantitative comparison showed that the general mean total PAH content found in "Trás-os-Montes" was almost 3-fold higher than in similar products from "Alentejo" and this factor was about 8-fold superior when the PAH8 and PAH4 indicators were compared, expressing benzo[a]pyrene toxic equivalencies (BaPE), 15 times (total mean toxicity), 34 times (PAH8) and 9 times (PAH4) higher. In general terms, the mean BaP content of all analyzed samples from "Alentejo" was 0.41 μg kg(-1). Differently that value in "Trás-os-Montes" reached 3.57 μg kg(-1), expressing concerning average contents of 5.35, 5.87 and 4.51 μg kg(-1) in Chouriço de Carne, Moura and Salpicão sausages, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Comparative Accuracy of Facial Models Fabricated Using Traditional and 3D Imaging Techniques.

    Science.gov (United States)

    Lincoln, Ketu P; Sun, Albert Y T; Prihoda, Thomas J; Sutton, Alan J

    2016-04-01

    The purpose of this investigation was to compare the accuracy of facial models fabricated using facial moulage impression methods to the three-dimensional printed (3DP) fabrication methods using soft tissue images obtained from cone beam computed tomography (CBCT) and 3D stereophotogrammetry (3D-SPG) scans. A reference phantom model was fabricated using a 3D-SPG image of a human control form with ten fiducial markers placed on common anthropometric landmarks. This image was converted into the investigation control phantom model (CPM) using 3DP methods. The CPM was attached to a camera tripod for ease of image capture. Three CBCT and three 3D-SPG images of the CPM were captured. The DICOM and STL files from the three 3dMD and three CBCT were imported to the 3DP, and six testing models were made. Reversible hydrocolloid and dental stone were used to make three facial moulages of the CPM, and the impressions/casts were poured in type IV gypsum dental stone. A coordinate measuring machine (CMM) was used to measure the distances between each of the ten fiducial markers. Each measurement was made using one point as a static reference to the other nine points. The same measuring procedures were accomplished on all specimens. All measurements were compared between specimens and the control. The data were analyzed using ANOVA and Tukey pairwise comparison of the raters, methods, and fiducial markers. The ANOVA multiple comparisons showed significant difference among the three methods (p 3D-SPG showed statistical difference in comparison to the models fabricated using the traditional method of facial moulage and 3DP models fabricated from CBCT imaging. 3DP models fabricated using 3D-SPG were less accurate than the CPM and models fabricated using facial moulage and CBCT imaging techniques. © 2015 by the American College of Prosthodontists.

  12. Traditional knowledge of wild edible plants used in Palestine (Northern West Bank: A comparative study

    Directory of Open Access Journals (Sweden)

    Khlaif Rasha B

    2008-05-01

    Full Text Available Abstract Background A comparative food ethnobotanical study was carried out in fifteen local communities distributed in five districts in the Palestinian Authority, PA (northern West Bank, six of which were located in Nablus, two in Jenin, two in Salfit, three in Qalqilia, and two in Tulkarm. These are among the areas in the PA whose rural inhabitants primarily subsisted on agriculture and therefore still preserve the traditional knowledge on wild edible plants. Methods Data on the use of wild edible plants were collected for one-year period, through informed consent semi-structured interviews with 190 local informants. A semi-quantitative approach was used to document use diversity, and relative importance of each species. Results and discussion The study recorded 100 wild edible plant species, seventy six of which were mentioned by three informants and above and were distributed across 70 genera and 26 families. The most significant species include Majorana syriaca, Foeniculum vulgare, Malvasylvestris, Salvia fruticosa, Cyclamen persicum, Micromeria fruticosa, Arum palaestinum, Trigonella foenum-graecum, Gundelia tournefortii, and Matricaria aurea. All the ten species with the highest mean cultural importance values (mCI, were cited in all five areas. Moreover, most were important in every region. A common cultural background may explain these similarities. One taxon (Majoranasyriaca in particular was found to be among the most quoted species in almost all areas surveyed. CI values, as a measure of traditional botanical knowledge, for edible species in relatively remote and isolated areas (Qalqilia, and Salfit were generally higher than for the same species in other areas. This can be attributed to the fact that local knowledge of wild edible plants and plant gathering are more spread in remote or isolated areas. Conclusion Gathering, processing and consuming wild edible plants are still practiced in all the studied Palestinian areas. About 26

  13. Emotional reactions of different interface formats: Comparing digital and traditional board games

    Directory of Open Access Journals (Sweden)

    Yu-Min Fang

    2016-03-01

    Full Text Available Some games provide both traditional board games and digital versions at the same time in the market. Why the rise of virtual games has not forced traditional physical board games to disappear? Do traditional physical games evoke different emotional reactions and interpersonal relationships? This article explored the subjects’ preferences toward traditional and digital versions of the same game and investigated social interaction while playing games. Based on Norman’s three emotional design levels—visceral, behavioral, and reflective levels—this study examined players’ satisfaction degree. This study also applied Positive and Negative Affect Schedule to measure subjects’ emotional reactions. Monopoly and Jenga games were selected as stimuli. A total of 77 subjects received tests of three different interface formats (physical, desktop, and tablet and then filled out the questionnaire. The findings successfully evidenced the significant differences between digital and traditional board games. The statistical results indicated that satisfaction degrees of digital games declined in visceral, behavioral, and reflective levels. Traditional games not only evoked users’ stronger emotional reactions but also received higher preferences. Traditional games could improve interpersonal relationships as well.

  14. Traditional Chinese Patent Medicine for Treating Impaired Glucose Tolerance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Pang, Bing; Ni, Qing; Lin, Yi-Qun; Wang, Yi-Tian; Zheng, Yu-Jiao; Zhao, Xue-Min; Feng, Shuo; Tong, Xiao-Lin

    2018-04-06

    To assess the effectiveness and safety of Traditional Chinese patent medicines (TCPMs) for managing impaired glucose tolerance (IGT). Seven databases were searched to identify eligible trials published from incepting to May 1, 2016. Randomized controlled trials (RCTs) involving TCPM for IGT with a minimum follow-up duration of 6 months were included for analysis. Data extraction and quality assessment were performed by two reviewers independently. Data synthesis was analyzed using Review Manager 5.3 software. Subgroup analysis was carried out to assess the robustness of results of meta-analysis. Eighteen trials with a total of 3172 participants met the inclusion criteria. The methodological quality of the RCTs was variable. Comparing with receiving lifestyle modification (LM) alone, TCPM plus LM was significantly better at reducing the incidence of diabetes (risk ratio [RR] 0.45; 95% confidence interval [CI] 0.36-0.57, p < 0.00001) and normalizing the blood glucose (RR 0.72; 95% CI 0.64-0.82, p < 0.00001). TCPM plus LM was superior in decreasing the levels of 2hPG, body mass index (BMI), fasting insulin, and 2 h insulin compared with LM alone (2hPG: mean difference [MD] -1.13; 95% CI -1.68 to -0.58, p < 0.0001; BMI: MD -0.42; 95% CI -0.71 to -0.14, p = 0.004; fasting insulin: MD -2.44; 95% CI -3.79 to -1.09, p = 0.0004; and 2 h insulin: MD -8.26; 95% CI -8.47 to -8.05, p < 0.00001). Compared with placebo plus LM, TCPM plus LM was superior in reducing diabetes (RR 0.54; 95% CI 0.42-0.69, p < 0.00001) and normalizing blood glucose (RR 0.55; 95% CI 0.41-0.73, p < 0.00001; the interventions were also associated with a decline in the two-hour postprandial blood glucose (2hPG) levels (MD -1.45; 95% CI -2.11 to -0.79, p < 0.0001) and BMI levels (MD -1.12; 95% CI -2.00 to -0.24, p < 0.0001). There were no significant differences in adverse events between two groups. Subgroup analysis found no significant difference in overall

  15. Consumers' acceptance of innovations in traditional cheese. A comparative study in France and Norway.

    Science.gov (United States)

    Almli, Valérie Lengard; Naes, Tormod; Enderli, Géraldine; Sulmont-Rossé, Claire; Issanchou, Sylvie; Hersleth, Margrethe

    2011-08-01

    This study explores consumers' acceptance of innovations in traditional cheese in France (n=120) and Norway (n=119). The respondents were presented with 16 photographs of a traditional cheese from their respective countries, varying according to six factors: pasteurisation, organic production, omega-3, packaging, price and appropriateness. For each of the scenarios the consumers indicated their willingness to buy the cheese on a nine-point scale. Results show that consumers' willingness to buy traditional cheese is highly driven by price, appropriateness and pasteurisation in both countries. However, on average consumers in the French sample prefer buying raw milk cheese, while consumers in the Norwegian sample prefer buying pasteurised cheese. These general trends are led by a pro-raw milk segment in France and a pro-pasteurised milk segment in Norway. Several interaction effects involving appropriateness are detected, indicating the importance of the consumption context on the acceptance of innovations in traditional cheese. On a general level, the results indicate that well-accepted innovations in traditional cheese are those that reinforce the traditional and authentic character of the product. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Liquidity Analysis Using Cash Flow Ratios as Compared to Traditional Ratios in the Pharmaceutical Sector in Jordan

    OpenAIRE

    Sulayman H. Atieh

    2014-01-01

    The purpose of this study is to examine the liquidity position of the Jordanian pharmaceutical sector using the traditional ratios as compared to the more recently developed cash flow ratios. The research involved the comparison between traditional ratios and cash flow ratios of the big seven companies of the pharmaceutical industry in Jordan over six years period (2007¨C2012). The companies were all from the same sector, and the data was obtained from the annual reports of these companies. T...

  17. Comparing abrupt and gradual smoking cessation: a randomized trial.

    Science.gov (United States)

    Etter, Jean-François

    2011-11-01

    To compare abrupt and gradual smoking cessation. Randomized trial and observational study, Internet, 2007-2010. Smokers with no strong preference for abrupt or gradual quitting were randomly assigned to quitting immediately (n=472), or to gradually reducing their cigarette consumption over 2 weeks and then quit (n=502). Smokers who strongly preferred to quit abruptly were instructed to do so immediately (n=2456), those who strongly preferred gradual were instructed to reduce their cigarette consumption over 2 weeks, then quit (n=1801). Follow-up was conducted 4 weeks after target quit dates. Those who preferred abrupt quitting were the most motivated to quit and the most confident in their ability to quit. At follow-up, quit rates were 16% in those who preferred abrupt cessation, 7% in those who preferred gradual cessation and 9% in those who had no preference (pmotivation to quit and confidence in ability to quit: those who had low levels of motivation or low levels of confidence were more likely to quit at follow-up if they preferred and used abrupt rather than gradual. In those who had no strong preference for either method, abrupt and gradual produced similar results. Those who preferred and used the abrupt method were more likely to quit than those who preferred and used the gradual method, in particular when they had low motivation and confidence. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. A Comparative Study on Power Point Presentation and Traditional Lecture Method in Material Understandability, Effectiveness and Attitude

    Science.gov (United States)

    Sewasew, Daniel; Mengestle, Missaye; Abate, Gebeyehu

    2015-01-01

    The aim of this study was to compare PPT and traditional lecture method in material understandability, effectiveness and attitude among university students. Comparative descriptive survey research design was employed to answer the research questions raised. Four hundred and twenty nine participants were selected randomly using stratified sampling…

  19. Raman spectroscopy compared against traditional predictors of shear force in lamb m. longissimus lumborum.

    Science.gov (United States)

    Fowler, Stephanie M; Schmidt, Heinar; van de Ven, Remy; Wynn, Peter; Hopkins, David L

    2014-12-01

    A Raman spectroscopic hand held device was used to predict shear force (SF) of 80 fresh lamb m. longissimus lumborum (LL) at 1 and 5days post mortem (PM). Traditional predictors of SF including sarcomere length (SL), particle size (PS), cooking loss (CL), percentage myofibrillar breaks and pH were also measured. SF values were regressed against Raman spectra using partial least squares regression and against the traditional predictors using linear regression. The best prediction of shear force values used spectra at 1day PM to predict shear force at 1day which gave a root mean square error of prediction (RMSEP) of 13.6 (Null=14.0) and the R(2) between observed and cross validated predicted values was 0.06 (R(2)cv). Overall, for fresh LL, the predictability SF, by either the Raman hand held probe or traditional predictors was low. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Randomized controlled trial assessing a traditional Chinese medicine remedy in the treatment of primary dysmenorrhea

    NARCIS (Netherlands)

    Kennedy, S.; Jin, X.; Yu, H.; Zhong, S.; Magill, P.; Vliet, T. van; Kistemaker, C.; Voors, C.; Pasman, W.

    2006-01-01

    A proof-of-concept study to assess the safety and efficacy of a traditional Chinese medicine formula as treatment for primary dysmenorrhea showed no statistically significant benefit over placebo. However, some efficacy parameters suggested possible superiority of the active treatment and so a

  1. Genetic ancestry in relation to the metabolic response to a US versus traditional Mexican diet: a randomized crossover feeding trial among women of Mexican descent.

    Science.gov (United States)

    Santiago-Torres, M; De Dieu Tapsoba, J; Kratz, M; Lampe, J W; Breymeyer, K L; Levy, L; Song, X; Villaseñor, A; Wang, C-Y; Fejerman, L; Neuhouser, M L; Carlson, C S

    2017-03-01

    Certain populations with a large proportion of indigenous American (IA) genetic ancestry may be evolutionarily adapted to traditional diets high in legumes and complex carbohydrates, and may have a detrimental metabolic response to US diets high in refined carbohydrates and added sugars. We tested whether IA ancestry modified the metabolic response to a US versus traditional Mexican diet in a controlled dietary intervention. First and second generation Mexican immigrant women (n=53) completed a randomized crossover feeding trial testing the effects of a US versus traditional Mexican diet. The metabolic response to the diets was measured by fasting serum concentrations of glucose, insulin, insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3), adiponectin, C-reactive protein, interleukin-6 and computed homeostasis model assessment for insulin resistance (HOMA IR ). Blood collected at baseline was used for genotyping, and estimation of African, European and IA ancestries with the use of 214 ancestry informative markers. The genetic ancestral background was 56% IA, 38% European and 6% African. Women in the highest IA ancestry tertile (>62%) were shorter in height, less educated and less acculturated to the US lifestyle, and tended to have higher waist-to-hip ratio compared with women in the middle and lowest IA ancestry tertiles, respectively. Compared with the US diet, the traditional Mexican diet tended to reduce glucose, insulin, IGF-1, IGFBP-3 and HOMA IR among women in the middle IA ancestry group (IA ancestry ⩽45-62%), whereas having no effect on biomarkers related to inflammation. We observed modest interactions between IA ancestry and the metabolic response to a US versus traditional Mexican diet among Mexican immigrant women.

  2. Comparing the Effectiveness of a Supplemental Online Tutorial to Traditional Instruction with Nutritional Science Students

    Science.gov (United States)

    Zubas, Patrice; Heiss, Cindy; Pedersen, Mary

    2006-01-01

    The purpose of this study was to ascertain if an online computer tutorial on diabetes mellitus, supplemented to traditional classroom lecture, is an effective tool in the education of nutrition students. Students completing a web-based tutorial as a supplement to classroom lecture displayed greater improvement in pre- vs. post-test scores compared…

  3. Digital and traditional slides for teaching cellular morphology: a comparative analysis of learning outcomes.

    Science.gov (United States)

    Solberg, Brooke L

    2012-01-01

    Recent advances in technology have brought forth an intriguing new tool for teaching hematopoietic cellular identification skills: the digital slide. Although digitized slides offer a number of appealing options for educators, little research has been done to examine how their utilization would impact learning outcomes. To fill that void, this study was designed to examine student performance, skill retention and transferability, and self-efficacy beliefs amongst undergraduate MLS students learning cellular morphology with digital versus traditional slides. Results showed that students learning with digital slides performed better on assessments containing only traditional slide specimens than students learning with traditional slides, both immediately following the learning activity and after a considerable duration of time. Students learning with digital slides also reported slightly higher levels of self-efficacy related to cellular identification. The findings of this study suggest that students learning cellular identification skills with digital slides are able to transfer that skill directly to traditional slides, and that their ability to identify cells is not negatively affected in present or future settings.

  4. Use of molecular markers to compare Escherichia coli transport to traditional groundwater tracers in epikarst

    Science.gov (United States)

    Bacterial contamination of karst aquifers is a concern as water quality across the globe deteriorates in the face of decreasing water security. Traditional groundwater tracers (dye and microspheres) do not exhibit surface properties similar to bacteria and pathogens and therefore are not good proxie...

  5. Comparing Two Survey Research Approaches: E-Mail and Web-Based Technology versus Traditional Mail.

    Science.gov (United States)

    Howes, Colleen M.; Mailloux, Mark R.

    2001-01-01

    Contrasted two survey methodologies: e-mail-Web and traditional mail. Found that: (1) e-mail-Web respondents were proportionately more likely to be male and enrolled in school full-time; (2) more individual question non-response was present for the e-mail-Web sample; and (3) e-mail-Web respondents value different aspects of graduate school. (EV)

  6. The Impact of Nintendo Wii to Physical Education Students' Balance Compared to the Traditional Approaches

    Science.gov (United States)

    Vernadakis, Nikolaos; Gioftsidou, Asimenia; Antoniou, Panagiotis; Ioannidis, Dionysis; Giannousi, Maria

    2012-01-01

    The purpose of this study was to determine whether there is a difference between an exergame-based and a traditional balance training program, in undergraduate Physical Education students. Thirty two third-year undergraduate students at the Democritus University of Thrace were randomly divided into two training program groups of 16 students each,…

  7. A Comparative Study of Entrance in Traditional and Contemporary Houses of Iran

    Directory of Open Access Journals (Sweden)

    Ramin Dehbandi

    2017-12-01

    Full Text Available In contemporary houses in Iran, because of changes in the methods of designing and building houses, importance of entrance reduced to such level that now in contemporary houses entrance is just a door. Entrance correlates indoor safe space of house and outdoors. It`s importance lays in controlling entry, exit, territory and hierarchy. Since house owners were satisfied with traditional form of entrance, it is a good idea to learn from them in designing new entrances. The purpose of this research is to find a way for designing appropriate entrances for Iranian contemporary houses. To do this at first 40 traditional houses and 40 contemporary houses in Isfahan and Kashan were selected. These two cities are from margin of desert and the origin of traditional houses of Iran. Analysis showed that blockage of visual and phonic relation, creating a space between outdoor public space and indoor private space, creating access patterns to internal spaces and traits that separate in and out were the most significant properties of traditional entrances. All these traits are ignored in contemporary entrances. Suggestions made for design include creating public meeting space in yard and creating a separate entrance space for each house in apartments.

  8. Comparing Traditional versus Alternative Sequencing of Instruction When Using Simulation Modeling

    Science.gov (United States)

    Bowen, Bradley; DeLuca, William

    2015-01-01

    Many engineering and technology education classrooms incorporate simulation modeling as part of curricula to teach engineering and STEM-based concepts. The traditional method of the learning process has students first learn the content from the classroom teacher and then may have the opportunity to apply the learned content through simulation…

  9. VOLATILE CONSTITUENTS OF GINGER OIL PREPARED ACCORDING TO IRANIAN TRADITIONAL MEDICINE AND CONVENTIONAL METHOD: A COMPARATIVE STUDY.

    Science.gov (United States)

    Shirooye, Pantea; Mokaberinejad, Roshanak; Ara, Leila; Hamzeloo-Moghadam, Maryam

    2016-01-01

    Herbal medicines formulated as oils were believed to possess more powerful effects than their original plants in Iranian Traditional Medicine (ITM). One of the popular oils suggested for treatment of various indications was ginger oil. In the present study, to suggest a more convenient method of oil preparation (compared to the traditional method), ginger oil has been prepared according to both the traditional and conventional maceration methods and the volatile oil constituents have been compared. Ginger oil was obtained in sesame oil according to both the traditional way and the conventional (maceration) methods. The volatile oil of dried ginger and both oils were obtained by hydro-distillation and analyzed by gas chromatography/mass spectroscopy. Fifty five, fifty nine and fifty one components consisting 94 %, 94 % and 98 % of the total compounds were identified in the volatile oil of ginger, traditional and conventional oils, respectively. The most dominant compounds of the traditional and conventional oils were almost similar; however they were different from ginger essential oil which has also been to possess limited amounts of anti-inflammatory components. It was concluded that ginger oil could be prepared through maceration method and used for indications mentioned in ITM.

  10. Ovulation induction using clomiphene citrate using stair – Step regimen versus traditional regimen in polycystic ovary syndrome women – A randomized control trial

    Directory of Open Access Journals (Sweden)

    K Agrawal

    2017-01-01

    Full Text Available Objective: To determine the efficacy of the stair-step protocol (SSP using clomiphene citrate (CC in patients with polycystic ovary syndrome (PCOS and compare it with traditional regimen. Design: This was randomized control trial. Setting: Infertility Clinic. Patient(s: Sixty infertile PCOS women. Intervention(s: Patients were randomized into the study (SSP – 30 patients and control group (traditional protocol – 30 patients. In the SSP, patients were treated with CC 50 mg/day for 5 days and in nonresponsive patients, the dosage was increased to 100 mg/day for 5 days in the same cycle. Maximum dose of 150 mg was given until the dominant follicle was generated. In control group, the dose increment in nonovulatory cases was done in subsequent cycle. Ultrasonography follow-up was done to detect ovulation. Main Outcome Measure(s: Ovulation rate and duration of treatment. Results: Ovulation (66.7% vs. 50% respectively and pregnancy rates (26.7% vs. 15.7% were similar between the stair step and the control group. The duration of treatment was significantly shorter in stair step compared to traditional protocol (17.23 vs. 53 days. CC 100 mg was the most effective dose for ovulation in either group. There were no significant differences in the systemic side effect. Conclusions: By using SSP, effective treatment is provided in significantly shorter time period without any detrimental effect on the ovulation and pregnancy rates.

  11. Single-session gamified virtual reality exposure therapy for spider phobia vs. traditional exposure therapy: study protocol for a randomized controlled non-inferiority trial.

    Science.gov (United States)

    Miloff, Alexander; Lindner, Philip; Hamilton, William; Reuterskiöld, Lena; Andersson, Gerhard; Carlbring, Per

    2016-02-02

    Traditional one-session exposure therapy (OST) in which a patient is gradually exposed to feared stimuli for up to 3 h in a one-session format has been found effective for the treatment of specific phobias. However, many individuals with specific phobia are reluctant to seek help, and access to care is lacking due to logistic challenges of accessing, collecting, storing, and/or maintaining stimuli. Virtual reality (VR) exposure therapy may improve upon existing techniques by facilitating access, decreasing cost, and increasing acceptability and effectiveness. The aim of this study is to compare traditional OST with in vivo spiders and a human therapist with a newly developed single-session gamified VR exposure therapy application with modern VR hardware, virtual spiders, and a virtual therapist. Participants with specific phobia to spiders (N = 100) will be recruited from the general public, screened, and randomized to either VR exposure therapy (n = 50) or traditional OST (n = 50). A behavioral approach test using in vivo spiders will serve as the primary outcome measure. Secondary outcome measures will include spider phobia questionnaires and self-reported anxiety, depression, and quality of life. Outcomes will be assessed using a non-inferiority design at baseline and at 1, 12, and 52 weeks after treatment. VR exposure therapy has previously been evaluated as a treatment for specific phobias, but there has been a lack of high-quality randomized controlled trials. A new generation of modern, consumer-ready VR devices is being released that are advancing existing technology and have the potential to improve clinical availability and treatment effectiveness. The VR medium is also particularly suitable for taking advantage of recent phobia treatment research emphasizing engagement and new learning, as opposed to physiological habituation. This study compares a market-ready, gamified VR spider phobia exposure application, delivered using consumer VR hardware, with

  12. Comparative study of phenolic compounds in Cabernet Sauvignon wines made in traditional and Ganimede fermenters.

    Science.gov (United States)

    Bai, Bianxia; He, Fei; Yang, Lili; Chen, Feng; Reeves, Malcolm J; Li, Jingming

    2013-12-15

    Chemical profiles of anthocyanin and non-anthocyanin phenolics of Cabernet Sauvignon wine made by two different winemaking techniques (traditional vinification and Ganimede method) were determined by high performance liquid chromatography-mass spectrometry (HPLC-MS). Particularly, effect of extraction on and subsequent stability of the phenolic compounds from the end of fermentation to bottling were investigated. The results showed that the total anthocyanin content was higher in the young wines produced in the Ganimede fermenter. The anthocyanin contents in these wines subsequently decreased significantly after two years of ageing. By contrast, the traditional vinification was slightly better than the Ganimede to yield the non-anthocyanin phenolics. This indicates that the Ganimede fermenter might be suitable for the production of brightly coloured red wines for early consumption, which could save time and labour cost for industrial production of highquality wines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Border or Horizon? Comparing the concept of "reason" in the liberal and republican traditions

    Directory of Open Access Journals (Sweden)

    Rafael Mesquita

    2015-12-01

    Full Text Available The current article analyzes the expectations of modernity's political philosophy, in its liberal and republican traditions, towards reason: its conceptualization, prerogatives and normative implications. In order to do so, we highlight the role of this human faculty in the theses of seminal authors of modernity and its conjugation the concepts of liberty and equality. Taking social contract theory for a starting point, we contrast the concept of reason in liberalism and republicanism, and after we analyze the implications of the social features of modern democracy (massive and egalitarian for the concept of the rational individual. In conclusion, it is argued that though reason is presented as the cornerstone of the political individual in modernity, locus of human autonomy and justification for its isonomy, its conceptualization varies according to the political tradition, with consequences for the legitimate limits of State action upon the citizen and for the expectations of moral progress of the population.

  14. Comparing the etiology and treatment of skin fissure in traditional and conventional medicine; a brief review

    Directory of Open Access Journals (Sweden)

    A. Jedkareh

    2016-01-01

    Full Text Available Dry skin is a common problem which affects wound healing, severity of other skin diseases and quality of life of people. One of its undesirable effects is fissure that is a cutaneous condition in which there is a linear loss of epidermis and dermis with sharply defined, nearly vertical walls. In the present study, we have investigated the etiology of the disease and its treatments in conventional medicine and Iranian Traditional Medicine (ITM. Two traditional medicine references, current scientific data bases and medicinal texts were explored with the selected keywords such as "sheqaq-e-poosti", "skin fissure" and "dry skin" to find the etiology and treatment of skin fissure. From the view point of both conventional medicine and ITM, dry skin is the cause of skin fissure and some causes of dry skin are similar. In conventional medicine, moisturizers are mainly used for treatment of dry skin; while in ITM some herbs, oils and other natural remedies have been used. A topical dosage form which was called "qeirooti", a mixture of wax and oil, was used to treat skin fissure in ITM. It comprised of oily ingredients that acted as occlusives and also some herbal components that directly improved dry skin (similar to moisturizers. Components efficacy of traditional dosage forms for treatment of dry skin lead us to study about formulation of “qeirooti” for treatment of dry skin.

  15. A blended design in acute care training: similar learning results, less training costs compared with a traditional format.

    Science.gov (United States)

    Dankbaar, Mary E W; Storm, Diana J; Teeuwen, Irene C; Schuit, Stephanie C E

    2014-09-01

    Introduction There is a demand for more attractive and efficient training programmes in postgraduate health care training. This retrospective study aims to show the effectiveness of a blended versus traditional face-to-face training design. For nurses in postgraduate Acute and Intensive Care training, the effectiveness of a blended course design was compared with a traditional design. Methods In a first pilot study 57 students took a traditional course (2-h lecture and 2-h workshop) and 46 students took a blended course (2-h lecture and 2-h online self-study material). Test results were compared for both groups. After positive results in the pilot study, the design was replicated for the complete programme in Acute and Intensive Care. Now 16 students followed the traditional programme (11 days face-to-face education) and 31 students did the blended programme (7 days face-to-face and 40 h online self-study). An evaluation was done after the pilot and course costs were calculated. Results Results show that the traditional and blended groups were similar regarding the main characteristics and did not differ in learning results for both the pilot and the complete programme. Student evaluations of both designs were positive; however, the blended group were more confident that they had achieved the learning objectives. Training costs were reduced substantially. Conclusion The blended training design offers an effective and attractive training solution, leading to a significant reduction in costs.

  16. Comparing Learning Outcomes of Blended Learning and Traditional Face-to-Face Learning of University Students in ESL Courses

    Science.gov (United States)

    Zhang, Wei; Zhu, Chang

    2018-01-01

    Combining elements of online and face-to-face education, blended learning is emerging as an important teaching and learning model in higher education. In order to examine the effectiveness of blended learning, as compared to the traditional face-to-face learning mode, this research investigated the learning outcomes of students following English…

  17. Physical Activity and Sedentary Time among Young Children in Full-Day Kindergarten: Comparing Traditional and Balanced Day Schedules

    Science.gov (United States)

    Vanderloo, Leigh M.; Tucker, Patricia

    2017-01-01

    Objective: To compare physical activity and sedentary time among young children whose schools adhere to traditional (i.e. three outdoor playtimes = 70 minutes) versus balanced day (i.e. two outdoor playtimes = ~55 minutes) schedules in Ontario full-day kindergarten classrooms. Design: The project was part of a larger, 2-year cross-sectional study.…

  18. Behind the Final Grade in Hybrid v. Traditional Courses: Comparing Student Performance by Assessment Type, Core Competency, and Course Objective

    Science.gov (United States)

    Bain, Lisa Z.

    2012-01-01

    There are many different delivery methods used by institutions of higher education. These include traditional, hybrid, and online course offerings. The comparisons of these typically use final grade as the measure of student performance. This research study looks behind the final grade and compares student performance by assessment type, core…

  19. Acute migraine therapy: recent evidence from randomized comparative trials

    DEFF Research Database (Denmark)

    Mett, A.; Tfelt-Hansen, P.

    2008-01-01

    (1) A wide array of data regarding acute migraine treatment are available, but few trials strictly adhere to International Headache Society guidelines for patient inclusion criteria. (2) Triptans appear to have similar efficacy profiles, but among newer triptans, almotriptan offers improved...

  20. COMPARATIVE STUDY BETWEEN TRADITIONAL AND ENTERPRISE RISK MANAGEMENT -A THEORETICAL APPROACH

    Directory of Open Access Journals (Sweden)

    Cican Simona-Iulia

    2014-07-01

    Full Text Available The complexity, volatility and unpredictability of the current economic environment are a daily reminder that organizations face many risks. The traditional approach, according to which risk is a necessary evil which must be removed, is no longer sufficient and that is why companies nowadays are forced to spend significant resources to manage risks. Risk transparency is what one looks for; therefore, identification and management of risks within an organization become increasingly necessary for success and longevity. Risk approach has a major role in a company’s ability to avoid, reduce and turn risks into opportunities. Enterprise risk management is a new concept that revolutionizes the traditional approach and summarizes risk management in an integrated, comprehensive and strategic system. Studies use several synonyms for enterprise risk management such as integrated risk management, holistic risk management, global risk management and strategic risk management. Enterprise risk management implements at the end of the last century a new way to deal with risks: the holistic approach. This risks approach – i.e. interaction of several types of risks which become increasingly threatening and varied and may cause more damage than individual risk – brings forward the need of risk management and raises issues at the highest level of company management. For a proper view on company risks, each individual risk and the possibility of risk interaction must be understood. This is essential to establish a risk classification according to their impact on the company. Traditional approach on risk management, as a management function, is limited to only threats and losses, so relatively few organizations see risks as potential earning-generated opportunities. However, risk management process is not radically changed. Enterprise risk management is an improved version of the traditional risk management, created by expanding its scope. The new risk

  1. Comparing the Effects of Objective Structured Assessment of Technical Skills (OSATS) and Traditional Method on Learning of Students.

    Science.gov (United States)

    Mansoorian, Mohammad Reza; Hosseiny, Marzeih Sadat; Khosravan, Shahla; Alami, Ali; Alaviani, Mehri

    2015-06-01

    Despite the benefits of the objective structured assessment of technical skills (OSATS) and it appropriateness for evaluating clinical abilities of nursing students , few studies are available on the application of this method in nursing education. The purpose of this study was to compare the effect of using OSATS and traditional methods on the students' learning. We also aimed to signify students' views about these two methods and their views about the scores they received in these methods in a medical emergency course. A quasi-experimental study was performed on 45 first semester students in nursing and medical emergencies passing a course on fundamentals of practice. The students were selected by a census method and evaluated by both the OSATS and traditional methods. Data collection was performed using checklists prepared based on the 'text book of nursing procedures checklists' published by Iranian nursing organization and a questionnaire containing learning rate and students' estimation of their received scores. Descriptive statistics as well as paired t-test and independent samples t-test were used in data analysis. The mean of students' score in OSATS was significantly higher than their mean score in traditional method (P = 0.01). Moreover, the mean of self-evaluation score after the traditional method was relatively the same as the score the students received in the exam. However, the mean of self-evaluation score after the OSATS was relatively lower than the scores the students received in the OSATS exam. Most students believed that OSATS can evaluate a wide range of students' knowledge and skills compared to traditional method. Results of this study indicated the better effect of OSATS on learning and its relative superiority in precise assessment of clinical skills compared with the traditional evaluation method. Therefore, we recommend using this method in evaluation of students in practical courses.

  2. Comparing intellectual and graphical complexities of traditional and image-derived landuse maps

    Institute of Scientific and Technical Information of China (English)

    STEIN; Alfred

    2010-01-01

    Remotely sensed images have become a powerful source for landuse mapping.So far,no quantitative comparison and evaluation exist on the differences between an image-derived landuse map and a traditional landuse map.The comparison and evaluation may indicate the possibility for the replacement of a traditional landuse map by an image-derived map.Map complexity is widely used to describe cartographic representations and map effectiveness from intellectual aspect and graphical aspect.This paper quantifies intellectual and graphical map complexities to explore the differences between these two kinds of maps.Intellectual complexity concerns the meaning or significations contained on a map.Graphical complexity concerns spatial characteristics of the graphical content on a map.Results show that the high graphical complexity of the image-derived landuse map is not harmonized with its low intellectual complexity.The intention of this paper is to encourage realistic cognition of the accuracy and problems existing in image-derived landuse maps.

  3. Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy.

    Science.gov (United States)

    Kiger, Mary; Brown, Catherine S; Watkins, Lynn

    2006-10-01

    This study compares the outcomes using VitalStim therapy to outcomes using traditional swallowing therapy for deglutition disorders. Twenty-two patients had an initial and a followup videofluoroscopic swallowing study or fiberoptic endoscopic evaluation of swallowing and were divided into an experimental group that received VitalStim treatments and a control group that received traditional swallowing therapy. Outcomes were analyzed for changes in oral and pharyngeal phase dysphagia severity, dietary consistency restrictions, and progression from nonoral to oral intake. Results of chi(2) analysis showed no statistically significant difference in outcomes between the experimental and control groups.

  4. Traditional and innovative experimental and clinical trial designs and their advantages and pitfalls.

    Science.gov (United States)

    Weimer, Katja; Enck, Paul

    2014-01-01

    Many study designs and design variants have been developed in the past to either overcome or enhance drug-placebo differences in clinical trials or to identify and characterize placebo responders in experimental studies. They share many commonalities as well as differences that are discussed here: the role of deception and ethical restrictions, habituation effects and the control of the natural course of disease, assay sensitivity testing and effective blinding, acceptability and motivation of patients and volunteers, and the development of individualized medicine. These are fostered by two opposite strategies: utilizing the beneficial aspects of the placebo response-and avoiding its negative counterpart, the nocebo effect-in medical routine for the benefit of patients, and minimizing-by controlling-the negative aspects of the placebo effect during drug development.

  5. "It is better to die": experiences of traditional health practitioners within the HIV treatment as prevention trial communities in rural South Africa (ANRS 12249 TasP trial).

    Science.gov (United States)

    Moshabela, Mosa; Zuma, Thembelihle; Orne-Gliemann, Joanna; Iwuji, Collins; Larmarange, Joseph; McGrath, Nuala

    2016-01-01

    The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a "test and treat" approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities and health systems with respect to TasP. Considering the rural nature of the trial setting, we sought to understand community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners (THPs). A qualitative study design was adopted using four repeat focus group discussions conducted with nine THPs, combined with community walks and photo-voice techniques, over a period of 18 months. A descriptive, interpretive and explanatory approach to analysis was adopted. Findings indicate that THPs engaged with the home-based testing services and HIV clinics established for TasP. Specifically, home-based testing services were perceived as relatively successful in increasing access to HIV testing. A major gap observed by THPs was linkage to HIV clinics. Most of their clients, and some of the THPs themselves, found it difficult to use HIV clinics due to fear of labelling, stigma and discrimination, and the ensuing personal implications of unsolicited disclosure. On the one hand, a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics. On the other hand, THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals. Therefore, acceptability of the TasP test and treat approach by THPs is a major boost to the intervention, but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care, including partnerships with THPs

  6. Racial Discipline Disproportionality in Montessori and Traditional Public Schools: A Comparative Study Using the Relative Rate Index

    Directory of Open Access Journals (Sweden)

    Katie E. Brown

    2015-11-01

    Full Text Available Research from the past 40 years indicates that African American students are subjected to exclusionary discipline, including suspension and expulsion, at rates two to three times higher than their White peers (Children’s Defense Fund, 1975; Skiba, Michael, Nardo, & Peterson, 2002. Although this phenomenon has been studied extensively in traditional public schools, rates of racially disproportionate discipline in public Montessori schools have not been examined. The purpose of this study is to examine racial discipline disproportionality in Montessori public elementary schools as compared to traditional elementary schools. The Relative Rate Index (RRI is used as a measure of racially disproportionate use of out-of-school suspensions (Tobin & Vincent, 2011. Suspension data from the Office of Civil Rights Data Collection was used to generate RRIs for Montessori and traditional elementary schools in a large urban district in the Southeast. While statistically significant levels of racial discipline disproportionality are found in both the Montessori and traditional schools, the effect is substantially less pronounced in Montessori settings. These findings suggest that Montessori schools are not immune to racially disproportionate discipline and should work to incorporate more culturally responsive classroom management techniques. Conversely, the lower levels of racially disproportionate discipline in the Montessori schools suggests that further study of discipline in Montessori environments may provide lessons for traditional schools to promote equitable discipline.

  7. Comparing and Contrasting Traditional Membrane Bioreactor Models with Novel Ones Based on Time Series Analysis

    Directory of Open Access Journals (Sweden)

    Parneet Paul

    2013-02-01

    Full Text Available The computer modelling and simulation of wastewater treatment plant and their specific technologies, such as membrane bioreactors (MBRs, are becoming increasingly useful to consultant engineers when designing, upgrading, retrofitting, operating and controlling these plant. This research uses traditional phenomenological mechanistic models based on MBR filtration and biochemical processes to measure the effectiveness of alternative and novel time series models based upon input–output system identification methods. Both model types are calibrated and validated using similar plant layouts and data sets derived for this purpose. Results prove that although both approaches have their advantages, they also have specific disadvantages as well. In conclusion, the MBR plant designer and/or operator who wishes to use good quality, calibrated models to gain a better understanding of their process, should carefully consider which model type is selected based upon on what their initial modelling objectives are. Each situation usually proves unique.

  8. A Comparative Study on the Status of Elderly In the Traditional and Modern Societies

    Directory of Open Access Journals (Sweden)

    Mohammad Esmaeil Riahi

    2008-10-01

    Full Text Available Over the past two centuries, the rapid socio-economic transformations along with substantial advances in medicine have resulted in decrease of mortality rate, the significant increase of life expectancy, and the growth of the population aging. In despite of the increased proportion of elderly in the recent periods, their status has significantly decreased. Elderly in the traditional societies had high levels of mastery and authority, especially power, wealth, and prestige. In the light of these assets, they were able to play the vital role in both family and society. However, experiencing rapid changes in the society and family at the present time, the status of elderly is no longer as high as before. The falling trend of elderly's status in the modem societies has resulted in the formation of such stereotypes as elder are not able to take part actively in society. It is important to find exact responses to such questions as whether elderly are useless? and how society can profit their potential and actual abilities? In this regard, the first step is the investigation about roots of decreasing status of old people in the modem world. Overall, the literature review shows that the followings are amongst the most important factors affecting the status of elderly in the modem societies: the decreasing importance of traditional values to control social interaction, the increasing role of mass media and new forms of information technologies to transfer knowledge and science, the decreasing demand to elderly' participation in economic activities, the substantial decreasing in the family size and the emergence of nuclear family, the decreasing responsibilities and duties of family as a social institution, the increasing trend of women employment, the increasing generational gap, the increasing value of youth and beauty, and changing the architecture of residences. Since aging is a multidimensional phenomenon, every effort to empowerment of elderly and

  9. Acupuncture and traditional Chinese medicine for hot flushes in menopause: a randomized trial.

    Science.gov (United States)

    Baccetti, Sonia; Da Frè, Monica; Becorpi, Angelamaria; Faedda, Marina; Guerrera, Antonella; Monechi, M Valeria; Munizzi, Rosa Maria; Parazzini, Fabio

    2014-07-01

    To evaluate the effect of acupuncture on hot flushes and other menopause-related symptoms used in an integrated system, including such therapeutic techniques as diet therapy and Tuina self-massage. Randomized trial. Outpatient center. One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training, but treatment with acupuncture started 6 weeks after they were enrolled into the study. Acupuncture treatments were scheduled twice weekly for 6 consecutive weeks. Mean change in frequency and/or intensity in menopause-related symptoms were estimated by questionnaire after treatment at week 4. Treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating (p<.001). Other symptoms (sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed) significantly improved. Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

  10. [Ambulatory laparoscopic cholecystectomy by minilaparoscopy versus traditional multiport ambulatory laparoscopic cholecystectomy. Prospective randomized trial].

    Science.gov (United States)

    Planells Roig, Manuel; Arnal Bertomeu, Consuelo; Garcia Espinosa, Rafael; Cervera Delgado, Maria; Carrau Giner, Miguel

    2016-02-01

    Difference analysis of ambulatorization rate, pain, analgesic requirements and daily activities recovery in patients undergoing laparoscopic cholecystectomy with standard multiport access (CLMP) versus a minilaparoscopic, 3mm size, technique. Prospective randomized trial of 40 consecutive patients undergoing laparoscopic cholecystectomy. Comparison criteria included predictive ultrasound factors of difficult cholecystectomy, previous history of complicated biliary disease and demographics. Results are analyzed in terms of ambulatorization rate, pain, analgesic requirements, postoperative recovery, technical difficulty, hemorrhage intensity, overnight stay, readmission rate and total or partial conversion. Both procedures were similar in surgery time, technical score and hemorrhage score. MLC was associated with similar ambulatorization rate, 85%, and over-night stay 15%, with only 15% partial conversion rate. MLC showed less postoperative pain (P=.026), less analgesic consumption (P=.006) and similar DAR (P=.879). MLC is similar to CLMP in terms of ambulatorization with less postoperative pain and analgesic requirements without differences in postoperative recovery. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. A Quantitative Comparative Study of Blended and Traditional Models in the Secondary Advanced Placement Statistics Classroom

    Science.gov (United States)

    Owens, Susan T.

    2017-01-01

    Technology is becoming an integral tool in the classroom and can make a positive impact on how the students learn. This quantitative comparative research study examined gender-based differences among secondary Advanced Placement (AP) Statistic students comparing Educational Testing Service (ETS) College Board AP Statistic examination scores…

  12. Comparative Analysis of the Thermal Insulation of Traditional and Newly Designed Protective Clothing for Foundry Workers

    Directory of Open Access Journals (Sweden)

    Iwona Frydrych

    2016-09-01

    Full Text Available An objective of the undertaken research was checking the applicability of aluminized basalt fabrics for the production of clothing for foundry workers. The results of flammability, the resistance to contact, convective and radiation heat, as well as the resistance to big molten metal splashes confirmed the thesis of applicability of the packages with the use of aluminized basalt fabric content for the assumed purpose; therefore, such protective clothing was produced. Thermal comfort of foundry workers is very important and related to many factors, i.e., the structure of the protective clothing package, the number of layers, their thickness, the distance between the body and appropriate underwear. In the paper, a comparison of the results of thermal insulation measurement of two kinds of protective clothing is presented: the traditional one made of aluminized glass fabrics and the new one made of aluminized basalt fabrics. Measurements of clothing thermal insulation were conducted using a thermal manikin dressed in the protective clothing and three kinds of underwear products covering the upper and lower part of the manikin.

  13. Comparative Genomic Analysis of Lactobacillus plantarum GB-LP1 Isolated from Traditional Korean Fermented Food.

    Science.gov (United States)

    Yu, Jihyun; Ahn, Sojin; Kim, Kwondo; Caetano-Anolles, Kelsey; Lee, Chanho; Kang, Jungsun; Cho, Kyungjin; Yoon, Sook Hee; Kang, Dae-Kyung; Kim, Heebal

    2017-08-28

    As probiotics play an important role in maintaining a healthy gut flora environment through antitoxin activity and inhibition of pathogen colonization, they have been of interest to the medical research community for quite some time now. Probiotic bacteria such as Lactobacillus plantarum , which can be found in fermented food, are of particular interest given their easy accessibility. We performed whole-genome sequencing and genomic analysis on a GB-LP1 strain of L. plantarum isolated from Korean traditional fermented food; this strain is well known for its functions in immune response, suppression of pathogen growth, and antitoxin effects. The complete genome sequence of GB-LP1 is a single chromosome of 3,040,388 bp with 2,899 predicted open reading frames. Genomic analysis of GB-LP1 revealed two CRISPR regions and genes showing accelerated evolution, which may have antibiotic and antitoxin functions. The aim of the present study was to predict strain specific-genomic characteristics and assess the potential of this new strain as lactic acid bacteria at the genomic level using in silico analysis. These results provide insight into the L. plantarum species as well as confirm the possibility of its utility as a candidate probiotic.

  14. COMPARATIVE ANALYSIS BETWEEN THE TRADITIONAL MODEL OF CORPORATE GOVERNANCE AND ISLAMIC MODEL

    Directory of Open Access Journals (Sweden)

    DAN ROXANA LOREDANA

    2016-08-01

    Full Text Available Corporate governance represents a set of processes and policies by which a company is administered, controlled and directed to achieve the predetermined management objectives settled by the shareholders. The most important benefits of the corporate governance to the organisations are related to business success, investor confidence and minimisation of wastage. For business, the improved controls and decision-making will aid corporate success as well as growth in revenues and profits. For the investor confidence, corporate governance will mean that investors are more likely to trust that the company is being well run. This will not only make it easier and cheaper for the company to raise finance, but also has a positive effect on the share price. When we talk about the minimisation of wastage we relate to the strong corporate governance that should help to minimise waste within the organisation, as well as the corruption, risks and mismanagement. Thus, in our research, we are trying to determine the common elements, and also, the differences that have occured between two well known models of corporate governance, the traditional Anglo – Saxon model and also, the Islamic model of corporate governance.

  15. One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Villat, Cyril; Attal, Jean-Pierre; Brulat, Nathalie; Decup, Franck; Doméjean, Sophie; Dursun, Elisabeth; Fron-Chabouis, Hélène; Jacquot, Bruno; Muller Bolla, Michèle; Plasse-Pradelle, Nelly; Roche, Laurent; Maucort-Boulch, Delphine; Nony, Patrice; Gritsch, Kerstin; Millet, Pierre; Gueyffier, François; Grosgogeat, Brigitte

    2016-08-15

    Current concepts in conservative dentistry advocate minimally invasive dentistry and pulp vitality preservation. Moreover, complete removal of carious dentin in deep carious lesions often leads to pulp exposure and root canal treatment, despite the absence of irreversible pulp inflammation. For years, partial caries removal has been performed on primary teeth, but little evidence supports its effectiveness for permanent teeth. Furthermore, the recent development of new antibacterial adhesive systems could be interesting in the treatment of such lesions. The objectives of this study are to compare the effectiveness of partial versus complete carious dentin removal in deep lesions (primary objective) and the use of an antibacterial versus a traditional two-step self-etch adhesive system (main secondary objective). The DEep CAries Treatment (DECAT) study protocol is a multicenter, randomized, controlled superiority trial comparing partial versus complete caries removal followed by adhesive restoration. The minimum sample size required is 464 patients. Two successive randomizations will be performed (allocation ratio 1:1): the first for the type of excavation (partial versus complete) and the second (if no root canal treatment is required) for the type of adhesive (antibacterial versus traditional). For the two objectives, the outcome is the success of the treatment after 1 year, measured according to a composite outcome of five FDI criteria: material fracture and retention, marginal adaptation, radiographic examination (including apical pathologies), postoperative sensitivity and tooth vitality, and carious lesion recurrence. The study will investigate the interest of a conservative approach for the management of deep carious lesions in terms of dentin excavation and bioactive adhesive systems. The results may help practitioners achieve the most efficient restorative procedure to maintain pulp vitality and increase the restoration longevity. ClinicalTrials

  16. The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs voriconazole.

    Science.gov (United States)

    Prajna, N Venkatesh; Krishnan, Tiruvengada; Mascarenhas, Jeena; Rajaraman, Revathi; Prajna, Lalitha; Srinivasan, Muthiah; Raghavan, Anita; Oldenburg, Catherine E; Ray, Kathryn J; Zegans, Michael E; McLeod, Stephen D; Porco, Travis C; Acharya, Nisha R; Lietman, Thomas M

    2013-04-01

    To compare topical natamycin vs voriconazole in the treatment of filamentous fungal keratitis. This phase 3, double-masked, multicenter trial was designed to randomize 368 patients to voriconazole (1%) or natamycin (5%), applied topically every hour while awake until reepithelialization, then 4 times daily for at least 3 weeks. Eligibility included smear-positive filamentous fungal ulcer and visual acuity of 20/40 to 20/400. The primary outcome was best spectacle-corrected visual acuity at 3 months; secondary outcomes included corneal perforation and/or therapeutic penetrating keratoplasty. A total of 940 patients were screened and 323 were enrolled. Causative organisms included Fusarium (128 patients [40%]), Aspergillus (54 patients [17%]), and other filamentous fungi (141 patients [43%]). Natamycintreated cases had significantly better 3-month best spectacle-corrected visual acuity than voriconazole-treated cases (regression coefficient=0.18 logMAR; 95% CI, 0.30 to 0.05; P=.006). Natamycin-treated cases were less likely to have perforation or require therapeutic penetrating keratoplasty (odds ratio=0.42; 95% CI, 0.22 to 0.80; P=.009). Fusarium cases fared better with natamycin than with voriconazole (regression coefficient=0.41 logMAR; 95% CI,0.61 to 0.20; P<.001; odds ratio for perforation=0.06; 95% CI, 0.01 to 0.28; P<.001), while non-Fusarium cases fared similarly (regression coefficient=0.02 logMAR; 95% CI, 0.17 to 0.13; P=.81; odds ratio for perforation=1.08; 95% CI, 0.48 to 2.43; P=.86). Natamycin treatment was associated with significantly better clinical and microbiological outcomes than voriconazole treatment for smear-positive filamentous fungal keratitis, with much of the difference attributable to improved results in Fusarium cases. Voriconazole should not be used as monotherapy in filamentous keratitis. clinicaltrials.gov Identifier: NCT00996736

  17. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries.

    Science.gov (United States)

    Lee, Gyusung I; Lee, Mija R; Clanton, Tameka; Clanton, Tamera; Sutton, Erica; Park, Adrian E; Marohn, Michael R

    2014-02-01

    We conducted this study to investigate how physical and cognitive ergonomic workloads would differ between robotic and laparoscopic surgeries and whether any ergonomic differences would be related to surgeons' robotic surgery skill level. Our hypothesis is that the unique features in robotic surgery will demonstrate skill-related results both in substantially less physical and cognitive workload and uncompromised task performance. Thirteen MIS surgeons were recruited for this institutional review board-approved study and divided into three groups based on their robotic surgery experiences: laparoscopy experts with no robotic experience, novices with no or little robotic experience, and robotic experts. Each participant performed six surgical training tasks using traditional laparoscopy and robotic surgery. Physical workload was assessed by using surface electromyography from eight muscles (biceps, triceps, deltoid, trapezius, flexor carpi ulnaris, extensor digitorum, thenar compartment, and erector spinae). Mental workload assessment was conducted using the NASA-TLX. The cumulative muscular workload (CMW) from the biceps and the flexor carpi ulnaris with robotic surgery was significantly lower than with laparoscopy (p NASA-TLX analysis showed that both robotic surgery novices and experts expressed lower global workloads with robotic surgery than with laparoscopy, whereas LEs showed higher global workload with robotic surgery (p > 0.05). Robotic surgery experts and novices had significantly higher performance scores with robotic surgery than with laparoscopy (p < 0.05). This study demonstrated that the physical and cognitive ergonomics with robotic surgery were significantly less challenging. Additionally, several ergonomic components were skill-related. Robotic experts could benefit the most from the ergonomic advantages in robotic surgery. These results emphasize the need for well-structured training and well-defined ergonomics guidelines to maximize the

  18. The transition from traditional banking to mobile internet finance: an organizational innovation perspective - a comparative study of Citibank and ICBC

    OpenAIRE

    Chen, Zhuming; Li, Yushan; Wu, Yawen; Luo, Junjun

    2017-01-01

    The development of Financial Technology (FinTech) in areas such as mobile Internet, cloud computing, big data, search engines, and blockchain technology have significantly changed the financial industry. FinTech is expected to overturn the traditional banking business model, forcing banks to upgrade and transform. This study adopts a comparative case study method to contrast and analyze the Industrial and Commercial Bank of China (ICBC) and Citibank. It analyzes the strategies, organizations,...

  19. Comparative analysis of energy impacts of traditional and partly electronic environmental auditing: Learning from the Japanese automotive industry case

    OpenAIRE

    Mbohwa, C

    2008-01-01

    This paper does a comparative analysis and assessment of energy impacts of traditional and partly electronic ISO 14001 environmental management system auditing that using videoconferencing systems. The focus is on the Japanese automotive industry. The idea is to quantify the environmental impacts of auditing and resolve the important question on whether or not the use of information and communication technology (ICT) in environmental auditing reduces environmental impacts in IS...

  20. Comparative Analysis of Music Recordings from Western and Non-Western traditions by Automatic Tonal Feature Extraction

    Directory of Open Access Journals (Sweden)

    Emilia Gómez

    2008-09-01

    Full Text Available The automatic analysis of large musical corpora by means of computational models overcomes some limitations of manual analysis, and the unavailability of scores for most existing music makes necessary to work with audio recordings. Until now, research on this area has focused on music from the Western tradition. Nevertheless, we might ask if the available methods are suitable when analyzing music from other cultures. We present an empirical approach to the comparative analysis of audio recordings, focusing on tonal features and data mining techniques. Tonal features are related to the pitch class distribution, pitch range and employed scale, gamut and tuning system. We provide our initial but promising results obtained when trying to automatically distinguish music from Western and non- Western traditions; we analyze which descriptors are most relevant and study their distribution over 1500 pieces from different traditions and styles. As a result, some feature distributions differ for Western and non-Western music, and the obtained classification accuracy is higher than 80% for different classification algorithms and an independent test set. These results show that automatic description of audio signals together with data mining techniques provide means to characterize huge music collections from different traditions and complement musicological manual analyses.

  1. Comparative pharmacognostical investigation on four ethanobotanicals traditionally used as Shankhpushpi in India.

    Science.gov (United States)

    Sethiya, Neeraj K; Trivedi, Ashish; Patel, Mayur B; Mishra, S H

    2010-10-01

    People in Indian region often apply Shankhpushpi and other Sanskrit-based common name to Evolvulus alsinoides, Convolvulus pluricaulis, Canscora decussata, and Clitorea ternatea. These are pre-European names that are applied to a medicinal plant. Before the establishment of British rule, like the other books, ayurvedic treatises were also hand written. This might be one of the reasons due to which ayurveda could not stand parallel to the western medicine and an ambiguity is reflected in the interpretation of names and description of drugs found in the books like Charaka Samhita and Sushruta Samhita. The most widespread application of Shankhpushpi is for mental problems, but they have been considered for an array of other human maladies. The present investigation deals with the comparative pharmacognostical evaluation of four ethanobotanicals of Shankhpushpi. A comparative morphoanatomy of the root, stem, and leaves has been studied with the aim to aid pharmacognostic and taxonomic species identification. Various physicochemical, morphological, histological parameters, comparative high-performance thin-layer chromatography (HPTLC), and comparative high-performance liquid chromatography (HPLC), chromatogram of methanolic extract presented in this communication may serve the purpose of standard parameters to establish the authenticity of commercialized varieties and can possibly help to differentiate the drug from the other species. All the parameters were studied according to the WHO and pharmacopoeial guidelines.

  2. Comparative pharmacognostical investigation on four ethanobotanicals traditionally used as Shankhpushpi in India

    Directory of Open Access Journals (Sweden)

    Neeraj K Sethiya

    2010-01-01

    Full Text Available People in Indian region often apply Shankhpushpi and other Sanskrit-based common name to Evolvulus alsinoides, Convolvulus pluricaulis, Canscora decussata, and Clitorea ternatea. These are pre-European names that are applied to a medicinal plant. Before the establishment of British rule, like the other books, ayurvedic treatises were also hand written. This might be one of the reasons due to which ayurveda could not stand parallel to the western medicine and an ambiguity is reflected in the interpretation of names and description of drugs found in the books like Charaka Samhita and Sushruta Samhita. The most widespread application of Shankhpushpi is for mental problems, but they have been considered for an array of other human maladies. The present investigation deals with the comparative pharmacognostical evaluation of four ethanobotanicals of Shankhpushpi. A comparative morphoanatomy of the root, stem, and leaves has been studied with the aim to aid pharmacognostic and taxonomic species identification. Various physicochemical, morphological, histological parameters, comparative high-performance thin-layer chromatography (HPTLC, and comparative high-performance liquid chromatography (HPLC, chromatogram of methanolic extract presented in this communication may serve the purpose of standard parameters to establish the authenticity of commercialized varieties and can possibly help to differentiate the drug from the other species. All the parameters were studied according to the WHO and pharmacopoeial guidelines.

  3. Rethinking Critical Mathematics: A Comparative Analysis of Critical, Reform, and Traditional Geometry Instructional Texts

    Science.gov (United States)

    Brantlinger, Andrew

    2011-01-01

    This paper presents findings from a comparative analysis of three similar secondary geometry texts, one critical unit, one standards-based reform unit, and one specialist chapter. I developed the critical unit as I took the tenets of critical mathematics (CM) and substantiated them in printed curricular materials in which to teach as part of a…

  4. Comparing Computer Game and Traditional Lecture Using Experience Ratings from High and Low Achieving Students

    Science.gov (United States)

    Grimley, Michael; Green, Richard; Nilsen, Trond; Thompson, David

    2012-01-01

    Computer games are purported to be effective instructional tools that enhance motivation and improve engagement. The aim of this study was to investigate how tertiary student experiences change when instruction was computer game based compared to lecture based, and whether experiences differed between high and low achieving students. Participants…

  5. A Randomized Trial Comparing Skin Antiseptic Agents at Cesarean Delivery.

    Science.gov (United States)

    Tuuli, Methodius G; Liu, Jingxia; Stout, Molly J; Martin, Shannon; Cahill, Alison G; Odibo, Anthony O; Colditz, Graham A; Macones, George A

    2016-02-18

    Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine-alcohol for preoperative skin antisepsis was superior to the use of iodine-alcohol for the prevention of surgical-site infection after cesarean delivery. We randomly assigned patients undergoing cesarean delivery to skin preparation with either chlorhexidine-alcohol or iodine-alcohol. The primary outcome was superficial or deep surgical-site infection within 30 days after cesarean delivery, on the basis of definitions from the Centers for Disease Control and Prevention. From September 2011 through June 2015, a total of 1147 patients were enrolled; 572 patients were assigned to chlorhexidine-alcohol and 575 to iodine-alcohol. In an intention-to-treat analysis, surgical-site infection was diagnosed in 23 patients (4.0%) in the chlorhexidine-alcohol group and in 42 (7.3%) in the iodine-alcohol group (relative risk, 0.55; 95% confidence interval, 0.34 to 0.90; P=0.02). The rate of superficial surgical-site infection was 3.0% in the chlorhexidine-alcohol group and 4.9% in the iodine-alcohol group (P=0.10); the rate of deep infection was 1.0% and 2.4%, respectively (P=0.07). The frequency of adverse skin reactions was similar in the two groups. The use of chlorhexidine-alcohol for preoperative skin antisepsis resulted in a significantly lower risk of surgical-site infection after cesarean delivery than did the use of iodine-alcohol. (Funded by the National Institutes of Health and Washington University School of Medicine in St. Louis; ClinicalTrials.gov number, NCT01472549.).

  6. Comparative Study on Acoustic Behavior Between Light Multi-layered and Traditional Façades

    Directory of Open Access Journals (Sweden)

    Ruiz, L.

    2012-09-01

    Full Text Available Light multi-layered facade systems in general have been acoustically little studied. The data available suggests they do not usually fulfil the sound insulation values required in the Technical Building Code (CTE in particularly in noisy environments. Therefore the main objectives of this study, is to obtain light multi-layered façade systems with a high degree of acoustic insulation that can be used in noisy environments. While in turn showing excellent thermal characteristics, without neglecting important aspects such as the sustainability of materials, industrialization, costs, among others. This article will explain the process that has been followed to carry out an investigation on the acoustic behaviour of light multi-layered facades. For this purpose acoustic behaviour and sound intensimetry measurement methods have been used. After obtaining these results, a comparison between light multi-layered and traditional facades was made.Los sistemas de fachadas multicapas ligeras acústicamente, en general han sido poco estudiados. Los primeros datos que se tienen es que no suelen alcanzar los valores de aislamiento acústico requeridos en el Código Técnico de la Edificación (CTE en entornos especialmente ruidosos. Los objetivos principales de esta investigación son obtener fachadas multicapas ligeras con un alto grado de aislamiento acústico, que puedan ser empleados en entornos ruidosos. Al mismo tiempo que presenten excelentes características térmicas, sin descuidar aspectos tan importantes como la sostenibilidad, industrialización, costes, etc. En este artículo se explicará el proceso que se ha llevado a cabo para realizar una investigación relacionada con el comportamiento acústico de fachadas multicapas ligeras. Para ello se han empleado los métodos de medida del comportamiento acústico a ruido aéreo e intensimetría sonora. Una vez obtenidos estos resultados se realiza una comparativa entre las fachadas multicapas ligeras

  7. Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Brendan Kerr

    2013-07-01

    Full Text Available Introduction: Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods: Participants (N=27 were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results: Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76 nor did significantly decrease in the simulation group (d= − 0.44; p=0.19. Self-reported comfort in patient assessment parameters increased in both groups (p<0.05 in all. However, only the simulation group reported an increase in comfort in patient management (d=1.1, p=0.051 for the traditional group and d=1.3; p= 0.0003 for the simulation group. At 1 month, comfort measures in the traditional group increased consistently over time while these measures in the simulation group increased post-workshop but decreased by 1 month, suggesting that some of the effects of training with simulation may be short lived. Discussion: The use of simulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial.

  8. Relations and effects of transformational leadership: a comparative analysis with traditional leadership styles.

    Science.gov (United States)

    Molero, Fernando; Cuadrado, Isabel; Navas, Marisol; Morales, J Francisco

    2007-11-01

    This study has two main goals: (a) to compare the relationship between transformational leadership and other important leadership styles (i.e., democratic versus autocratic or relations- and task-oriented leadership) and (b) to compare the effects of transformational leadership and the other styles on some important organizational outcomes such as employees' satisfaction and performance. For this purpose, a sample of 147 participants, working in 35 various work-teams, was used. Results show high correlations between transformational leadership, relations-oriented, democratic, and task-oriented leadership. On the other hand, according to the literature, transformational leadership, especially high levels, significantly increases the percentage of variance accounted for by other leadership styles in relevant organizational outcome variables (subordinates' performance, satisfaction and extra effort).

  9. A randomized trial comparing didactics, demonstration, and simulation for teaching teamwork to medical residents.

    Science.gov (United States)

    Semler, Matthew W; Keriwala, Raj D; Clune, Jennifer K; Rice, Todd W; Pugh, Meredith E; Wheeler, Arthur P; Miller, Alison N; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A

    2015-04-01

    Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel "Recognize, Respond, Reassess" score. Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs(2)] = 0.267, P teamwork training by expert demonstration resulted in similar teamwork behavior to participation in high-fidelity simulation and was more effective than traditional didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities.

  10. Jianpi Bushen, a Traditional Chinese Medicine Therapy, Combined with Chemotherapy for Gastric Cancer Treatment: A Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Chen, Yunbo; Zhang, Guijuan; Chen, Xiaoping; Jiang, Xuefeng; Yuan, Naijun; Wang, Yurong; Hao, Xiaoqian

    2018-01-01

    Objective. To investigate the effects of Jianpi Bushen (JPBS), a traditional Chinese medicine that is used to invigorate the spleen and tonify the kidney, combined with chemotherapy for the treatment of gastric cancer. Methods. Literature retrieval was performed in PubMed, EMBASE, Cochrane Library, MEDLINE, CNKI, Wanfang Data Information Site, and VIP from inception to October 2017. Randomized controlled trials to evaluate the effects of JPBS combined with chemotherapy were identified. The primary reported outcomes were KPS (Karnofsky Performance Status), clinical curative efficiency, immune function, blood system, and nonhematologic system. Review Manager 5.3 (RevMan 5.3) was used for data analysis, and the quality of the studies was also appraised. Results. A total of 26 studies were included with 3098 individuals. The results of the meta-analysis indicated that treatment of gastric cancer with the combination of JPBS and chemotherapy resulted in better outcomes compared to chemotherapy alone. Conclusion. Evidence from the meta-analysis suggested that JPBS combined with chemotherapy has a positive effect on gastric cancer treatment. However, additional rigorously designed and large sample randomized controlled trials are required to confirm the efficacy and safety of this treatment. PMID:29675052

  11. Students' Perceptions of Teaching in Context-based and Traditional Chemistry Classrooms: Comparing content, learning activities, and interpersonal perspectives

    Science.gov (United States)

    Overman, Michelle; Vermunt, Jan D.; Meijer, Paulien C.; Bulte, Astrid M. W.; Brekelmans, Mieke

    2014-07-01

    Context-based curriculum reforms in chemistry education are thought to bring greater diversity to the ways in which chemistry teachers organize their teaching. First and foremost, students are expected to perceive this diversity. However, empirical research on how students perceive their teacher's teaching in context-based chemistry classrooms, and whether this teaching differs from traditional chemistry lessons, is scarce. This study aims to develop our understanding of what teaching looks like, according to students, in context-based chemistry classrooms compared with traditional chemistry classrooms. As such, it might also provide a better understanding of whether teachers implement and attain the intentions of curriculum developers. To study teacher behaviour we used three theoretical perspectives deemed to be important for student learning: a content perspective, a learning activities perspective, and an interpersonal perspective. Data were collected from 480 students in 24 secondary chemistry classes in the Netherlands. Our findings suggest that, according to the students, the changes in teaching in context-based chemistry classrooms imply a lessening of the emphasis on fundamental chemistry and the use of a teacher-centred approach, compared with traditional chemistry classrooms. However, teachers in context-based chemistry classrooms seem not to display more 'context-based' teaching behaviour, such as emphasizing the relation between chemistry, technology, and society and using a student-centred approach. Furthermore, students in context-based chemistry classrooms perceive their teachers as having less interpersonal control and showing less affiliation than teachers in traditional chemistry classrooms. Our findings should be interpreted in the context of former and daily experiences of both teachers and students. As only chemistry is reformed in the schools in which context-based chemistry is implemented, it is challenging for both students and teachers to

  12. A randomised placebo-controlled trial of a traditional Chinese herbal formula in the treatment of primary dysmenorrhoea.

    Directory of Open Access Journals (Sweden)

    Lan Lan Liang Yeh

    Full Text Available BACKGROUND: Most traditional Chinese herbal formulas consist of at least four herbs. Four-Agents-Decoction (Si Wu Tang is a documented eight hundred year old formula containing four herbs and has been widely used to relieve menstrual discomfort in Taiwan. However, no specific effect had been systematically evaluated. We applied Western methodology to assess its effectiveness and safety for primary dysmenorrhoea and to evaluate the compliance and feasibility for a future trial. METHODOLOGY/PRINCIPAL FINDINGS: A randomised, double-blind, placebo-controlled, pilot clinical trial was conducted in an ad hoc clinic setting at a teaching hospital in Taipei, Taiwan. Seventy-eight primary dysmenorrheic young women were enrolled after 326 women with self-reported menstrual discomfort in the Taipei metropolitan area of Taiwan were screened by a questionnaire and subsequently diagnosed by two gynaecologists concurrently with pelvic ultrasonography. A dosage of 15 odorless capsules daily for five days starting from the onset of bleeding or pain was administered. Participants were followed with two to four cycles for an initial washout interval, one to two baseline cycles, three to four treatment cycles, and three follow-up cycles. Study outcome was pain intensity measured by using unmarked horizontal visual analog pain scale in an online daily diary submitted directly by the participants for 5 days starting from the onset of bleeding or pain of each menstrual cycle. Overall-pain was the average pain intensity among days in pain and peak-pain was the maximal single-day pain intensity. At the end of treatment, both the overall-pain and peak-pain decreased in the Four-Agents-Decoction (Si Wu Tang group and increased in the placebo group; however, the differences between the two groups were not statistically significant. The trends persisted to follow-up phase. Statistically significant differences in both peak-pain and overall-pain appeared in the first follow

  13. Explaining feast or famine in randomized field trials. Medical science and criminology compared.

    Science.gov (United States)

    Shepherd, Jonathan P

    2003-06-01

    A feast of randomized controlled trials (RCTs) in medical science and comparative famine in criminology can be explained in terms of cultural and structural factors. Of central importance is the context in which the evaluation of interventions is done and the difference in status of situational research in the two disciplines. Evaluation of medical interventions has traditionally been led by practitioner (clinical) academics. This is not the case in criminal justice, where theory has had higher status than intervention research. Medical science has advanced in, or closely associated with, university teaching hospitals, but links between criminology and criminal justice services are far more tenuous. The late development of situational crime prevention seems extraordinary from a medical perspective, as does the absence of university police schools in the United Kingdom and elsewhere. These structural and cultural factors explain concentration of expectation, resource, and RCT productivity in medical science. The Campbell Collaboration and the Academy of Experimental Criminology are forces which are reducing this polarization of feast and famine in RCTs. But unless scientific criminology is embedded in university schools which are responsible for the education and training of law, probation, and police practitioners, convergence in terms of RCTs and implementation of findings in practice seems unlikely.

  14. Characterization of kink actuators as compared to traditional chevron shaped Bent-Beam electrothermal actuators

    KAUST Repository

    Rawashdeh, E.; Karam, A.; Foulds, Ian G.

    2012-01-01

    This paper compares the design and performance of kink actuators, a modified version of the bent-beam thermal actuator, to the standard chevron-shaped designs. A variety of kink and chevron actuator designs were fabricated from polysilicon. While the actuators were electrically probed, these designs were tested using a probe station connected to a National Instruments (NI) controller that uses LabVIEW to extract the displacement results via image processing. The displacement results were then used to validate the thermal-electric-structural simulations produced by COMSOL. These results, in turn, were used to extract the stiffness for both actuator types. The data extracted show that chevron actuators can have larger stiffness values with increasing offsets, but at the cost of lower amplification factors. In contrast, kink actuators showed a constant stiffness value equivalent to the chevron actuator with the highest amplification factor. The kink actuator also had larger amplification factors than chevrons at all designs tested. Therefore, kink actuators are capable of longer throws at lower power levels than the standard chevron designs.

  15. Laparoscopic surgery compared to traditional abdominal surgery in the management of early stage cervical cancer.

    Science.gov (United States)

    Simsek, T; Ozekinci, M; Saruhan, Z; Sever, B; Pestereli, E

    2012-01-01

    The purpose of the study was to compare laparoscopic total radical hysterectomy with classic radical hysterectomy regarding parametrial, and vaginal resection, and lymphadenectomy. Laparoscopic or laparotomic total radical hysterectomy with advantages and disadvantages was offered to the patients diagnosed as having operable cervical cancer between 2007 and 2010. Lymph node status, resection of the parametria and vagina, and margin positivity were recorded for both groups. Data were collected prospectively. Statistical analysis was performed with the SPSS statistical software program. Totally, 53 cases had classical abdominal radical hysterectomy and 35 laparoscopic radical hysterectomy, respectively. Parametrial involvement was detected in four (11.4%) cases in laparoscopic radical surgery versus nine (16.9%) in laparatomic surgery. All the cases with parametrial involvement had free surgical margins of tumor. Also there were no significant statistical differences in lymph node number and metastasis between the two groups. There is no difference in anatomical considerations between laparoscopic and laparatomic radical surgery in the surgical management of cervical cancer.

  16. Preliminary comparative analysis of four botanicals used in the traditional medicines of pakistan

    International Nuclear Information System (INIS)

    Hussain, J.; Rehman, N.U.; Khan, A.L.

    2014-01-01

    In present study, the proximate parameters and nutrient profile of four medicinal plants viz., Datura innoxia, Adhotoda visica, Solanum surattens, and Acacia nilotica (leaves and roots) were determined through standard procedures of AOAC and Inductively Coupled Plasma Emission Spectrometer (ICP-OES DV 7300, Perkin Elmer, USA). In proximate parameters, significantly higher (p<0.05) ash content and crude fats was observed in Datura innoxia as compared to other medicinal plants. The concentration of fiber was highest in Adhotoda visica (42.186%) and lowest in Solanum surattens (18%). The highest energy value was recorded (329.11 Kcal/100g) for Acacia nilotica (roots), while protein and carbohydrates were significant in S. surattens. The concentration of the macronutrients ranged from 54.242 to 97.468 ng/g for calcium, 27.552-97.468 ng/g for potassium, 3.457-21.707 ng/g for magnesium, 6.546-9.136 ng/g for sodium, 2.617-8.976 ng/g for potassium and 0.047-0.74 ng/g for sulfur. In conclusion, D. innoxia and S. surattens were found to be a good source of ash, fats, fiber, carbohydrates and macronutrients (Ca, K, Mg, Na, P, and Si), which can be considered for healthy life besides their medicinal values. (author)

  17. Characterization of kink actuators as compared to traditional chevron shaped Bent-Beam electrothermal actuators

    KAUST Repository

    Rawashdeh, E.

    2012-07-06

    This paper compares the design and performance of kink actuators, a modified version of the bent-beam thermal actuator, to the standard chevron-shaped designs. A variety of kink and chevron actuator designs were fabricated from polysilicon. While the actuators were electrically probed, these designs were tested using a probe station connected to a National Instruments (NI) controller that uses LabVIEW to extract the displacement results via image processing. The displacement results were then used to validate the thermal-electric-structural simulations produced by COMSOL. These results, in turn, were used to extract the stiffness for both actuator types. The data extracted show that chevron actuators can have larger stiffness values with increasing offsets, but at the cost of lower amplification factors. In contrast, kink actuators showed a constant stiffness value equivalent to the chevron actuator with the highest amplification factor. The kink actuator also had larger amplification factors than chevrons at all designs tested. Therefore, kink actuators are capable of longer throws at lower power levels than the standard chevron designs.

  18. Clinical trial to compare tinnitus masking and tinnitus retraining therapy.

    Science.gov (United States)

    Henry, J A; Schechter, M A; Zaugg, T L; Griest, S; Jastreboff, P J; Vernon, J A; Kaelin, C; Meikle, M B; Lyons, K S; Stewart, B J

    2006-12-01

    Both tinnitus masking (TM) and tinnitus retraining therapy (TRT) can be effective therapies for amelioration of tinnitus. TM may be more effective for patients in the short term, but with continued treatment TRT may produce the greatest effects. Although TM and TRT have been used for many years, research has not documented definitively the efficacy of these methods. The present study was a controlled clinical trial to prospectively evaluate the clinical efficacy of these two methods for US military veterans with severe tinnitus. Over 800 veterans were screened to ensure that enrolled patients had tinnitus of sufficient severity to justify 18 months of individualized treatment. Qualifying patients (n=123) were placed quasi-randomly (alternating placement) into treatment with either TM or TRT. Treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated primarily using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index). Findings are presented from the three written questionnaires with respect to three categories of patients: describing tinnitus as a 'moderate,' 'big,' and 'very big' problem at baseline. Based on effect sizes, both groups showed considerable improvement overall. In general, TM effects remained fairly constant over time while TRT effects improved incrementally. For the patients with a 'moderate' and 'big' problem, TM provided the greatest benefit at 3 and 6 months; benefit to these TRT patients was slightly greater at 12 months, and much greater at 18 months. For patients with a 'very big' problem, TM provided the greatest benefit at 3 months. For these latter patients, results were about the same between groups at 6 months, and improvement for TRT was much greater at 12 months, with further gains at 18 months.

  19. Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial

    Science.gov (United States)

    Kerr, Brendan; Hawkins, Trisha Lee-Ann; Herman, Robert; Barnes, Sue; Kaufmann, Stephanie; Fraser, Kristin; Ma, Irene W. Y.

    2013-01-01

    Introduction Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence. Methods Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop. Results Post-training, knowledge assessment score neither did increase significantly in the traditional group (d=0.13; p=0.76) nor did significantly decrease in the simulation group (d= − 0.44; p=0.19). Self-reported comfort in patient assessment parameters increased in both groups (psimulation-based training was not associated with benefits in knowledge acquisition, knowledge retention, or comfort in patient assessment. It was associated with superior outcomes in comfort in patient management, but this benefit may be short-lived. Further studies are required to better define the conditions under which simulation-based training is beneficial. PMID:23870304

  20. Chromium-Containing Traditional Chinese Medicine, Tianmai Xiaoke Tablet, for Newly Diagnosed Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Gu, Yuming; Xu, Xuemin; Wang, Zhe; Xu, Yunsheng; Liu, Xiuzhi; Cao, Lejun; Wang, Xueyang; Li, Zhengxin; Feng, Bo

    2018-01-01

    Chromium-containing traditional Chinese medicine Tianmai Xiaoke tablet (TMXKT) is approved for treating newly diagnosed type 2 diabetes mellitus (T2DM) in China. This review aimed to compile the evidence from randomized clinical trials (RCTs) and quantify the effects of TMXKT on newly diagnosed T2DM. Seven online databases were investigated up to March 20, 2017. The meta-analysis included RCTs investigating the treatment of newly diagnosed T2DM, in which TMXKT combined with conventional therapy was compared with placebo or conventional therapy. The risk of bias was evaluated using the Cochrane Collaboration tool. The estimated mean difference (MD) and the standardized mean difference were within 95% confidence intervals (CI) with respect to the interstudy heterogeneity. The outcomes were measured using fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin A1c (HbA1c), and body mass index (BMI) levels. TMXKT combined with conventional therapy lowered FBG level (MD = -0.68, 95% CI -0.90 to -0.45, P < 0.00001), 2hPG (MD = -1.33, 95% CI -1.86 to -0.79, P < 0.00001), HbA1c (MD = -0.46, 95% CI -0.57 to -0.36, P < 0.00001), and BMI (MD = -0.77, 95% CI -1.12 to -0.41, P < 0.00001). TMXKT combined with conventional therapy is beneficial for patients with newly diagnosed T2DM. However, the effectiveness and safety of TMXKT are uncertain because of the limited number of trials and low methodological quality. Therefore, practitioners should be cautious when applying TMXKT in daily practice. Also, well-designed clinical trials are needed in the future.

  1. Kinematic real-time feedback is more effective than traditional teaching method in learning ankle joint mobilisation: a randomised controlled trial.

    Science.gov (United States)

    González-Sánchez, Manuel; Ruiz-Muñoz, Maria; Ávila-Bolívar, Ana Belén; Cuesta-Vargas, Antonio I

    2016-10-06

    To analyse the effect of real-time kinematic feedback (KRTF) when learning two ankle joint mobilisation techniques comparing the results with the traditional teaching method. Double-blind randomized trial. Faculty of Health Sciences. undergraduate students with no experience in manual therapy. Each student practised intensely for 90 min (45 min for each mobilisation) according to the random methodology assigned (G1: traditional method group and G2: KRTF group). G1: an expert professor supervising the student's practice, the professorstudent ratio was 1:8. G2: placed in front of a station where, while they performed the manoeuvre, they received a KRTF on a laptop. total time of mobilisation, time to reach maximum amplitude, maximum angular displacement in the three axes, maximum and average velocity to reach the maximum angular displacement, average velocity during the mobilisation. Among the pre-post intervention measurements, there were significant differences within the two groups for all outcome variables, however, G2 (KRTF) achieved significantly greater improvements in kinematic parameters for the two mobilisations (significant increase in displacement, velocity and significant reduction in the mobilisations runtime) than G1. Ankle plantar flexion: G1's measurement stability (post-intervention) ranged between 0.491 and 0.687, while G2's measurement stability ranged between 0.899 and 0.984. Ankle dorsal flexion mobilisation: G1 the measurement stability (post-intervention) ranged from 0.543 and 0.684 while G2 ranged between 0.899 and 0.974. KRTF was proven to be more effective tool than traditional teaching method in the teaching - learning process of two joint mobilisation techniques. NCT02504710.

  2. Training community healthcare workers on the use of information and communication technologies: a randomised controlled trial of traditional versus blended learning in Malawi, Africa.

    Science.gov (United States)

    Mastellos, Nikolaos; Tran, Tammy; Dharmayat, Kanika; Cecil, Elizabeth; Lee, Hsin-Yi; Wong, Cybele C Peng; Mkandawire, Winnie; Ngalande, Emmanuel; Wu, Joseph Tsung-Shu; Hardy, Victoria; Chirambo, Baxter Griphin; O'Donoghue, John Martin

    2018-04-02

    Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The 'Introduction to Information and Communication Technology and eHealth' course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach. Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs' knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests. Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both

  3. Traditional Chinese and western medicine for the prevention of deep venous thrombosis after lower extremity orthopedic surgery: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhu, Shibai; Song, Yi; Chen, Xi; Qian, Wenwei

    2018-04-10

    Chinese herbal medicine has traditionally been considered to promote blood circulation to remove obstruction in the channels and clear pathogenic heat to drain dampness effects. We conducted this meta-analysis to evaluate its benefits for the prevention of deep venous thrombosis (DVT) after lower extremity orthopedic surgery. Relevant, published studies were identified using the following keywords: lower extremity orthopedic surgery, arthroplasty, joint replacement, fracture, traditional Chinese and western medicine, Chinese herbal medicine, deep venous thrombosis (DVT), and Venous thromboembolism (VTE). The following databases were used to identify the literature consisting of RCTs with a date of search of 31 May 2017: PubMed, Cochrane Library, Web of knowledge, the Chinese National Knowledge Infrastructure Database, the Chongqing VIP Database, the Chinese Biomedical Database, and the Wanfang Database (including three English and four Chinese databases). All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were the incidence rate of DVT, activated partial thromboplastin time (APTT), prothrombin time (PT), and D-dimer; subcutaneous hematoma; and other reported outcomes. RevMan5.2. software was adopted for the meta-analysis. A total of 20 published studies (1862 cases) met the inclusion criteria. The experimental group, 910 patients (48.87%), received the Chinese herbal medicine or traditional Chinese and western medicine for prevention of DVT; the control group, 952 patients (51.13%), received the standard western treatment. The meta-analysis showed that traditional Chinese and western medicine therapy reduced the incidence rates of DVT significantly when compared with controls (risk ratio [RR] = 0.40; 95% CI, 0.30 to 0.54; P < 0.00001), and the D-dimer was lower in the experimental group (P = 0.01). Besides, the incidence rate of subcutaneous hematoma was lower in the experimental group (P < 0

  4. A randomised controlled trial comparing the effect of adjuvant ...

    African Journals Online (AJOL)

    Background: Intrathecal adjuvants are added to local anaesthetics to improve the quality of neuraxial blockade and prolong the duration of analgesia during spinal anaesthesia. Used intrathecally, fentanyl improves the quality of spinal blockade as compared to plain bupivacaine and confers a short duration of post ...

  5. Clinical trial comparing excision and primary closure with modified ...

    African Journals Online (AJOL)

    Walid Galal Elshazly

    2011-12-03

    Dec 3, 2011 ... sure, advancement flap (Karydakis procedure), local advance- ment flap (V-Y advancement flap), and rotational flap. (Limberg flap, modified Limberg flap, gluteus maximus myo- cutaneous flap).5,6. However, there have been few clinical studies to compare the rhomboid fasciocutaneous transposition flap ...

  6. Clinical trial comparing excision and primary closure with modified ...

    African Journals Online (AJOL)

    The aim of this study was to compare modified Limberg flap procedure with excision and primary closure in the treatment of uncomplicated pilonidal disease. Methods: This study was conducted on 120 patients with uncomplicated sacrococcygeal pilonidal disease that were randomly allocated into two groups: group I ...

  7. Pain Relief in Labor: A Randomized Controlled Trial Comparing ...

    African Journals Online (AJOL)

    Conclusions: This study showed that 600 mg intramuscular paracetamol provides similar and modest pain relief in labor when compared to 100 mg intramuscular tramadol. It also has fewer maternal adverse effects and favorable neonatal outcome such as tramadol. It is concluded that intramuscular paracetamol is simple, ...

  8. The use of traditional versus e-marketing in SMEs in a developing country: A comparative analysis

    Directory of Open Access Journals (Sweden)

    Leanne L. Manley

    2015-09-01

    Full Text Available The revolution of the internet has changed the way many organisations conduct business in today’s market environment, and has specifically changed in the way companies market products to consumers. E-marketing allows a marketer to not only reach a broader target market than traditional methods, but substantially reduces marketing costs as well, which can mean the difference between success or failure in small medium enterprises (SMEs. Multiple studies have investigated traditional and e-marketing practices, however, few studies have focused on SME marketing practices and their use of e-marketing in developing economies. This article provides an insight into current marketing tools employed by SMEs in South Africa and provides a comparative analysis between traditional and e-marketing tool usage. A self-administered questionnaire was distributed to SME owners, whereby data was analysed by means of frequency occurrence. The main results stemming from the research indicate that SME owners have no preference in using either traditional or e-marketing tools, with majority preferring to use both. However, the majority of marketing tools being used and receiving the most effective rating according to SME owners is directed towards e-marketing tools. From the results obtained recommendations are made to policy-makers, SME managers, development agencies and business owners so as to establish an appropriate strategy to improve SME marketability within South Africa. The findings can be universally applied as studies have shown that there is a lot of similarity in the challenges faced by SMEs irrespective of where they come from.

  9. PRIVATE MANUFACTURERS’ THRESHOLDS TO INVEST IN COMPARATIVE EFFECTIVENESS TRIALS

    OpenAIRE

    Basu, Anirban; Meltzer, David

    2012-01-01

    The recent rush of enthusiasm for public investment in comparative effectiveness research (CER) in the United States has focused attention on these public investments. However, little attention has been given to how changing public investment in CER may affect private manufacturers’ incentives for CER, which has long been a major source of CER. In this work, based on a simple revenue maximizing economic framework, we generate predictions on thresholds to invest in CER for a private manufactur...

  10. Compared leaf anatomy and water relations of commercial and traditional Prunus dulcis (Mill.) cultivars under rain-fed conditions

    DEFF Research Database (Denmark)

    Oliveira, I.; Meyer, A.; Afonso, S.

    2018-01-01

    Leaf anatomy and water relations of seven almond (Prunus dulcis Mill.) cultivars, traditional (Bonita, Casanova, Parada, Pegarinhos and Verdeal) and commercial (Ferragnès and Glorieta), grown under rain-fed conditions, were studied. The performed measurements included thickness of leaf tissues...... cuticle thickness, while Pegarinhos adds a thicker epidermis and palisade parenchyma to increase protection to water loss. These data is one of the first comparative approaches to the leaf characterization of these cultivars, and should now be combined with physiological and biochemical studies...

  11. Understanding Patient Values and the Manifestations in Clinical Research with Traditional Chinese Medicine—With Practical Suggestions for Trial Design and Implementation

    Directory of Open Access Journals (Sweden)

    Wei Mu

    2013-01-01

    Full Text Available Objective. To define patient values, identify their manifestations in a randomized clinical trial, and investigate the possible implications for clinical research of traditional Chinese medicine. Methods. We categorized patient values manifestations into patient choice, preference, compliance, and patient-reported outcomes and summarized the underlying personal values through purposeful electronic searches for relevant reports. By hypothesizing a set of positive versus negative circumstances occurring in the enrollment, intervention allocation, treatment, and the follow-up stage of a trial, it is possible to discuss the potential implications of patient values manifestation on a trial with traditional Chinese medicine. Results. Patient values and its manifestations are ubiquitous in the process of clinical research with traditional Chinese medicine. These values may provide motivation for participation or engender the internal and external validity of the study. Conclusions. Trialists should attach sufficient importance to the needs and concerns of individual participant. To incorporate patient values into the design and conduct of a clinical study with traditional Chinese medicine, researchers are recommended to adopt participant-friendly design and use patient-reported outcomes, take convenience-for-patients measures, and help foster rational beliefs and behaviors of trial participants.

  12. Understanding patient values and the manifestations in clinical research with traditional chinese medicine-with practical suggestions for trial design and implementation.

    Science.gov (United States)

    Mu, Wei; Shang, Hongcai

    2013-01-01

    Objective. To define patient values, identify their manifestations in a randomized clinical trial, and investigate the possible implications for clinical research of traditional Chinese medicine. Methods. We categorized patient values manifestations into patient choice, preference, compliance, and patient-reported outcomes and summarized the underlying personal values through purposeful electronic searches for relevant reports. By hypothesizing a set of positive versus negative circumstances occurring in the enrollment, intervention allocation, treatment, and the follow-up stage of a trial, it is possible to discuss the potential implications of patient values manifestation on a trial with traditional Chinese medicine. Results. Patient values and its manifestations are ubiquitous in the process of clinical research with traditional Chinese medicine. These values may provide motivation for participation or engender the internal and external validity of the study. Conclusions. Trialists should attach sufficient importance to the needs and concerns of individual participant. To incorporate patient values into the design and conduct of a clinical study with traditional Chinese medicine, researchers are recommended to adopt participant-friendly design and use patient-reported outcomes, take convenience-for-patients measures, and help foster rational beliefs and behaviors of trial participants.

  13. Prospective Randomized Controlled Trial Comparing Plasmakinetic Vaporesection and Conventional Transurethral Resection of the Prostate

    Directory of Open Access Journals (Sweden)

    Berry Tat-Chow Fung

    2005-01-01

    Conclusion: PKVP achieved comparable results to traditional TURP and was an effective and safe procedure. However, it did not demonstrate obvious advantages over TURP in this acute regional hospital regular TURP list setting.

  14. The efficacy of maggot debridement therapy - a review of comparative clinical trials

    DEFF Research Database (Denmark)

    Zarchi, K.; Jemec, G.B.

    2012-01-01

    in a variety of ulcers. However, comparative clinical trials and in particular randomized controlled trials investigating the efficacy of MDT are sparse. A systematic search in the literature showed three randomized clinical trials and five non randomized studies evaluating the efficacy of sterile Lucilia......, including hydrocolloid, hydrogel and saline moistened gauze. However, the design of the studies was suboptimal, with important differences in the use of other therapies, such as compression, that may influence both debridement and healing between the compared groups, as well as inappropriately short follow...

  15. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial.

    Science.gov (United States)

    Mohan, Deepika; Farris, Coreen; Fischhoff, Baruch; Rosengart, Matthew R; Angus, Derek C; Yealy, Donald M; Wallace, David J; Barnato, Amber E

    2017-12-12

    To determine whether a behavioral intervention delivered through a video game can improve the appropriateness of trauma triage decisions in the emergency department of non-trauma centers. Randomized clinical trial. Online intervention in national sample of emergency medicine physicians who make triage decisions at US hospitals. 368 emergency medicine physicians primarily working at non-trauma centers. A random sample (n=200) of those with primary outcome data was reassessed at six months. Physicians were randomized in a 1:1 ratio to one hour of exposure to an adventure video game (Night Shift) or apps based on traditional didactic education (myATLS and Trauma Life Support MCQ Review), both on iPads. Night Shift was developed to recalibrate the process of using pattern recognition to recognize moderate-severe injuries (representativeness heuristics) through the use of stories to promote behavior change (narrative engagement). Physicians were randomized with a 2×2 factorial design to intervention (game v traditional education apps) and then to the experimental condition under which they completed the outcome assessment tool (low v high cognitive load). Blinding could not be maintained after allocation but group assignment was masked during the analysis phase. Outcomes of a virtual simulation that included 10 cases; in four of these the patients had severe injuries. Participants completed the simulation within four weeks of their intervention. Decisions to admit, discharge, or transfer were measured. The proportion of patients under-triaged (patients with severe injuries not transferred to a trauma center) was calculated then (primary outcome) and again six months later, with a different set of cases (primary outcome of follow-up study). The secondary outcome was effect of cognitive load on under-triage. 149 (81%) physicians in the game arm and 148 (80%) in the traditional education arm completed the trial. Of these, 64/100 (64%) and 58/100 (58%), respectively

  16. Trial of Labor Compared With Cesarean Delivery in Superobese Women.

    Science.gov (United States)

    Grasch, Jennifer L; Thompson, Jennifer L; Newton, J Michael; Zhai, Amy W; Osmundson, Sarah S

    2017-11-01

    To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data. A sample size of 338 women determined the study period and was selected to show a 30% difference in the incidence of the primary outcome between the two groups. Multivariate logistic regression adjusted for potential confounders. There were 344 women with BMIs of 50 or greater who met eligibility criteria, of whom 201 (58%) labored and 143 (42%) underwent planned cesarean delivery. Women who labored were younger, more likely to be nulliparous, and less likely to have pre-existing diabetes. Among women who labored, 45% underwent a cesarean delivery, most commonly for labor arrest (61%) or nonreassuring fetal status (28%). Composite maternal and neonatal morbidity was reduced among women who labored even after adjusting for age, parity, pre-existing diabetes, and prior cesarean delivery (adjusted odds ratio 0.42, 95% CI 0.24-0.75). In the subgroup of women (n=234) who underwent a cesarean delivery, whether planned (n=143) or after labor (n=91), there were no differences in maternal and neonatal morbidity except that severe maternal morbidity was increased in women (n=12) who labored (8.8% compared with 2.1%, relative risk 4.2, 95% CI 1.14-15.4). Despite high rates of cesarean delivery in women with superobesity, labor is associated with lower composite maternal and neonatal morbidity. Severe maternal morbidity may be higher in women who require a cesarean delivery after labor.

  17. Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.

    Science.gov (United States)

    Paddock, Michael T; Bailitz, John; Horowitz, Russ; Khishfe, Basem; Cosby, Karen; Sergel, Michelle J

    2015-03-01

    Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team. We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups. We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between

  18. The decision to conduct a head-to-head comparative trial: a game-theoretic analysis.

    Science.gov (United States)

    Mansley, Edward C; Elbasha, Elamin H; Teutsch, Steven M; Berger, Marc L

    2007-01-01

    Recent Medicare legislation calls on the Agency for Healthcare Research and Quality to conduct research related to the comparative effectiveness of health care items and services, including prescription drugs. This reinforces earlier calls for head-to-head comparative trials of clinically relevant treatment alternatives. Using a game-theoretic model, the authors explore the decision of pharmaceutical companies to conduct such trials. The model suggests that an important factor affecting this decision is the potential loss in market share and profits following a result of inferiority or comparability. This hidden cost is higher for the market leader than the market follower, making it less likely that the leader will choose to conduct a trial. The model also suggests that in a full-information environment, it will never be the case that both firms choose to conduct such a trial. Furthermore, if market shares and the probability of proving superiority are similar for both firms, it is quite possible that neither firm will choose to conduct a trial. Finally, the results indicate that incentives that offset the direct cost of a trial can prevent a no-trial equilibrium, even when both firms face the possibility of an inferior outcome.

  19. Randomized Controlled Trial Comparing Daycare and Overnight Stay Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Salleh, A A M; Affirul, C A; Hairol, O; Zamri, Z; Azlanudin, A; Hilmi, M A; Razman, J

    2015-01-01

    This present study sought to review the feasibility and patients' satisfaction of laparoscopic cholecystectomy to be perform as daycare procedure. Sixty-two patients with symptomatic gallstones were recruited within a year. They were randomized into overnight stay and daycare groups. The outcomes and post-operative complications were analyzed. Fifty-eight patients were eligible for analysis and four patients were excluded because of conversion to open cholecystectomy. All patients in daycare group reported no fever but two patients in the overnight stay group complaint of post-operative fever (p=0.150). The mean pain score using Visual Analogue Score (VAS) in daycare group was 2.93 but in the overnight stay was recorded as 3.59 (p=0.98). Five patients had post-operative nausea and vomiting (PONV) in daycare group compared to 2 patients in the overnight stay group (p=0.227). Patient's satisfaction were higher in the daycare group (p=0.160). All patients in daycare group were back at work within a week but in overnight stay, 11 patients had to stay off work for more than one week (p=0.01). Daycare laparoscopic cholecystectomy is safe and feasible. The satisfaction of daycare surgery is higher than overnight stay group. Patients' selection is an important aspect of its success.

  20. Randomised controlled trial comparing hypnotherapy versus gabapentin for the treatment of hot flashes in breast cancer survivors: a pilot study

    Science.gov (United States)

    MacLaughlan David, Shannon; Salzillo, Sandra; Bowe, Patrick; Scuncio, Sandra; Malit, Bridget; Raker, Christina; Gass, Jennifer S; Granai, C O; Dizon, Don S

    2013-01-01

    Objectives To compare the efficacy of hypnotherapy versus gabapentin for the treatment of hot flashes in breast cancer survivors, and to evaluate the feasibility of conducting a clinical trial comparing a drug with a complementary or alternative method (CAM). Design Prospective randomised trial. Setting Breast health centre of a tertiary care centre. Participants 15 women with a personal history of breast cancer or an increased risk of breast cancer who reported at least one daily hot flash. Interventions Gabapentin 900 mg daily in three divided doses (control) compared with standardised hypnotherapy. Participation lasted 8 weeks. Outcome measures The primary endpoints were the number of daily hot flashes and hot flash severity score (HFSS). The secondary endpoint was the Hot Flash Related Daily Interference Scale (HFRDIS). Results 27 women were randomised and 15 (56%) were considered evaluable for the primary endpoint (n=8 gabapentin, n=7 hypnotherapy). The median number of daily hot flashes at enrolment was 4.5 in the gabapentin arm and 5 in the hypnotherapy arm. HFSS scores were 7.5 in the gabapentin arm and 10 in the hypnotherapy arm. After 8 weeks, the median number of daily hot flashes was reduced by 33.3% in the gabapentin arm and by 80% in the hypnotherapy arm. The median HFSS was reduced by 33.3% in the gabapentin arm and by 85% in the hypnotherapy arm. HFRDIS scores improved by 51.6% in the gabapentin group and by 55.2% in the hypnotherapy group. There were no statistically significant differences between groups. Conclusions Hypnotherapy and gabapentin demonstrate efficacy in improving hot flashes. A definitive trial evaluating traditional interventions against CAM methods is feasible, but not without challenges. Further studies aimed at defining evidence-based recommendations for CAM are necessary. Trial registration clinicaltrials.gov (NCT00711529). PMID:24022390

  1. Comparative analysis of traditional and modern apricot breeding programs: A case of study with Spanish and Tunisian apricot breeding germplasm

    Directory of Open Access Journals (Sweden)

    Mohamed A. Batnini

    2016-08-01

    Full Text Available Traditional plant breeding is based on the observation of variation and the selection of the best phenotypes, whereas modern breeding is characterised by the use of controlled mating and the selection of descendants using molecular markers. In this work, a comparative analysis of genetic diversity in a traditional (Tunisian and a modern (Spanish apricot breeding programme was performed at the phenotypic and molecular level using simple sequence repeat (SSR markers. Seven phenotypic traits were evaluated in 42 Tunisian apricot accessions and 30 genotypes from the Spanish apricot programme. In addition, 20 SSR markers previously described as linked to specific phenotypic traits were assayed. Results showed that modern breeding using controlled crosses increases the size of the fruit. The fruit weight average observed in the Tunisian cultivars was of 20.15 g. In the case of traditional Spanish cultivars the average weight was 47.12 g, whereas the average weight of the other progenitors from France, USA and South Africa was 72.85 g. Finally, in the new releases from the CEBAS-CSIC breeding programme, the average weight was 72.82 g. In addition, modern bred cultivars incorporate desirable traits such as self-compatibility and firmness. Cluster and structural analysis based on SSR data clearly differentiates the genotypes according to their geographic origin and pedigree. Finally, results showed an association between some alleles of PaCITA7 and UDP96003 SSR markers with apricot fruit weight, one allele of UDAp407 marker with fruit firmness and one allele of UDP98406 marker with fruit ripening.

  2. Comparative analysis of traditional and modern apricot breeding programs: A case of study with Spanish and Tunisian apricot breeding germplasm

    Energy Technology Data Exchange (ETDEWEB)

    Batnini, M.A.; Krichen, L.; Bourguiba, H.; Trifi-Farah, N.; Ruiz, D.; Martínez-Gómez, P.; Rubio, M.

    2016-11-01

    Traditional plant breeding is based on the observation of variation and the selection of the best phenotypes, whereas modern breeding is characterised by the use of controlled mating and the selection of descendants using molecular markers. In this work, a comparative analysis of genetic diversity in a traditional (Tunisian) and a modern (Spanish) apricot breeding programme was performed at the phenotypic and molecular level using simple sequence repeat (SSR) markers. Seven phenotypic traits were evaluated in 42 Tunisian apricot accessions and 30 genotypes from the Spanish apricot programme. In addition, 20 SSR markers previously described as linked to specific phenotypic traits were assayed. Results showed that modern breeding using controlled crosses increases the size of the fruit. The fruit weight average observed in the Tunisian cultivars was of 20.15 g. In the case of traditional Spanish cultivars the average weight was 47.12 g, whereas the average weight of the other progenitors from France, USA and South Africa was 72.85 g. Finally, in the new releases from the CEBAS-CSIC breeding programme, the average weight was 72.82 g. In addition, modern bred cultivars incorporate desirable traits such as self-compatibility and firmness. Cluster and structural analysis based on SSR data clearly differentiates the genotypes according to their geographic origin and pedigree. Finally, results showed an association between some alleles of PaCITA7 and UDP96003 SSR markers with apricot fruit weight, one allele of UDAp407 marker with fruit firmness and one allele of UDP98406 marker with fruit ripening. (Author)

  3. Comparative studies on Indian traditional nanomedicine Yashadha Bhasma and zinc oxide nanoparticles for anti-diabetic activity

    Science.gov (United States)

    Durgalakshmi, D.; Ajay Rakkesh, R.; Bhargavi Ram, T.; Balakumar, S.

    2017-07-01

    Diabetes mellitus is the most common endocrine disorder due to carbohydrate metabolism. Also, zinc and its supplements have been used in Indian traditional medicines for treating urinary tract infections. In this work, an attempt has been made to compare the properties of ‘Yashadha Bhasma’ a traditional ayurvedic ZnO supplement for diabetic treatment with the laboratory-synthesized ZnO nanoparticles. The nano-sized ZnO particles are synthesized using co-precipitation method and calcined at 400 °C for further purification. Confirmation of ZnO and presence of Ca and K elements additional to Zn in Yashadha Bhasma is confirmed from XPS. The morphology of ZnO is found to be spherical with average diameter of 15 nm. TEM results show that ZnO rods of Yashadha Bhasma are porous and non-uniform. Glucose degradation studies revealed good performance with ZnO nanoparticles with 80% degradation occurring within 15 min itself. Antibacterial studies also performed well establishing efficacy of ZnO nanoparticles against both gram-positive and gram-negative bacterial strains, thereby establishing suitable material for treating diabetes mellitus and also curing bacterial wound infections arising due to diabetes mellitus.

  4. Comparing the Microsoft Kinect to a traditional mouse for adjusting the viewed tissue densities of three-dimensional anatomical structures

    Science.gov (United States)

    Juhnke, Bethany; Berron, Monica; Philip, Adriana; Williams, Jordan; Holub, Joseph; Winer, Eliot

    2013-03-01

    Advancements in medical image visualization in recent years have enabled three-dimensional (3D) medical images to be volume-rendered from magnetic resonance imaging (MRI) and computed tomography (CT) scans. Medical data is crucial for patient diagnosis and medical education, and analyzing these three-dimensional models rather than two-dimensional (2D) slices would enable more efficient analysis by surgeons and physicians, especially non-radiologists. An interaction device that is intuitive, robust, and easily learned is necessary to integrate 3D modeling software into the medical community. The keyboard and mouse configuration does not readily manipulate 3D models because these traditional interface devices function within two degrees of freedom, not the six degrees of freedom presented in three dimensions. Using a familiar, commercial-off-the-shelf (COTS) device for interaction would minimize training time and enable maximum usability with 3D medical images. Multiple techniques are available to manipulate 3D medical images and provide doctors more innovative ways of visualizing patient data. One such example is windowing. Windowing is used to adjust the viewed tissue density of digital medical data. A software platform available at the Virtual Reality Applications Center (VRAC), named Isis, was used to visualize and interact with the 3D representations of medical data. In this paper, we present the methodology and results of a user study that examined the usability of windowing 3D medical imaging using a Kinect™ device compared to a traditional mouse.

  5. A Randomized Trial Comparing Didactics, Demonstration, and Simulation for Teaching Teamwork to Medical Residents

    Science.gov (United States)

    Keriwala, Raj D.; Clune, Jennifer K.; Rice, Todd W.; Pugh, Meredith E.; Wheeler, Arthur P.; Miller, Alison N.; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A.

    2015-01-01

    Rationale: Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. Objectives: In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. Methods: This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel “Recognize, Respond, Reassess” score. Measurements and Main Results: Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs2] = 0.267, P didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities. PMID:25730661

  6. Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.

    Science.gov (United States)

    Müller, Kai Ivar; Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

    2016-05-30

    The feasibility of telemedicine in diagnosing and treating nonacute headaches, such as primary headaches (migraine and tension-type) and medication-overuse headaches has not been previously investigated. By eliminating the need of travel to specialists, telemedicine may offer significant time and money savings. Our objective was to estimate the acceptance of telemedicine and investigate the feasibility and cost savings of telemedicine consultations in diagnosing and treating nonacute headaches. From September 2012 to March 2015, nonacute headache patients from Northern Norway who were referred to neurologists through an electronic application system were consecutively screened and randomized to participate in either telemedicine or traditional specialist visits. All patients were consulted by two neurologists at the neurological department in Tromsø University Hospital. Feasibility outcomes were compared between telemedicine and traditional groups. Baseline characteristics and costs were then compared between rural and urban patients. Travel costs were calculated by using the probabilistic method of the Norwegian traveling agency: the cheapest means of public transport for each study participant. Loss of pay was calculated based on the Norwegian full-time employee's average salary: 3.5 hours spent on travel and consultation=one day's salary. Distance and time spent on travel were estimated by using Google Maps. Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not statistically

  7. Personal digital assistants are comparable to traditional diaries for dietary self-monitoring during a weight loss program.

    Science.gov (United States)

    Yon, Bethany A; Johnson, Rachel K; Harvey-Berino, Jean; Gold, Beth Casey; Howard, Alan B

    2007-04-01

    Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (pself-monitoring that is fitting to their lifestyle and skills.

  8. Comparative Study Between the Two Experimental Design Approaches Taguchi and Traditional in Presence of Control by Control Interactions

    Directory of Open Access Journals (Sweden)

    Arias-Nava Elías Heriberto

    2015-03-01

    Full Text Available Design of experiments plays an important role in the field of creating and innovating process and products directly in manufacturing and improving areas. There are several areas into designs of experiments; robust design is one of them. Robust parameter design is a principle that emphasize in products creation through a correct selection of values called “control” which make a product robust to the variability by the noise introducing by another factors known as “noise” factors. This article aims for a comparative study between two well-known robust design methodologies, making a special emphasis in the control by control interaction effects over optimal operating conditions. The results showed that Taguchi´s crossed arrays are unable to estimate all significant terms in a model. The optimizations result concludes that the Taguchi´s approach is less efficient than the traditional approach in both; maximization and minimization.

  9. A Comparative Effectiveness Education Trial for Lifestyle Health Behavior Change in African Americans

    Science.gov (United States)

    Halbert, Chanita Hughes; Bellamy, Scarlett; Briggs, Vanessa; Delmoor, Ernestine; Purnell, Joseph; Rogers, Rodney; Weathers, Benita; Johnson, Jerry C.

    2017-01-01

    Obesity and excess weight are significant clinical and public health issues that disproportionately affect African Americans because of physical inactivity and unhealthy eating. We compared the effects of alternate behavioral interventions on obesity-related health behaviors. We conducted a comparative effectiveness education trial in a…

  10. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); E.J. Topol (Eric); R.M. Califf (Robert); F.J.J. van de Werf (Frans); P.W. Armstrong (Paul); P.E. Aylward (Philip Edmund); G.I. Barbash; E.R. Bates (Eric); A. Betriu; J.H. Chesebro (James); J.J. Col (Jacques); D.P. de Bono (David); J.M. Gore (Joel); A.D. Guerci (Alan); J.R. Hampton (John)

    1993-01-01

    textabstractBACKGROUND: The relative efficacy of streptokinase and tissue plasminogen activator and the roles of intravenous as compared with subcutaneous heparin as adjunctive therapy in acute myocardial infarction are unresolved questions. The current trial was designed to compare new, aggressive

  11. Comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: a randomized trial

    Science.gov (United States)

    Background: Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis. Objective: To compare Tai Chi with standard physical therapy f...

  12. A Comparative Study on the Motivation and Attitudes of Language Learners of Online Distance and Traditional in-Classroom Education

    Directory of Open Access Journals (Sweden)

    Gulten GENC

    2016-10-01

    Full Text Available In recent years, the increase in the use of computer and the internet has led to a change in the traditional concept of formal education today. Distance learning as a more student-centered system has been frequently used at universities. In this context, education has been applied to the individuals consisting of all age groups in accordance with their aspirations, expectations and interest in a more flexible way. This study aims to determine and compare the motivation and attitudes of language learners of online distance and traditional in-classroom education, in a state university in Turkey. Participants were 500 undergraduate university students in various disciplines. About 250 (half of the participants studied English as a foreign language through traditional in-classroom education whereas the rest of the participants (250 studied English through online distance education in the same university by the same instructors. Two questionnaires (one to evaluate motivation level and one to evaluate attitudes of the participants related to English as a foreign language and a background information form investigating individual information of the participants were used to collect data from the students of nine faculties at the University (including Faculty of Dentistry, Faculty of Pharmacy, Faculty of Education, Faculty of Arts and Sciences, Faculty of Fine Arts and Design, Faculty of Law, Faculty of Economics and Administrative Sciences, Faculty of Engineering, and Faculty of Medicine. According to the nature of the research, the study used descriptive statistics (frequencies, range, means, and standard deviations, t-test and ANOVA as the statistical analysis methods. All collected data were coded and computerized using the SPSS software and the alpha level for the tests was set at .05. After calculating each participant’s motivation and attitudes scores, their scores were compared to the variables selected for the study and each other. The

  13. Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

    Directory of Open Access Journals (Sweden)

    Gabriel O. L. Carapeba

    2016-01-01

    Full Text Available The purpose of this study was to compare the efficacy of the intra-articular (IA hyaluronic acid injection to traditional conservative treatment (TCT in dogs with osteoarthritis (OA induced by hip dysplasia. Sixteen dogs were distributed into two groups: Hyal: IA injection of hyaluronic acid (5–10 mg, and Control: IA injection with saline solution (0.5–1.0 mL in combination with a TCT using an oral nutraceutical (750–1000 mg every 12 h for 90 days and carprofen (2.2 mg/kg every 12 h for 15 days. All dogs were assessed by a veterinarian on five occasions and the owner completed an assessment form (HCPI and CPBI at the same time. The data were analyzed using unpaired t test, ANOVA, and Tukey’s test (P<0.05. Compared with baseline, lower scores were observed in both groups over the 90 days in the veterinarian evaluation, HCPI, and CPBI (P<0.001. The Hyal group exhibited lower scores from 15 to 90 and 60 to 90 days, in the CBPI and in the veterinarian evaluation, respectively, compared to the Control group. Both treatments reduced the clinical signs associated with hip OA. However, more significant results were achieved with intra-articular hyaluronic acid injection.

  14. Clinical Efficacy of Traditional Chinese Medicine, Suan Zao Ren Tang, for Sleep Disturbance during Methadone Maintenance: A Randomized, Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    Chan, Yuan-Yu; Chen, Yi-Hung; Yang, Szu-Nian; Lo, Wan-Yu; Lin, Jaung-Geng

    2015-01-01

    Methadone maintenance therapy is an effective treatment for opiate dependence, but more than three-quarters of persons receiving the treatment report sleep quality disturbances. In this double-blind, randomized, controlled trial, we recruited 90 individuals receiving methadone for at least one month who reported sleep disturbances and had Pittsburgh Sleep Quality Index (PSQI) scores > 5. The purpose of this study was to determine whether Suan Zao Ren Tang, one of the most commonly prescribed traditional Chinese medications for treatment of insomnia, improves subjective sleep among methadone-maintained persons with disturbed sleep quality. Ninety patients were randomly assigned to intervention group (n = 45) and placebo group (n = 45), and all participants were analyzed. Compared with placebo treatment, Suan Zao Ren Tang treatment for four weeks produced a statistically significant improvement in the mean total PSQI scores (P = 0.007) and average sleep efficiency (P = 0.017). All adverse events (e.g., lethargy, diarrhea, and dizziness) were mild in severity. Suan Zao Ren Tang is effective for improving sleep quality and sleep efficiency among methadone-maintained patients with sleep complaints. PMID:26346534

  15. Clinical Efficacy of Traditional Chinese Medicine, Suan Zao Ren Tang, for Sleep Disturbance during Methadone Maintenance: A Randomized, Double-Blind, Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Yuan-Yu Chan

    2015-01-01

    Full Text Available Methadone maintenance therapy is an effective treatment for opiate dependence, but more than three-quarters of persons receiving the treatment report sleep quality disturbances. In this double-blind, randomized, controlled trial, we recruited 90 individuals receiving methadone for at least one month who reported sleep disturbances and had Pittsburgh Sleep Quality Index (PSQI scores > 5. The purpose of this study was to determine whether Suan Zao Ren Tang, one of the most commonly prescribed traditional Chinese medications for treatment of insomnia, improves subjective sleep among methadone-maintained persons with disturbed sleep quality. Ninety patients were randomly assigned to intervention group (n=45 and placebo group (n=45, and all participants were analyzed. Compared with placebo treatment, Suan Zao Ren Tang treatment for four weeks produced a statistically significant improvement in the mean total PSQI scores (P=0.007 and average sleep efficiency (P=0.017. All adverse events (e.g., lethargy, diarrhea, and dizziness were mild in severity. Suan Zao Ren Tang is effective for improving sleep quality and sleep efficiency among methadone-maintained patients with sleep complaints.

  16. Additive Effect of Qidan Dihuang Grain, a Traditional Chinese Medicine, and Angiotensin Receptor Blockers on Albuminuria Levels in Patients with Diabetic Nephropathy: A Randomized, Parallel-Controlled Trial

    Science.gov (United States)

    Xiang, Lei; Jiang, Pingping; Zhou, Lin; Sun, Xiaomin; Bi, Jianlu; Cui, Lijuan; Nie, Xiaoli; Luo, Ren; Liu, Yanyan

    2016-01-01

    Albuminuria is characteristic of early-stage diabetic nephropathy (DN). The conventional treatments with angiotensin receptor blockers (ARB) are unable to prevent the development of albuminuria in normotensive individuals with type 2 diabetes mellitus (T2DM). Purpose. The present study aimed to evaluate the effect of ARB combined with a Chinese formula Qidan Dihuang grain (QDDHG) in improving albuminuria and Traditional Chinese Medicine Symptom (TCMS) scores in normotensive individuals with T2DM. Methods. Eligible patients were randomized to the treatment group and the control group. Results. Compared with baseline (week 0), both treatment and control groups markedly improved the 24-hour albuminuria, total proteinuria (TPU), and urinary albumin to creatinine ratio (A/C) at 4, 8, and 12 weeks. Between treatment and the control group, the levels of albuminuria in the treatment group were significantly lower than in the control group at 8 and 12 weeks (p < 0.05). In addition, treatment group markedly decreased the scores of TCMS after treatment. Conclusion. This trial suggests that QDDHG combined with ARB administration decreases the levels of albuminuria and the scores for TCMS in normotensive individuals with T2DM. PMID:27375762

  17. A Randomized Controlled Trial on the Effectiveness of Court-Type Traditional Thai Massage versus Amitriptyline in Patients with Chronic Tension-Type Headache

    Directory of Open Access Journals (Sweden)

    Peerada Damapong

    2015-01-01

    Full Text Available This study aimed to evaluate the effectiveness of the court-type traditional Thai massage (CTTM to treat patients with chronic tension-type headaches (CTTHs comparing with amitriptyline taking. A randomized controlled trial was conducted. Sixty patients diagnosed with CTTH were equally divided into a treatment and a control group. The treatment group received a 45-minute course of CTTM twice per week lasting 4 weeks while the control group was prescribed 25 mg of amitriptyline once a day before bedtime lasting 4 weeks. Outcome measures were evaluated in week 2, week 4 and followed up in week 6 consisting of visual analog scale (VAS, tissue hardness, pressure pain threshold (PPT, and heart rate variability (HRV. The results demonstrated a significant decrease in VAS pain intensity for the CTTM group at different assessment time points while a significant difference occurred in within-group and between-group comparison (P < 0.05 for each evaluated measure. Moreover, the tissue hardness of the CTTM group was significantly lower than the control group at week 4 (P < 0.05. The PPT and HRV of the CTTM group were significantly increased (P < 0.05. CTTM could be an alternative therapy for treatment of patients with CTTHs.

  18. A traditional Chinese herbal formula improves pressure ulcers in paraplegic patients: A randomized, parallel-group, retrospective trial.

    Science.gov (United States)

    Liu, Xin; Meng, Qingxi; Song, Hua; Zhao, Tingbao

    2013-06-01

    In this study, the efficacy of a novel Chinese herbal formula, cure rot and flat sore ointment (CRFSO), in the management of stage IV pressure ulcers, and the effect of simultaneous comprehensive rehabilitation in improving the outcome were evaluated. A total of 35 paraplegic patients with stage IV pressure ulcers who underwent reconstruction and inpatient rehabilitation from January 2004 to September 2010 were included in the study. Arnebia root oil (ARO) was used on 16 patients with 11 ulcers (stage IV). The remaining 19 patients with 20 ulcers (stage IV) received a traditional Chinese herbal formula (CRFSO). After 28 days of treatment, the wound healing results, in particular, the healing rate, effectiveness rate, improvement rate and no response rate were evaluated. Six patients from the ARO group sought other types of therapy due to their own consideration of poor efficacy. After 28 days of treatment, the wound healing result and no response rate demonstrated a statistically significant difference (P<0.005) between the two groups, suggesting that the novel Chinese herbal formula is an effective treatment for pressure sores in paraplegic patients. All outcome variables demonstrated significant improvement in the CRFSO group compared with the ARO group after 28 days of treatment, with a higher healing rate (85% in the CRFSO group and 45.45% in the ARO group) and lower no response rate (5% in the CRFSO group and 18.18% in the ARO group). The traditional Chinese herbal formula improved pressure sores in paraplegic patients effectively and inpatient rehabilitation was also significantly improved.

  19. Offending and Victimization in the Digital Age : Comparing Correlates of Cybercrime and Traditional Offending-Only, Victimization-Only and the Victimization-Offending Overlap

    NARCIS (Netherlands)

    Kranenbarg, Marleen Weulen; Holt, Thomas J.; van Gelder, Jean Louis

    2017-01-01

    Cybercrime research suggests that, analogous to traditional crime, victims are more likely to be offenders. This overlap could be caused by shared risk factors, but it is unclear if these are comparable to traditional risk factors. Utilizing a high risk sample of computer-dependent cyber-offenders

  20. Meta-analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis.

    Science.gov (United States)

    Wang, Shijun; Tang, Qiaofei; Qian, Wei; Fan, Yu

    2012-05-01

    Chinese herbal medicine (CHM) has been used for the prevention and treatment of persistent allergic rhinitis (PAR), but results are still equivocal. This study was to assess the clinical effectiveness of CHM in patients with PAR. Databases searched included articles published in the Cochrane library, MEDLINE, EMBASE, China National Knowledge Infrastructure, and Wanfang database from 1999 to 2011. The studies included were randomized controlled trials (RCTs) comparing CHM to placebo if they included patients with PAR. The main outcomes were the changes in the standardized mean difference (SMD) of nasal symptom scores and total serum IgE level. Methodological quality was assessed by the modified Jadad's scale. Seven RCTs with 533 patients were identified and analyzed. In the meta-analysis, CHM reduced the total nasal symptom scores compared to placebo (SMD, -1.82; 95% confidence interval [CI], -3.03 to -0.62; P = 0.003). The effect estimate was in favor of the CHM intervention (SMD, -1.09; 95% CI, -2.74 to 0.55) in reducing the total serum IgE level, although this was not significant (P = 0.19). CHM interventions appear to have beneficial effects in patients with PAR. However, the published efficacy studies are too small to draw firm conclusion. © 2012 John Wiley & Sons A/S.

  1. Traditional knowledge of wild edible plants used in the northwest of the Iberian Peninsula (Spain and Portugal: a comparative study

    Directory of Open Access Journals (Sweden)

    Lastra Juan

    2007-06-01

    Full Text Available Abstract Background We compare traditional knowledge and use of wild edible plants in six rural regions of the northwest of the Iberian Peninsula as follows: Campoo, Picos de Europa, Piloña, Sanabria and Caurel in Spain and Parque Natural de Montesinho in Portugal. Methods Data on the use of 97 species were collected through informed consent semi-structured interviews with local informants. A semi-quantitative approach was used to document the relative importance of each species and to indicate differences in selection criteria for consuming wild food species in the regions studied. Results and discussion The most significant species include many wild berries and nuts (e.g. Castanea sativa, Rubus ulmifolius, Fragaria vesca and the most popular species in each food-category (e.g. fruits or herbs used to prepare liqueurs such as Prunus spinosa, vegetables such as Rumex acetosa, condiments such as Origanum vulgare, or plants used to prepare herbal teas such as Chamaemelum nobile. The most important species in the study area as a whole are consumed at five or all six of the survey sites. Conclusion Social, economic and cultural factors, such as poor communications, fads and direct contact with nature in everyday life should be taken into account in determining why some wild foods and traditional vegetables have been consumed, but others not. They may be even more important than biological factors such as richness and abundance of wild edible flora. Although most are no longer consumed, demand is growing for those regarded as local specialties that reflect regional identity.

  2. The comparative analysis of rocks' resistance to forward-slanting disc cutters and traditionally installed disc cutters

    Science.gov (United States)

    Zhang, Zhao-Huang; Fei, Sun; Liang, Meng

    2016-08-01

    At present, disc cutters of a full face rock tunnel boring machine are mostly mounted in the traditional way. Practical use in engineering projects reveals that this installation method not only heavily affects the operation life of disc cutters, but also increases the energy consumption of a full face rock tunnel boring machine. To straighten out this issue, therefore, a rock-breaking model is developed for disc cutters' movement after the research on the rock breaking of forward-slanting disc cutters. Equations of its displacement are established based on the analysis of velocity vector of a disc cutter's rock-breaking point. The functional relations then are brought forward between the displacement parameters of a rock-breaking point and its coordinate through the analysis of micro displacement of a rock-breaking point. Thus, the geometric equations of rock deformation are derived for the forward-slanting installation of disc cutters. With a linear relationship remaining between the acting force and its deformation either before or after the leap breaking, the constitutive relation of rock deformation can be expressed in the form of generalized Hooke law, hence the comparative analysis of the variation in the resistance of rock to the disc cutters mounted in the forward-slanting way with that in the traditional way. It is discovered that with the same penetration, strain of the rock in contact with forward-slanting disc cutters is apparently on the decline, in other words, the resistance of rock to disc cutters is reduced. Thus wear of disc cutters resulted from friction is lowered and energy consumption is correspondingly decreased. It will be useful for the development of installation and design theory of disc cutters, and significant for the breakthrough in the design of full face rock tunnel boring machine.

  3. The value of adding transcutaneous neuromuscular electrical stimulation (VitalStim) to traditional therapy for post-stroke dysphagia: a randomized controlled trial.

    Science.gov (United States)

    Li, L; Li, Y; Huang, R; Yin, J; Shen, Y; Shi, J

    2015-02-01

    Dysphagia is not uncommon after stroke. Dysphagia may delay the functional recovery and substantially affects the quality of life after stroke, mainly if lest untreated. To detect and treat dysphagia as early as possible is critical for patients' recovery after stroke. Electrical stimulation has been reported as a treatment for pharyngeal dysphagia in recent studies, but the therapeutic effects of neuromuscular electrical stimulation (VitalStim®) therapy lacks convincing supporting evidence, needs further clinical investigation. To investigate the effects of neuromuscular electrical stimulation (VitalStim®) and traditional swallowing therapy on recovery of swallowing difficulties after stroke. Randomized controlled trial. University hospital. 135 stroke patients who had a diagnosis of dysphagia at the age between 50-80. 135 subjects were randomly divided into three groups: traditional swallowing therapy (N. = 45), VitalStim® therapy (N. = 45), and VitalStim® therapy plus traditional swallowing therapy (N. = 45). The traditional swallowing therapy included basic training and direct food intake training. Electrical stimulation was applied by an occupational therapist, using a modified hand-held battery-powered electrical stimulator (VitalStim® Dual Channel Unit and electrodes, Chattanooga Group, Hixson, TN, USA). Surface electromyography (sEMG), the Standardized Swallowing Assessment (SSA), Videofluoroscopic Swallowing Study (VFSS) and visual analog scale (VAS) were used to assess swallowing function before and 4 weeks after the treatment. The study included 118 subjects with dysphagia, 40 in the traditional swallowing therapy group and VitalStim® therapy group, 38 in the VitalStim and traditional swallowing therapy group. There were significant differences in sEMG value, SSA and VFSS scores in each group after the treatment (P VitalStim® and traditional swallowing therapy group than the other two groups (P VitalStim® therapy coupled with traditional

  4. Comparative analysis of energy impacts of traditional and partly electronic environmental auditing: learning from the Japanese automotive industry case

    Directory of Open Access Journals (Sweden)

    Charles Mbohwa

    2008-04-01

    Full Text Available This paper does a comparative analysis and assessment of energy impacts of traditional and partly electronic ISO 14001 environmental management system auditing that using videoconferencing systems. The focus is on the Japanese automotive industry. The idea is to quantify the environmental impacts of auditing and resolve the important question on whether or not the use of information and communication technology (ICT in environmental auditing reduces environmental impacts in ISO 14001 environmental management systems. The main results show that there are no clear energy savings or environmental advantages associated with ICT use in environmental auditing for the set system boundary. However electronic auditing is shown to have clear advantages for stated variables within the model, for example when the distance travelled by the auditors by train and by car is less than 75 km and 17 km per day respectively. A comparison of modes of travel by auditors, shows that rail travel offers the most environmental and energy benefits. It is also noted that travel dominates in terms of energy consumption and environmental burdens compared to all other environmental aspects associated with auditing. The study contributes to knowledge in that among other things, it enables researchers to draw parallels from it applicable to other industrial sectors and other countries. Southern African countries can use this methodology in analysing auditing methods with little or no changes in the model used.

  5. Clinical Trials

    Medline Plus

    Full Text Available ... questions and clinical trials. Optimizing our Clinical Trials Enterprise NHLBI has a strong tradition of supporting clinical ... multi-pronged approach to Optimize our Clinical Trials Enterprise that will make our clinical trials enterprise even ...

  6. A prospective randomized controlled multicenter trial comparing antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis (APPAC trial).

    Science.gov (United States)

    Paajanen, Hannu; Grönroos, Juha M; Rautio, Tero; Nordström, Pia; Aarnio, Markku; Rantanen, Tuomo; Hurme, Saija; Dean, Kirsti; Jartti, Airi; Mecklin, Jukka-Pekka; Sand, Juhani; Salminen, Paulina

    2013-02-08

    Although the standard treatment of acute appendicitis (AA) consists of an early appendectomy, there has recently been both an interest and an increase in the use of antibiotic therapy as the primary treatment for uncomplicated AA. However, the use of antibiotic therapy in the treatment of uncomplicated AA is still controversial. The APPAC trial is a randomized prospective controlled, open label, non-inferiority multicenter trial designed to compare antibiotic therapy (ertapenem) with emergency appendectomy in the treatment of uncomplicated AA. The primary endpoint of the study is the success of the randomized treatment. In the antibiotic treatment arm successful treatment is defined as being discharged from the hospital without the need for surgical intervention and no recurrent appendicitis during a minimum follow-up of one-year (treatment efficacy). Treatment efficacy in the operative treatment arm is defined as successful appendectomy evaluated to be 100%. Secondary endpoints are post-intervention complications, overall morbidity and mortality, the length of hospital stay and sick leave, treatment costs and pain scores (VAS, visual analoque scale). A maximum of 610 adult patients (aged 18-60 years) with a CT scan confirmed uncomplicated AA will be enrolled from six hospitals and randomized by a closed envelope method in a 1:1 ratio either to undergo emergency appendectomy or to receive ertapenem (1 g per day) for three days continued by oral levofloxacin (500 mg per day) plus metronidazole (1.5 g per day) for seven days. Follow-up by a telephone interview will be at 1 week, 2 months and 1, 3, 5 and 10 years; the primary and secondary endpoints of the trial will be evaluated at each time point. The APPAC trial aims to provide level I evidence to support the hypothesis that approximately 75-85% of patients with uncomplicated AA can be treated with effective antibiotic therapy avoiding unnecessary appendectomies and the related operative morbidity, also resulting

  7. Audio computer-assisted self interview compared to traditional interview in an HIV-related behavioral survey in Vietnam.

    Science.gov (United States)

    Le, Linh Cu; Vu, Lan T H

    2012-10-01

    Globally, population surveys on HIV/AIDS and other sensitive topics have been using audio computer-assisted self interview for many years. This interview technique, however, is still new to Vietnam and little is known about its application and impact in general population surveys. One plausible hypothesis is that residents of Vietnam interviewed using this technique may provide a higher response rate and be more willing to reveal their true behaviors than if interviewed with traditional methods. This study aims to compare audio computer-assisted self interview with traditional face-to-face personal interview and self-administered interview with regard to rates of refusal and affirmative responses to questions on sensitive topics related to HIV/AIDS. In June 2010, a randomized study was conducted in three cities (Ha Noi, Da Nan and Can Tho), using a sample of 4049 residents aged 15 to 49 years. Respondents were randomly assigned to one of three interviewing methods: audio computer-assisted self interview, personal face-to-face interview, and self-administered paper interview. Instead of providing answers directly to interviewer questions as with traditional methods, audio computer-assisted self-interview respondents read the questions displayed on a laptop screen, while listening to the questions through audio headphones, then entered responses using a laptop keyboard. A MySQL database was used for data management and SPSS statistical package version 18 used for data analysis with bivariate and multivariate statistical techniques. Rates of high risk behaviors and mean values of continuous variables were compared for the three data collection methods. Audio computer-assisted self interview showed advantages over comparison techniques, achieving lower refusal rates and reporting higher prevalence of some sensitive and risk behaviors (perhaps indication of more truthful answers). Premarital sex was reported by 20.4% in the audio computer-assisted self-interview survey

  8. Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background It is becoming increasingly necessary for community health centers to make rehabilitation services available to patients with osteoarthritis of the knee. However, for a number of reasons, including a lack of expertise, the small size of community health centers and the availability of only simple medical equipment, conventional rehabilitation therapy has not been widely used in China. Consequently, most patients with knee osteoarthritis seek treatment in high-grade hospitals. However, many patients cannot manage the techniques that they were taught in the hospital. Methods such as acupuncture, tuina, Chinese medical herb fumigation-washing and t’ai chi are easy to do and have been reported to have curative effects in those with knee osteoarthritis. To date, there have been no randomized controlled trials validating comprehensive traditional Chinese medicine for the rehabilitation of knee osteoarthritis in a community health center. Furthermore, there is no standard rehabilitation protocol using traditional Chinese medicine for knee osteoarthritis. The aim of the current study is to develop a comprehensive rehabilitation protocol using traditional Chinese medicine for the management of knee osteoarthritis in a community health center. Method/design This will be a randomized controlled clinical trial with blinded assessment. There will be a 4-week intervention utilizing rehabilitation protocols from traditional Chinese medicine and conventional therapy. Follow-up will be conducted for a period of 12 weeks. A total of 722 participants with knee osteoarthritis will be recruited. Participants will be randomly divided into two groups: experimental and control. Primary outcomes will include range of motion, girth measurement, the visual analogue scale, and results from the manual muscle, six-minute walking and stair-climbing tests. Secondary outcomes will include average daily consumption of pain medication, ability to perform daily tasks and health

  9. Economic evaluation of the randomized European Achalasia trial comparing pneumodilation with Laparoscopic Heller myotomy

    NARCIS (Netherlands)

    Moonen, A.; Busch, O.; Costantini, M.; Finotti, E.; Tack, J.; Salvador, R.; Boeckxstaens, G.; Zaninotto, G.

    2017-01-01

    BackgroundA recent multicenter randomized trial in achalasia patients has shown that pneumatic dilation resulted in equivalent relief of symptoms compared to laparoscopic Heller myotomy. Additionally, the cost of each treatment should be also taken in consideration. Therefore, the aim of the present

  10. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears : a randomized controlled trial

    NARCIS (Netherlands)

    Lambers Heerspink, Okke; van Raay, Jos J. A. M.; Koorevaar, Rinco C. T.; van Eerden, Pepijn J. M.; Westerbeek, Robin E.; van 't Riet, Esther; van den Akker-Scheek, Inge; Diercks, Ronald L.

    Background: Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff

  11. Comparative Genomics of Acetobacterpasteurianus Ab3, an Acetic Acid Producing Strain Isolated from Chinese Traditional Rice Vinegar Meiguichu.

    Science.gov (United States)

    Xia, Kai; Li, Yudong; Sun, Jing; Liang, Xinle

    2016-01-01

    Acetobacter pasteurianus, an acetic acid resistant bacterium belonging to alpha-proteobacteria, has been widely used to produce vinegar in the food industry. To understand the mechanism of its high tolerance to acetic acid and robust ability of oxidizing ethanol to acetic acid (> 12%, w/v), we described the 3.1 Mb complete genome sequence (including 0.28 M plasmid sequence) with a G+C content of 52.4% of A. pasteurianus Ab3, which was isolated from the traditional Chinese rice vinegar (Meiguichu) fermentation process. Automatic annotation of the complete genome revealed 2,786 protein-coding genes and 73 RNA genes. The comparative genome analysis among A. pasteurianus strains revealed that A. pasteurianus Ab3 possesses many unique genes potentially involved in acetic acid resistance mechanisms. In particular, two-component systems or toxin-antitoxin systems may be the signal pathway and modulatory network in A. pasteurianus to cope with acid stress. In addition, the large numbers of unique transport systems may also be related to its acid resistance capacity and cell fitness. Our results provide new clues to understanding the underlying mechanisms of acetic acid resistance in Acetobacter species and guiding industrial strain breeding for vinegar fermentation processes.

  12. Does Feedback Design Matter? A Neurofeedback Study Comparing Immersive Virtual Reality and Traditional Training Screens in Elderly

    Directory of Open Access Journals (Sweden)

    Silvia Erika Kober

    2017-09-01

    Full Text Available Neurofeedback (NF is a Brain-Computer Interface (BCI application, in which the brain activity is fed back to the user in real-time enabling voluntary brain control. In this context, the significance of the feedback design is mainly unexplored. Highly immersive feedback scenarios using virtual reality (VR technique are available. However, their effects on subjective user experience as well as on objective outcome measures remain open. In the present article, we discuss the general pros and cons of using VR as feedback modality in BCI applications. Furthermore, we report on the results of an empirical study, in which the effects of traditional two-dimensional and three-dimensional VR based feedback scenarios on NF training performance and user experience in healthy older individuals and neurologic patients were compared. In conclusion, we suggest indications and contraindications of immersive VR feedback designs in BCI applications. Our results show that findings in healthy individuals are not always transferable to patient populations having an impact on serious game and feedback design.

  13. Sea state estimation from an advancing ship – A comparative study using sea trial data

    DEFF Research Database (Denmark)

    Nielsen, Ulrik Dam; Stredulinsky, David C.

    2012-01-01

    of a traditional wave rider buoy. The paper studies the ‘wave buoy analogy’, and a large set of full-scale motion measurements is considered. It is shown that the wave buoy analogy gives fairly accurate estimates of integrated sea state parameters when compared to corresponding estimates from real wave rider buoys...

  14. Albendazole versus praziquantel in the treatment of neurocysticercosis: a meta-analysis of comparative trials.

    Directory of Open Access Journals (Sweden)

    Dimitrios K Matthaiou

    Full Text Available BACKGROUND: Neurocysticercosis, infection of the brain with larvae of Taenia solium (pork tapeworm, is one of several forms of human cysticercosis caused by this organism. We investigated the role of albendazole and praziquantel in the treatment of patients with parenchymal neurocysticercosis by performing a meta-analysis of comparative trials of their effectiveness and safety. METHODS AND PRINCIPAL FINDINGS: We performed a search in the PubMed database, Cochrane Database of Controlled Trials, and in references of relevant articles. Six studies were included in the meta-analysis. Albendazole was associated with better control of seizures than praziquantel in the pooled data analysis, when the generic inverse variance method was used to combine the incidence of seizure control in the included trials (patients without seizures/[patients x years at risk] (156 patients in 4 studies, point effect estimate [incidence rate ratio] = 4.94, 95% confidence interval 2.45-9.98. In addition, albendazole was associated with better effectiveness than praziquantel in the total disappearance of cysts (335 patients in 6 studies, random effects model, OR = 2.30, 95% CI 1.06-5.00. There was no difference between albendazole and praziquantel in reduction of cysts, proportion of patients with adverse events, and development of intracranial hypertension due to the administered therapy. CONCLUSIONS: A critical review of the available data from comparative trials suggests that albendazole is more effective than praziquantel regarding clinically important outcomes in patients with neurocysticercosis. Nevertheless, given the relative scarcity of trials, more comparative interventional studies--especially randomized controlled trials--are required to draw a safe conclusion about the best regimen for the treatment of patients with parenchymal neurocysticercosis.

  15. Where on earth to publish? A sample survey comparing traditional and open access publishing in the oncological field.

    Science.gov (United States)

    Poltronieri, Elisabetta; Bravo, Elena; Camerini, Tiziana; Ferri, Maurizio; Rizzo, Roberto; Solimini, Renata; Cognetti, Gaetana

    2013-01-22

    The paper intends to help scientific authors to make the best choice of journals in which to publish, by describing and comparing journal features in the area of oncology. For this purpose, the authors identified impact factor (IF) ranking, cost options and copyright conditions offered to authors wishing to publish in full open access (OA), subscription-based or hybrid journals. Data referring to articles published in 2010 by three Italian research institutions (National Institute of Health - Rome (ISS), Regina Elena National Cancer Institute - Rome (IRE), National Cancer Institute - Milan (INT) in journals (78) managed according to different business models, all listed in the Journal Citation Reports, subject category Oncology, were collected and analysed. The journals surveyed were ranked according to IF, position in quartiles, publication charges, usage rights in published articles, self-archiving conditions in OAI-compliant repositories digital archives. Almost half (34) the journals surveyed were included in the first quartile, thus revealing authors' preference for journals with a high IF. The prevalent journal business model was the hybrid formula (based on subscriptions but also offering a paid OA option) with 51 journals, followed by subscription-based only journals accounting for 22, while just 5 full OA journals were identified. In general, no relationship was found between IF and article publication charges, in terms of correspondence between more expensive fees and higher IF. The issue of OA journals as compared with traditional subscription-based journals is highly debated among stakeholders: library administrators facing financial restrictions, authors seeking to locate the best outlet for their research, publishers wishing to increase their revenues by offering journals with wider appeal. Against this background, factors such as the quest for alternatives to high-cost business models, investments in setting up institutional repositories hosting the

  16. Traditional Knowledge and Social Science on Trial: Battles over Evidence in Indigenous Rights Litigation in Canada and Australia

    Directory of Open Access Journals (Sweden)

    Arthur J. Ray

    2015-05-01

    Full Text Available Traditional knowledge and oral traditions history are crucial lines of evidence in Aboriginal claims litigation and alternative forms of resolution, most notably claims commissions. This article explores the ways in which these lines of evidence pose numerous challenges in terms of how and where they can be presented, who is qualified to present it, questions about whether this evidence can stand on its own, and the problems of developing appropriate measures to protect it from inappropriate use by outsiders while not unduly restricting access by the traditional owners.

  17. Comparative effect of high pressure processing and traditional thermal treatment on the physicochemical, microbiology, and sensory analysis of olive jam

    Directory of Open Access Journals (Sweden)

    Delgado-Adamez, J.

    2013-09-01

    Full Text Available In the present work the effect of the processing by high hydrostatic pressures (HPP was assessed as an alternative to the thermal treatment of pasteurization in olive jam. The effects of both treatments on the product after processing were compared and stability during storage under refrigeration was assessed through the characterization of physicochemical, microbiological and sensory aspects. To assess the effect of processing, two HPP treatments (450 and 600MPa and thermal pasteurization (80 °C for 20 min were applied, comparing them with the unprocessed product. HPP 600MPa versus the rest of treatments showed a reduction in microorganisms, greater clarity and less browning, and sensory acceptance. The shelf-life of the refrigerated product would indicate the feasibility of the application of the HPP technology for food with similar shelf-life to that obtained with the traditional treatment of pasteurization, but with a better sensory quality.En el presente trabajo se valoró el efecto del procesado por altas presiones hidrostáticas (HPP como método alternativo al tratamiento térmico de pasteurización en la mermelada de aceitunas. Para ello se comparó el efecto de ambos tratamientos sobre el producto procesado y se evaluó su estabilidad durante el almacenamiento en refrigeración, mediante la caracterización de los aspectos físico-químicos, microbiológicos, y sensoriales. Para evaluar el efecto del procesado, se aplicaron dos tratamientos de HPP (450 y 600MPa y otro de pasteurización térmica (80 °C durante 20 min, comparándose con el producto no procesado. Las muestras tratadas con HPP 600MPa presentaron, frente al resto de tratamientos una reducción en la presencia de microorganismos, mayor claridad y menor pardeamiento, y una mayor aceptación sensorial. El estudio de la vida útil del producto en refrigeración, indicaría la viabilidad de la aplicación de la tecnología de HPP para obtener alimentos con vida útil similar

  18. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial.

    Science.gov (United States)

    Panahi, Yunes; Taghizadeh, Mohsen; Marzony, Eisa Tahmasbpour; Sahebkar, Amirhossein

    2015-01-01

    Rosmarinus officinalis L. is a medicinal plant with diverse activities including enhancement microcapillary perfusion. The present study aimed to investigate the clinical efficacy of rosemary oil in the treatment of androgenetic alopecia (AGA) and compare its effects with minoxidil 2%. Patients with AGA were randomly assigned to rosemary oil (n = 50) or minoxidil 2% (n = 50) for a period of 6 months. After a baseline visit, patients returned to the clinic for efficacy and safety evaluations every 3 months. A standardized professional microphotographic assessment of each volunteer was taken at the initial interview and after 3 and 6 months of the trial. No significant change was observed in the mean hair count at the 3-month endpoint, neither in the rosemary nor in the minoxidil group (P > .05). In contrast, both groups experienced a significant increase in hair count at the 6-month endpoint compared with the baseline and 3-month endpoint (P .05). The frequencies of dry hair, greasy hair, and dandruff were not found to be significantly different from baseline at either month 3 or month 6 trial in the groups (P > .05). The frequency of scalp itching at the 3- and 6-month trial points was significantly higher compared with baseline in both groups (P minoxidil group at both assessed endpoints (P < .05). The findings of the present trial provided evidence with respect to the efficacy of rosemary oil in the treatment of AGA.

  19. The Therapeutic Effects of a Traditional Chinese Medicine Formula Wuzi Yanzong Pill for the Treatment of Oligoasthenozoospermia: A Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Shi, Xiao; Kong, Grace Wing Shan; Wu, Justin Che Yuen; Li, Tin Chiu

    2018-01-01

    Oligoasthenozoospermia is a crucial factor in male infertility. Wuzi Yanzong (WZYZ) pill is a popular traditional Chinese medicine (TCM) formula which has been used for male infertility treatment for years. However, its effects on semen quality remain controversial. We conducted a preregistered meta-analysis to assess the effect of WZYZ pill for the therapeutic effects on oligoasthenozoospermia. Five randomized controlled trials including 960 participants were selected from databases of domains in North-East Asian regions, PubMed, Embase, and Cochrane Library. WZYZ pill group yielded a greater mean increment on sperm concentration (5 trials: MD 5.99, 95% CI 2.12–9.85, P = 0.002), sperm motility (5 trials: MD 4.57, 95% CI 0.47–8.68, P = 0.03), sperm morphology (2 trials: MD −1.93, 95% CI −4.87–1.01, P = 0.20), activity of acrosomal enzyme (2 trials: MD 28.27, 95% CI 12.41–44.14, P < 0.01), volume of semen (2 trials: MD 0.56, 95% CI 0.21–0.91, P = 0.002), and a decrement of sperm DNA fragmentation index (2 trials: MD −3.82, 95% CI −6.45–−1.19, P = 0.004). However, qualities of selected studies were generally unsatisfactory, and there was inherent heterogeneity among some of the outcomes. Despite these limitations, the WZYZ pill improved sperm quality by improving several semen parameters and decreasing DNA damage in oligoasthenozoospermia patients. PMID:29576794

  20. The use of traditional versus e-marketing in SMEs in a developing country: A comparative analysis

    OpenAIRE

    Leanne L. Manley

    2015-01-01

    The revolution of the internet has changed the way many organisations conduct business in today’s market environment, and has specifically changed in the way companies market products to consumers. E-marketing allows a marketer to not only reach a broader target market than traditional methods, but substantially reduces marketing costs as well, which can mean the difference between success or failure in small medium enterprises (SMEs). Multiple studies have investigated traditional and e-mark...

  1. [Characteristics of traditional Chinese medicine syndromes in patients with acute ischemic stroke of yin or yang syndrome: a multicenter trial].

    Science.gov (United States)

    You, Jin-song; Huang, Yan; Cai, Ye-feng; Guo, Jian-wen; Liang, Wei-xiong; Huang, Pei-xin; Liu, Mao-cai

    2008-04-01

    To explore the composition characteristics of traditional Chinese medicine (TCM) syndromes in patients with acute ischemic stroke of yin or yang syndrome by investigating the characteristics of TCM syndromes at different periods after onset. One thousand two hundred and forty-six patients with acute ischemic stroke were admitted in twenty hospitals. According to the "diagnostic criteria of syndrome differentiation of stroke", the characteristics of syndromes in the patients were investigated at the periods of 1-3 days, 4-10 days and 11-30 days after they had ischemic stroke. General distribution of six basic syndromes was compared between the patients with yin syndrome and the patients with yang syndrome at the three periods. The six basic syndromes were wind syndrome, pathogenic fire syndrome, phlegm syndrome, blood stasis syndrome, qi deficiency syndrome, and syndrome of yin deficiency and yang hyperactivity. The percentages of wind, pathogenic fire, and phlegm syndromes in the patients were decreased at the period of 11-30 days as compared with the period of 1-3 days (87.1% vs 79.3%, 52.1% vs 38.7% and 67.1% vs 57.4% respectively, P0.05). There were no differences in the distribution of yin and yang syndromes among the three periods (P>0.05). The percentages of syndromes of wind, pathogenic fire, phlegm, and yin deficiency and yang hyperactivity were higher (Pfour or five syndromes were higher, and the percentages of single-syndromes and complex syndromes of two syndromes were lower in patients with yang syndrome than in patients with yin syndrome (P<0.05, P<0.01). The most frequent complex syndromes in patients with yin syndrome were complex syndrome of wind, phlegm, blood stasis and qi deficiency, and complex syndrome of wind, phlegm and qi deficiency; while the most frequent complex syndromes in patients with yang syndrome were complex syndrome of wind, pathogenic fire, phlegm and qi deficiency, and complex syndrome of wind, pathogenic fire and phlegm. The

  2. Comparative effects of cholesteryl ester transfer protein inhibition, statin or ezetimibe on lipid factors: The ACCENTUATE trial.

    Science.gov (United States)

    Nicholls, Stephen J; Ray, Kausik K; Ballantyne, Christie M; Beacham, Lauren A; Miller, Debra L; Ruotolo, Giacomo; Nissen, Steven E; Riesmeyer, Jeffrey S

    2017-06-01

    The optimal approaches to management of patients treated with moderate statin doses on lipid parameters are unknown. The ACCENTUATE study aimed to compare the effects of adding the cholesteryl ester transfer protein inhibitor (CETP) evacetrapib, ezetimibe or increasing statin dose in atorvastatin-treated high-vascular risk patients on lipid parameters. 366 patients with atherosclerotic cardiovascular disease (ASCVD) and/or diabetes were treated with atorvastatin 40 mg/day for 28 days prior to randomization to atorvastatin 40 mg plus evacetrapib 130 mg, atorvastatin 80 mg, atorvastatin 40 mg plus ezetimibe 10 mg or atorvastatin 40 mg plus placebo, daily for 90 days at 64 centers in the United States. Lipid parameters, safety and tolerability were measured. Addition of evacetrapib significantly reduced LDL-C (-33%) compared with ezetimibe (-27%, p=0.045), increasing statin dose (-6%) and statin alone (0%, pstatin dose (pstatin dose, and p=0.004 vs. statin alone). Addition of evacetrapib to atorvastatin produced an increase in hsCRP compared with ezetimibe (p=0.02). While evacetrapib improved traditional atherogenic and putative protective lipid measures compared with ezetimibe and increasing statin dose in patients with ASCVD and/or diabetes, it also adversely affected novel atherogenic risk factors. These findings may contribute to the lack of clinical benefit observed in the ACCELERATE trial. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. A randomized, double-blind, placebo-controlled trial of a traditional herbal formula, Yukmijihwang-tang in elderly subjects with xerostomia.

    Science.gov (United States)

    Han, Gajin; Ko, Seok-Jae; Kim, Juyeon; Oh, Ja-Young; Park, Jae-Woo; Kim, Jinsung

    2016-04-22

    Yukmijihwang-tang (YMJ) is a typical herbal formula to treat Yin-deficiency (YD) syndrome by enriching the fluid-humor of the body. YMJ has been used to treat dry mouth symptoms for hundreds of years in traditional East Asian medicine. Xerostomia, a subjective oral dryness, is common in the elderly and results in impaired quality of life. Many conventional treatments for xerostomia provide only temporary symptom relief, and have side effects. The aim of this study is to investigate the efficacy and safety of YMJ for the treatment of xerostomia in the elderly. This study was designed as a randomized, placebo-controlled, double-blinded, two center trial. Ninety-six subjects aged 60-80 years who had experienced xerostomia for at least 3 months and presented with score>40 on the visual analog scale (VAS) for subjective oral dryness were recruited and randomly allocated to YMJ and placebo groups. YMJ or placebo was administered to each group for 8 weeks (3g of YMJ or placebo, three times per day). The primary outcome was change of VAS for xerostomia from 0 to 8 weeks. VAS for xerostomia was decreased by 22.04±22.76 in the YMJ group and 23.58±23.04 in the placebo group. YMJ had no effect on xerostomia. However, participants with BMIs lower than 29.37kg/m(2) showed improvement of xerostomia after 8 weeks of treatment with YMJ compared to placebo. In addition, YMJ improved oral moisture, which is associated with subjective oral dryness in the YMJ group, and the relationship between VAS for xerostomia and YD was significant. A trend was observed in which YMJ improved oral moisture status and subjective oral dryness in elderly subjects with lower BMI and greater tendency toward YD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo-controlled trial.

    Science.gov (United States)

    Mobeen, N; Durocher, J; Zuberi, Nf; Jahan, N; Blum, J; Wasim, S; Walraven, G; Hatcher, J

    2011-02-01

    to determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries. a randomised, double-blind, placebo-controlled trial. Chitral, Khyber Pakhtunkhwa Province, Pakistan. a total of 1119 women giving birth at home. from June 2006 to June 2008, consenting women were randomised to receive 600 microg oral misoprostol (n = 534) or placebo (n = 585) after delivery to determine whether misoprostol reduced the incidence of PPH (≥ 500 ml). the primary outcomes were measured blood loss ≥ 500 ml after delivery and drop in haemoglobin >2 g/dl from before to after delivery. oral misoprostol was associated with a significant reduction in the rate of PPH (≥ 500 ml) (16.5 versus 21.9%; relative risk 0.76, 95% CI 0.59-0.97). There were no measurable differences between study groups for drop in haemoglobin >2 g/dl (relative risk 0.79, 95% CI 0.62-1.02); but significantly fewer women receiving misoprostol had a drop in haemoglobin >3 g/dl, compared with placebo (5.1 versus 9.6%; relative risk 0.53, 95% CI 0.34-0.83). Shivering and chills were significantly more common with misoprostol. There were no maternal deaths among participants. postpartum administration of 600 microg oral misoprostol by trained TBAs at home deliveries reduces the rate of PPH by 24%. Given its ease of use and low cost, misoprostol could reduce the burden of PPH in community settings where universal oxytocin prophylaxis is not feasible. Continual training and skill-building for TBAs, along with monitoring and evaluation of programme effectiveness, should accompany any widespread introduction of this drug.

  5. Therapeutic efficacy of Traditional Chinese medicine, "Kuan-Sin-Yin", in patients undergoing chemotherapy for advanced colon cancer - A controlled trial.

    Science.gov (United States)

    Chien, Tsai-Ju; Liu, Chia-Yu; Lu, Ruey-Hwa; Kuo, Chin-Wei; Lin, Yang-Chao; Hsu, Chung-Hua

    2016-12-01

    Traditional Chinese Medicine (TCM) has been used increasingly as complementary medicine in cancer care. Kuan-Sin-Yin (KSY) is a TCM decoction containing seven herbs known to cause immunomodulation or anticancer activity, and which are associated with the TCM concept of Qi and energy supply. Kuan-Sin-Yin has cytostatic effects on cancer cells in animal models. The aim of this study is to evaluate the level of improvement in meridian energy and heart-rate variability (HRV) and to assess whether these observations are compatible with TCM theory. A non-randomized controlled trial was designed with monitoring of the meridian electro-conductivity and heart-rate variability (HRV) to compare the efficacy of Kuan-Sin-Yin in the control and experimental groups. 52 patients were enrolled in this study. We also measured cancer-related symptoms and quality of life as secondary outcomes. We found that colon cancer patients who received KSY as complementary therapy benefitted with enhancement of meridian energy (Yin meridian: 27.90:35.45μA; p=0.014; Yang meridian: 27.09:33.55μA; p=0.024) and increases in HRV activity (78.40:129.04ms; SDNN: p=0.001) and parasympathetic tone(HF:1644.80:3217.92 ms 2 ; p=0.003; RMMSD:99.76:164.52ms; p=0.002). Cancer-related symptoms decreased (ECOG>1:46.2:7.7%; p=0.0001), and quality of life (KSY group: PCS 35.46:42.12, p=0.0001; MCS: 44.50:47.55, p=0.209) was improved with statistical significance. The correlation of positive results reflected in meridian energy and HRV activity confirms the positive role of complementary medicine of Kuan-Sin-Yin in cancer care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia.

    Science.gov (United States)

    Wang, Jingyun; Neely, Daniel E; Galli, Jay; Schliesser, Joshua; Graves, April; Damarjian, Tina G; Kovarik, Jessica; Bowsher, James; Smith, Heather A; Donaldson, Dana; Haider, Kathryn M; Roberts, Gavin J; Sprunger, Derek T; Plager, David A

    2016-08-01

    To compare the effectiveness of intermittent occlusion therapy (IO therapy) using liquid crystal glasses and continuous occlusion therapy using traditional adhesive patches for treating amblyopia. Children 3-8 years of age with previously untreated, moderate, unilateral amblyopia (visual acuity of 20/40 to 20/100 in the amblyopic eye) were enrolled in this randomized controlled trial. Amblyopia was associated with strabismus, anisometropia, or both. All subjects had worn any optimal refractive correction for at least 12 weeks without improvement. Subjects were randomized into two treatment groups: a 4-hour IO therapy group with liquid crystal glasses (Amblyz), set at 30-second opaque/transparent intervals (occluded 50% of wear time), and a 2-hour continuous patching group (occluded 100% of wear time). For each patient, visual acuity was measured using ATS-HOTV before and after 12 weeks of treatment. Data from 34 patients were available for analysis. Amblyopic eye visual acuity improvement from baseline was 0.15 ± 0.12 logMAR (95% CI, 0.09-0.15) in the IO therapy group (n = 19) and 0.15 ± 0.11 logMAR (95% CI, 0.1-0.15) in the patching group (n = 15). In both groups improvement was significant, but the difference between groups was not (P = 0.73). No adverse effects were reported. In this pilot study, IO therapy with liquid crystal glasses is not inferior to adhesive patching and is a promising alternative treatment for children 3-8 years of age with moderate amblyopia. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  7. Heart rate and perceived exertion during self-selected intensities for exergaming compared to traditional exercise in college-age participants.

    Science.gov (United States)

    Kraft, Justin A; Russell, William D; Bowman, Tracy A; Selsor, Clifford W; Foster, Grant D

    2011-06-01

    Exergames may be useful for promoting physical activity in younger populations. Heart rate (HRs) responses and rating of perceived exertion (RPE) at self-selected intensities were compared in college-age participants during 2 modes of exergame activity vs. traditional exercise. Thirty-seven participants (men: 20, women: 17) completed 3 30-minute self-selected intensity trials: (a) video game interactive bicycle ergometer (GB) (CatEye GB300), (b) interactive video dance game (Dance Dance Revolution [DDR]), and (c) traditional cycle ergometer (CE) while watching television. Mean HR, peak HR (PkHR), and minutes above target HR (THR) were significantly higher for GB (144 ± 22 b · min(-1) [57% HR reserve (HRR)], 161 ± 23 b · min(-1), and 22.5 ± 11.1 minutes) than for DDR (119 ± 16 b · min(-1) [37% HRR], 138 ± 20 b · min(-1), and 11.2 ± 11.9 minutes) or for CE (126 ± 20 b · min(-1) [42% HRR], 144 ± 24 b · min(-1), and 14.2 ± 12.6 minutes). The RPE was significantly higher for GB (4.2 ± 1.5) and CE (3.8 ± 1.2) than for DDR (2.7 ± 1.3). Recovery HR (RecHR) (15 minutes postexercise) was significantly higher for GB (91 ± 14 b · min(-1)) than for DDR (80 ± 11 b · min(-1)) and neared significance vs. CE (84 ± 14 b · min(-1), p = 0.059). No difference in PkHR, RecHR, or minutes above THR was observed between DDR and CE. Session RPE was significantly higher for GB (4.6 ± 1.7) and CE (4.1 ± 1.6) than for DDR (2.8 ± 1.5). All modes elicited extended proportions of time above THR; GB: 75%, DDR: 37%, and CE: 47%. Results support that exergames are capable of eliciting physiological responses necessary for fitness improvements. Practitioners might consider exergames as periodic activity options for clients needing motivation to be regularly active.

  8. Comparative study on nutritional and sensory quality of barnyard and foxtail millet food products with traditional rice products.

    Science.gov (United States)

    Verma, Suman; Srivastava, Sarita; Tiwari, Neha

    2015-08-01

    colour, flavor, texture, appearance and overall acceptability of foxtail and barnyard millet laddu and halwa when compared to control. Foxtail millet biryani was most acceptable compared to barnyard millet and control biryani. Nutritive value of formulated products was calculated and it was compared with the rice. The protein, fat and fibre content of the formulated products from foxtail and barnyard millet were higher than the rice products. Thus from the present study it was concluded that the foxtail millet and barnyard millet are superior in nutritive value to rice and have potential for use in traditional food products.

  9. A comparative analysis of quality management standards for contract research organisations in clinical trials.

    Science.gov (United States)

    Murray, Elizabeth; McAdam, Rodney

    2007-01-01

    This article compares and contrasts the main quality standards in the highly regulated pharmaceutical industry with specific focus on Good Clinical Practice (GCP), the standard for designing, conducting, recording and reporting clinical trials involving human participants. Comparison is made to ISO quality standards, which can be applied to all industries and types of organisation. The study is then narrowed to that of contract research organisations (CROs) involved in the conduct of clinical trials. The paper concludes that the ISO 9000 series of quality standards can act as a company-wide framework for quality management within such organisations by helping to direct quality efforts on a long-term basis without any loss of compliance. This study is valuable because comparative analysis in this domain is uncommon.

  10. The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Huang, Jia; Lin, Zhengkun; Wang, Qin; Liu, Feiwen; Liu, Jiao; Fang, Yunhua; Chen, Shanjia; Zhou, Xiaoxuan; Hong, Wenjun; Wu, Jinsong; Madrigal-Mora, Natalia; Zheng, Guohua; Yang, Shanli; Tao, Jing; Chen, Lidian

    2015-06-16

    Post-stroke cognitive impairment (PSCI) lessens quality of life, restricts the rehabilitation of stroke, and increases the social and economic burden stroke imposes on patients and their families. Therefore effective treatment is of paramount importance. However, the treatment of PSCI is very limited. The primary aim of this protocol is to propose a lower cost and more effective therapy, and to confirm the long-term effectiveness of a therapeutic regimen of Traditional Chinese Medicine (TCM) rehabilitation for PSCI. A prospective, multicenter, large sample, randomized controlled trial will be conducted. A total of 416 eligible patients will be recruited from seven inpatient and outpatient stroke rehabilitation units and randomly allocated into a therapeutic regimen of TCM rehabilitation group or cognitive training (CT) control group. The intervention period of both groups will last 12 weeks (30 minutes per day, five days per week). Primary and secondary outcomes will be measured at baseline, 12 weeks (at the end of the intervention), and 36 weeks (after the 24-week follow-up period). This protocol presents an objective design of a multicenter, large sample, randomized controlled trial that aims to put forward a lower cost and more effective therapy, and confirm the long-term effectiveness of a therapeutic regimen of TCM rehabilitation for PSCI through subjective and objective assessments, as well as highlight its economic advantages. This trial was registered with the Chinese Clinical Trial Registry (identifier: ChiCTR-TRC-14004872 ) on 23 June 2014.

  11. Zhen gan xi feng decoction, a traditional chinese herbal formula, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Xiong, Xingjiang; Yang, Xiaochen; Feng, Bo; Liu, Wei; Duan, Lian; Gao, Ao; Li, Haixia; Ma, Jizheng; Du, Xinliang; Li, Nan; Wang, Pengqian; Su, Kelei; Chu, Fuyong; Zhang, Guohao; Li, Xiaoke; Wang, Jie

    2013-01-01

    Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH). Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP). Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain. Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.

  12. Prospective controlled trial comparing colostomy irrigation with "spontaneous-action" method.

    OpenAIRE

    Williams, N S; Johnston, D

    1980-01-01

    Thirty randomly selected patients with permanent colostomies entered a prospective controlled trial comparing colostomy irrigation with spontaneous action. Each patient was interviewed and examined before irrigation was begun and again after the technique had been used for three months. Each then reverted to spontaneous action for a further three months and was then reassessed. Eight patients abandoned irrigation and 22 (73%) adhered to the protocol. Irrigation caused no mishaps or complicati...

  13. Randomized Trial of a Smartphone Mobile Application Compared to Text Messaging to Support Smoking Cessation

    OpenAIRE

    Buller, David B.; Borland, Ron; Bettinghaus, Erwin P.; Shane, James H.; Zimmerman, Donald E.

    2014-01-01

    Background: Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Materials and Methods: Young adult smokers 18–30 years old (n=102) participated in a randomized pretest–posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Self-reported usability of REQ-Mobile and qu...

  14. CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials

    OpenAIRE

    Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

    2010-01-01

    ABSTRACT Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of kn...

  15. Scientific writing: a randomized controlled trial comparing standard and on-line instruction

    OpenAIRE

    Phadtare, Amruta; Bahmani, Anu; Shah, Anand; Pietrobon, Ricardo

    2009-01-01

    Abstract Background Writing plays a central role in the communication of scientific ideas and is therefore a key aspect in researcher education, ultimately determining the success and long-term sustainability of their careers. Despite the growing popularity of e-learning, we are not aware of any existing study comparing on-line vs. traditional classroom-based methods for teaching scientific writing. Methods Forty eight participants from a medical, nursing and physiotherapy background from US ...

  16. Comparing Hybrid Learning with Traditional Approaches on Learning the Microsoft Office Power Point 2003 Program in Tertiary Education

    Science.gov (United States)

    Vernadakis, Nikolaos; Antoniou, Panagiotis; Giannousi, Maria; Zetou, Eleni; Kioumourtzoglou, Efthimis

    2011-01-01

    The purpose of this study was to determine the effectiveness of a hybrid learning approach to deliver a computer science course concerning the Microsoft office PowerPoint 2003 program in comparison to delivering the same course content in the form of traditional lectures. A hundred and seventy-two first year university students were randomly…

  17. Assessment of reflectivity of noise barriers in the far field – QUIESST method compared to traditional approach

    NARCIS (Netherlands)

    Roo, F. de

    2013-01-01

    The sound reflectivity of noise barriers elements is one of the major acoustic product characteristics. Traditionally this property was tested in reverberation rooms according to EN 1793-1 and the results were used to predict the effect of sound reflections in the far field. As in many cases these

  18. A Comparative Study on the Motivation and Attitudes of Language Learners of Online Distance and Traditional In-Classroom Education

    Science.gov (United States)

    Genc, Gulten; Kulusakli, Emine; Aydin, Savas

    2016-01-01

    In recent years, the increase in the use of computer and the internet has led to a change in the traditional concept of formal education today. Distance learning as a more student-centered system has been frequently used at universities. In this context, education has been applied to the individuals consisting of all age groups in accordance with…

  19. Traditional Mold Analysis Compared to a DNA-based Method of Mold Analysis with Applications in Asthmatics' Homes

    Science.gov (United States)

    Traditional environmental mold analysis is based-on microscopic observations and counting of mold structures collected from the air on a sticky surface or culturing of molds on growth media for identification and quantification. A DNA-based method of mold analysis called mol...

  20. Math Anxiety, Math Self-Concept, and Math Self-Efficacy in Adult Learners Compared to Traditional Undergraduate Students

    Science.gov (United States)

    Jameson, Molly M.; Fusco, Brooke R.

    2014-01-01

    Adult learners comprise a significant portion of current undergraduate populations, and projections indicate steady or growing numbers of adult learners in the future. Previous research has suggested that adult learners possess lower self-confidence than and face barriers not experienced by traditional undergraduate students. These constructs have…

  1. The Effect of Chinese Traditional Exercise-Baduanjin on Physical and Psychological Well-Being of College Students: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Moyi Li

    Full Text Available The physical and mental health of college students tends to continuously decline around the world, therefore, it is important to improve their health during college period. Baduanjin, a traditional Chinese exercise which combines movements with breath and mind, may be one of the selectable effective exercises. However, the effect of Baduanjin exercise on college students has not been established. In this study, we systematically assessed the effectiveness and safety of Baduanjin exercise on physical and mental health of college students by a rigorous randomized, parallel-controlled design.A total of 222 college students from Fujian University of Traditional Chinese Medicine were recruited and randomly allocated at an equal ratio into control or Baduanjin training. Participants in control group were informed to maintain their original activity habit, and those in Baduanjin exercise group received a 12-week Baduanjin exercise training with a frequency of 1 hour per day and 5 days per week on the basis of their original activity habit. The physical and psychological outcomes, including lumbar muscle strength, lower limb proprioception function, physical fitness, as well as self-reported symptom intensity, stress, self-esteem, mood, quality of life, quality of sleep, and adverse events, were evaluated at baseline, 13 weeks (at the end of 12-week intervention, and 25 weeks (after the 12-week follow-up period. Intention-to-treat analysis was performed for the above outcomes.Compared with controls, significant improvements in Baduanjin exercise group at the end of 12-week intervention period were found on lower limb proprioception function (the rate of average trace error on right lower limb (%: control 23.50±5.50, Baduanjin 21.92±6.54, P=0.004; the rate of average trace error on left lower limb (%: control 22.32±6.62, Baduanjin 20.63±4.62, P=0.046, cardiorespiratory endurance (step test index: control 47.66±5.94, Baduanjin 50.07±9.30, P=0

  2. The Effect of Chinese Traditional Exercise-Baduanjin on Physical and Psychological Well-Being of College Students: A Randomized Controlled Trial.

    Science.gov (United States)

    Li, Moyi; Fang, Qianying; Li, Junzhe; Zheng, Xin; Tao, Jing; Yan, Xinghui; Lin, Qiu; Lan, Xiulu; Chen, Bai; Zheng, Guohua; Chen, Lidian

    2015-01-01

    The physical and mental health of college students tends to continuously decline around the world, therefore, it is important to improve their health during college period. Baduanjin, a traditional Chinese exercise which combines movements with breath and mind, may be one of the selectable effective exercises. However, the effect of Baduanjin exercise on college students has not been established. In this study, we systematically assessed the effectiveness and safety of Baduanjin exercise on physical and mental health of college students by a rigorous randomized, parallel-controlled design. A total of 222 college students from Fujian University of Traditional Chinese Medicine were recruited and randomly allocated at an equal ratio into control or Baduanjin training. Participants in control group were informed to maintain their original activity habit, and those in Baduanjin exercise group received a 12-week Baduanjin exercise training with a frequency of 1 hour per day and 5 days per week on the basis of their original activity habit. The physical and psychological outcomes, including lumbar muscle strength, lower limb proprioception function, physical fitness, as well as self-reported symptom intensity, stress, self-esteem, mood, quality of life, quality of sleep, and adverse events, were evaluated at baseline, 13 weeks (at the end of 12-week intervention), and 25 weeks (after the 12-week follow-up period). Intention-to-treat analysis was performed for the above outcomes. Compared with controls, significant improvements in Baduanjin exercise group at the end of 12-week intervention period were found on lower limb proprioception function (the rate of average trace error on right lower limb (%): control 23.50±5.50, Baduanjin 21.92±6.54, P=0.004; the rate of average trace error on left lower limb (%): control 22.32±6.62, Baduanjin 20.63±4.62, P=0.046), cardiorespiratory endurance (step test index: control 47.66±5.94, Baduanjin 50.07±9.30, P=0.025), flexibility

  3. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial.

    Science.gov (United States)

    Firoozabadi, Mohammad Dehghani; Navabzadeh, Maryam; Roudsari, Mohammad Khodashenas; Zahmatkash, Mohsen

    2014-12-01

    Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients) and conventional treatment group (30 patients). An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months). Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6) and 32.6 (±12.7) years, respectively (P = 0.45). After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80), frequency of migraine attacks (P = 0.63) and duration of attacks per hours (P = 0.48) were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

  4. Documentation of tests on particle size methodologies for laser diffraction compared to traditional sieving and sedimentation analysis

    DEFF Research Database (Denmark)

    Rasmussen, Charlotte; Dalsgaard, Kristian

    Sieving and sedimentation analyses by pipette or hydrometer are historically the traditional methods for determining particle size distributions (PSD). A more informative and faster alternative has for years been laser diffraction (LD). From 2003 to 2013 the authors of this paper have worked...... intensively with PSD and performed various tests and investigations, using LD, sedimentation (by pipette) and sieving. The aim was to improve and understand the relationship between these various techniques, pre-treatment effects and preferably find a unifying correlation factor. As a result, method...... comparisons of LD and sieving/sedimentation are difficult, as LD is a 3D optical volume measurement, sieving is a 2D width measurement, and sedimentation is density dependent. Platy particles like clay are generally measured to be coarser than traditional methods when LD is used. For LD the clay...

  5. Modified Right Heart Contrast Echocardiography Versus Traditional Method in Diagnosis of Right-to-Left Shunt: A Comparative Study

    OpenAIRE

    Wang, Yi; Zeng, Jie; Yin, Lixue; Zhang, Mei; Hou, Dailun

    2016-01-01

    BACKGROUND: The purpose of this study was to evaluate the reliability, effectiveness, and safety of modified right heart contrast transthoracic echocardiography (cTTE) in comparison with the traditional method. MATERIAL AND METHODS: We performed a modified right heart cTTE using saline mixed with a small sample of patient's own blood. Samples were agitated with varying intensity. This study protocol involved microscopic analysis and patient evaluation. 1. Microscopic analysis: After two contr...

  6. Alcohol, indomethacin, and salbutamol. A comparative trial of their use in preterm labor.

    Science.gov (United States)

    Spearing, G

    1979-02-01

    In a comparative trial, ethanol effectively arrested preterm labor for 48 hours for more in 32% of cases, a beta-adrenergic agent (salbutamol) in 60% of cases (not statistically significant), and a combination of ethanol and indomethacin in 70% of cases (statistically significant, P less than 0.5). Labor was delayed for 14 days or more in 36, 60, and 50%, respectively (not statistically significant). The numbers studied were small, and tests of statistical significance were of doubtful value. Salbutamol was more acceptable to patients and the staff than ethanol. The trial was suspended and eventually abandoned due to reports of prostaglandin synthetase inhibitors causing premature closure of the ductus arteriosus. In this series no problems were encountered with the use of indomethacin.

  7. Traditional and new strategies in the primary prevention of eating disorders: a comparative study in Spanish adolescents

    Directory of Open Access Journals (Sweden)

    Ignacio Jáuregui Lobera

    2010-09-01

    Full Text Available Ignacio Jáuregui Lobera1, Pilar León Lozano2, Patricia Bolaños Ríos3, Juan Romero Candau2, Gregorio Sánchez del Villar y Lebreros4, M Teresa Morales Millán1,5, M Teresa Montaña González1,5, Lourdes Andrés Martín2, Isabela Justo Villalobos2, Nuria Vargas Sánchez21Área de Nutrición y Bromatología, Universidad Pablo de Olavide; 2Colegio Oficial de Farmacéuticos; 3Instituto de Ciencias de la Conducta; 4Instituto de Enseñanza Secundaria “Murillo”; 5Facultad de Farmacia, Universidad de Sevilla, Sevilla, SpainBackground: Research conducted to date into the primary prevention of eating disorders (ED has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the target population.Objective: This study describes an adaptation of the Girls’ Group model to the Spanish context, the main objective being to compare two types of intervention, ie, one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED.Methods: On the basis of previous research on the primary prevention of ED, and taking into account recognized risk and protective factors, the following topics were addressed: nutritional aspects; self-esteem; coping strategies; the ideal image of what is attractive and role of the media; and body image. The total sample (174 girls and 197 boys was divided into 12 work groups, six for the intervention group (one school and six for the control group (two schools. School-based input (intervention group was provided by a pharmacist, a psychologist, a qualified nutritionist/dietician, and specialist support staff (psychologists and/or educators and teachers of the three schools

  8. Comparing Amazon Mechanical Turk with unpaid internet resources in online clinical trials

    Directory of Open Access Journals (Sweden)

    Eduardo Bunge

    2018-06-01

    Full Text Available Internet interventions face significant challenges in recruitment and attrition rates are typically high and problematic. Finding innovative yet scientifically valid avenues for attaining and retaining participants is therefore of considerable importance. The main goal of this study was to compare recruitment process and participants characteristics between two similar randomized control trials of mood management interventions. One of the trials (Bunge et al., 2016 was conducted with participants recruited from Amazon's Mechanical Turk (AMT, and the other trial recruited via Unpaid Internet Resources (UIR. Methods: The AMT sample (Bunge et al., 2016 consisted of 765 adults, and the UIR sample (recruited specifically for this study consisted of 329 adult US residents. Participants' levels of depression, anxiety, confidence, motivation, and perceived usefulness of the intervention were assessed. The AMT sample was financially compensated whereas the UIR was not. Results: AMT yielded higher recruitment rates per month (p < .05. At baseline, the AMT sample reported significantly lower depression and anxiety scores (p < .001 and p < .005, respectively and significantly higher mood, motivation, and confidence (all p < .001 compared to the UIR sample. AMT participants spent significantly less time on the site (p < .05 and were more likely to complete follow-ups than the UIR sample (p < .05. Both samples reported a significant increase in their level of confidence and motivation from pre- to post-intervention. AMT participants showed a significant increase in perceived usefulness of the intervention (p < .0001, whereas the UIR sample did not (p = .1642. Conclusions: By using AMT, researchers can recruit very rapidly and obtain higher retention rates; however, these participants may not be representative of the general online population interested in clinical interventions. Considering that AMT and UIR participants

  9. Traditional Chinese medicine for stable angina pectoris via TCM pattern differentiation and TCM mechanism: study protocol of a randomized controlled trial.

    Science.gov (United States)

    Zhang, Zhe; Zhang, Fan; Wang, Yang; Du, Yi; Zhang, Huiyong; Kong, Dezhao; Liu, Yue; Yang, Guanlin

    2014-10-30

    Stable angina pectoris is experienced as trans-sternal or retro-sternal pressure or pain that may radiate to the left arm, neck or back. Although available evidence relating to its effectiveness and mechanism are weak, traditional Chinese medicine is used as an alternative therapy for stable angina pectoris. We report a protocol of a randomized controlled trial using traditional Chinese medicine to investigate the effectiveness, mechanism and safety for patients with stable angina pectoris. This is a north-east Chinese, multi-center, multi-blinded, placebo-controlled and superiority randomized trail. A total of 240 patients with stable angina pectoris will be randomly assigned to three groups: two treatment groups and a control group. The treatment groups will receive Chinese herbal medicine consisting of Yi-Qi-Jian-Pi and Qu-Tan-Hua-Zhuo granule and Yi-Qi-Jian-Pi and Qu-Tan-Hua-Yu granule, respectively, and conventional medicine. The control group will receive placebo medicine in addition to conventional medicine. All 3 groups will undergo a 12-week treatment and 2-week follow-up. Four visits in sum will be scheduled for each subject: 1 visit each in week 0, week 4, week 12 and week 14. The primary outcomes include: the frequency of angina pectoris attack; the dosage of nitroglycerin; body limited dimension of Seattle Angina Questionnaire. The secondary outcomes include: except for the body limited dimension of SAQ, traditional Chinese medicine pattern questionnaire and so on. Therapeutic mechanism outcomes, safety outcomes and endpoint outcomes will be also assessed. The primary aim of this trial is to develop a standard protocol to utilize high-quality EBM evidence for assessing the effectiveness and safety of SAP via TCM pattern differentiation as well as exploring the efficacy mechanism and regulation with the molecular biology and systems biology. ChiCTR-TRC-13003608, registered 18 June 2013.

  10. Development and Psychometric Evaluation of the HPV Clinical Trial Survey for Parents (CTSP-HPV) Using Traditional Survey Development Methods and Community Engagement Principles.

    Science.gov (United States)

    Cunningham, Jennifer; Wallston, Kenneth A; Wilkins, Consuelo H; Hull, Pamela C; Miller, Stephania T

    2015-12-01

    This study describes the development and psychometric evaluation of HPV Clinical Trial Survey for Parents with Children Aged 9 to 15 (CTSP-HPV) using traditional instrument development methods and community engagement principles. An expert panel and parental input informed survey content and parents recommended study design changes (e.g., flyer wording). A convenience sample of 256 parents completed the final survey measuring parental willingness to consent to HPV clinical trial (CT) participation and other factors hypothesized to influence willingness (e.g., HPV vaccine benefits). Cronbach's a, Spearman correlations, and multiple linear regression were used to estimate internal consistency, convergent and discriminant validity, and predictively validity, respectively. Internal reliability was confirmed for all scales (a ≥ 0.70.). Parental willingness was positively associated (p < 0.05) with trust in medical researchers, adolescent CT knowledge, HPV vaccine benefits, advantages of adolescent CTs (r range 0.33-0.42), supporting convergent validity. Moderate discriminant construct validity was also demonstrated. Regression results indicate reasonable predictive validity with the six scales accounting for 31% of the variance in parents' willingness. This instrument can inform interventions based on factors that influence parental willingness, which may lead to the eventual increase in trial participation. Further psychometric testing is warranted. © 2015 Wiley Periodicals, Inc.

  11. Studying Student Benefits of Assigning a Service-Learning Project Compared to a Traditional Final Project in a Business Statistics Class

    Science.gov (United States)

    Phelps, Amy L.; Dostilio, Lina

    2008-01-01

    The present study addresses the efficacy of using service-learning methods to meet the GAISE guidelines (http://www.amstat.org/education/gaise/GAISECollege.htm) in a second business statistics course and further explores potential advantages of assigning a service-learning (SL) project as compared to the traditional statistics project assignment.…

  12. Undergraduate Biology Lab Courses: Comparing the Impact of Traditionally Based "Cookbook" and Authentic Research-Based Courses on Student Lab Experiences

    Science.gov (United States)

    Brownell, Sara E.; Kloser, Matthew J.; Fukami, Tadishi; Shavelson, Rich

    2012-01-01

    Over the past decade, several reports have recommended a shift in undergraduate biology laboratory courses from traditionally structured, often described as "cookbook," to authentic research-based experiences. This study compares a cookbook-type laboratory course to a research-based undergraduate biology laboratory course at a Research 1…

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

    Science.gov (United States)

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

    2013-01-01

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

  14. Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.

    Science.gov (United States)

    LaStayo, Paul; Marcus, Robin; Dibble, Leland; Wong, Bob; Pepper, Ginette

    2017-07-17

    Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period. Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis. The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up fall or near fall. There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival. NCT01080196 ; March 2, 2010 (retrospectively registered).

  15. Gestational Weight Gain: Results from the Delta Healthy Sprouts Comparative Impact Trial

    Directory of Open Access Journals (Sweden)

    Jessica L. Thomson

    2016-01-01

    Full Text Available Introduction. Delta Healthy Sprouts trial was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of Southern African American women and their infants. Results pertaining to the primary outcome, gestational weight gain, are reported. Methods. Participants (n=82, enrolled early in their second trimester of pregnancy, were randomly assigned to one of two treatment arms. Gestational weight gain, measured at six monthly home visits, was calculated by subtracting measured weight at each visit from self-reported prepregnancy weight. Weight gain was classified as under, within, or exceeding the Institute of Medicine recommendations based on prepregnancy body mass index. Chi-square tests and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges. Results. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits. Conclusions. Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of primarily low income African American women. The impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women. This trial is registered with ClinicalTrials.gov NCT01746394, registered 4 December 2012.

  16. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial

    Directory of Open Access Journals (Sweden)

    Mohammad Dehghani Firoozabadi

    2014-01-01

    Full Text Available Background: Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. Materials and Methods: This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients and conventional treatment group (30 patients. An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months. Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Results: Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6 and 32.6 (±12.7 years, respectively (P = 0.45. After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80, frequency of migraine attacks (P = 0.63 and duration of attacks per hours (P = 0.48 were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P < 0.001. Conclusion: There was no significant difference between cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

  17. A Bayesian Analysis of a Randomized Clinical Trial Comparing Antimetabolite Therapies for Non-Infectious Uveitis.

    Science.gov (United States)

    Browne, Erica N; Rathinam, Sivakumar R; Kanakath, Anuradha; Thundikandy, Radhika; Babu, Manohar; Lietman, Thomas M; Acharya, Nisha R

    2017-02-01

    To conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief. A RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan-uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts' estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial's primary outcome. A total of 11 of the 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03-45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1-1.2) and 0.7 (95% CrI 0.2-1.7) from the Bayesian analysis. A Bayesian analysis combining expert belief with the trial's result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT.

  18. ?A good method of quitting smoking? or ?just an alternative to smoking?? Comparative evaluations of e-cigarette and traditional cigarette usage by dual users

    OpenAIRE

    Vandrevala, Tushna; Coyle, Adrian; Walker, Victoria; Cabrera Torres, Joshelyn; Ordo?a, Izobel; Rahman, Panna

    2017-01-01

    The development of e-cigarettes was initially hailed as a resource in facilitating a reduction in or cessation of cigarette smoking. Many users of e-cigarettes are ‘dual users’, smoking traditional cigarettes and e-cigarettes. The present qualitative study examines the factors that a group of 20 dual users considered to have been influential in their decisions to use e-cigarettes and their comparative evaluations of e-cigarettes and traditional cigarettes. Health concerns were not found to be...

  19. Iohexol and iopamidol myelography in the dog: a clinical trial comparing adverse effects and myelographic quality

    International Nuclear Information System (INIS)

    Widmer, W.R.; Blevins, W.E.; Jakovljevic, S.; Teclaw, R.F.; Han, C.M.; Hurd, C.D.

    1992-01-01

    In a blind clinical trial, adverse effects after iohexol and iopamidol myelography were evaluated in 151 dogs. Eighty-one dogs were given iohexol (240 mgI/ml) and 70 dogs were given iopamidol (200 mgI/ml) by pre-determined assignment. Each dog was evaluated postmyelographically for seizures, hyperthermia, prolonged recovery from anesthesia and intensification of pre-existing neural signs. Myelographic quality was evaluated with a subjective scoring method. In comparing iohexol and iopamidol groups, there was not a statistically significant difference in the incidence of adverse effects or in myelographic quality. Iopamidol and iohexol appeared to be equally efficacious for routine canine myelography

  20. Comparing the Knotless Tension Band and the Traditional Stainless Steel Wire Tension Band Fixation for Medial Malleolus Fractures: A Retrospective Clinical Study

    Directory of Open Access Journals (Sweden)

    Michael W. Downey

    2016-01-01

    Full Text Available The traditional stainless steel wire tension band (WTB has been popularized for small avulsion fractures at the medial malleolus. Despite the tension band principle creating a stable construct, complications continue to arise utilizing the traditional stainless steel WTB with patients experiencing hardware irritation at the tension band site and subsequent hardware removal. Coupled with hardware irritation is fatigue failure with the wire. The goal of this investigation was to retrospectively compare this traditional wire technique to an innovative knotless tension band (KTB technique in order to decrease costly complications. A total of 107 patients were reviewed with a minimum follow-up of 1 year. Outcome measures include descriptive data, fracture classification, results through economic costs, and fixation results (including hardware status, healing status, pain status, and time to healing. The KTB group had a 13% lower true cost as compared to the WTB group while the fixation results were equivocal for the measured outcomes. Our results demonstrate that the innovative KTB is comparable to the traditional WTB while offering a lower true cost, an irritation free reduction all without the frustration of returning to the operating room for additional hardware removal, which averages approximately to $8,288.

  1. Randomized Controlled Trial Comparing Open Versus Laparoscopic Placement of a Peritoneal Dialysis Catheter and Outcomes: The CAPD I Trial.

    Science.gov (United States)

    van Laanen, Jorinde H H; Cornelis, Tom; Mees, Barend M; Litjens, Elisabeth J; van Loon, Magda M; Tordoir, Jan H M; Peppelenbosch, Arnoud G

    2018-01-01

    had a paramedian wound infection. In the laparoscopic group, 1 patient had a transient cardiac event, 1 patient had intraabdominal bleeding requiring reoperation, and 1 patient had fluid leakage that could be managed conservatively. The survival curve demonstrated a good long-term function of PD. This randomized controlled trial (RCT) comparing open vs laparoscopic placement of PD catheters demonstrates equal clinical success rates between the 2 techniques. Advanced laparoscopic techniques such as catheter fixation techniques and omentopexy might further improve clinical outcome. Copyright © 2018 International Society for Peritoneal Dialysis.

  2. Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS-LUMINA Study.

    Science.gov (United States)

    Veizi, Elias; Hayek, Salim M; North, James; Brent Chafin, T; Yearwood, Thomas L; Raso, Louis; Frey, Robert; Cairns, Kevin; Berg, Anthony; Brendel, John; Haider, Nameer; McCarty, Matthew; Vucetic, Henry; Sherman, Alden; Chen, Lilly; Mekel-Bobrov, Nitzan

    2017-08-01

    The aim of this study was to determine whether spinal cord stimulation (SCS) using 3D neural targeting provided sustained overall and low back pain relief in a broad routine clinical practice population. This was a multicenter, open-label observational study with an observational arm and retrospective analysis of a matched cohort. After IPG implantation, programming was done using a patient-specific, model-based algorithm to adjust for lead position (3D neural targeting) or previous generation software (traditional). Demographics, medical histories, SCS parameters, pain locations, pain intensities, disabilities, and safety data were collected for all patients. A total of 213 patients using 3D neural targeting were included, with a trial-to-implant ratio of 86%. Patients used seven different lead configurations, with 62% receiving 24 to 32 contacts, and a broad range of stimulation parameters utilizing a mean of 14.3 (±6.1) contacts. At 24 months postimplant, pain intensity decreased significantly from baseline (ΔNRS = 4.2, N = 169, P  pain subgroup (ΔNRS = 5.3, N = 91, P  low back pain also decreased significantly from baseline to 24 months (ΔNRS = 4.1, N = 70, P  pain responder rates of 51% (traditional SCS) and 74% (neural targeting SCS) and axial low back pain responder rates of 41% and 71% in the traditional SCS and neural targeting SCS cohorts, respectively. Lastly, complications occurred in a total of 33 of the 213 patients, with a 1.6% lead replacement rate and a 1.6% explant rate. Our results suggest that 3D neural targeting SCS and its associated hardware flexibility provide effective treatment for both chronic leg and chronic axial low back pain that is significantly superior to traditional SCS. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. A comparative study on medicinal plants used in Akha's traditional medicine in China and Thailand, cultural coherence or ecological divergence?

    DEFF Research Database (Denmark)

    Inta, A.; Shengji, P.; Balslev, Henrik

    2008-01-01

    Aim of the study : The survey aims to study the effect of geographic separation of ethnic groups on local knowledge of medicinal plants used by Akha people in Thailand and China, who were separated 100-120 years ago, to see how different the two geographically distinct but culturally similar groups...... were in this respect. Materials and methods : Interviewing 10 villagers in each of five Akha villages, three in Thailand and two in China, about which plants they used and how they used them. Results : A total of 95 medicinal plants registered in the five villages only 16 were shared between China......, but that when using these new species they have maintained other traditions relating to medicinal plants....

  4. Comparative Studies of Traditional (Non-Energy Integration and Energy Integration of Catalytic Reforming Unit using Pinch Analysis

    Directory of Open Access Journals (Sweden)

    M. Alta

    2012-12-01

    Full Text Available Energy Integration of Catalytic Reforming Unit (CRU of Kaduna Refinery and petrochemicals Company Kaduna Nigeria was carried out using Pinch Technology. The pinch analysis was carried out using Maple. Optimum minimum approach temperature of 20 °C was used to determine the energy target. The pinch point temperature was found to be 278 °C. The utilities targets for the minimum approach temperature were found to be 72711839.47 kJ/hr and 87105834.43 kJ/hr for hot and cold utilities respectively. Pinch analysis as an energy integration technique was found to save more energy and utilities cost than the traditional energy technique. Key words: Pinch point, CRU, Energy Target, Maple

  5. Comparative analysis of a nontraditional general chemistry textbook and selected traditional textbooks used in Texas community colleges

    Science.gov (United States)

    Salvato, Steven Walter

    The purpose of this study was to analyze questions within the chapters of a nontraditional general chemistry textbook and the four general chemistry textbooks most widely used by Texas community colleges in order to determine if the questions require higher- or lower-order thinking according to Bloom's taxonomy. The study employed quantitative methods. Bloom's taxonomy (Bloom, Engelhart, Furst, Hill, & Krathwohl, 1956) was utilized as the main instrument in the study. Additional tools were used to help classify the questions into the proper category of the taxonomy (McBeath, 1992; Metfessel, Michael, & Kirsner, 1969). The top four general chemistry textbooks used in Texas community colleges and Chemistry: A Project of the American Chemical Society (Bell et al., 2005) were analyzed during the fall semester of 2010 in order to categorize the questions within the chapters into one of the six levels of Bloom's taxonomy. Two coders were used to assess reliability. The data were analyzed using descriptive and inferential methods. The descriptive method involved calculation of the frequencies and percentages of coded questions from the books as belonging to the six categories of the taxonomy. Questions were dichotomized into higher- and lower-order thinking questions. The inferential methods involved chi-square tests of association to determine if there were statistically significant differences among the four traditional college general chemistry textbooks in the proportions of higher- and lower-order questions and if there were statistically significant differences between the nontraditional chemistry textbook and the four traditional general chemistry textbooks. Findings indicated statistically significant differences among the four textbooks frequently used in Texas community colleges in the number of higher- and lower-level questions. Statistically significant differences were also found among the four textbooks and the nontraditional textbook. After the analysis of

  6. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

    Science.gov (United States)

    Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

    2010-06-08

    Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Would guidance from a technician be as effective as guidance from a clinician? Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (ptechnician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Australian New

  7. Similar early migration when comparing CR and PS in Triathlon™ TKA: A prospective randomised RSA trial.

    Science.gov (United States)

    Molt, Mats; Toksvig-Larsen, Sören

    2014-10-01

    The objective of this study was to compare the early migration of the cruciate retaining and posterior stabilising versions of the recently introduced Triathlon™ total knee system, with a view to predicting long term fixation performance. Sixty patients were prospectively randomised to receive either Triathlon™ posterior stabilised cemented knee prosthesis or Triathlon™ cruciate retaining cemented knee prosthesis. Tibial component migration was measured by radiostereometric analysis postoperatively and at three months, one year and two years. Clinical outcome was measured by the American Knee Society Score and Knee Osteoarthritis and Injury Outcome Score. There were no differences in rotation around the three coordinal axes or in the maximum total point motion (MTPM) during the two year follow-up. The posterior stabilised prosthesis had more posterior-anterior translation at three months and one year and more caudal-cranial translation at one year and two years. There were no differences in functional outcome between the groups. The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability. Level I. Article focus: This was a prospective randomised trial aiming to compare the single radius posterior stabilised (PS) Triathlon™ total knee arthroplasty (TKA) to the cruciate retaining Triathlon™ TKA system with regard to fixation. Strengths and limitations of this study: Strength of this study was that it is a randomised prospective trial using an objective measuring tool. The sample size of 25-30 patients was reportedly sufficient for the screening of implants using RSA [1]. ClinicalTrials.gov Identifier: NCT00436982. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. The effects of Red Bull energy drink compared with caffeine on cycling time-trial performance.

    Science.gov (United States)

    Quinlivan, Alannah; Irwin, Christopher; Grant, Gary D; Anoopkumar-Dukie, Sheilandra; Skinner, Tina; Leveritt, Michael; Desbrow, Ben

    2015-10-01

    This study investigated the ergogenic effects of a commercial energy drink (Red Bull) or an equivalent dose of anhydrous caffeine in comparison with a noncaffeinated control beverage on cycling performance. Eleven trained male cyclists (31.7 ± 5.9 y 82.3 ± 6.1 kg, VO2max = 60.3 ± 7.8 mL · kg-1 · min-1) participated in a double-blind, placebo-controlled, crossover-design study involving 3 experimental conditions. Participants were randomly administered Red Bull (9.4 mL/kg body mass [BM] containing 3 mg/kg BM caffeine), anhydrous caffeine (3 mg/kg BM given in capsule form), or a placebo 90 min before commencing a time trial equivalent to 1 h cycling at 75% peak power output. Carbohydrate and fluid volumes were matched across all trials. Performance improved by 109 ± 153 s (2.8%, P = .039) after Red Bull compared with placebo and by 120 ± 172 s (3.1%, P = .043) after caffeine compared with placebo. No significant difference (P > .05) in performance time was detected between Red Bull and caffeine treatments. There was no significant difference (P > .05) in mean heart rate or rating of perceived exertion among the 3 treatments. This study demonstrated that a moderate dose of caffeine consumed as either Red Bull or in anhydrous form enhanced cycling time-trial performance. The ergogenic benefits of Red Bull energy drink are therefore most likely due to the effects of caffeine, with the other ingredients not likely to offer additional benefit.

  9. Comparing methods to combine functional loss and mortality in clinical trials for amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    van Eijk RPA

    2018-03-01

    Full Text Available Ruben PA van Eijk,1 Marinus JC Eijkemans,2 Dimitris Rizopoulos,3 Leonard H van den Berg,4,* Stavros Nikolakopoulos5,* 1Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands; 2Department of Biostatistics, University Medical Center Utrecht, Utrecht, the Netherlands; 3Department of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands; 4Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands; 5Department of Biostatistics, University Medical Center Utrecht, Utrecht, the Netherlands *These authors contributed equally to this work Objective: Amyotrophic lateral sclerosis (ALS clinical trials based on single end points only partially capture the full treatment effect when both function and mortality are affected, and may falsely dismiss efficacious drugs as futile. We aimed to investigate the statistical properties of several strategies for the simultaneous analysis of function and mortality in ALS clinical trials. Methods: Based on the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT database, we simulated longitudinal patterns of functional decline, defined by the revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R and conditional survival time. Different treatment scenarios with varying effect sizes were simulated with follow-up ranging from 12 to 18 months. We considered the following analytical strategies: 1 Cox model; 2 linear mixed effects (LME model; 3 omnibus test based on Cox and LME models; 4 composite time-to-6-point decrease or death; 5 combined assessment of function and survival (CAFS; and 6 test based on joint modeling framework. For each analytical strategy, we calculated the empirical power and sample size. Results: Both Cox and LME models have increased false-negative rates when treatment exclusively affects either function or survival. The joint model has superior power compared to other strategies. The composite end point

  10. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell; Stengaard-Pedersen, Kristian; Buchbinder, Rachelle; Fredberg, Ulrich; Bliddal, Henning; Christensen, Robin

    2013-06-01

    Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available. To assess the comparative effectiveness and safety of injection therapies in patients with lateral epicondylitis. Systematic review and meta-analysis. Randomized controlled trials comparing different injection therapies for lateral epicondylitis were included provided they contained data for change in pain intensity (primary outcome). Trials were assessed using the Cochrane risk of bias tool. Network (random effects) meta-analysis was applied to combine direct and indirect evidence within and across trial data using the final end point reported in the trials, and results for the arm-based network analyses are reported as standardized mean differences (SMDs). Seventeen trials (1381 participants; 3 [18%] at low risk of bias) assessing injection with 8 different treatments-glucocorticoid (10 trials), botulinum toxin (4 trials), autologous blood (3 trials), platelet-rich plasma (2 trials), and polidocanol, glycosaminoglycan, prolotherapy, and hyaluronic acid (1 trial each)-were included. Pooled results (SMD [95% confidence interval]) showed that beyond 8 weeks, glucocorticoid injection was no more effective than placebo (-0.04 [-0.45 to 0.35]), but only 1 trial (which did not include a placebo arm) was at low risk of bias. Although botulinum toxin showed marginal benefit (-0.50 [-0.91 to -0.08]), it caused temporary paresis of finger extension, and all trials were at high risk of bias. Both autologous blood (-1.43 [-2.15 to -0.71]) and platelet-rich plasma (-1.13 [-1.77 to -0.49]) were also statistically superior to placebo, but only 1 trial was at low risk of bias. Prolotherapy (-2.71 [-4.60 to -0.82]) and hyaluronic acid (-5.58 [-6.35 to -4.82]) were both more efficacious than placebo, whereas polidocanol (0.39 [-0.42 to 1.20]) and glycosaminoglycan (-0.32 [-1.02 to 0

  11. Comparative Investigation on the Performance of Modified System Poles and Traditional System Poles Obtained from PDC Data for Diagnosing the Ageing Condition of Transformer Polymer Insulation Materials

    Directory of Open Access Journals (Sweden)

    Jiefeng Liu

    2018-02-01

    Full Text Available The life expectancy of a transformer is largely depended on the service life of transformer polymer insulation materials. Nowadays, several papers have reported that the traditional system poles obtained from polarization and depolarization current (PDC data can be used to assess the condition of transformer insulation systems. However, the traditional system poles technique only provides limited ageing information for transformer polymer insulation. In this paper, the modified system poles obtained from PDC data are proposed to assess the ageing condition of transformer polymer insulation. The aim of the work is to focus on reporting a comparative investigation on the performance of modified system poles and traditional system poles for assessing the ageing condition of a transformer polymer insulation system. In the present work, a series of experiments have been performed under controlled laboratory conditions. The PDC measurement data, degree of polymerization (DP and moisture content of the oil-immersed polymer pressboard specimens were carefully monitored. It is observed that, compared to the relationships between traditional system poles and DP values, there are better correlations between the modified system poles and DP values, because the modified system poles can obtain much more ageing information on transformer polymer insulation. Therefore, the modified system poles proposed in the paper are more suitable for the diagnosis of the ageing condition of transformer polymer insulation.

  12. Comparing energy sources for surgical ablation of atrial fibrillation: a Bayesian network meta-analysis of randomized, controlled trials.

    Science.gov (United States)

    Phan, Kevin; Xie, Ashleigh; Kumar, Narendra; Wong, Sophia; Medi, Caroline; La Meir, Mark; Yan, Tristan D

    2015-08-01

    Simplified maze procedures involving radiofrequency, cryoenergy and microwave energy sources have been increasingly utilized for surgical treatment of atrial fibrillation as an alternative to the traditional cut-and-sew approach. In the absence of direct comparisons, a Bayesian network meta-analysis is another alternative to assess the relative effect of different treatments, using indirect evidence. A Bayesian meta-analysis of indirect evidence was performed using 16 published randomized trials identified from 6 databases. Rank probability analysis was used to rank each intervention in terms of their probability of having the best outcome. Sinus rhythm prevalence beyond the 12-month follow-up was similar between the cut-and-sew, microwave and radiofrequency approaches, which were all ranked better than cryoablation (respectively, 39, 36, and 25 vs 1%). The cut-and-sew maze was ranked worst in terms of mortality outcomes compared with microwave, radiofrequency and cryoenergy (2 vs 19, 34, and 24%, respectively). The cut-and-sew maze procedure was associated with significantly lower stroke rates compared with microwave ablation [odds ratio <0.01; 95% confidence interval 0.00, 0.82], and ranked the best in terms of pacemaker requirements compared with microwave, radiofrequency and cryoenergy (81 vs 14, and 1, <0.01% respectively). Bayesian rank probability analysis shows that the cut-and-sew approach is associated with the best outcomes in terms of sinus rhythm prevalence and stroke outcomes, and remains the gold standard approach for AF treatment. Given the limitations of indirect comparison analysis, these results should be viewed with caution and not over-interpreted. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  13. Behavioral Effects of Neurofeedback Compared to Stimulants and Physical Activity in Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Geladé, Katleen; Janssen, Tieme W. P.; Bink, Marleen; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap

    2016-01-01

    The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, is still an intensely debated subject. The current randomized controlled trial compared neurofeedback to (1) optimally

  14. Behavioral Effects of Neurofeedback Compared to Stimulants and Physical Activity in Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Gelade, K.; Janssen, T.W.P.; Bink, M.; van Mourik, R.; Maras, A.; Oosterlaan, J.

    2016-01-01

    Objective: The efficacy of neurofeedback as treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, are still intensely debated subjects. The current randomised controlled trial compared neurofeedback to (1) optimally

  15. INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia

    Directory of Open Access Journals (Sweden)

    Gilmore Rose

    2010-01-01

    Full Text Available Abstract Background Congenital hemiplegia is the most common form of cerebral palsy (CP accounting for 1 in 1300 live births. These children have limitations in capacity to use the impaired upper limb and bimanual coordination deficits which impact on daily activities and participation in home, school and community life. There are currently two diverse intensive therapy approaches. Traditional therapy has adopted a bimanual approach (BIM training and recently, constraint induced movement therapy (CIMT has emerged as a promising unimanual approach. Uncertainty remains about the efficacy of these interventions and characteristics of best responders. This study aims to compare the efficacy of CIMT to BIM training to improve outcomes across the ICF for school children with congenital hemiplegia. Methods/Design A matched pairs randomised comparison design will be used with children matched by age, gender, side of hemiplegia and level of upper limb function. Based on power calculations a sample size of 52 children (26 matched pairs will be recruited. Children will be randomised within pairs to receive either CIMT or BIM training. Both interventions will use an intensive activity based day camp model, with groups receiving the same dosage of intervention delivered in the same environment (total 60 hours over 10 days. A novel circus theme will be used to enhance motivation. Groups will be compared at baseline, then at 3, 26 and 52 weeks following intervention. Severity of congenital hemiplegia will be classified according to brain structure (MRI and white matter fibre tracking, cortical excitability using Transcranial Magnetic Stimulation (TMS, functional use of the hand in everyday tasks (Manual Ability Classification System and Gross Motor Function Classification System (GMFCS. Outcomes will address neurovascular changes (functional MRI, functional connectivity, and brain (reorganisation (TMS, body structure and function (range of motion, spasticity

  16. The IDvIP Trial: A two-centre randomised double-blind controlled trial comparing intramuscular diamorphine and intramuscular pethidine for labour analgesia

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    Thomas Peter

    2011-07-01

    Full Text Available Abstract Background Intramuscular pethidine is routinely used throughout the UK for labour analgesia. Studies have suggested that pethidine provides little pain relief in labour and has a number of side effects affecting mother and neonate. It can cause nausea, vomiting and dysphoria in mothers and can cause reduced fetal heart rate variability and accelerations. Neonatal effects include respiratory depression and impaired feeding. There are few large studies comparing the relative side effects and efficacy of different opioids in labour. A small trial comparing intramuscular pethidine with diamorphine, showed diamorphine to have some benefits over pethidine when used for labour analgesia but the study did not investigate the adverse effects of either opioid. Methods The Intramuscular Diamorphine versus Intramuscular Pethidine (IDvIP trial is a randomised double-blind two centre controlled trial comparing intramuscular diamorphine and pethidine regarding their analgesic efficacy in labour and their side effects in mother, fetus and neonate. Information about the trial will be provided to women in the antenatal period or in early labour. Consent and recruitment to the trial will be obtained when the mother requests opioid analgesia. The sample size requirement is 406 women with data on primary outcomes. The maternal primary outcomes are pain relief during the first 3 hours after trial analgesia and specifically pain relief after 60 minutes. The neonatal primary outcomes are need for resuscitation and Apgar Score Discussion If the trial demonstrates that diamorphine provides better analgesia with fewer side effects in mother and neonate this could lead to a change in national practice and result in diamorphine becoming the preferred intramuscular opioid for analgesia in labour. Trial Registration ISRCTN14898678 Eudra No: 2006-003250-18, REC Reference No: 06/Q1702/95, MHRA Authorisation No: 1443/0001/001-0001, NIHR UKCRN reference 6895, RfPB grant

  17. Nootropic activity of lipid-based extract of Bacopa monniera Linn. compared with traditional preparation and extracts.

    Science.gov (United States)

    Lohidasan, Sathiyanarayanan; Paradkar, Anant R; Mahadik, Kakasaheb R

    2009-11-01

    The aim was to design an alternative solvent-free extraction method using the hydrophilic lipid Gelucire (polyethylene glycol glycerides) for herbal extraction and to confirm the efficacy of extraction using biological screening. Bacopa monniera Linn. (BM) was selected for the study. Conventional methanolic extract (MEBM), Ayurvedic ghrita (AGBM) and lipid extracts (LEBM) were prepared and standardised by high-performance thin-layer chromatography (HPTLC). Nootropic activity in rats was evaluated using the two-trial Y-maze test and the anterograde amnesia induced by scopolamine (1 mg/kg i.p.) determined by the conditioned avoidance response. The extracts were administered daily at doses of 100, 200 and 400 mg/kg orally. At the end of the conditioned avoidance response test, brain monoamine levels were estimated by HPLC. The LEBM, MEBM and AGBM contained 3.56%, 4.10% and 0.005% bacoside A, respectively. Significantly greater spatial recognition was observed with LEBM (P nootropic activity to the MEBM.

  18. Xenosurveillance reflects traditional sampling techniques for the identification of human pathogens: A comparative study in West Africa.

    Directory of Open Access Journals (Sweden)

    Joseph R Fauver

    2018-03-01

    Full Text Available Novel surveillance strategies are needed to detect the rapid and continuous emergence of infectious disease agents. Ideally, new sampling strategies should be simple to implement, technologically uncomplicated, and applicable to areas where emergence events are known to occur. To this end, xenosurveillance is a technique that makes use of blood collected by hematophagous arthropods to monitor and identify vertebrate pathogens. Mosquitoes are largely ubiquitous animals that often exist in sizable populations. As well, many domestic or peridomestic species of mosquitoes will preferentially take blood-meals from humans, making them a unique and largely untapped reservoir to collect human blood.We sought to take advantage of this phenomenon by systematically collecting blood-fed mosquitoes during a field trail in Northern Liberia to determine whether pathogen sequences from blood engorged mosquitoes accurately mirror those obtained directly from humans. Specifically, blood was collected from humans via finger-stick and by aspirating bloodfed mosquitoes from the inside of houses. Shotgun metagenomic sequencing of RNA and DNA derived from these specimens was performed to detect pathogen sequences. Samples obtained from xenosurveillance and from finger-stick blood collection produced a similar number and quality of reads aligning to two human viruses, GB virus C and hepatitis B virus.This study represents the first systematic comparison between xenosurveillance and more traditional sampling methodologies, while also demonstrating the viability of xenosurveillance as a tool to sample human blood for circulating pathogens.

  19. Traditional career versus self-directed or protean career: a comparative study of satisfaction with career, profession and work

    Directory of Open Access Journals (Sweden)

    Guilherme Assunção de Andrade

    2011-12-01

    Full Text Available DOI: 10.5007/2175-8077.2011v13n31p58 This research has analyzed if the attitudes and values of news professionals are more adherent to the traditional idea of career or self-directed/protean careers. The objectives were to identify the anchors of respondents’ careers, the degree of satisfaction towards their careers, professions and work and the relationship between these variables and their career profiles. The data collection instrument used was a questionnaire and a sample consisted of 113 graduate and undergraduate students in the area of Administration. As a result, we have found the “Lifestyle” career anchor with the highest average, indicating a tendency to pursue a career that allows integrating personal, family and work lives. We have detected a trend of the subjects to track the protean career. And no correlation was found between career anchors and career satisfaction, indicating that there is not a specific anchor that could provide greater work satisfaction than others. The study contributes to the proposition questions about the career profile that has been used, with the identification of the level of professional satisfaction. Besides it has indicated there should be a revision of the scale of Career Anchors, in order to increase its reliability.

  20. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial

    Science.gov (United States)

    Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

    2018-01-01

    Abstract Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Design Prospective, randomized, 52 week, single blind comparative effectiveness trial. Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016. Participants 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Interventions Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. Main outcome measures The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. Results FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with

  1. FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups.

    Science.gov (United States)

    Howard, Courtney; Rose, Caren Lee; Trouton, Konia; Stamm, Holly; Marentette, Danielle; Kirkpatrick, Nicole; Karalic, Sanja; Fernandez, Renee; Paget, Julie

    2011-06-01

    To determine whether menstrual cups are a viable alternative to tampons. Randomized controlled trial. Prince George, Victoria, and Vancouver, BC. A total of 110 women aged 19 to 40 years who had previously used tampons as their main method of menstrual management. Participants were randomized into 2 groups, a tampon group and a menstrual cup group. Using online diaries, participants tracked 1 menstrual cycle using their regular method and 3 menstrual cycles using the method of their allocated group. Overall satisfaction; secondary outcomes included discomfort, urovaginal infection, cost, and waste. Forty-seven women in each group completed the final survey, 5 of whom were subsequently excluded from analysis (3 from the tampon group and 2 from the menstrual cup group). Overall satisfaction on a 7-point Likert scale was higher for the menstrual cup group than for the tampon group (mean [standard deviation] score 5.4 [1.5] vs 5.0 [1.0], respectively; P=.04). Approximately 91% of women in the menstrual cup group said they would continue to use the cup and recommend it to others. Women used a median of 13 menstrual products per cycle, or 169 products per year, which corresponds to approximately 771,248,400 products used annually in Canada. Estimated cost for tampon use was $37.44 a year (similar to the retail cost of 1 menstrual cup). Subjective vaginal discomfort was initially higher in the menstrual cup group, but the discomfort decreased with continued use. There was no significant difference in physician-diagnosed urovaginal symptoms between the 2 groups. Both of the menstrual management methods evaluated were well tolerated by subjects. Menstrual cups are a satisfactory alternative to tampons and have the potential to be a sustainable solution to menstrual management, with moderate cost savings and much-reduced environmental effects compared with tampons. Trial registration number C06-0478 (ClinicalTrials.gov).

  2. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence.

    Science.gov (United States)

    McGaghie, William C; Issenberg, S Barry; Cohen, Elaine R; Barsuk, Jeffrey H; Wayne, Diane B

    2011-06-01

    This article presents a comparison of the effectiveness of traditional clinical education toward skill acquisition goals versus simulation-based medical education (SBME) with deliberate practice (DP). This is a quantitative meta-analysis that spans 20 years, 1990 to 2010. A search strategy involving three literature databases, 12 search terms, and four inclusion criteria was used. Four authors independently retrieved and reviewed articles. Main outcome measures were extracted to calculate effect sizes. Of 3,742 articles identified, 14 met inclusion criteria. The overall effect size for the 14 studies evaluating the comparative effectiveness of SBME compared with traditional clinical medical education was 0.71 (95% confidence interval, 0.65-0.76; P medical education in achieving specific clinical skill acquisition goals. SBME is a complex educational intervention that should be introduced thoughtfully and evaluated rigorously at training sites. Further research on incorporating SBME with DP into medical education is needed to amplify its power, utility, and cost-effectiveness.

  3. DIAGNOSTIC CARDIAC CATHETERIZATION USING THE MEDRAD AVANTA FLUID MANAGEMENT SYSTEM AS COMPARED TO THE TRADITIONAL MANUAL INJECTION METHOD

    Energy Technology Data Exchange (ETDEWEB)

    Winniford, Michael D

    2013-02-08

    Nearly 4 million patient procedures performed annually in US cardiac catheterization laboratories utilize contrast media to achieve vessel opacification. The amount of contrast media used is variable and depends on the complexity of the procedure, the method of contrast delivery as well as the skill-level of the operator. Since the total amount of contrast used for each procedure can have both patient safety and economic implications, it is essential for cardiologists to have the ability to control contrast delivery such that optimal angiographic image quality is achieved using the least amount of contrast. Although the complication rate associated with cardiac catheterization remains low, the most common serious complication, contrast-induced nephropathy (CIN), is associated with poor prognosis and a high mortality rate. Numerous interventional strategies for preventing and reducing the severity of CIN have demonstrated varying degrees of clinical benefit, but none has been shown to reliably prevent this serious complication. To date, the most effective approach for reducing the risk of CIN is to properly hydrate the patient and to minimize the amount of contrast media administered. Automated injection systems are intended for use in virtually all cardiac catheterization procedures and have numerous features which can provide potential advantages over traditional methods. With automated injection technology the operator is able to control and precisely monitor contrast delivery. Additionally, the MEDRAD Avanta Fluid Management Injection System utilizes a sterile contrast reservoir which eliminates the need to discard unused contrast in individual opened containers following each procedure. Considering that an average of 50% of opened contrast media is wasted using manual injection methods, this savings can provide a substantial economic benefit. Automated systems also facilitate the use of smaller (5 French) catheter sizes. Precise flow control and the use of

  4. Green Building between Tradition and Modernity Study Comparative Analysis between Conventional Methods and Updated Styles of Design and Architecture Processors

    Directory of Open Access Journals (Sweden)

    H Elshimy

    2017-03-01

    Full Text Available Green house   concept appeared from the ancient to the modern age ages and there is a tendency to use a traditional architecture with a pristine ecological environment areas and through sophisticated systems arrived to modern systems of the upgraded systems by Treatment architectural achieve environmental   sustainability   in   recent   years,   sustainability concept has become the common interest of numerous disciplines. The reason for this popularity is to perform the sustainable development. The Concept of Green Architecture, also known as "sustainable architecture” or “green house,” is the theory, science and style of buildings designed and constructed in accordance   with environmentally   friendly   principles.   Green house strives to minimize the number of resources consumed in the   building's  construction,   use   and   operation,   as  well  as curtailing  the  harm  done  to  the  environment  through  the emission, pollution and waste of its components.To design, construct, operate and maintain buildings energy, water and new materials are utilized as well as amounts of waste causing negative effects to health and environment is generated. In order to limit these effects and design environmentally sound and resource efficient buildings; "green building systems" must be introduced, clarified, understood and practiced.This paper aims at highlighting these difficult and complex issues of sustainability which encompass the scope of almost every aspect of human life.

  5. Comparative evaluation of reproductive parameters between the automatic GEDIS cervical insemination method and the traditional in multicolor bristles

    Directory of Open Access Journals (Sweden)

    Núñez-Torres Oscar Patricio

    2017-04-01

    Full Text Available The research was carried out in Ecuador, in the province of Tungurahua, Cevallos county. A comparison of reproductive parameters between the cervical self insemination method and the traditional one in multiparous sows was performed using 12 sows (hybrid females between the second and fourth calving, dividing In two groups of 6 sows respectively, using the insemination protocol 12h - 24h - 36h. Fresh semen was prepared with long-term diluent + bidistilled water, at a concentration of 3 x 109 spermatozoa/mL in total volume per 100 mL straw. At the time of insemination the amount of seminal reflux was determined and when the Student's T test was applied with paired observations in the results, they statistically reported a significant difference at 5% among the evaluated methods, the calculated T value was 9.50 Which is greater than the T of tables at 5% of 2.57. The duration of each method was determined, results that reported similarity between the two methods (15 min. At 21 days post insemination pregnancy was diagnosed by ultrasound and evaluation of no return of heat, results that reported in both methods 100% effectiveness. Subsequently, at the time of delivery, the number of total born piglets was evaluated, using the Student's T-test with paired observations that statistically there was no significant difference at 5% between the two methods, the calculated T value was 0, 14 which is less than the T of tables at 5% of 2.57. We also determined the weight of piglets at birth, reported by Student's t-test with paired observations that there is a statistically significant difference to 5% among the evaluated methods, the calculated T value was 5.17, which is higher than the T Of tables at 5% of 2.57. As for costs there is no considerable difference.

  6. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial.

    Science.gov (United States)

    Tan, Peng Chiong; Norazilah, Mat Jin; Omar, Siti Zawiah

    2013-02-01

    To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum. Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours. Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different. Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes. ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409. I.

  7. Do traditional techniques produce better conventional complete dentures than simplified techniques? A 10-year follow-up of a randomized clinical trial.

    Science.gov (United States)

    Kawai, Yasuhiko; Muarakami, Hiroshi; Feine, Jocelyne S

    2018-07-01

    The use of a simplified method (S) of fabricating complete dentures has been shown to be more cost-efficient than the traditional method (T), and there are no negative consequences that detract from the cost savings in the short term. However, it is not clear whether this remains constant over a decade. The objective of this study was to clarify patients' perspectives and determine any differences between the dentures fabricated with these two different techniques after a decade of use. Edentate individuals participated in a randomized controlled clinical trial and completed a 6-month follow-up from 2001 to 2003 (T group n = 50; S group n = 54). For this 10-year follow-up, they were interviewed by telephone. The assessment included whether the denture was still in use or replaced, the condition of the dentures, patient satisfaction and oral health-related quality of life (OHRQoL). Between and within-group differences and the factors that cause deterioration of oral health-related quality of life (OHRQoL) were determined. Among 54 responders (25 T and 29 S), 14T and 21S kept the original dentures. Both groups were similar in ratings of satisfaction and OHRQoL (maxilla T: 80.0 S: 86.0, p = 0.36; mandibular; T: 66.1 S: 72.3, p = 0.48; OHRQoL T: 111.1 S: 108.5, p = 0.46). Irrespective of fabrication method, discomfort, chewing difficulty and esthetics were the factors that deteriorate OHRQoL (adjusted r = 0.76, p < 0.001). The results indicate that the simplified method remains more cost-efficient than the traditional method over a 10-year period. (IRB approval: A09-E71-12 B McGill University, trial registry: ClinicalTrial.org; NCT02289443). Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia.

    Science.gov (United States)

    Steele, Catriona M; Bayley, Mark T; Peladeau-Pigeon, Melanie; Nagy, Ahmed; Namasivayam, Ashwini M; Stokely, Shauna L; Wolkin, Talia

    2016-06-01

    The objective of this study was to compare the outcomes of two tongue resistance training protocols. One protocol ("tongue-pressure profile training") emphasized the pressure-timing patterns that are typically seen in healthy swallows by focusing on gradual pressure release and saliva swallowing tasks. The second protocol ("tongue-pressure strength and accuracy training") emphasized strength and accuracy in tongue-palate pressure generation and did not include swallowing tasks. A prospective, randomized, parallel allocation trial was conducted. Of 26 participants who were screened for eligibility, 14 received up to 24 sessions of treatment. Outcome measures of posterior tongue strength, oral bolus control, penetration-aspiration and vallecular residue were made based on videofluoroscopy analysis by blinded raters. Complete data were available for 11 participants. Significant improvements were seen in tongue strength and post-swallow vallecular residue with thin liquids, regardless of treatment condition. Stage transition duration (a measure of the duration of the bolus presence in the pharynx prior to swallow initiation, which had been chosen to capture impairments in oral bolus control) showed no significant differences. Similarly, significant improvements were not seen in median scores on the penetration-aspiration scale. This trial suggests that tongue strength can be improved with resistance training for individuals with tongue weakness following stroke. We conclude that improved penetration-aspiration does not necessarily accompany improvements in tongue strength; however, tongue-pressure resistance training does appear to be effective for reducing thin liquid vallecular residue.

  9. A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain

    Science.gov (United States)

    Cherkin, Daniel C.; Sherman, Karen J.; Avins, Andrew L.; Erro, Janet H.; Ichikawa, Laura; Barlow, William E.; Delaney, Kristin; Hawkes, Rene; Hamilton, Luisa; Pressman, Alice; Khalsa, Partap S.; Deyo, Richard A.

    2009-01-01

    Background Acupuncture is a popular complementary and alternative treatment for chronic back pain. Recent European trials suggest similar short-term benefits from real and sham acupuncture needling. This trial addresses the importance of needle placement and skin penetration in eliciting acupuncture effects for patients with chronic low back pain. Methods 638 adults with chronic mechanical low back pain were randomized to: individualized acupuncture, standardized acupuncture, simulated acupuncture, or usual care. Ten treatments were provided over 7 weeks by experienced acupuncturists. The primary outcomes were back-related dysfunction (Roland Disability score, range: 0 to 23) and symptom bothersomeness (0 to 10 scale). Outcomes were assessed at baseline and after 8, 26 and 52 weeks. Results At 8 weeks, mean dysfunction scores for the individualized, standardized, and simulated acupuncture groups improved by 4.4, 4.5, and 4.4 points, respectively, compared with 2.1 points for those receiving usual care (P0.05). Conclusions Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture, or our simulated method of acupuncture, provide physiologically important stimulation or represent placebo or non-specific effects. PMID:19433697

  10. A comparative analysis of the electrical activity of the abdominal muscles during traditional and Pilates-based exercises under two conditions

    Directory of Open Access Journals (Sweden)

    Mariana Felipe Silva

    2013-04-01

    Full Text Available The use of Pilates-based exercises for trunk strengthening has been reported in the literature. The objective of this study was to analyze and compare the electrical activity of the rectus abdominis and external oblique muscles during a traditional abdominal exercise program and an exercise program based on the Pilates method using a ball and an elastic band. The sample was composed of 10 healthy women, non-practitioners of Pilates, who performed the traditional abdominal exercise and roll-up with the ball and elastic band. The sign was normalized by the electromyographic peak of the dynamics activity and was adjusted for 2000 samples/s; the filter was set in a frequency band from 20 to 450 Hz. In the comparison between exercises, the external oblique muscle in the concentric phase had a higher recruitment in the roll-up with the ball (P =0.042. In the comparison between muscles in each exercise, the rectus abdominis showed a higher activation in the concentric phase (P = 0.009 and in the eccentric phase (P = 0.05 of the traditional abdominal exercise. Activation percentages ranged from 15% to 22%. The traditional abdominal exercise had the largest activation percentage.

  11. Comparative trial of Aloe vera/olive oil combination cream versus phenytoin cream in the treatment of chronic wounds.

    Science.gov (United States)

    Panahi, Y; Izadi, M; Sayyadi, N; Rezaee, R; Jonaidi-Jafari, N; Beiraghdar, F; Zamani, A; Sahebkar, A

    2015-10-01

    Aloe vera is a medicinal plant that has been traditionally used to accelerate wound healing. Olive oil is also a natural product that may contribute to wound healing owing to its antimicrobial and anti-inflammatory effects. The present study aimed to evaluate the effect of an Aloe vera-olive oil (AVO) combination cream on the healing process of chronic wounds. In this randomised, double-blind, comparator-controlled, parallel-group trial, patients with chronic wounds were treated with either AVO cream or phenytoin cream as the standard treatment for a period of 30 days. Wound healing was evaluated using Bates-Jensen assessment tool and the severity of pain was assessed using a visual analogue scale (VAS). After initial assessment, 60 patients with chronic wounds (41 with pressure ulcer, 13 with diabetic wounds and 6 with venous ulcers), were recruited and randomised into 2 groups of 30. After 30 days of treatment, significant improvements in the wound size, depth, and edges; necrotic tissue type and amount; exudate type and amount; colour of wound surroundings; and peripheral tissue oedema score were observed in the AVO cream group (p<0.001). The total score of wound healing showed significant improvement with both AVO (p<0.001) and phenytoin (p<0.01) creams, although AVO was more efficacious (p<0.001). Likewise, although both treatments reduced the initial VAS score, the efficacy of AVO was significantly greater (p<0.001). AVO cream significantly accelerates biological healing of chronic wounds and helps to reduce pain severity with a higher efficacy compared with phenytoin cream.

  12. Comparative study of cranial anthropometric measurement by traditional calipers to computed tomography and three-dimensional photogrammetry.

    Science.gov (United States)

    Mendonca, Derick A; Naidoo, Sybill D; Skolnick, Gary; Skladman, Rachel; Woo, Albert S

    2013-07-01

    Craniofacial anthropometry by direct caliper measurements is a common method of quantifying the morphology of the cranial vault. New digital imaging modalities including computed tomography and three-dimensional photogrammetry are similarly being used to obtain craniofacial surface measurements. This study sought to compare the accuracy of anthropometric measurements obtained by calipers versus 2 methods of digital imaging.Standard anterior-posterior, biparietal, and cranial index measurements were directly obtained on 19 participants with an age range of 1 to 20 months. Computed tomographic scans and three-dimensional photographs were both obtained on each child within 2 weeks of the clinical examination. Two analysts measured the anterior-posterior and biparietal distances on the digital images. Measures of reliability and bias between the modalities were calculated and compared.Caliper measurements were found to underestimate the anterior-posterior and biparietal distances as compared with those of the computed tomography and the three-dimensional photogrammetry (P photogrammetry (P = 0.002). The coefficients of variation for repeated measures based on the computed tomography and the three-dimensional photogrammetry were 0.008 and 0.007, respectively.In conclusion, measurements based on digital modalities are generally reliable and interchangeable. Caliper measurements lead to underestimation of anterior-posterior and biparietal values compared with digital imaging.

  13. Performance of FLT-PET for pulmonary lesion diagnosis compared with traditional FDG-PET: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zixing; Wang, Yuyan [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China); Sui, Xin; Zhang, Wei [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Shi, Ruihong [National Institutes for Food and Drug Control, Beijing, 100000 (China); Zhang, Yingqiang; Dang, Yonghong; Qiao, Zhen [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Zhang, Biao [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China); Song, Wei, E-mail: cjr.songwei@vip.163.com [Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100005 (China); Jiang, Jingmei, E-mail: jingmeijiang238@hotmail.com [Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100005 (China)

    2015-07-15

    Highlights: • FDG PET is more sensitive compared with FLT for detecting small and early staged lung cancers. • FLT can reduce false positives of FDG for inflammation-based lesions such as tuberculosis. • FLT shows comparable accuracies for diagnoses of late stage tumors and larger pulmonary lesions. - Abstract: Purpose: Widely used {sup 18}F 2′-deoxy-2′-fluoro-D-glucose (FDG) positron emission tomography (PET) can be problematic with false positives in cancer imaging. This study aims to investigate the diagnostic accuracy of a candidate PET tracer, {sup 18}F 2′,3′-dideoxy-3′-fluoro-2-thiothymidine (FLT), in diagnosing pulmonary lesions compared with FDG. Materials and methods: After comprehensive search and study selection, a meta-analysis was performed on data from 548 patients pooled from 17 studies for evaluating FLT accuracy, in which data from 351 patients pooled from ten double-tracer studies was used for direct comparison with FDG. Weighted sensitivity and specificity were used as main indicators of test performance. Individual data was extracted and patient subgroup analyses were performed. Results: Overall, direct comparisons showed lower sensitivity (0.80 vs. 0.89) yet higher specificity (0.82 vs. 0.66) for FLT compared with FDG (both p < 0.01). Patient subgroup analysis showed FLT was less sensitive than FDG in detecting lung cancers staged as T1 or T2, and those ≤2.0 cm in diameter (0.81 vs. 0.93, and 0.53 vs. 0.78, respectively, both p < 0.05), but was comparable for cancers staged as T3 or T4, and those >2.0 cm in diameter (0.95 vs. 1.00, 0.96 vs. 0.88, both p > 0.05). For benignities, FLT performed better compared with FDG in ruling out inflammation-based lesions (0.57 vs. 0.32, p < 0.05), and demonstrated greater specificity regardless of lesion sizes. Conclusions: Although FLT cannot replace FDG in detecting small and early lung cancers, it may help to prevent patients with larger or inflammatory lesions from cancer misdiagnosis

  14. Comparative randomised active drug controlled clinical trial of a herbal eye drop in computer vision syndrome.

    Science.gov (United States)

    Chatterjee, Pranab Kr; Bairagi, Debasis; Roy, Sudipta; Majumder, Nilay Kr; Paul, Ratish Ch; Bagchi, Sunil Ch

    2005-07-01

    A comparative double-blind placebo-controlled clinical trial of a herbal eye drop (itone) was conducted to find out its efficacy and safety in 120 patients with computer vision syndrome. Patients using computers for more than 3 hours continuously per day having symptoms of watering, redness, asthenia, irritation, foreign body sensation and signs of conjunctival hyperaemia, corneal filaments and mucus were studied. One hundred and twenty patients were randomly given either placebo, tears substitute (tears plus) or itone in identical vials with specific code number and were instructed to put one drop four times daily for 6 weeks. Subjective and objective assessments were done at bi-weekly intervals. In computer vision syndrome both subjective and objective improvements were noticed with itone drops. Itone drop was found significantly better than placebo (pcomputer vision syndrome.

  15. A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers

    DEFF Research Database (Denmark)

    Rasmussen, Benjamin S B; Froekjaer, Johnny; Bjerregaard, Mads R

    2015-01-01

    OBJECTIVE: The role of telemedical monitoring in diabetic foot ulcer care is still uncertain. Our aim was to compare telemedical and standard outpatient monitoring in the care of patients with diabetic foot ulcers in a randomized controlled trial. RESEARCH DESIGN AND METHODS: Of the 736 screened...... individuals with diabetic foot ulcers, 401 met the eligibility criteria and were randomized between October 2010 and November 2014. The per-protocol telemedical monitoring consisted of two consultations in the patient's own home and one consultation at the outpatient clinic. Standard practice consisted...... monitoring, a higher mortality throws into question the role of telemedicine in monitoring diabetic foot ulcers. Further studies are needed to investigate effects of telemedicine on mortality and other clinical outcomes and to identify patient subgroups that may have a poorer outcome through telemedical...

  16. Comparability of patients with ANCA-associated vasculitis enrolled in clinical trials or in observational cohorts

    Science.gov (United States)

    Pagnoux, Christian; Carette, Simon; Khalidi, Nader A.; Walsh, Michael; Hiemstra, Thomas F.; Cuthbertson, David; Langford, Carol; Hoffman, Gary S.; Koening, Curry L.; Monach, Paul A.; Moreland, Larry; Mouthon, Luc; Seo, Phil; Specks, Ulrich; Ytterberg, Steven; Westman, Kerstin; Hoglund, Peter; Harper, Lorraine; Flossmann, Oliver; Luqmani, Raashid; Savage, Caroline; Rasmussen, Niels; de Groot, Kirstin; Tesar, Vladimir; Jayne, David; Merkel, Pater A.; Guillevin, Loic

    2015-01-01

    Objective To analyse the differences between patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) entered into randomised clinical trials (RCTs) and those followed in large observational cohorts. Methods The main characteristics and outcomes of patients with generalised and/or severe GPA or MPA with a five-factor score ≥1 enrolled in the French Vasculitis Study Group (FVSG) or the US-Canadian-based Vasculitis Clinical Research Consortium cohorts were compared to those enrolled in one of 2 FVSG clinical RCTs (WEG91, WEGENT) or 3 European Vasculitis Society clinical trials (CYCLOPS, CYCAZAREM, IMPROVE). Results 657 patients (65.3% with GPA) in RCTs were compared to 437 in cohorts (90.6% with GPA). RCT patients were older at diagnosis than the cohort patients (56.6±13.9 vs. 46.8±17.3 years), had higher Birmingham vasculitis activity score (19.5±9.1 vs. 16.9±7.4), and more frequent kidney disease (84.0% vs. 54.9%) but fewer ear, nose, and throat symptoms (56.8% vs. 72.2%). At 56 months post-diagnosis, mortality and relapse rates, adjusted for age and renal function, were higher for patients with GPA in RCTs vs. cohorts (10.7% vs. 2.5% [p=0.001] and 22.5% vs. 15.6% [p=0.03], respectively) but similar for patients with MPA (6.2% vs. 6.6% [p=0.92] and 16.6% vs. 10.1% [p=0.39], respectively). Conclusion Patients with GPA or MPA in RCTs and those in observational cohorts show important differences that should be remembered when interpreting results based on these study populations. PMID:26016754

  17. Economic evaluation of the randomized European Achalasia trial comparing pneumodilation with Laparoscopic Heller myotomy.

    Science.gov (United States)

    Moonen, A; Busch, O; Costantini, M; Finotti, E; Tack, J; Salvador, R; Boeckxstaens, G; Zaninotto, G

    2017-11-01

    A recent multicenter randomized trial in achalasia patients has shown that pneumatic dilation resulted in equivalent relief of symptoms compared to laparoscopic Heller myotomy. Additionally, the cost of each treatment should be also taken in consideration. Therefore, the aim of the present study was to perform an economic analysis of the European achalasia trial. Patients with newly diagnosed achalasia were enrolled from to 2003 to 2008 in 14 centers in five European countries and were randomly assigned to either pneumatic dilation (PD) or laparoscopic Heller (LHM). The economic analysis was performed in the three centers in three different countries where most patients were enrolled (Amsterdam [NL], Leuven, [B] and Padova [I]) and then applied to all patients included in the study. The total raw costs of the two treatments per patient include the initial costs, the costs of complications, and the costs of retreatments. Two hundred and one patients, 107 (57 males and 50 females, mean age 46 CI: 43-49 years) were randomized to LHM and 94 (59 males and 34 females, mean age 46 CI 43-50 years) to PD. The total cost of PD per patient was quite comparable in the three different centers; €3397 in Padova, €3259 in Amsterdam and €3792 in Leuven. For LHM, the total costs per patient were highest in Amsterdam: €4488 in Padova, €6720 in Amsterdam, and €5856 in Leuven. In conclusion, the strategy of treating achalasia starting with PD appears the most economic approach, independent of the health system. © 2017 John Wiley & Sons Ltd.

  18. Randomized clinical trial to comparing efficacy of daily, weekly and monthly administration of vitamin D3.

    Science.gov (United States)

    Takács, István; Tóth, Béla E; Szekeres, László; Szabó, Boglárka; Bakos, Bence; Lakatos, Péter

    2017-01-01

    The comparative efficacy and safety profiles of selected daily 1000 IU, weekly 7000 IU and monthly 30,000 IU vitamin D 3 -not previously investigated-will be evaluated. Here, a prospective, randomized clinical trial, comparing efficacy and safety of a daily single dose of 1000 IU (group A) to a once-weekly 7000 IU dose (group B), or monthly 30,000 IU dose (group C) of vitamin D 3 . The present study is a controlled, randomized, open-label, multicenter clinical trial, 3  months in duration. Sixty-four adult subjects with vitamin D deficiency (25OHD<20 ng/ml), were included according to the inclusion and exclusion criteria. Dose-responses for increases in serum vitamin 25OHD were statistically equivalent for each of the three groups: A, B and C. Outcomes were 13.0 ± 1.5; 12.6 ± 1.1 and 12.9 ± 0.9 ng/ml increases in serum 25OHD per 1000 IU, daily, weekly and monthly, respectively. The treatment of subjects with selected doses restored 25OHD values to levels above 20 ng/ml in all groups. Treatment with distinct administration frequency of vitamin D 3 did not exhibit any differences in safety parameters. The daily, weekly and monthly administrations of daily equivalent of 1000 IU of vitamin D 3 provide equal efficacy and safety profiles.

  19. Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.

    Science.gov (United States)

    Robinson, Emma; Titov, Nickolai; Andrews, Gavin; McIntyre, Karen; Schwencke, Genevieve; Solley, Karen

    2010-06-03

    Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (ptechnician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the

  20. To compare the efficacy of two kinds of Zhizhu pills in the treatment of functional dyspepsia of spleen-deficiency and qi-stagnation syndrome:a randomized group sequential comparative trial

    Science.gov (United States)

    2011-01-01

    Background In Traditional Chinese Medicine (TCM) theory, functional dyspepsia (FD) can be divided into different syndromes according to different clinical symptoms and signs, and the most common one is spleen-deficiency and qi-stagnation syndrome that can be treated by Chinese traditional patent medicine ---- two kinds of Zhizhu pills, between which the primary difference in ingredients is that one contains immature orange fruit of Citrus aurantium L.(IFCA) and the other contains that of Citrus sinensis Osbeck (IFCS). The trial's objective was to compare the efficacy of two kinds of Zhizhu pills on symptom changes in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods A randomized, group sequential, double-blinded, multicenter trial was conducted in patients with FD of spleen-deficiency and qi-stagnation syndrome at 3 hospitals in Beijing between June 2003 and May 2005. Participants were randomly allocated into two groups (IFCA group and IFCS group) in a 1:1 ratio, and respectively took one of the two kinds of Zhizhu pills orally, 6 g each time, 3 times a day, for 4 weeks. Statistical analysis was performed with use of a group sequential method, the triangular test (TT). Results A total of 163 patients were randomized, and 3 patients were excluded from analysis because of early dropouts, leaving 160 patients (IFCA group: n = 82; IFCS group: n = 78) for statistical analysis. Three interim analyses were done after 62, 116, and 160 patients had completed their 4-week treatment, respectively. At the third interim analysis, the sample path crossed the upper boundary and the trial was stopped, the cure-markedly effective rates were 45% for IFCS group and 67% for IFCA group, respectively, the one-sided p-value was 0.0036, the median unbiased estimate of the odds ratio (OR) for the benefit of IFCA relative to IFCS was 2.91 with 95%CI: 1.40 to 6.06. No adverse events were observed in the two groups. Conclusions Zhizhu pills containing IFCA was superior

  1. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial

    Science.gov (United States)

    2011-01-01

    Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. Trial

  2. A comparative study of traditional lecture methods and interactive lecture methods in introductory geology courses for non-science majors at the college level

    Science.gov (United States)

    Hundley, Stacey A.

    In recent years there has been a national call for reform in undergraduate science education. The goal of this reform movement in science education is to develop ways to improve undergraduate student learning with an emphasis on developing more effective teaching practices. Introductory science courses at the college level are generally taught using a traditional lecture format. Recent studies have shown incorporating active learning strategies within the traditional lecture classroom has positive effects on student outcomes. This study focuses on incorporating interactive teaching methods into the traditional lecture classroom to enhance student learning for non-science majors enrolled in introductory geology courses at a private university. Students' experience and instructional preferences regarding introductory geology courses were identified from survey data analysis. The information gained from responses to the questionnaire was utilized to develop an interactive lecture introductory geology course for non-science majors. Student outcomes were examined in introductory geology courses based on two teaching methods: interactive lecture and traditional lecture. There were no significant statistical differences between the groups based on the student outcomes and teaching methods. Incorporating interactive lecture methods did not statistically improve student outcomes when compared to traditional lecture teaching methods. However, the responses to the survey revealed students have a preference for introductory geology courses taught with lecture and instructor-led discussions and students prefer to work independently or in small groups. The results of this study are useful to individuals who teach introductory geology courses and individuals who teach introductory science courses for non-science majors at the college level.

  3. Puzzle-based versus traditional lecture: comparing the effects of pedagogy on academic performance in an undergraduate human anatomy and physiology II lab.

    Science.gov (United States)

    Stetzik, Lucas; Deeter, Anthony; Parker, Jamie; Yukech, Christine

    2015-06-23

    A traditional lecture-based pedagogy conveys information and content while lacking sufficient development of critical thinking skills and problem solving. A puzzle-based pedagogy creates a broader contextual framework, and fosters critical thinking as well as logical reasoning skills that can then be used to improve a student's performance on content specific assessments. This paper describes a pedagogical comparison of traditional lecture-based teaching and puzzle-based teaching in a Human Anatomy and Physiology II Lab. Using a single subject/cross-over design half of the students from seven sections of the course were taught using one type of pedagogy for the first half of the semester, and then taught with a different pedagogy for the second half of the semester. The other half of the students were taught the same material but with the order of the pedagogies reversed. Students' performance on quizzes and exams specific to the course, and in-class assignments specific to this study were assessed for: learning outcomes (the ability to form the correct conclusion or recall specific information), and authentic academic performance as described by (Am J Educ 104:280-312, 1996). Our findings suggest a significant improvement in students' performance on standard course specific assessments using a puzzle-based pedagogy versus a traditional lecture-based teaching style. Quiz and test scores for students improved by 2.1 and 0.4% respectively in the puzzle-based pedagogy, versus the traditional lecture-based teaching. Additionally, the assessments of authentic academic performance may only effectively measure a broader conceptual understanding in a limited set of contexts, and not in the context of a Human Anatomy and Physiology II Lab. In conclusion, a puzzle-based pedagogy, when compared to traditional lecture-based teaching, can effectively enhance the performance of students on standard course specific assessments, even when the assessments only test a limited

  4. The effects of nocturnal compared with conventional hemodialysis on mineral metabolism: A randomized-controlled trial.

    Science.gov (United States)

    Walsh, Michael; Manns, Braden J; Klarenbach, Scott; Tonelli, Marcello; Hemmelgarn, Brenda; Culleton, Bruce

    2010-04-01

    Hyperphosphatemia is common among patients receiving dialysis and is associated with increased mortality. Nocturnal hemodialysis (NHD) is a long, slow dialytic modality that may improve hyperphosphatemia and disorders of mineral metabolism. We performed a randomized-controlled trial of NHD compared with conventional hemodialysis (CvHD); in this paper, we report detailed results of mineral metabolism outcomes. Prevalent patients were randomized to receive NHD 5 to 6 nights per week for 6to 10 hours per night or to continue CvHD thrice weekly for 6 months. Oral phosphate binders and vitamin D analogs were adjusted to maintain phosphate, calcium and parathyroid hormone (PTH) levels within recommended targets. Compared with CvHD patients, patients in the NHD group had a significant decrease in serum phosphate over the course of the study (0.49 mmol/L, 95% confidence interval 0.24-0.74; P=0.002) despite a significant reduction in the use of phosphate binders. Sixty-one percent of patients in the NHD group compared with 20% in the CvHD group had a decline in intact PTH (P=0.003). Nocturnal hemodialysis lowers serum phosphate, calcium-phosphate product and requirement for phosphate binders. The effects of NHD on PTH are variable. The impact of these changes on long-term cardiovascular and bone-related outcomes requires further investigation.

  5. Protocol for the saMS trial (supportive adjustment for multiple sclerosis: a randomized controlled trial comparing cognitive behavioral therapy to supportive listening for adjustment to multiple sclerosis

    Directory of Open Access Journals (Sweden)

    McCrone Paul

    2009-08-01

    Full Text Available Abstract Background Multiple Sclerosis (MS is an incurable, chronic, potentially progressive and unpredictable disease of the central nervous system. The disease produces a range of unpleasant and debilitating symptoms, which can have a profound impact including disrupting activities of daily living, employment, income, relationships, social and leisure activities, and life goals. Adjusting to the illness is therefore particularly challenging. This trial tests the effectiveness of a Cognitive Behavioural intervention compared to Supportive Listening to assist adjustment in the early stages of MS. Methods/Design This is a two arm randomized multi-centre parallel group controlled trial. 122 consenting participants who meet eligibility criteria will be randomly allocated to receive either Cognitive Behavioral Therapy or Supportive Listening. Eight one hour sessions of therapy (delivered over a period of 10 weeks will be delivered by general nurses trained in both treatments. Self-report questionnaire data will be collected at baseline (0 weeks, mid-therapy (week 5 of therapy, post-therapy (15 weeks and at six months (26 weeks and twelve months (52 weeks follow-up. Primary outcomes are distress and MS-related social and role impairment at twelve month follow-up. Analysis will also consider predictors and mechanisms of change during therapy. In-depth interviews to examine participants' experiences of the interventions will be conducted with a purposively sampled sub-set of the trial participants. An economic analysis will also take place. Discussion This trial is distinctive in its aims in that it aids adjustment to MS in a broad sense. It is not a treatment specifically for depression. Use of nurses as therapists makes the interventions potentially viable in terms of being rolled out in the NHS. The trial benefits from incorporating patient input in the development and evaluation stages. The trial will provide important information about the

  6. A prospective randomised trial comparing mesh types and fixation in totally extraperitoneal inguinal hernia repairs.

    Science.gov (United States)

    Cristaudo, Adam; Nayak, Arun; Martin, Sarah; Adib, Reza; Martin, Ian

    2015-05-01

    The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique. Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 × 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 × 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 × 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 × 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores. At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12. In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  7. Greenhouse gas emissions under conservation agriculture compared to traditional cultivation of maize in the central highlands of Mexico

    International Nuclear Information System (INIS)

    Dendooven, Luc; Gutiérrez-Oliva, Vicente F.; Patiño-Zúñiga, Leonardo; Ramírez-Villanueva, Daniel A.; Verhulst, Nele; Luna-Guido, Marco; Marsch, Rodolfo; Montes-Molina, Joaquín; Gutiérrez-Miceli, Federico A.; Vásquez-Murrieta, Soledad; Govaerts, Bram

    2012-01-01

    In 1991, the ‘International Maize and Wheat Improvement Center’ (CIMMYT) started a field experiment in the rain fed Mexican highlands to investigate conservation agriculture (CA) as a sustainable alternative for conventional maize production practices (CT). CT techniques, characterized by deep tillage, monoculture and crop residue removal, have deteriorated soil fertility and reduced yields. CA, which combines minimum tillage, crop rotations and residue retention, restores soil fertility and increases yields. Soil organic matter increases in CA compared to CT, but increases in greenhouse gas emissions (GHG) in CA might offset the gains obtained to mitigate global warming. Therefore, CO 2 , CH 4 and N 2 O emissions, soil temperature, C and water content were monitored in CA and CT treatments in 2010–2011. The cumulative GHG emitted were similar for CA and CT in both years, but the C content in the 0–60 cm layer was higher in CA (117.7 Mg C ha −1 ) than in CT (69.7 Mg C ha −1 ). The net global warming potential (GWP) of CA (considering soil C sequestration, GHG emissions, fuel use, and fertilizer and seeds production) was − 7729 kg CO 2 ha −1 y −1 in 2008–2009 and − 7892 kg CO 2 ha −1 y −1 in 2010–2011, whereas that of CT was 1327 and 1156 kg CO 2 ha −1 y −1 . It was found that the contribution of CA to GWP was small compared to that of CT. - Highlights: ► Conservation agriculture (CA) and conventional agriculture (CT) systems ► Greenhouse gasses emitted were similar from CA and CT. ► C content in the 0–60 cm layer was much higher in CA than in CT. ► The net global warming potential of CA was negative, but positive in CT. ► C sequestered in soil is far more important than GHG emitted.

  8. A budget impact analysis comparing use of a modern fecal management system to traditional fecal management methods in two canadian hospitals.

    Science.gov (United States)

    Langill, Mike; Yan, Songkai; Kommala, Dheerendra; Michenko, Michael

    2012-12-01

    Research suggests that fecal management systems (FMS) offer advantages, including potential cost savings, over traditional methods of caring for patients with little or no bowel control and liquid or semi-liquid stool. A budget impact model accounting for material costs of managing fecal incontinence was developed, and 1 year of experiential data from two hospitals' ICUs were applied to it. Material costs were estimated for traditional methods (ie, use of absorbent briefs/pads, skin cleansers, moisturizers) and compared with material costs of using a modern FMS for both average (normal-range weight) and complex (bariatric with wounds) ICU patients at hospital 1 and any ICU patient at hospital 2. Reductions in daily material costs per ICU patient using FMS versus traditional methods were reported by hospital 1 ($93.74 versus $143.89, average patient; $150.55 versus $476.41, complex patient) and by hospital 2 ($61.15 versus $104.85 per patient). When extrapolated to the total number of patients expected to use FMS at each institution, substantial annual cost savings were projected (hospital 1: $57,216; hospital 2: $627,095). In addition, total nursing time per day for managing fecal incontinence (ie, changing, cleaning, repositioning patients, changing pads, linens, and the like) was estimated at hospital 1, showing substantial reductions with FMS (120 minutes versus 348 minutes for average patients; 240 minutes versus 760 minutes for complex). Nursing time was not included in cost calculations to keep the analysis conservative. Results of this study suggest the materials cost of using the FMS in ICU patients was substantially lower than the cost of traditional fecal incontinence management protocols of care in both hospitals. Comparative studies using patient level data, materials, and nursing time costs, as well as complication rates, are warranted.

  9. Comparing two methods of education (virtual versus traditional) on learning of Iranian dental students: a post-test only design study.

    Science.gov (United States)

    Moazami, Fariborz; Bahrampour, Ehsan; Azar, Mohammad Reza; Jahedi, Farzad; Moattari, Marzieh

    2014-03-05

    The importance of using technologies such as e-learning in different disciplines is discussed in the literature. Researchers have measured the effectiveness of e-learning in a number of fields.Considering the lack of research on the effectiveness of online learning in dental education particularly in Iran, the advantages of these learning methods and the positive university atmosphere regarding the use of online learning. This study, therefore, aims to compare the effects of two methods of teaching (virtual versus traditional) on student learning. This post-test only design study approached 40, fifth year dental students of Shiraz University of Medical Sciences. From this group, 35 students agreed to participate. These students were randomly allocated into two groups, experimental (virtual learning) and comparison (traditional learning). To ensure similarity between groups, we compared GPAs of all participants by the Mann-Whitney U test (P > 0.05). The experimental group received a virtual learning environment courseware package specifically designed for this study, whereas the control group received the same module structured in a traditional lecture form. The virtual learning environment consisted of online and offline materials. Two identical valid, reliable post-tests that consisted of 40 multiple choice questions (MCQs) and 4 essay questions were administered immediately (15 min) after the last session and two months later to assess for knowledge retention. Data were analyzed by SPSS version 20. A comparison of the mean knowledge score of both groups showed that virtual learning was more effective than traditional learning (effect size = 0.69). The newly designed virtual learning package is feasible and will result in more effective learning in comparison with lecture-based training. However further studies are needed to generalize the findings of this study.

  10. Comparing the Effectiveness of a Clinical Registry and a Clinical Data Warehouse for Supporting Clinical Trial Recruitment: A Case Study

    Science.gov (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual

    2010-01-01

    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost. PMID:21347102

  11. Comparative costs and activity from a sample of UK clinical trials units.

    Science.gov (United States)

    Hind, Daniel; Reeves, Barnaby C; Bathers, Sarah; Bray, Christopher; Corkhill, Andrea; Hayward, Christopher; Harper, Lynda; Napp, Vicky; Norrie, John; Speed, Chris; Tremain, Liz; Keat, Nicola; Bradburn, Mike

    2017-05-02

    The costs of medical research are a concern. Clinical Trials Units (CTUs) need to better understand variations in the costs of their activities. Representatives of ten CTUs and two grant-awarding bodies pooled their experiences in discussions over 1.5 years. Five of the CTUs provided estimates of, and written justification for, costs associated with CTU activities required to implement an identical protocol. The protocol described a 5.5-year, nonpharmacological randomized controlled trial (RCT) conducted at 20 centres. Direct and indirect costs, the number of full time equivalents (FTEs) and the FTEs attracting overheads were compared and qualitative methods (unstructured interviews and thematic analysis) were used to interpret the results. Four members of the group (funding-body representatives or award panel members) reviewed the justification statements for transparency and information content. Separately, 163 activities common to trials were assigned to roles used by nine CTUs; the consistency of role delineation was assessed by Cohen's κ. Median full economic cost of CTU activities was £769,637 (range: £661,112 to £1,383,323). Indirect costs varied considerably, accounting for between 15% and 59% (median 35%) of the full economic cost of the grant. Excluding one CTU, which used external statisticians, the total number of FTEs ranged from 2.0 to 3.0; total FTEs attracting overheads ranged from 0.3 to 2.0. Variation in directly incurred staff costs depended on whether CTUs: supported particular roles from core funding rather than grants; opted not to cost certain activities into the grant; assigned clerical or data management tasks to research or administrative staff; employed extensive on-site monitoring strategies (also the main source of variation in non-staff costs). Funders preferred written justifications of costs that described both FTEs and indicative tasks for funded roles, with itemised non-staff costs. Consistency in role delineation was fair (κ

  12. Complications and Adverse Events of a Randomized Clinical Trial Comparing 3 Graft Types for ACL Reconstruction.

    Science.gov (United States)

    Mohtadi, Nicholas; Barber, Rhamona; Chan, Denise; Paolucci, Elizabeth Oddone

    2016-05-01

    ). This article reports on the complications/adverse events that were prospectively identified up to 2 years postoperatively, in a defined patient population participating in a large double-blind randomized clinical trial comparing PT, single-bundle hamstring, and DB hamstring reconstructions for ACL rupture.

  13. Greenhouse gas emissions under conservation agriculture compared to traditional cultivation of maize in the central highlands of Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Dendooven, Luc, E-mail: dendooven@me.com [Laboratory of Soil Ecology, ABACUS, Cinvestav, Avenida Instituto Politecnico Nacional 2508, C.P. 07360 Mexico, D.F. (Mexico); Gutierrez-Oliva, Vicente F. [Laboratory of Plant Biotechnology, Instituto Tecnologico de Tuxtla-Gutierrez, Tuxtla-Gutierrez, Chiapas (Mexico); Patino-Zuniga, Leonardo [Laboratory of Soil Ecology, ABACUS, Cinvestav, Avenida Instituto Politecnico Nacional 2508, C.P. 07360 Mexico, D.F. (Mexico); Ramirez-Villanueva, Daniel A. [Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-IPN, Av. Prolongacion de Carpio y Plan de Ayala, C.P. 11340 Mexico, D.F. (Mexico); Verhulst, Nele [International Maize and Wheat Improvement Centre (CIMMYT), Apdo. Postal 6-641, 06600, Mexico D.F. (Mexico); Luna-Guido, Marco; Marsch, Rodolfo [Laboratory of Soil Ecology, ABACUS, Cinvestav, Avenida Instituto Politecnico Nacional 2508, C.P. 07360 Mexico, D.F. (Mexico); Montes-Molina, Joaquin; Gutierrez-Miceli, Federico A. [Laboratory of Plant Biotechnology, Instituto Tecnologico de Tuxtla-Gutierrez, Tuxtla-Gutierrez, Chiapas (Mexico); Vasquez-Murrieta, Soledad [Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-IPN, Av. Prolongacion de Carpio y Plan de Ayala, C.P. 11340 Mexico, D.F. (Mexico); Govaerts, Bram [International Maize and Wheat Improvement Centre (CIMMYT), Apdo. Postal 6-641, 06600, Mexico D.F. (Mexico)

    2012-08-01

    In 1991, the 'International Maize and Wheat Improvement Center' (CIMMYT) started a field experiment in the rain fed Mexican highlands to investigate conservation agriculture (CA) as a sustainable alternative for conventional maize production practices (CT). CT techniques, characterized by deep tillage, monoculture and crop residue removal, have deteriorated soil fertility and reduced yields. CA, which combines minimum tillage, crop rotations and residue retention, restores soil fertility and increases yields. Soil organic matter increases in CA compared to CT, but increases in greenhouse gas emissions (GHG) in CA might offset the gains obtained to mitigate global warming. Therefore, CO{sub 2}, CH{sub 4} and N{sub 2}O emissions, soil temperature, C and water content were monitored in CA and CT treatments in 2010-2011. The cumulative GHG emitted were similar for CA and CT in both years, but the C content in the 0-60 cm layer was higher in CA (117.7 Mg C ha{sup -1}) than in CT (69.7 Mg C ha{sup -1}). The net global warming potential (GWP) of CA (considering soil C sequestration, GHG emissions, fuel use, and fertilizer and seeds production) was - 7729 kg CO{sub 2} ha{sup -1} y{sup -1} in 2008-2009 and - 7892 kg CO{sub 2} ha{sup -1} y{sup -1} in 2010-2011, whereas that of CT was 1327 and 1156 kg CO{sub 2} ha{sup -1} y{sup -1}. It was found that the contribution of CA to GWP was small compared to that of CT. - Highlights: Black-Right-Pointing-Pointer Conservation agriculture (CA) and conventional agriculture (CT) systems Black-Right-Pointing-Pointer Greenhouse gasses emitted were similar from CA and CT. Black-Right-Pointing-Pointer C content in the 0-60 cm layer was much higher in CA than in CT. Black-Right-Pointing-Pointer The net global warming potential of CA was negative, but positive in CT. Black-Right-Pointing-Pointer C sequestered in soil is far more important than GHG emitted.

  14. Porcine dermis compared with polypropylene mesh for laparoscopic sacrocolpopexy: a randomized controlled trial.

    Science.gov (United States)

    Culligan, Patrick J; Salamon, Charbel; Priestley, Jennifer L; Shariati, Amir

    2013-01-01

    To compare the surgical outcomes 12 months after laparoscopic sacrocolpopexy performed with porcine dermis and the current gold standard of polypropylene mesh. Patients scheduled for laparoscopic sacrocolpopexy were eligible for this randomized controlled trial. Both our clinical research nurse and the patients were blinded as to which material was used. Our primary end point was objective anatomic cure defined as no pelvic organ prolapse quantification (POP-Q) points Stage 2 or greater at any postoperative interval. Our sample size calculation called for 57 patients in each group to achieve 90% power to detect a 23% difference in objective anatomic cure at 12 months (α=0.05). Our secondary end point was clinical cure. Any patient with a POP-Q point greater than zero, or Point C less than or equal to -5, or any complaints of prolapse symptoms whatsoever on Pelvic Floor Distress Inventory-20 or Pelvic Floor Impact Questionnaire, Short Form 7, or reoperation for prolapse were considered "clinical failures"; the rest were "clinical cures." Statistical comparisons were performed using the χ or independent samples t test as appropriate. As expected, there were no preoperative differences between the porcine (n=57) and mesh (n=58) groups. The 12-month objective anatomic cure rates for the porcine and mesh groups were 80.7% and 86.2%, respectively (P=.24), and the "clinical cure" rates for the porcine and mesh groups were 84.2% and 89.7%, respectively (P=.96). Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire, Short Form 7 score improvements were significant for both groups with no differences found between groups. There were no major operative complications. There were similar outcomes in subjective or objective results 12 months after laparoscopic sacrocolpopexy performed with either porcine dermis or polypropylene mesh. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00564083. I.

  15. Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures.

    Science.gov (United States)

    Bueno, Letícia Rossi; Binda, Marcia; Monego, Heleusa; Scherer, Roberta Luísa; Rolim, Karen Machado; Bottini, Alessandra Leal; Fregnani, José H T G; dos Reis, Ricardo

    2015-06-01

    Compare blood loss during cold knife conization of the cervix with and without lateral hemostatic sutures in the cervical branches of the uterine arteries. Randomized clinical trial. Hospital de Clínicas de Porto Alegre (HCPA). 102 patients that underwent cold knife conization. Women that underwent cold knife conization of the cervix were randomized to undergo the procedure with or without lateral hemostatic sutures. blood loss measured in grams. operative time and postoperative intervention. Only the participants were blinded to group assignment. From March 2009 to August 2012, patients were randomly assigned to one of the study groups. There were no differences in amount of blood loss between patients that underwent the procedure with and without sutures (p = 0.39). Operative time was shorter in the group without suture (p = 0.020). There were no differences in intervention due to bleeding (p = 0.20). Blood loss was greater among menstruating women than for menopausal women (p = 0.011). There were no differences in amount of blood lost between smoking and nonsmoking patients (p = 0.082). Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. ClinicalTrials. gov identifier: NCT02184975. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  16. A prospective randomized controlled trial comparing early postoperative complications in patients undergoing loop colostomy with and without a stoma rod.

    Science.gov (United States)

    Franklyn, J; Varghese, G; Mittal, R; Rebekah, G; Jesudason, M R; Perakath, B

    2017-07-01

    A stoma rod or bridge has been traditionally placed under the bowel loop while constructing a loop colostomy. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis. This single-centre prospective randomized controlled trial compared outcomes after creation of loop colostomy with and without a supporting stoma rod. The primary outcome studied was stoma retraction rate; other stoma-related complications were studied as secondary outcomes. One hundred and fifty-one patients were randomly allotted to one of two arms, colostomy with or without a supporting rod. Postoperative complications such as retraction, mucocutaneous separation, congestion and re-exploration for stoma-related complications were recorded. There was no difference in the stoma retraction rate between the two arms (8.1% in the rod arm and 6.6% in the no-rod arm; P = 0.719). Stomal necrosis (10.7% vs 1.3%; P = 0.018), oedema (23% vs 3.9%; P = 0.001), congestion (20.3% vs 2.6%; P = 0.001) and re-admission rates (8.5% vs 0%; P = 0.027) were significantly increased in the arm randomized to the rod. The stoma rod does not prevent stomal retraction. However, complication rates are significantly higher when a stoma rod is used. Routine use of a stoma rod for construction of loop colostomy can be avoided. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  17. Comparative study of peripherally inserted central venous catheter and traditional central catheter assisted with X-ray

    International Nuclear Information System (INIS)

    Yu Jianchun; Wang Xiurong; Jiang Zhuming

    1999-01-01

    Objective: To study the feasibility, complications, mid- and long-term advantages of peripherally inserted central catheters (PICC) compared with central venous access assisted with X-ray. Methods: From Jan 1997 to Dec 1998, the authors conducted a study in 60 patients with placed PICC lines and 60 patients with central lines. Study variables included tip placement and complication rates. Results: Tere were on significant differences between PICC and CVC in the successful placement 95.0% and 88.3%, t = 1.745, P 0.19; the mean duration 13(6-98) days and 14 (7-104) days, F = 0.049, P = 0.83; the total occlusion rate 6.7% (4/60) and 5.0%(3/60), t = 0.152, P = 0.70. In PICC patients, the occlusion rate was slightly higher in 3 Fr (20-gauge) catheter (3/20, 15.0%) than in 4 Fr(18-gauge) catheters (1/20, 5.0%), t = 1.111, P=0.29. Phlebitis occurred in 5.0% of patients (3/60) and one catheter fracture was happened on the catheter hub junction (1.7%). In 3 catheter tips dislocation cases, the catheter tips were moved to the optional position assisted with X-ray image. In CVC group, pneumothorax happened in 1 case (1.7%). In 4 catheter dislocation cases, the catheters were with drawn. No catheter-related sepsis and hemo-pneumothorax happened in both group patients. Conclusions: Both PICC and CVC can be acceptable in clinical use. PICC assisted with X-ray possesses the advantages of less trauma, accurate localization preventing some possible severe complications of central venous access such as pneumothorax. The new method provides a reliable, effective venous access for mid-and long-term usage in patients receiving a variety of solutions, primarily parenteral alimentation, chemotherapy or antibiotic infusion

  18. Traditional versus commercial food processing techniques - A comparative study based on chemical analysis of selected foods consumed in rural Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Abraham I. C. Mwadiwa

    2012-01-01

    Full Text Available With the advent of industrialisation, food processors are constantly looking for ways to cut costs, increase production and maximise profits at the expense of quality. Commercial food processors have since shifted their focus from endogenous ways of processing food to more profitable commercial food processing techniques. The aim of this study was to investigate the holistic impact of commercial food processing techniques on nutrition by comparing commercially (industrially processed food products and endogenously processed food products through chemical analysis of selected foods. Eight food samples which included commercially processed peanut butter, mealie-meal, dried vegetables (mufushwa and rice and endogenously processed peanut butter, mealie-meal, dried vegetables (mufushwa and rice were randomly sampled from rural communities in the south-eastern and central provinces of Zimbabwe. They were analysed for ash, zinc, iron, copper, magnesium, protein, fat, carbohydrates, energy, crude fibre, vitamin C and moisture contents. The results of chemical analysis indicate that endogenously processed mealie-meal, dried vegetables and rice contained higher ash values of 2.00g/100g, 17.83g/100g, and 3.28g/100g respectively than commercially processed mealie-meal, dried vegetables and rice, which had ash values of 1.56g/100g, 15.25g/100g and 1.46g/100g respectively. The results also show that endogenously processed foods have correspondingly higher iron, zinc and magnesium contents and, on the whole, a higher protein content. The results also indicate that commercially processed foods have higher fat and energy contents. The result led to the conclusion that the foods are likely to pose a higher risk of causing adverse conditions to health, such as obesity and cardiovascular diseases to susceptible individuals. Based on these findings, it can, therefore, be concluded that endogenously processed foods have a better nutrient value and health implications

  19. Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials.

    Science.gov (United States)

    James, Erica; Freund, Megan; Booth, Angela; Duncan, Mitch J; Johnson, Natalie; Short, Camille E; Wolfenden, Luke; Stacey, Fiona G; Kay-Lambkin, Frances; Vandelanotte, Corneel

    2016-08-01

    Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors. This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and; c) differences in trial retention between simultaneously and sequentially delivered interventions. MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken. Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches. There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A clinical trial comparing Lanconone® with ibuprofen for rapid relief in acute joint pain.

    Science.gov (United States)

    Girandola, Robert N; Srivastava, Shalini; Loullis, Costas C

    2016-04-06

    To study the effect of Lanconone® (1000 mg) on acute pain on exertion as compared to the standard of care, Ibuprofen (400 mg). The study recruited 72 subjects diagnosed with mild to moderate knee joint pain on exertion. Subjects with Pain Visual Analogue Scale of more than 40 mm were included. Uphill walking was provided as the stressor using Naughton's protocol on a treadmill. The subjects walked for 10 minutes continuously followed by a rest period and baseline pain score for index knee joint was recorded. Subjects were administered a single dose of Lanconone® (1000 mg)/Ibuprofen (400 mg). Thereafter the same stressor was provided at 0.5, 1, 2, 3, 4, and 6 hours, subsequently, pain scores were recorded on a visual analogue scale. Double stopwatch method was used to evaluate the onset of pain relief and time taken to meaningful pain relief. Both Lanconone® and Ibuprofen showed the first perceived pain relief at 65.31 ± 35.57 mins as compared to 60.82 ± 32.56 mins respectively. The mean time taken to experience meaningful pain relief in Lanconone® group was 196.59 ± 70.85 mins compared to 167.13 ± 71.41 mins amongst Ibuprofen group. The meaningful pain relief continued for 6 hours. The current study successfully demonstrated rapid pain-relieving potential of Lanconone® which was comparable to Ibuprofen. No adverse event related to the interventions was reported in the study. Clinical trials.gov NCT02417506 . 21 January 2015.

  1. A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder.

    Science.gov (United States)

    Marsden, Zoe; Lovell, Karina; Blore, David; Ali, Shehzad; Delgadillo, Jaime

    2018-01-01

    This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive-compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen's d and multilevel modelling. Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive-compulsive scale severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90). EMDR and CBT had comparable completion rates and clinical outcomes. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.

    Science.gov (United States)

    Saffari, Elnaz; Mohammad-Alizadeh-Charandabi, Sakineh; Adibpour, Mohammad; Mirghafourvand, Mojgan; Javadzadeh, Yousef

    2017-01-01

    This triple-blind trial examined the effects of Calendula officinalis vaginal cream on the treatment of vaginal Candidiasis (primary outcome) and sexual function (secondary outcome). Married women aged 18-45 years with vaginal Candidiasis (n = 150) were recruited from April to October 2014 and randomized into Calendula and clotrimazole groups, using 5-g vaginal cream every night for seven nights. Clinical and laboratory assessments were conducted at 10-15 and 30-35 days after intervention and the female sexual function index was assessed at 30-35 days. Six women were lost to follow-up. The frequency of testing negative for Candidiasis in the Calendula group was significantly lower at the first (49% vs. 74%; odds ratio (OR) 0.32; 95% confidence interval (CI) 0.16-0.67) but higher at the second (77% vs. 34%; OR 3.1; 95% CI 1.5-6.2) follow-up compared to the clotrimazole group. The frequency of most signs and symptoms were almost equal in the two groups at the first follow-up, but were significantly lower in the Calendula group at the second follow-up. Sexual function had almost equal significant improvement in both groups. Calendula vaginal cream appears to have been effective in the treatment of vaginal Candidiasis and to have a delayed but greater long-term effect compared to clotrimazole.

  3. Metformin compared with insulin in the management of gestational diabetes mellitus: a randomized clinical trial.

    Science.gov (United States)

    Niromanesh, Shirin; Alavi, Azin; Sharbaf, Fatemeh Rahimi; Amjadi, Nooshin; Moosavi, Sanaz; Akbari, Soheila

    2012-12-01

    To evaluate the effect of metformin and insulin in glycemic control and compare pregnancy outcome in women with gestational diabetes mellitus (GDM). This randomized controlled trial was conducted in GDM women with singleton pregnancy and gestational age between 20 and 34 weeks who did not achieve glycemic control on diet were assigned randomly to receive either metformin (n=80) or insulin (n=80). The primary outcomes were maternal glycemic control and birth weight. The secondary outcomes were neonatal and obstetric complications. Two groups were comparable regarding the maternal characteristics. Two groups were similar in mean FBS (P=0.68) and postprandial measurements (P=0.87) throughout GDM treatment. The neonates of metformin group had less rate of birth weight centile >90 than insulin group (RR: 0.5, 95% CI: 0.3-0.9, P=0.012). Maternal weight gain was reduced in the metformin group (P0.05). In metformin group 14% of women needed to supplemental insulin to achieve euglycemia. Metformin is an effective and safe alternative treatment to insulin for women with GDM. This study does not show significant risk of maternal or neonatal adverse outcome with the use of metformin. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

    Science.gov (United States)

    Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

    2017-08-01

    To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

  5. Subcutaneous Injection of Adalimumab Trial compared with Control (SCIATiC): a randomised controlled trial of adalimumab injection compared with placebo for patients receiving physiotherapy treatment for sciatica.

    Science.gov (United States)

    Williams, Nefyn H; Jenkins, Alison; Goulden, Nia; Hoare, Zoe; Hughes, Dyfrig A; Wood, Eifiona; Foster, Nadine E; Walsh, David A; Carnes, Dawn; Sparkes, Valerie; Hay, Elaine M; Isaacs, John; Konstantinou, Kika; Morrissey, Dylan; Karppinen, Jaro; Genevay, Stephane; Wilkinson, Clare

    2017-10-01

    Biological treatments such as adalimumab (Humira ® ; AbbVie Ltd, Maidenhead, UK) are antibodies targeting tumour necrosis factor alpha, released from ruptured intervertebral discs, which might be useful in sciatica. Recent systematic reviews concluded that they might be effective, but that a definitive randomised controlled trial was needed. Usual care in the NHS typically includes a physiotherapy intervention. To test whether or not injections of adalimumab plus physiotherapy are more clinically effective and cost-effective than injections of saline plus physiotherapy for patients with sciatica. Pragmatic, parallel-group, randomised controlled trial with blinded participants and clinicians, and an outcome assessment and statistical analysis with concurrent economic evaluation and internal pilot. Participants were referred from primary care and musculoskeletal services to outpatient physiotherapy clinics. Adults with persistent symptoms of sciatica of 1-6 months' duration and with moderate to high levels of disability. Eligibility was assessed by research physiotherapists according to clinical criteria for diagnosing sciatica. After a second eligibility check, trial participants were randomised to receive two doses of adalimumab (80 mg and then 40 mg 2 weeks later) or saline injections. Both groups were referred for a course of physiotherapy. Outcomes were measured at the start, and after 6 weeks' and 6 months' follow-up. The main outcome measure was the Oswestry Disability Index (ODI). Other outcomes: leg pain version of the Roland-Morris Disability Questionnaire, Sciatica Bothersomeness Index, EuroQol-5 Dimensions, 5-level version, Hospital Anxiety and Depression Scale, resource use, risk of persistent disabling pain, pain trajectory based on a single question, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia and adverse effects. To detect an effect size of 0.4 with 90% power, a 5% significance level for a two-tailed t -test and 80% retention

  6. Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10 year-old children.

    Science.gov (United States)

    Angelopoulou, Matina V; Kavvadia, Katerina; Taoufik, Konstantina; Oulis, Constantine J

    2015-04-28

    School based oral health education through traditional lecturing has been found successful only in improving oral health knowledge, while has low effectiveness in oral hygiene and gingival health. The aim of this study was to evaluate the effectiveness of experiential learning (EL) oral health education to traditional lecturing (TL), on enhancing oral health knowledge, attitude and behavior as well as oral hygiene, gingival health and caries of 10-year-old children. Eighty-four children were recruited for the EL and 100 for the TL group from 3 locations in Greece. Data regarding oral health knowledge, attitude and behavior were collected via questionnaires. Data regarding dental plaque, gingivitis and caries were collected by clinical examination. The evaluation using questionnaires and clinical examination was assessed at baseline and 6 and 18 months afterwards. Two calibrated pediatric dentists examined the students using a periodontal probe and artificial light. Modified hygiene index (HI) was used for dental plaque recording, the simplified gingival index (GI-S) was used for gingivitis and DMFT, based on BASCD criteria, for dental caries. Based on a dedicated manual, the teacher applied in the classroom the oral health educational program using EL. EL group had statistically significant better hygiene than the TL at 6 months (p 0.05) and attitude (p > 0.05) at 6 months in comparison to baseline. EL program was found more successful than TL in oral hygiene improvement. Both oral health education programs improved the oral health knowledge, attitude and behavior of children. ClinicalTrials.gov (NCT02320162).

  7. COMPARATIVE STUDY OF CHEMICAL COMPOSITION, PHYSICO-CHEMICAL AND ANTIOXIDANT PROPERTIES OF OILS EXTRACTED BY TRADITIONAL AND HEXANE METHODS FROM TERMINALIA CATAPPA L. KERNELS

    Directory of Open Access Journals (Sweden)

    Bérenger A. L. Ladele

    2017-10-01

    Full Text Available The comparative study of physico-chemical characteristics of Terminalia catappa L. kernel oils extracted by two methods has been done. The oil yields were 28.13 % and 61.78 % respectively for traditional and hexane methods and the fatty acid profiles showed palmitic acid (40.79 % and 40.03 % respectively oleic acid (25.55 % and 26.09 % respectively, linoleic acid (26.72 % and 26.64 % respectively and stearic acid (4.35 % and 4.49 % respectively as major components. The oils extracted by the two ways showed similar physico-chemical properties, good calorific values and non-toxicity against Artemia salina L. Oil obtained by traditional method exhibited more antioxidant capacity (1.40 than the hexane one (0.15. This traditional method helps to extract 45 % of the total oil. It gives oil free of organic solvent, with good physico-chemical properties that could be useful as edible oil and for industrial applications.

  8. Use of Western Medicine and Traditional Korean Medicine for Joint Disorders: A Retrospective Comparative Analysis Based on Korean Nationwide Insurance Data

    Science.gov (United States)

    2017-01-01

    This study aimed to compare the usage of Western medicine and traditional Korean medicine for treating joint disorders in Korea. Data of claims from all medical institutions with billing statements filed to HIRA from 2011 to 2014 for the four most frequent joint disorders were used for the analysis. Data from a total of 1,100,018 patients who received medical services from 2011 to 2014 were analyzed. Descriptive statistics are presented as type of care and hospital type. All statistical analyses were performed using IBM SPSS for Windows version 21. Of the 1,100,018 patients with joint disorders, 456,642 (41.5%) were males and 643,376 (58.5%) were females. Per diem costs of hospitalization in Western medicine clinics and traditional Korean medicine clinics were approximately 160,000 KRW and 50,000 KRW, respectively. Among costs associated with Western medicine, physiotherapy cost had the largest proportion (28.78%). Among costs associated with traditional Korean medicine, procedural costs and treatment accounted for more than 70%, followed by doctors' fees (21.54%). There were distinct differences in patterns of medical care use and cost of joint disorders at the national level in Korea. This study is expected to contribute to management decisions for musculoskeletal disease involving joint disorders. PMID:29456569

  9. The efficacy of the traditional Chinese medicine Juanbi pill combined with methotrexate in active rheumatoid arthritis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Wang, Qiong; Wang, Yi-Ru; Jia, Qing-Yun; Liu, Li; Xu, Chong-Qing; Wang, Xiao-Yun; Yao, Min; Cui, Xue-Jun; Shi, Qi; Wang, Yong-Jun; Liang, Qian-Qian

    2018-03-20

    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by swelling and painful joints, eventually leading to joint destruction. There is still a lack of effective therapy to treat RA. The Juanbi pill is a Chinese medicine that has been widely used to treat active RA in China for hundreds of years, relieving pain and protecting the affected joints from malformation. However, there is no solid evidence to show the effect of the Juanbi pill on the management of active RA. We will conduct a multicenter, randomized, double-blind, placebo-controlled clinical trial to determine whether the traditional Chinese medicine Juanbi pill could relieve joint pain in RA and protect the joints. A total of 120 patients with active RA will be enrolled and treated with the Juanbi pill or a placebo for 3 months. The primary outcome measures are as follows: rate of in the American College of Rheumatology (ACR)50, change in the 28-joint Disease Activity Score (DAS28) from baseline at beginning of therapy to 3 months, and a change in the van der Heijde modified Sharp score measured from baseline to 12 months. The secondary outcome measures are as follows: rate of change in ACR20, ACR70, Health Assessment Questionnaire-Disability Index (HAQ-DI), and change in score in the Patient Assessment of Arthritis Pain, Patient Global Assessment of Arthritis, and the Athens Insomnia Scale (AIS) from baseline to 2-week, 1-month, 2-month, 3-month, 6-month, and 12-month follow up. In addition, the rate of change (score) in the ACR50 and DAS28 from the baseline to 2-week, 1-month, 2-month, 6-month, and 12-month follow up are also the secondary outcome measures. Although the Juanbi pill has been used in China for many years to treat RA, there is a lack of consensus about its effectiveness. This trial will provide convincing evidence about the effect of Juanbi pill on active RA. ClinicalTrials.gov, NCT02885597 . Registered on 30 August 2016.

  10. Comparing student clinical self-efficacy and team process outcomes for a DEU, blended, and traditional clinical setting: A quasi-experimental research study.

    Science.gov (United States)

    Plemmons, Christina; Clark, Michele; Feng, Du

    2018-03-01

    Clinical education is vital to both the development of clinical self-efficacy and the integration of future nurses into health care teams. The dedicated education unit clinical teaching model is an innovative clinical partnership, which promotes skill development, professional growth, clinical self-efficacy, and integration as a team member. Blended clinical teaching models are combining features of the dedicated education unit and traditional clinical model. The aims of this study are to explore how each of three clinical teaching models (dedicated education unit, blended, traditional) affects clinical self-efficacy and attitude toward team process, and to compare the dedicated education unit model and blended model to traditional clinical. A nonequivalent control-group quasi-experimental design was utilized. The convenience sample of 272 entry-level baccalaureate nursing students included 84 students participating in a dedicated education unit model treatment group, 66 students participating in a blended model treatment group, and 122 students participating in a traditional model control group. Perceived clinical self-efficacy was evaluated by the pretest/posttest scores obtained on the General Self-Efficacy scale. Attitude toward team process was evaluated by the pretest/posttest scores obtained on the TeamSTEPPS® Teamwork Attitude Questionnaire. All three clinical teaching models resulted in significant increases in both clinical self-efficacy (p=0.04) and attitude toward team process (p=0.003). Students participating in the dedicated education unit model (p=0.016) and students participating in the blended model (pteam process among entry-level baccalaureate nursing students. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Perceptions of veterinary admissions committee members of undergraduate credits earned from community colleges or online compared to traditional 4-year institutions.

    Science.gov (United States)

    Kogan, L R; Stewart, S M; Schoenfeld-Tacher, R; Hellyer, P W

    2015-01-01

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, there has been little attention paid to how and where an applicant acquires his/her undergraduate coursework. Quality of academic program is an important component of applicant files, and it is suggested that the source of a candidate's coursework might influence admissions committee decisions, perhaps even outside of the committee's immediate awareness. Options for undergraduate education include taking classes at a traditional four-year institution, a community college, or online. This study provides an overview of the current state of online courses and community colleges in the US as a foundation to explore the views of veterinary admissions committee members pertaining to coursework completed at traditional residential 4-year schools or at community colleges and whether they are delivered on campus or online (at either type of institution). Survey participants reported a pattern of preference for traditional four-year residential coursework compared to online or community college courses. These results are interesting given the exponential growth of students taking online courses and data showing community colleges are providing a successful gateway to obtaining a four-year degree. This also points to the need for admission committees to discuss potential biases since the information about type of school and/or course may not be consistently available for all applicants. Finally, at a time when admitting a diverse class of students is a goal of many programs, it is of special concern that there are potential biases against courses taken online or from community colleges - venues that tend to draw a more diverse population than traditional 4-year

  12. Perceptions of veterinary admissions committee members of undergraduate credits earned from community colleges or online compared to traditional 4-year institutions

    Directory of Open Access Journals (Sweden)

    L.R. Kogan

    2015-06-01

    Full Text Available Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA as a predictive value of later academic success, there has been little attention paid to how and where an applicant acquires his/her undergraduate coursework. Quality of academic program is an important component of applicant files, and it is suggested that the source of a candidate’s coursework might influence admissions committee decisions, perhaps even outside of the committee’s immediate awareness. Options for undergraduate education include taking classes at a traditional four-year institution, a community college, or online. This study provides an overview of the current state of online courses and community colleges in the US as a foundation to explore the views of veterinary admissions committee members pertaining to coursework completed at traditional residential 4-year schools or at community colleges and whether they are delivered on campus or online (at either type of institution. Survey participants reported a pattern of preference for traditional four-year residential coursework compared to online or community college courses. These results are interesting given the exponential growth of students taking online courses and data showing community colleges are providing a successful gateway to obtaining a four-year degree. This also points to the need for admission committees to discuss potential biases since the information about type of school and/or course may not be consistently available for all applicants. Finally, at a time when admitting a diverse class of students is a goal of many programs, it is of special concern that there are potential biases against courses taken online or from community colleges - venues that tend to draw a more diverse population than

  13. Comparative study of chemical composition, isolation and identification of micro-flora in traditional fermented camel milk products: Gariss, Suusac, and Shubat

    Directory of Open Access Journals (Sweden)

    Amal Bakr Shori

    2012-06-01

    Full Text Available The importance of micro-flora in dairy products cannot be overemphasised. Although there are scores of academic papers that elucidated on this subject, however, to the best knowledge of the researcher, there is no published paper that compares the composition of the traditional fermented camel milk products. Therefore, this paper aims to compare the preparation methods, chemical compositions, microbial counts and pH, isolation and identification of lactic acid bacteria, as well as yeasts in Gariss, Suusac, and Shubat. Through comparative analysis of previous existing published papers, the researcher discovered that different preparation methods of these three products have effects on their chemical compositions, microbial counts and pH, and as well as growth of lactic acid bacteria and yeast species.

  14. Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair.

    LENUS (Irish Health Repository)

    Joyce, C W

    2014-01-01

    We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

  15. Risk factors for low vision related functioning in the Mycotic Ulcer Treatment Trial: a randomised trial comparing natamycin with voriconazole.

    Science.gov (United States)

    Rose-Nussbaumer, Jennifer; Prajna, N Venkatesh; Krishnan, Tiruvengada; Mascarenhas, Jeena; Rajaraman, Revathi; Srinivasan, Muthiah; Raghavan, Anita; Oldenburg, Catherine E; O'Brien, Kieran S; Ray, Kathryn J; Porco, Travis C; McLeod, Stephen D; Acharya, Nisha R; Keenan, Jeremy D; Lietman, Thomas M

    2016-07-01

    The Mycotic Ulcer Treatment Trial I (MUTT I) was a double-masked, multicentre, randomised controlled trial, which found that topical natamycin is superior to voriconazole for the treatment of filamentous fungal corneal ulcers. In this study, we determine risk factors for low vision-related quality of life in patients with fungal keratitis. The Indian visual function questionnaire (IND-VFQ) was administered to MUTT I study participants at 3 months. Associations between patient and ulcer characteristics and IND-VFQ subscale score were assessed using generalised estimating equations. 323 patients were enrolled in the trial, and 292 (90.4%) completed the IND-VFQ at 3 months. Out of a total possible score of 100, the average VFQ score for all participants was 81.3 (range 0-100, SD 23.6). After correcting for treatment arm, each logMAR line of worse baseline visual acuity in the affected eye resulted in an average 1.2 points decrease on VFQ at 3 months (95% CI -1.8 to 0.6, p<0.001). Those who required therapeutic penetrating keratoplasty had an average of 25.2 points decrease on VFQ after correcting for treatment arm (95% CI -31.8 to -18.5, p<0.001). Study participants who were unemployed had on average 28.5 points decrease on VFQ (95% CI -46.9 to -10.2, p=0.002) after correcting for treatment arm. Monocular vision loss from corneal opacity due to fungal keratitis reduced vision-related quality of life. Given the relatively high worldwide burden of corneal opacity, improving treatment outcomes of corneal infections should be a public health priority. Clinicaltrials.gov Identifier: NCT00996736. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Authors attain comparable or slightly higher rates of citation publishing in an open access journal (CytoJournal) compared to traditional cytopathology journals - A five year (2007-2011) experience.

    Science.gov (United States)

    Frisch, Nora K; Nathan, Romil; Ahmed, Yasin K; Shidham, Vinod B

    2014-01-01

    The era of Open Access (OA) publication, a platform which serves to better disseminate scientific knowledge, is upon us, as more OA journals are in existence than ever before. The idea that peer-reviewed OA publication leads to higher rates of citation has been put forth and shown to be true in several publications. This is a significant benefit to authors and is in addition to another relatively less obvious but highly critical component of the OA charter, i.e. retention of the copyright by the authors in the public domain. In this study, we analyzed the citation rates of OA and traditional non-OA publications specifically for authors in the field of cytopathology. We compared the citation patterns for authors who had published in both OA and traditional non-OA peer-reviewed, scientific, cytopathology journals. Citations in an OA publication (CytoJournal) were analyzed comparatively with traditional non-OA cytopathology journals (Acta Cytologica, Cancer Cytopathology, Cytopathology, and Diagnostic Cytopathology) using the data from web of science citation analysis site (based on which the impact factors (IF) are calculated). After comparing citations per publication, as well as a time adjusted citation quotient (which takes into account the time since publication), we also analyzed the statistics after excluding the data for meeting abstracts. Total 28 authors published 314 publications as articles and meeting abstracts (25 authors after excluding the abstracts). The rate of citation and time adjusted citation quotient were higher for OA in the group where abstracts were included (P citation than the publications in the traditional non-OA journals in the field of cytopathology over a 5 year period (2007-2011). However, this increase was statistically insignificant if the meeting abstracts were excluded from the analysis. Overall, the rates of citation for OA and non-OA were slightly higher to comparable.

  17. Comparing interventions and exploring neural mechanisms of exercise in Parkinson disease: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Earhart, Gammon M; Duncan, Ryan P; Huang, John L; Perlmutter, Joel S; Pickett, Kristen A

    2015-02-05

    Effective treatment of locomotor dysfunction in Parkinson disease (PD) is essential, as gait difficulty is an early and major contributor to disability. Exercise is recommended as an adjunct to traditional treatments for improving gait, balance, and quality of life. Among the exercise approaches known to improve walking, tango and treadmill training have recently emerged as two promising therapies for improving gait, disease severity and quality of life, yet these two interventions have not been directly compared to each other. Prior studies have been helpful in identifying interventions effective in improving gait function, but have done little to elucidate the neural mechanisms underlying functional improvements. The primary objective of the proposed work is to compare the effects of three community-based exercise programs, tango, treadmill training and stretching, on locomotor function in individuals with PD. In addition, we aim to determine whether and how these interventions alter functional connectivity of locomotor control networks in the brain. One hundred and twenty right-handed individuals with idiopathic PD who are at least 30 years of age will be assigned in successive waves to one of three community-based exercise groups: tango dancing, treadmill training or stretching (control). Each group will receive three months of exercise training with twice weekly one-hour group classes. Each participant will be evaluated at three time points: pre-intervention (baseline), post-intervention (3 months), and follow-up (6 months). All evaluations will include assessment of gait, balance, disease severity, and quality of life. Baseline and post-intervention evaluations will also include task-based functional magnetic resonance imaging (fMRI) and resting state functional connectivity MRI. All MRI and behavioral measures will be conducted with participants OFF anti-Parkinson medication, with behavioral measures also assessed ON medication. This study will provide

  18. Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions.

    Science.gov (United States)

    Johns, Claire; Seav, Susan M; Dominick, Sally A; Gorman, Jessica R; Li, Hongying; Natarajan, Loki; Mao, Jun James; Irene Su, H

    2016-04-01

    Patient-centered decision making about hot flash treatments often incorporates a balance of efficacy and side effects in addition to patient preference. This systematic review examines randomized controlled trials (RCTs) comparing at least two non-hormonal hot flash treatments in breast cancer survivors. In July 2015, PubMed, SCOPUS, CINAHL, Cochrane, and Web of Science databases were searched for RCTs comparing active, non-hormonal hot flash treatments in female breast cancer survivors. Thirteen trials were included after identifying 906 potential studies. Four trials were dose comparison studies of pharmacologic treatments citalopram, venlafaxine, gabapentin, and paroxetine. Hot flash reduction did not differ by tamoxifen or aromatase inhibitor use. Citalopram 10, 20, and 30 mg daily had comparable outcomes. Venlafaxine 75 mg daily improved hot flashes without additional side effects from higher dosing. Gabapentin 900 mg daily improved hot flashes more than 300 mg. Paroxetine 10 mg daily had fewer side effects than 20 mg. Among four trials comparing different pharmacologic treatments, venlafaxine alleviated hot flash symptoms faster than clonidine; participants preferred venlafaxine over gabapentin. Five trials compared pharmacologic to non-pharmacologic treatments. Acupuncture had similar efficacy to venlafaxine and gabapentin but may have longer durability after completing treatment and fewer side effects. We could not perform a pooled meta-analysis because outcomes were not reported in comparable formats. Clinical trial data on non-hormonal hot flash treatments provide comparisons of hot flash efficacy and other patient important outcomes to guide clinical management. Clinicians can use the information to help patients select hot flash interventions.

  19. Comparison of a Web-Based Teaching Tool and Traditional Didactic Learning for In Vitro Fertilization Patients: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Vause, Tannys Dawn Reiko; Allison, David J; Vause, Tricia; Tekok-Kilic, Ayda; Ditor, David S; Min, Jason K

    2018-05-01

    The objective of this prospective RCT was to compare the efficacy of a web-based teaching tool to traditional didactic teaching in IVF patients. Forty women undergoing their first IVF cycle were randomly allocated to an interactive web-based teaching session or a nurse-led didactic teaching session. The primary outcome measure was participant knowledge regarding the IVF process, risks, and logistics assessed before and after the respective teaching session. Secondary outcomes included patient stress, assessed before and after the respective teaching session, and patient satisfaction, assessed following the respective teaching session and on the day of embryo transfer (following implementation of the teaching protocol). Both groups demonstrated similar and significant improvements in knowledge and stress after exposure to their respective teaching sessions. The web-based group was significantly more satisfied than the didactic teaching group. Web-based teaching was also shown to be equally effective for participants of high versus low income and education status for knowledge, stress, and satisfaction. This study provides preliminary support for the use of web-based teaching as an equally effective tool for increasing knowledge and reducing stress compared to traditional didactic teaching in IVF patients, with the added benefit of increased patient satisfaction. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  20. Scientific writing: a randomized controlled trial comparing standard and on-line instruction

    Directory of Open Access Journals (Sweden)

    Phadtare Amruta

    2009-05-01

    Full Text Available Abstract Background Writing plays a central role in the communication of scientific ideas and is therefore a key aspect in researcher education, ultimately determining the success and long-term sustainability of their careers. Despite the growing popularity of e-learning, we are not aware of any existing study comparing on-line vs. traditional classroom-based methods for teaching scientific writing. Methods Forty eight participants from a medical, nursing and physiotherapy background from US and Brazil were randomly assigned to two groups (n = 24 per group: An on-line writing workshop group (on-line group, in which participants used virtual communication, google docs and standard writing templates, and a standard writing guidance training (standard group where participants received standard instruction without the aid of virtual communication and writing templates. Two outcomes, manuscript quality was assessed using the scores obtained in Six subgroup analysis scale as the primary outcome measure, and satisfaction scores with Likert scale were evaluated. To control for observer variability, inter-observer reliability was assessed using Fleiss's kappa. A post-hoc analysis comparing rates of communication between mentors and participants was performed. Nonparametric tests were used to assess intervention efficacy. Results Excellent inter-observer reliability among three reviewers was found, with an Intraclass Correlation Coefficient (ICC agreement = 0.931882 and ICC consistency = 0.932485. On-line group had better overall manuscript quality (p = 0.0017, SSQSavg score 75.3 ± 14.21, ranging from 37 to 94 compared to the standard group (47.27 ± 14.64, ranging from 20 to 72. Participant satisfaction was higher in the on-line group (4.3 ± 0.73 compared to the standard group (3.09 ± 1.11 (p = 0.001. The standard group also had fewer communication events compared to the on-line group (0.91 ± 0.81 vs. 2.05 ± 1.23; p = 0.0219. Conclusion Our protocol

  1. Randomised trial comparing hysterectomy with endometrial ablation for dysfunctional uterine bleeding: psychiatric and psychosocial aspects.

    Science.gov (United States)

    Alexander, D. A.; Naji, A. A.; Pinion, S. B.; Mollison, J.; Kitchener, H. C.; Parkin, D. E.; Abramovich, D. R.; Russell, I. T.

    1996-01-01

    OBJECTIVE: To compare in psychiatric and psychosocial terms the outcome of hysterectomy and endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Prospective randomised controlled trial. SETTING--Obstetrics and gynaecology department of a large teaching hospital. SUBJECTS: 204 women with dysfunctional bleeding for whom hysterectomy would have been the preferred treatment were recruited over 24 months and randomly allocated to hysterectomy (99 women) or to hysteroscopic surgery (transcervical resection (52 women) or laser ablation (53 women). MAIN OUTCOME MEASURES: Mental state, martial relationship, psychosocial and sexual adjustment in assessments conducted before the operation and one month, six months, and 12 months later. RESULTS: Both treatments significantly reduced the anxiety and depression present before the operation, and there were no differences in mental health between the groups at 12 months. Hysterectomy did not lead to postoperative psychiatric illness. Sexual interest after the operation did not vary with treatment. Overall, 46 out of 185 (25%) women reported a loss sexual interest and 50 out of 185 (27%) reported increased sexual interest. Marital relationships were unaffected by surgery. Personality and duration of dysfunctional uterine bleeding played no significant part in determining outcome. CONCLUSIONS: Hysteroscopic surgery and hysterectomy have a similar effect on psychiatric and psychosocial outcomes. There is no evidence that hysterectomy leads to postoperative psychiatric illness. PMID:8611783

  2. Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation.

    Science.gov (United States)

    Buller, David B; Borland, Ron; Bettinghaus, Erwin P; Shane, James H; Zimmerman, Donald E

    2014-03-01

    Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Young adult smokers 18-30 years old (n = 102) participated in a randomized pretest-posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Self-reported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (ptext messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging.

  3. Troxipide in the Management of Gastritis: A Randomized Comparative Trial in General Practice

    Directory of Open Access Journals (Sweden)

    Bhupesh Dewan

    2010-01-01

    Full Text Available Background. A trial of empirical acid-suppressive therapy is the usual practice for most patients with symptoms of gastritis in primary care. Aim. To assess the relative efficacy of Troxipide and Ranitidine in patients with endoscopic gastritis over a four-week period. Methods. In all, 142 patients were randomized to Troxipide (100 mg tid or Ranitidine (150 mg bid for a period of four weeks. The severity of the signs of endoscopic gastritis at baseline and week 4 using a four-point scale and the subjective symptom severity at baseline and week 2 & week 4 using a Visual analog scale (VAS were documented. Results. Troxipide was found to be superior to Ranitidine for both, the complete resolution and improvement of endoscopic gastritis. Higher proportion of patients showed complete healing of erosions (88.14%, oozing (96.77%, and edema (93.88% with Troxipide as compared to Ranitidine (<.01. Patients receiving Troxipide also showed a greater improvement in the VAS scores for abdominal pain, bloating, and heartburn (<.01. Both the drugs were found to be well tolerated. Conclusion. In patients with endoscopic gastritis, Troxipide, with its superior rate of improvement, resolution of signs, and subjective clinical symptoms, can be considered as an alternative to the commonly used antisecretory agents.

  4. Prospective controlled trial comparing colostomy irrigation with "spontaneous-action" method.

    Science.gov (United States)

    Williams, N S; Johnston, D

    1980-07-12

    Thirty randomly selected patients with permanent colostomies entered a prospective controlled trial comparing colostomy irrigation with spontaneous action. Each patient was interviewed and examined before irrigation was begun and again after the technique had been used for three months. Each then reverted to spontaneous action for a further three months and was then reassessed. Eight patients abandoned irrigation and 22 (73%) adhered to the protocol. Irrigation caused no mishaps or complications. The mean time spent managing the stoma was 45 +/- SEM 9 min/24 hours during spontaneous action and 53 +/- 9 min/24 hours during irrigation. This difference was not significant. The numbers of bowel actions weekly were 13 +/ SEM 2 during spontaneous action and 6 +/- 1 during irrigation (p Irrigation reduced odour and flatus in 20 patients and enabled 12 out of 18 to stop using drugs and seven to discard their appliance. Irrigation also improved the social life of 18 patients and the working conditions of eight out of 14. These finding show that some patients may not be suitable for irrigation but that for many it is better than the conventional British method of colostomy management. With modern apparatus the technique is safe.

  5. Impersonality, Traditional Heritage and Intertextuality: A Comparative Study between Salah Abd al-Sabur, Badr Shakir Al-Sayyab and T.S.Eliot

    Directory of Open Access Journals (Sweden)

    Mohammed A. A. Hizabr Alhusami

    2017-10-01

    Full Text Available This comparative study aims to investigate the similarities and differences between the two Arab poets, Badr Shaker Al-Sayyab and Salah Abd al-Sabur from one hand and T. S. Eliot from the other. The study attempts to investigate the attitudes of those poets towards impersonality. It shows how impersonality from the perspective of Abd al-Sabur is not like Eliot’s, who emphasizes that impersonality is critical to poetry while Abd al-Sabur argues that personality and impersonality together form a perfect work. Unlike them, Al-Sayyab does not have critical comments on the terms of personality and impersonality. The study also aims to investigate the resemblance between those poets, regarding their attitudes towards traditional heritage. It also attempts to investigate intertextuality between their texts. The analysis is comparatively based on some selected poems composed by the three above-mentioned poets. The study concludes that Al-Sayyab, Abd al-Sabur and Eliot hold similar views on traditional heritageas they emphasize the necessity of a positive relation between modern and traditional heritage. In regards to impersonality in poetry, Eliot contradicts himself because he could not escape being impersonal in his poetry. On the other hand, Abd al-Sabur’s and Al-Sayyab’s poems bear stamps of personality and impersonality. The study also concludes that intertexulaity between Al-Sayyab and Abd al-Sabur, from one hand and T. S. Eliot from the other, is due to acculturation rather than influence and eurocentrism.

  6. Comparing the Effects of Simulation-Based and Traditional Teaching Methods on the Critical Thinking Abilities and Self-Confidence of Nursing Students.

    Science.gov (United States)

    AlAmrani, Mashael-Hasan; AlAmmar, Kamila-Ahmad; AlQahtani, Sarah-Saad; Salem, Olfat A

    2017-10-10

    Critical thinking and self-confidence are imperative to success in clinical practice. Educators should use teaching strategies that will help students enhance their critical thinking and self-confidence in complex content such as electrocardiogram interpretation. Therefore, teaching electrocardiogram interpretation to students is important for nurse educators. This study compares the effect of simulation-based and traditional teaching methods on the critical thinking and self-confidence of students during electrocardiogram interpretation sessions. Thirty undergraduate nursing students volunteered to participate in this study. The participants were divided into intervention and control groups, which were taught respectively using the simulation-based and traditional teaching programs. All of the participants were asked to complete the study instrumentpretest and posttest to measure their critical thinking and self-confidence. Improvement was observed in the control and experimental groups with respect to critical thinking and self-confidence, as evidenced by the results of the paired samples t test and the Wilcoxon signed-rank test (p .05). This study evaluated an innovative simulation-based teaching method for nurses. No significant differences in outcomes were identified between the simulator-based and traditional teaching methods, indicating that well-implemented educational programs that use either teaching method effectively promote critical thinking and self-confidence in nursing students. Nurse educators are encouraged to design educational plans with clear objectives to improve the critical thinking and self-confidence of their students. Future research should compare the effects of several teaching sessions using each method in a larger sample.

  7. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.

    Science.gov (United States)

    Wang, Chenchen; Schmid, Christopher H; Fielding, Roger A; Harvey, William F; Reid, Kieran F; Price, Lori Lyn; Driban, Jeffrey B; Kalish, Robert; Rones, Ramel; McAlindon, Timothy

    2018-03-21

    To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. Prospective, randomized, 52 week, single blind comparative effectiveness trial. Urban tertiary care academic hospital in the United States between March 2012 and September 2016. 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group. Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone. The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient's global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life. FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient's global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group

  8. Clinical Trials

    Medline Plus

    Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key ... Enterprise NHLBI has a strong tradition of supporting clinical trials that have not only shaped medical practice around the world, but have improved the health ...

  9. 'A good method of quitting smoking' or 'just an alternative to smoking'? Comparative evaluations of e-cigarette and traditional cigarette usage by dual users.

    Science.gov (United States)

    Vandrevala, Tushna; Coyle, Adrian; Walker, Victoria; Cabrera Torres, Joshelyn; Ordoña, Izobel; Rahman, Panna

    2017-01-01

    The development of e-cigarettes was initially hailed as a resource in facilitating a reduction in or cessation of cigarette smoking. Many users of e-cigarettes are 'dual users', smoking traditional cigarettes and e-cigarettes. The present qualitative study examines the factors that a group of 20 dual users considered to have been influential in their decisions to use e-cigarettes and their comparative evaluations of e-cigarettes and traditional cigarettes. Health concerns were not found to be sole motivators. Participants pointed to financial and contextual considerations, particularly peer influence on uptake and continued usage of e-cigarettes. E-cigarettes were evaluated as comparable to cigarettes in some ways but not in other important respects such as sensation and satisfaction. Different social evaluations of cigarette and e-cigarette usage were discerned which influenced how participants identified as smokers, 'vapers' or neither. Findings are discussed in relation to social representations, identity and implications for continued e-cigarette usage among dual users.

  10. COST AND TIME ESTIMATES DURING THE SUPPLIER SELECTION OF AN INFORMATION SYSTEM FOR LEGAL AREA: A CASE STUDY COMPARING TRADITIONAL AND AGILE PROJECT APPROACHES

    Directory of Open Access Journals (Sweden)

    Vieira, G. L. S.

    2017-06-01

    Full Text Available Considering a direct correlation between projects requirements details levels and their performance, this paper aims to evaluate whether the adoption of more extensive and detailed cost, time and scope estimation processes based on both practices, traditional and agile, and executed concurrently with the supplier selection stage, could guarantee greater accuracy in these estimates, thus increasing project success rates. Based on a case study for the information system project implementation into the legal area of a large Brazilian company, five suppliers had their proposals analyzed and compared in terms of the costs and deadlines involved, as well as the project management processes used in theirs estimates. From the obtained results, it was possible to observe that not all companies follow, at least during the prospecting phase, their service proposals described management processes, according to the theory. Another important finding was that the proposals involving, at least partially, agile approach concepts, were more likely to justify their estimates. These proposals still presented lower values, whenever compared to those less adherents to the theoretical concepts, as those based on traditional concepts.

  11. Raisins compared with other snack effects on glycemia and blood pressure: a randomized, controlled trial.

    Science.gov (United States)

    Anderson, James W; Weiter, Kathy M; Christian, Amber L; Ritchey, Michelle B; Bays, Harold E

    2014-01-01

    To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors. A 12-week, randomized, controlled trial compared 3-times-a-day consumption of raisins with intake of processed snacks on glycemia and cardiovascular risk factors. Men and women were randomized to snacks (n = 15) or raisins (n = 31). Outcome measures were performed at baseline, 4, 8, and 12 weeks. Fasting plasma glucose levels were not significantly affected by intake of raisins or snacks. Mean subject post prandial glucose levels were significantly reduced by raisin intake at 12 weeks; changes with raisin intake were -13.1 mg/dL (P = 0.003 vs baseline; P = 0.03 vs snacks). Eating raisins significantly decreased glycated hemoglobin (HbA1c) level (-0.12%; P = 0.004), a significantly greater level decrease than seen with snack intake (P = 0.036). Snack intake did not significantly affect subject systolic or diastolic blood pressure (BP). Raisin intake was associated with reductions in systolic blood pressure (SBP) at 4, 8, and 12 weeks with mean changes of -6.0 to 10.2 mmHg; all these changes were statistically significant (P = 0.015 to 0.001). Raisins were associated with significantly greater changes in diastolic blood pressure (DBP) at 4, 8, and 12 weeks than snacks (P < 0.05). Body weight did not significantly change within or between groups. Regular consumption of raisins may reduce glycemia and cardiovascular risk factors, including BP rate.

  12. End-tidal control vs. manually controlled minimal-flow anesthesia: a prospective comparative trial.

    Science.gov (United States)

    Wetz, A J; Mueller, M M; Walliser, K; Foest, C; Wand, S; Brandes, I F; Waeschle, R M; Bauer, M

    2017-11-01

    To ensure safe general anesthesia, manually controlled anesthesia requires constant monitoring and numerous manual adjustments of the gas dosage, especially for low- and minimal-flow anesthesia. Oxygen flow-rate and administration of volatile anesthetics can also be controlled automatically by anesthesia machines using the end-tidal control technique, which ensures constant end-tidal concentrations of oxygen and anesthetic gas via feedback and continuous adjustment mechanisms. We investigated the hypothesis that end-tidal control is superior to manually controlled minimal-flow anesthesia (0.5 l/min). In this prospective trial, we included 64 patients undergoing elective surgery under general anesthesia. We analyzed the precision of maintenance of the sevoflurane concentration (1.2-1.4%) and expiratory oxygen (35-40%) and the number of necessary adjustments. Target-concentrations of sevoflurane and oxygen were maintained at more stable levels with the use of end-tidal control (during the first 15 min 28% vs. 51% and from 15 to 60 min 1% vs. 19% deviation from sevoflurane target, P tidal oxygen (5, IQR 3-6). The target-concentrations were reached earlier with the use of end-tidal compared with manual controlled minimal-flow anesthesia but required slightly greater use of anesthetic agents (6.9 vs. 6.0 ml/h). End-tidal control is a superior technique for setting and maintaining oxygen and anesthetic gas concentrations in a stable and rapid manner compared with manual control. Consequently, end-tidal control can effectively support the anesthetist. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. Randomized controlled trial comparing esophageal dilation to no dilation among adults with esophageal eosinophilia and dysphagia.

    Science.gov (United States)

    Kavitt, R T; Ates, F; Slaughter, J C; Higginbotham, T; Shepherd, B D; Sumner, E L; Vaezi, M F

    2016-11-01

    The role of esophageal dilation in patients with esophageal eosinophilia with dysphagia remains unknown. The practice of dilation is currently based on center preferences and expert opinion. The aim of this study is to determine if, and to what extent, dysphagia improves in response to initial esophageal dilation followed by standard medical therapies. We conducted a randomized, blinded, controlled trial evaluating adult patients with dysphagia and newly diagnosed esophageal eosinophilia from 2008 to 2013. Patients were randomized to dilation or no dilation at time of endoscopy and blinded to dilation status. Endoscopic features were graded as major and minor. Subsequent to randomization and endoscopy, all patients received fluticasone and dexlansoprazole for 2 months. The primary study outcome was reduction in overall dysphagia score, assessed at 30 and 60 days post-intervention. Patients with severe strictures (less than 7-mm esophageal diameter) were excluded from the study. Thirty-one patients were randomized and completed the protocol: 17 randomized to dilation and 14 to no dilation. Both groups were similar with regard to gender, age, eosinophil density, endoscopic score, and baseline dysphagia score. The population exhibited moderate to severe dysphagia and moderate esophageal stricturing at baseline. Overall, there was a significant (P dysphagia score at 30 and 60 days post-randomization compared with baseline in both groups. No significant difference in dysphagia scores between treatment groups after 30 (P = 0.93) or 60 (P = 0.21) days post-intervention was observed. Esophageal dilation did not result in additional improvement in dysphagia score compared with treatment with proton pump inhibitor and fluticasone alone. In patients with symptomatic esophageal eosinophilia without severe stricture, dilation does not appear to be a necessary initial treatment strategy. © 2015 International Society for Diseases of the Esophagus.

  14. Data extraction from machine-translated versus original language randomized trial reports: a comparative study.

    Science.gov (United States)

    Balk, Ethan M; Chung, Mei; Chen, Minghua L; Chang, Lina Kong Win; Trikalinos, Thomas A

    2013-11-07

    Google Translate offers free Web-based translation, but it is unknown whether its translation accuracy is sufficient to use in systematic reviews to mitigate concerns about language bias. We compared data extraction from non-English language studies with extraction from translations by Google Translate of 10 studies in each of five languages (Chinese, French, German, Japanese and Spanish). Fluent speakers double-extracted original-language articles. Researchers who did not speak the given language double-extracted translated articles along with 10 additional English language trials. Using the original language extractions as a gold standard, we estimated the probability and odds ratio of correctly extracting items from translated articles compared with English, adjusting for reviewer and language. Translation required about 30 minutes per article and extraction of translated articles required additional extraction time. The likelihood of correct extractions was greater for study design and intervention domain items than for outcome descriptions and, particularly, study results. Translated Spanish articles yielded the highest percentage of items (93%) that were correctly extracted more than half the time (followed by German and Japanese 89%, French 85%, and Chinese 78%) but Chinese articles yielded the highest percentage of items (41%) that were correctly extracted >98% of the time (followed by Spanish 30%, French 26%, German 22%, and Japanese 19%). In general, extractors' confidence in translations was not associated with their accuracy. Translation by Google Translate generally required few resources. Based on our analysis of translations from five languages, using machine translation has the potential to reduce language bias in systematic reviews; however, pending additional empirical data, reviewers should be cautious about using translated data. There remains a trade-off between completeness of systematic reviews (including all available studies) and risk of

  15. CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials.

    Science.gov (United States)

    Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

    2011-03-01

    Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of knowledge about patients' lifestyle behaviors that may affect cancer's progression and recurrence, and limited ability to compile and interpret the wide range of variables that must be considered in the cancer treatment. This lack of data integration limits the potential for patients and clinicians to engage in fully informed decision-making regarding cancer prevention, treatment, and survivorship care, and the translation of research results into mainstream medical care. Particularly important, as noted in a 2009 report on CER to the President and Congress, the limited focus on health behavior-change interventions was a major hindrance in this research landscape (DHHS 2009). This paper describes an initiative to improve CER for cancer by addressing several of these limitations. The Cyberinfrastructure for Comparative Effectiveness Research (CYCORE) project, informed by the National Science Foundation's 2007 report "Cyberinfrastructure Vision for 21(st) Century Discovery" has, as its central aim, the creation of a prototype for a user-friendly, open-source cyberinfrastructure (CI) that supports acquisition, storage, visualization, analysis, and sharing of data important for cancer-related CER. Although still under development, the process of gathering requirements for CYCORE has revealed new ways in which CI design can significantly improve the collection and analysis of a wide variety of data types, and has resulted in new and important partnerships among cancer researchers engaged in

  16. [Meta-analysis of randomized controlled trials comparing procedure for prolapse and hemorrhoids with Milligan-Morgan hemorrhoidectomy in the treatment of prolapsed hemorrhoids].

    Science.gov (United States)

    He, Ping; Chen, Hongliang

    2015-12-01

    To compare the safety and efficacy of procedure for prolapse and hemorrhoids (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of prolapsed hemorrhoids. All the randomized controlled trials (RCT) comparing PPH with MMH in the treatment of prolapsed hemorrhoids published between January 1998 and January 2015 were retrieved from PubMed, Embase, Cochrane Library, CBM, CNKI, Wangfang, VIP databases. Hand search was applied in Chinese Journal of Gastrointestinal Surgery, Chinese Journal of Coloproctology and Journal of Colorectal and Anal Surgery from the library of Chengdu University of Traditional Chinese Medicine. Associated reference documents in enrolled trials were reviewed. The methodological quality of enrolled trials was evaluated according to the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using RevMan 5.3 software. Sixteen RCTs recruiting 1411 patients were identified. Among them, 702 patients underwent PPH, and other 709 patients MMH. Meta-analysis showed that as compared to MMH, PPH had shorter operating time(WMD=-12.34, 95% CI:-17.87 to -6.80, P=0.000], shorter hospital stay (WMD=-1.48, 95% CI: -1.81 to -1.14, P=0.000) and shorter time to recover normal activity (WMD=-14.11, 95% CI: -24.51 to -3.70, P=0.008). Patients in PPH group experienced less pain at postoperative 24 h, postoperative 1 week and the first postoperative bowel movement (all P0.05). Satisfaction degree of patients in PPH group was better than that in MMH group (OR=2.36, 95% CI:1.36 to 4.07, P=0.002). Procedure for prolapse and hemorrhoids offers some short-term benefits over Milligan-Morgan hemorrhoidectomy, but is associated with a higher rate of recurrent disease.

  17. The IDvIP trial: a two-centre randomised double-blind controlled trial comparing intramuscular diamorphine and intramuscular pethidine for labour analgesia.

    Science.gov (United States)

    Wee, Michael Y K; Tuckey, Jenny P; Thomas, Peter; Burnard, Sara

    2011-07-08

    Intramuscular pethidine is routinely used throughout the UK for labour analgesia. Studies have suggested that pethidine provides little pain relief in labour and has a number of side effects affecting mother and neonate. It can cause nausea, vomiting and dysphoria in mothers and can cause reduced fetal heart rate variability and accelerations. Neonatal effects include respiratory depression and impaired feeding. There are few large studies comparing the relative side effects and efficacy of different opioids in labour. A small trial comparing intramuscular pethidine with diamorphine, showed diamorphine to have some benefits over pethidine when used for labour analgesia but the study did not investigate the adverse effects of either opioid. The Intramuscular Diamorphine versus Intramuscular Pethidine (IDvIP) trial is a randomised double-blind two centre controlled trial comparing intramuscular diamorphine and pethidine regarding their analgesic efficacy in labour and their side effects in mother, fetus and neonate. Information about the trial will be provided to women in the antenatal period or in early labour. Consent and recruitment to the trial will be obtained when the mother requests opioid analgesia. The sample size requirement is 406 women with data on primary outcomes. The maternal primary outcomes are pain relief during the first 3 hours after trial analgesia and specifically pain relief after 60 minutes. The neonatal primary outcomes are need for resuscitation and Apgar Score analgesia, whether method of analgesia would be used again, use of Entonox, umbilical arterial and venous pH, fetal heart rate, meconium staining, time from delivery to first breath, Apgar scores at 5 mins, naloxone requirement, transfer to neonatal intensive care unit, neonatal haemoglobin oxygen saturation at 30, 60, 90, and 120 mins after delivery, and neonatal sedation and feeding behaviour during first 2 hours. If the trial demonstrates that diamorphine provides better analgesia

  18. Effect of rest-pause vs. traditional bench press training on muscle strength, electromyography, and lifting volume in randomized trial protocols.

    Science.gov (United States)

    Korak, J Adam; Paquette, Max R; Brooks, Justin; Fuller, Dana K; Coons, John M

    2017-09-01

    Rest-pause (4-s unloaded rest between repetitions) training effects on one repetition maximum (1 RM), lifting volume, and neural activation via electromyography (EMG) are currently vague in the literature and can benefit strength and conditioning professionals for resistance training programme design. Therefore, this study compared 1 RM, neural activation via (EMG), and volume differences between rest-pause vs. traditional resistance training. Trained males (N = 20) were randomly assigned to either a rest-pause or a traditional training group. Pre- and post-1 RM testing was recorded. Training sessions were completed twice a week for 4 weeks and consisted of four sets of bench press to volitional fatigue at 80% of pre-test 1 RM with a 2-min rest between sets. Total volume completed was recorded on each training day. Neural activation of the pectoralis major was measured on the first and last training days. A two-way repeated-measures ANOVA indicated both groups significantly increased their 1 RMs following the 4-week training protocol (p  .05). An independent samples t test indicated that total volume lifted was significantly higher for the rest-pause group (56,778 vs. 38,315 lbs; p < .05) throughout the protocol and independently during weeks 2, 3, and 4. While strength and neural activation changes did not differ between groups, both increased 1 RMs and the rest-pause group achieved greater increases in volume than the traditional group. If volume is the focus of training, the rest-pause method should be utilized.

  19. Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations.

    Science.gov (United States)

    NeCamp, Timothy; Kilbourne, Amy; Almirall, Daniel

    2017-08-01

    Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

  20. Comparability of patients with ANCA-associated vasculitis enrolled in clinical trials or in observational cohorts

    NARCIS (Netherlands)

    Pagnoux, C.; Carette, S.; Khalidi, N. A.; Walsh, M.; Hiemstra, T. F.; Cuthbertson, D.; Langford, C.; Hoffman, G.; Koening, C. L.; Monach, P. A.; Moreland, L.; Mouthon, L.; Seo, P.; Specks, U.; Ytterbere, S.; Westman, K.; Hoglund, P.; Harper, L.; Flossmann, O.; Luqmani, R.; Savage, C.; Rasmussen, N.; de Groot, K.; Tesar, V.; Jayne, D.; Merkel, P. A.; Guillevin, L.; Stegeman, C. A.

    2015-01-01

    Objective. To analyse the differences between patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) entered into randomised clinical trials (RCTs) and those followed in large observational cohorts. Methods. The main characteristics and outcomes of patients with

  1. Study design considerations in a large COPD trial comparing effects of tiotropium with salmeterol on exacerbations

    NARCIS (Netherlands)

    K-M. Beeh (Kai-Michael); B. Hederer (Bettina); T. Glaab (Thomas); A. Müller (Achim); M.P.M.H. Rutten-van Mölken (Maureen); S. Kesten (Steven); C. Vogelmeier (Claus)

    2009-01-01

    textabstractAbstract Currently available long-acting inhaled bronchodilators (tiotropium, salmeterol, formoterol) have demonstrated beneficial effects on exacerbations in placebo-controlled trials. However, there have been no direct comparisons of these drugs with exacerbations as the primary

  2. Traditional Chinese Herbal Patch for Short-Term Management of Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Xuezong Wang

    2012-01-01

    Full Text Available Objective. To assess the short-term efficacy and safety of two kinds of Traditional Chinese herbal patches, Fufang Nanxing Zhitong Gao (FNZG and Shangshi Jietong Gao (SJG, for painful knee osteoarthritis (OA. Methods. Patients were randomly enrolled in a double-blind, placebo-controlled study to receive FNZG (n=60, SJG (n=60, or placebo patch (n=30 for 7 days. Outcome measures included visual analogue scale (VAS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, and Traditional Chinese Medicine Syndrome Questionnaire (TCMSQ subscale. Results. Although there was no significant difference among, three groups in short-term pain management, patients receiving FNZG got significant improvement in symptom of fear of coldness as compared with placebo patch (P=0.029. The most common local adverse events of rash, itching, erythema, and slightly damaged skin were observed in 7% of participants. Conclusions. FNZG may be a useful treatment for symptom of knee OA and merits long-term study in broader populations.

  3. Contura Multi-Lumen Balloon Breast Brachytherapy Catheter: Comparative Dosimetric Findings of a Phase 4 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Arthur, Douglas W., E-mail: darthur@mcvh-vcu.edu [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States); Todor, Dorin A. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Julian, Thomas B. [Allegheny General Hospital, Temple University School of Medicine, Pittsburgh, Pennsylvania (United States); Cuttino, Laurie W.; Mukhopadhyay, Nitai D. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States)

    2013-06-01

    Purpose: Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Methods and Materials: Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥95% of the prescribed dose (PD) covering ≥95% of the target volume (TV); maximum skin dose ≤125% of the PD; maximum rib dose ≤145% of the PD; and V150 ≤50 cc and V200 ≤10 cc. Results: Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Conclusions: Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals.

  4. Contura Multi-Lumen Balloon breast brachytherapy catheter: comparative dosimetric findings of a phase 4 trial.

    Science.gov (United States)

    Arthur, Douglas W; Vicini, Frank A; Todor, Dorin A; Julian, Thomas B; Cuttino, Laurie W; Mukhopadhyay, Nitai D

    2013-06-01

    Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥ 95% of the prescribed dose (PD) covering ≥ 95% of the target volume (TV); maximum skin dose ≤ 125% of the PD; maximum rib dose ≤ 145% of the PD; and V150 ≤50 cc and V200 ≤ 10 cc. Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P ≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals. Copyright © 2013 Elsevier Inc. All rights

  5. Cost utility analysis of co-prescribed heroin compared with methadone maintenance treatment in heroin addicts in two randomised trials

    NARCIS (Netherlands)

    Dijkgraaf, Marcel G. W.; van der Zanden, Bart P.; de Borgie, Corianne A. J. M.; Blanken, Peter; van Ree, Jan M.; van den Brink, Wim

    2005-01-01

    Objective To determine the cost utility of medical co-prescription of heroin compared with methadone maintenance treatment for chronic, treatment resistant heroin addicts. Design Cost utility analysis of two pooled open label randomised controlled trials. Setting Methadone maintenance programmes in

  6. Conservative treatment of a mandibular condyle fracture: comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial

    NARCIS (Netherlands)

    van den Bergh, B.; Blankestijn, J.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

    2015-01-01

    Introduction A mandibular condyle fracture can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation (ORIF). Many IMF-modalities can be chosen, including IMF-screws (IMFS). This prospective multi-centre randomised clinical trial compared the use of

  7. Conservative treatment of a mandibular condyle fracture: Comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial

    NARCIS (Netherlands)

    van den Bergh, B.; Blankestijn, J.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

    2015-01-01

    Introduction A mandibular condyle fracture can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation (ORIF). Many IMF-modalities can be chosen, including IMF-screws (IMFS). This prospective multi-centre randomised clinical trial compared the use of

  8. A randomized trial comparing perinatal outcomes using insulin detemir or neutral protamine Hagedorn in type 1 diabetes

    DEFF Research Database (Denmark)

    Hod, Moshe; Mathiesen, Elisabeth R; Jovanovič, Lois

    2014-01-01

    OBJECTIVE: This randomized controlled trial aimed to compare the efficacy and safety of insulin detemir (IDet) with neutral protamine Hagedorn (NPH), both with insulin aspart, in pregnant women with type 1 diabetes. The perinatal and obstetric pregnancy outcomes are presented. METHODS: Subjects w...

  9. Examination of Individual Differences in Outcomes from a Randomized Controlled Clinical Trial Comparing Formal and Informal Individual Auditory Training Programs

    Science.gov (United States)

    Smith, Sherri L.; Saunders, Gabrielle H.; Chisolm, Theresa H.; Frederick, Melissa; Bailey, Beth A.

    2016-01-01

    Purpose: The purpose of this study was to determine if patient characteristics or clinical variables could predict who benefits from individual auditory training. Method: A retrospective series of analyses were performed using a data set from a large, multisite, randomized controlled clinical trial that compared the treatment effects of at-home…

  10. A multicenter, randomized trial comparing synthetic surfactant with modified bovine surfactant extract in the treatment of neonatal respiratory distress syndrome

    NARCIS (Netherlands)

    Adams, E; Vollman, J; Giebner, D; Maurer, M; Dreyer, G; Bailey, L; Anderson, M; Mefford, L; Beaumont, E; Sutton, D; Puppala, B; Mangurten, HH; Secrest, J; Lewis, WJ; Carteaux, P; Bednarek, F; Welsberger, S; Gosselin, R; Pantoja, AF; Belenky, A; Campbell, P; Patole, S; Duenas, M; Kelly, M; Alejo, W; Lewallen, P; DeanLieber, S; Hanft, M; Ferlauto, J; Newell, RW; Bagwell, J; Levine, D; Lipp, RW; Harkavy, K; Vasa, R; Birenbaum, H; Broderick, KA; Santos, AQ; Long, BA; Gulrajani, M; Stern, M; Hopgood, G; Hegyi, T; Alba, J; Christmas, L; McQueen, M; Nichols, N; Brown, M; Quissell, BJ; Rusk, C; Marks, K; Gifford, K; Hoehn, G; Pathak, A; Marino, B; Hunt, P; Fox, [No Value; Sharpstein, C; Feldman, B; Johnson, N; Beecham, J; Balcom, R; Helmuth, W; Boylan, D; Frakes, C; Magoon, M; Reese, K; Schwersenski, J; Schutzman, D; Soll, R; Horbar, JD; Leahy, K; Troyer, W; Juzwicki, C; Anderson, P; Dworsky, M; Reynolds, L; Urrutia, J; Gupta, U; Adray, C

    Objective. To compare the efficacy of a synthetic surfactant (Exosurf Neonatal, Burroughs-Wellcome Co) and a modified bovine surfactant extract (Survanta, Ross Laboratories) in the treatment of neonatal respiratory distress syndrome (RDS). Design. Multicenter, randomized trial. Setting. Thirty-eight

  11. A comparative study of the mechanical properties and the behavior of carbon and boron in stainless steel cladding tubes fabricated by PM HIP and traditional technologies

    Energy Technology Data Exchange (ETDEWEB)

    Shulga, A.V., E-mail: avshulga@mephi.ru [Moscow Engineering Physics Institute, State University, 31 Kashirskoe Sh., Moscow 115409 (Russian Federation)

    2013-03-15

    Highlights: ► The ring tensile test method was optimized and successfully used. ► The cladding tubes fabricated by PM HIP and traditional technologies were tested. ► Improvement of the cladding tubes properties fabricated by PM HIP was found. ► Correlation of the homogeneity of carbon, boron with the properties was revealed. -- Abstract: The ring tensile test method was optimized and successfully used to obtain precise data for specimens of the cladding tubes of AISI type 316 austenitic stainless steels and ferritic–martensitic stainless steel. The positive modifications in the tensile properties of the stainless steel cladding tubes fabricated by powder metallurgy and hot isostatic pressing of melt atomized powders (PM HIP) when compared with the cladding tubes produced by traditional technology were found. Presently, PM HIP is also used in the fabrication of oxide dispersion strengthened (ODS) ferritic–martensitic steels. The high degree of homogeneity of the distribution of carbon and boron as well the high dispersivity of the phase-structure elements in the specimens manufactured via PM HIP were determined by direct autoradiography methods. These results correlate well with the increase of the tensile properties of the specimens produced by PM HIP technology.

  12. [Traditional risk factors for cardiovascular disease in primary antiphospholipid syndrome (APS) when compared with secondary APS: a study with 96 patients].

    Science.gov (United States)

    Ribeiro, A R; Carvalho, J F

    2010-01-01

    To evaluate the prevalence of traditional risk factors in patients with primary antiphospholipid syndrome (APS) in comparison to those with systemic lupus erythematosus-secondary APS. Transversal study of 96 APS patients (Sapporo's criteria). Demographic and clinical data, cardiovascular risk factors and drug use were investigated. Thirty-nine Primary APS and 57 secondary APS were included. The groups did not differ regarding age (38.5 +/- 9.9 vs. 39.4 +/- 10.5 years, p=0.84) and female gender (84.6 vs. 96.5%, p=0.06), respectively. Arterial events were more observed in primary than secondary APS (59 vs. 36.8%, p=0.04) patients. No difference was seen concerning venous and obstetric events. In regard to traditional risk factors for cardiovascular disease, both groups were comparable related to current or previous smoking, sedentarism, family history for coronary disease, systemic hypertension, diabetes mellitus, overweight and obesity. The frequencies of altered lipid profiles were alike in the two groups, except for a higher prevalence of low HDL-c levels in primary APS group (84.6 vs. 45.5%, p=0.0001). Concerning drug use, no significant differences were observed related to chloroquine and statin use, however the secondary APS patients had a higher rate of prednisone use (10.2 vs. 57.9%, pAPS, except for a high frequency of low HDL-c in primary APS patients.

  13. Comparing Efficacy of Implementing Two Teaching Methods Contract Learning and Traditional Instruction on Clinical Skills of Nursing Students in Psychiatric Wards of Hospitals of Tehran

    Directory of Open Access Journals (Sweden)

    Jamileh Mohtashami

    2009-06-01

    Full Text Available Background and purpose: A learning contract is defined as a written agreement between teacher and student which makes explicit what a learner will do to achieve specified learning outcomes.Learning contracts have been used as a teaching and learning strategy for both undergraduate and graduate nursing students in many countries.Methods : This research is a quasi-experimental study that compares effect of two different teaching methods , Contract learning and traditional on clinical skills for a group of nursing students who were in fourth year of study in a pre-registration bachelor of nursing degree program in Tehran . A learning contract was implemented as a learning tool in the students clinical placement in psychiatric nursing .Data were connected from questionnaires , interviews and clinical evaluation papers with students .Results : The results showed that students agreed that there was an increase in students autonomy and motivation in learning with the use of learning contract . It also increased the sharing between students and clinical instructors.Conclusion : According to the findings of this study , contract learning is considered beneficial to students learning and has the potential to be used in clinical learning .Key words : NURSING STUDENTS, LEARNING CONTRACTS , TRADITIONAL METHOD , MOTIVATION , AUTONOMY, PSYCHIATRIC WARDS .

  14. A comparative study: The spatial organization of pre and post disaster house in traditional cultured area; study case: Core house project in Kasongan, Yogyakarta, Indonesia

    Science.gov (United States)

    Agustina, Vicky

    2017-11-01

    This study involves revealing the spatial organization typology differences between pre and post disaster houses through core house project in Kasongan, Yogyakarta, Indonesia. The goal is to gain understanding of the way of traditional cultured people re-shaping their space and environment after disaster reconstruction through the core house and find the factors that determine the form. The study has been done by comparing and analyzing the spatial properties and functions between both objects using justified graph technique which is one of the basic methodology that able to identify how people are organized in space. Upon the comparison and analysis of these aspects, it appears that the old house size has impact toward significant changes of the spatial properties also the dwellers put physical factor over culture when evaluating the present house. Through these findings, this study highlights that spatial organization of traditional house has temporal spatial value and the core house concept had influenced the changes of the local spatial behaviour and their perception of their house standard.

  15. A Traditional Mouthwash (Punica granatum var pleniflora) for Controlling Gingivitis of Diabetic Patients: A Double-Blind Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Sedigh-Rahimabadi, Massih; Fani, Mohammadmehdi; Rostami-Chijan, Mahsa; Zarshenas, Mohammad M; Shams, Mesbah

    2017-01-01

    This study evaluates the safety and efficacy of Punica granatum var pleniflora mouthwash in treatment of diabetic gingivitis. In a double-blind randomized clinical trial 80 patients with diabetes mellitus and gingivitis were assigned to Golnaar and chlorhexidine 0.2% groups. After using mouthwashes for 2 weeks; participants underwent tooth scaling and the last visit was 2 weeks after scaling. The primary outcome measures were plaque, modified gingival and gingival bleeding indices, and pocket depth. Both interventions had significant improvement on all of the gingival and plaque indices (P < .001 for all indices). There were no significant differences between Golnaar and chlorhexidine in primary outcome measures except for modified gingival index for which Golnaar mouthwash had a superiority after 2 weeks when comparing with chlorhexidine (P = .039). Meanwhile, Golnaar mouthwash had no staining effect. Golnaar mouthwash is safe and effective in treatment of gingivitis in diabetic patients although further studies are recommended. © The Author(s) 2016.

  16. Methodological reporting of randomized controlled trials in major hepato-gastroenterology journals in 2008 and 1998: a comparative study

    Science.gov (United States)

    2011-01-01

    Background It was still unclear whether the methodological reporting quality of randomized controlled trials (RCTs) in major hepato-gastroenterology journals improved after the Consolidated Standards of Reporting Trials (CONSORT) Statement was revised in 2001. Methods RCTs in five major hepato-gastroenterology journals published in 1998 or 2008 were retrieved from MEDLINE using a high sensitivity search method and their reporting quality of methodological details were evaluated based on the CONSORT Statement and Cochrane Handbook for Systematic Reviews of interventions. Changes of the methodological reporting quality between 2008 and 1998 were calculated by risk ratios with 95% confidence intervals. Results A total of 107 RCTs published in 2008 and 99 RCTs published in 1998 were found. Compared to those in 1998, the proportion of RCTs that reported sequence generation (RR, 5.70; 95%CI 3.11-10.42), allocation concealment (RR, 4.08; 95%CI 2.25-7.39), sample size calculation (RR, 3.83; 95%CI 2.10-6.98), incomplete outecome data addressed (RR, 1.81; 95%CI, 1.03-3.17), intention-to-treat analyses (RR, 3.04; 95%CI 1.72-5.39) increased in 2008. Blinding and intent-to-treat analysis were reported better in multi-center trials than in single-center trials. The reporting of allocation concealment and blinding were better in industry-sponsored trials than in public-funded trials. Compared with historical studies, the methodological reporting quality improved with time. Conclusion Although the reporting of several important methodological aspects improved in 2008 compared with those published in 1998, which may indicate the researchers had increased awareness of and compliance with the revised CONSORT statement, some items were still reported badly. There is much room for future improvement. PMID:21801429

  17. Smoking-Cessation Interventions for Urban Hospital Patients: A Randomized Comparative Effectiveness Trial.

    Science.gov (United States)

    Sherman, Scott E; Link, Alissa R; Rogers, Erin S; Krebs, Paul; Ladapo, Joseph A; Shelley, Donna R; Fang, Yixin; Wang, Binhuan; Grossman, Ellie

    2016-10-01

    Hospitalization is a unique opportunity for smoking cessation, but prior interventions have measured efficacy with narrowly defined populations. The objective of this study was to enroll smokers admitted to two "safety net" hospitals and compare the effectiveness of two post-discharge cessation interventions. A randomized comparative effectiveness trial was conducted. At two New York City public hospitals, every hospitalized patient identified as a smoker (based on admission records) was approached. Inclusion criteria were: smoked cigarettes in the past 30 days; spoke English, Spanish, or Mandarin; had a U.S. phone number; not discharged to an institution where follow-up or smoking was limited; and not pregnant/breastfeeding. Of 18,797 patients identified as current smokers between July 2011 and April 2014, a total of 3,047 (16%) were discharged before being approached, 3,273 (17%) were not current smokers, 4,026 (21%) had no U.S. phone number, 2,831 (15%) were ineligible for other reasons, and 3,983 (21%) refused participation. In total, 1,618 (9%) participants enrolled in the study. During follow-up, 69% of participants were reached at 2 months and 68% at 6 months. At discharge, participants were randomized to multisession telephone counseling from study staff (n=804) or referral to the state quitline for proactive outreach and counseling (n=814). Self-reported abstinence at 6 months was measured. Analyses were conducted in late 2015. One quarter of participants were homeless or in unstable housing, 60% had a history of substance abuse, 43% reported current hazardous drinking, and half had a psychiatric diagnosis other than substance abuse. At follow-up, the rate of abstinence (30-day point prevalence) was higher in the intensive counseling arm than the quitline arm at 2 months (29.0% vs 20.7%; relative risk=1.40; 95% CI=1.13, 1.73) and 6 months (37.4% vs 31.5%; relative risk=1.19; 95% CI=1.01, 1.40). Intensive counseling was more effective than referral to the

  18. Impact of different nasal masks on CPAP therapy for obstructive sleep apnea: a randomized comparative trial.

    Science.gov (United States)

    Neuzeret, Pierre-Charles; Morin, Laurent

    2017-11-01

    Patient interface is important for the success of continuous positive airway pressure (CPAP), but few trials have examined the influence of mask choice on CPAP adherence. To compare the impact of different nasal masks on CPAP in patients with newly-diagnosed obstructive sleep apnea (OSA). OSA patients were randomized in a 2:3 ratio to receive CPAP via different first-line nasal masks: ResMed Mirage FX® (MFX) or control mask (Fisher & Paykel Zest ® , HC407 ® or Philips EasyLife ® ). Mask acceptance, CPAP compliance and Home Care Provider (HCP) interventions were compared between groups after 3 months of CPAP therapy using modified intent-to-treat (mITT; after exclusion of patients with mouth leaks during CPAP initiation) and on-treatment (OT; CPAP adherent) analyses. Of 285 randomized patients, 90 requiring a full-face mask were excluded, leaving 195 and 151 in the mITT and OT analyses, respectively. Mask acceptance rate was higher in the MFX versus control group (mITT: 79% vs 68%, P = 0.067; OT: 90% vs 76%, P = 0.022). CPAP compliance was higher (5.9 ± 1.8 vs 5.1 ± 1.6 h/night, P = 0.011) and nasal mask issue-related HCP visits lower (3% vs 17%, P = 0.006) in the MFX group. Nasal mask failures due to mask discomfort (5% vs 1%) or unintentional leakage (5% vs 0%) were higher in control vs MFX group. Mask acceptance was significantly associated with fewer mask leaks (P = 0.002) and higher pressure therapy (P = 0.042). This study highlights differences between nasal masks for CPAP delivery and shows that initial mask selection can influence adherence and healthcare utilization during CPAP. © 2016 ResMed Germany Inc. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

  19. A comparative study of the mechanical properties and the behavior of carbon and boron in stainless steel cladding tubes fabricated by PM HIP and traditional technologies

    Science.gov (United States)

    Shulga, A. V.

    2013-03-01

    The ring tensile test method was optimized and successfully used to obtain precise data for specimens of the cladding tubes of AISI type 316 austenitic stainless steels and ferritic-martensitic stainless steel. The positive modifications in the tensile properties of the stainless steel cladding tubes fabricated by powder metallurgy and hot isostatic pressing of melt atomized powders (PM HIP) when compared with the cladding tubes produced by traditional technology were found. Presently, PM HIP is also used in the fabrication of oxide dispersion strengthened (ODS) ferritic-martensitic steels. The high degree of homogeneity of the distribution of carbon and boron as well the high dispersivity of the phase-structure elements in the specimens manufactured via PM HIP were determined by direct autoradiography methods. These results correlate well with the increase of the tensile properties of the specimens produced by PM HIP technology.

  20. Low-field MR imaging of the spine. A comparative study of a traditional and a new, completely balanced gradient-echo sequence

    International Nuclear Information System (INIS)

    Drejer, J.; Thomsen, H.S.; Tanttu, J.

    1995-01-01

    49 patients underwent 53 examinations with both a traditional T1-weighted gradient-echo (PS) sequence and a new completely balanced steady-state 3-D (CBASS3D) sequence; 20 examinations included the cervical spine, 8 the thoracic spine and 25 the lumbar spine. All 106 examinations were reviewed twice regarding visibility of selected structures in the spinal region and diagnostic usefulness. The CBASS3D sequence delineated the medulla, nerve roots, CSF, the intervertebral discs and the posterior longitudinal ligament significantly better than the PS sequence. Disc hernia was also better visualised (p<0.01). There were significantly more artefacts on images obtained with the CBASS3D sequence, but they were usually outside the region of interest and occurred less frequently over time due to increased experience of the staff. Both reviewers found the diagnostic usefulness of CBASS3D to be superior compared to that of PS and excellent for diagnostic purposes. (orig./MG)

  1. Low-field MR imaging of the spine. A comparative study of a traditional and a new, completely balanced gradient-echo sequence

    Energy Technology Data Exchange (ETDEWEB)

    Drejer, J. [Dept. of Diagnostic Radiology, Herlev Hospital, Univ. Copenhagen (Denmark); Thomsen, H.S. [Dept. of Diagnostic Radiology, Herlev Hospital, Univ. Copenhagen (Denmark); Tanttu, J. [Picker Nordstar, Helsinki (Finland)

    1995-09-01

    49 patients underwent 53 examinations with both a traditional T1-weighted gradient-echo (PS) sequence and a new completely balanced steady-state 3-D (CBASS3D) sequence; 20 examinations included the cervical spine, 8 the thoracic spine and 25 the lumbar spine. All 106 examinations were reviewed twice regarding visibility of selected structures in the spinal region and diagnostic usefulness. The CBASS3D sequence delineated the medulla, nerve roots, CSF, the intervertebral discs and the posterior longitudinal ligament significantly better than the PS sequence. Disc hernia was also better visualised (p<0.01). There were significantly more artefacts on images obtained with the CBASS3D sequence, but they were usually outside the region of interest and occurred less frequently over time due to increased experience of the staff. Both reviewers found the diagnostic usefulness of CBASS3D to be superior compared to that of PS and excellent for diagnostic purposes. (orig./MG).

  2. Patient-specific targeting guides compared with traditional instrumentation for glenoid component placement in shoulder arthroplasty: a multi-surgeon study in 70 arthritic cadaver specimens.

    Science.gov (United States)

    Throckmorton, Thomas W; Gulotta, Lawrence V; Bonnarens, Frank O; Wright, Stephen A; Hartzell, Jeffrey L; Rozzi, William B; Hurst, Jason M; Frostick, Simon P; Sperling, John W

    2015-06-01

    The purpose of this study was to compare the accuracy of patient-specific guides for total shoulder arthroplasty (TSA) with traditional instrumentation in arthritic cadaver shoulders. We hypothesized that the patient-specific guides would place components more accurately than standard instrumentation. Seventy cadaver shoulders with radiographically confirmed arthritis were randomized in equal groups to 5 surgeons of varying experience levels who were not involved in development of the patient-specific guidance system. Specimens were then randomized to patient-specific guides based off of computed tomography scanning, standard instrumentation, and anatomic TSA or reverse TSA. Variances in version or inclination of more than 10° and more than 4 mm in starting point were considered indications of significant component malposition. TSA glenoid components placed with patient-specific guides averaged 5° of deviation from the intended position in version and 3° in inclination; those with standard instrumentation averaged 8° of deviation in version and 7° in inclination. These differences were significant for version (P = .04) and inclination (P = .01). Multivariate analysis of variance to compare the overall accuracy for the entire cohort (TSA and reverse TSA) revealed patient-specific guides to be significantly more accurate (P = .01) for the combined vectors of version and inclination. Patient-specific guides also had fewer instances of significant component malposition than standard instrumentation did. Patient-specific targeting guides were more accurate than traditional instrumentation and had fewer instances of component malposition for glenoid component placement in this multi-surgeon cadaver study of arthritic shoulders. Long-term clinical studies are needed to determine if these improvements produce improved functional outcomes. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Comparison of the Effects on Rib Fracture between the Traditional Japanese Medicine Jidabokuippo and Nonsteroidal Anti-Inflammatory Drugs: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hajime Nakae

    2012-01-01

    Full Text Available Jidabokuippo is a traditional Japanese medicine used for contusion-induced swelling and pain. This open multicenter randomized study was designed to compare the efficacies of jidabokuippo and nonsteroidal anti-inflammatory drugs (NSAIDs in patients with rib fracture by analyzing the treatment duration. Our study involved 170 rib fracture patients capable of oral ingestion divided randomly into 2 groups: the jidabokuippo and NSAID groups. We compared the duration of treatment and healthcare expenditure between these 2 groups. Medication was continued in both groups until the visual analogue scale score decreased to less than 50% of the pretreatment score. We excluded the patients in whom medication was prematurely discontinued. We analyzed 81 patients belonging to the jidabokuippo and NSAIDs groups. No significant intergroup differences were observed in age, gender, severity (injury severity score, and presence/absence of underlying disease. The treatment duration was significantly shorter in the jidabokuippo group than in the NSAIDs group (P=0.0003. Healthcare expenditure was significantly lower in the jidabokuippo group than in the NSAIDs group (P<0.0001. Our results suggest that compared to NSAIDs, jidabokuippo can shorten the duration of treatment in patients with rib fracture and is a promising analgesic agent based on the medical economic viewpoint.

  4. Authors attain comparable or slightly higher rates of citation publishing in an open access journal (CytoJournal compared to traditional cytopathology journals - A five year (2007-2011 experience

    Directory of Open Access Journals (Sweden)

    Nora K Frisch

    2014-01-01

    Full Text Available Background: The era of Open Access (OA publication, a platform which serves to better disseminate scientific knowledge, is upon us, as more OA journals are in existence than ever before. The idea that peer-reviewed OA publication leads to higher rates of citation has been put forth and shown to be true in several publications. This is a significant benefit to authors and is in addition to another relatively less obvious but highly critical component of the OA charter, i.e. retention of the copyright by the authors in the public domain. In this study, we analyzed the citation rates of OA and traditional non-OA publications specifically for authors in the field of cytopathology. Design: We compared the citation patterns for authors who had published in both OA and traditional non-OA peer-reviewed, scientific, cytopathology journals. Citations in an OA publication (CytoJournal were analyzed comparatively with traditional non-OA cytopathology journals (Acta Cytologica, Cancer Cytopathology, Cytopathology, and Diagnostic Cytopathology using the data from web of science citation analysis site (based on which the impact factors (IF are calculated. After comparing citations per publication, as well as a time adjusted citation quotient (which takes into account the time since publication, we also analyzed the statistics after excluding the data for meeting abstracts. Results: Total 28 authors published 314 publications as articles and meeting abstracts (25 authors after excluding the abstracts. The rate of citation and time adjusted citation quotient were higher for OA in the group where abstracts were included (P < 0.05 for both. The rates were also slightly higher for OA than non-OA when the meeting abstracts were excluded, but the difference was statistically insignificant (P = 0.57 and P = 0.45. Conclusion : We observed that for the same author, the publications in the OA journal attained a higher rate of citation than the publications in the

  5. Protocol for a multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapy-led care for femoroacetabular impingement (FAI): the Australian FASHIoN trial.

    Science.gov (United States)

    Murphy, Nicholas J; Eyles, Jillian; Bennell, Kim L; Bohensky, Megan; Burns, Alexander; Callaghan, Fraser M; Dickenson, Edward; Fary, Camdon; Grieve, Stuart M; Griffin, Damian R; Hall, Michelle; Hobson, Rachel; Kim, Young Jo; Linklater, James M; Lloyd, David G; Molnar, Robert; O'Connell, Rachel L; O'Donnell, John; O'Sullivan, Michael; Randhawa, Sunny; Reichenbach, Stephan; Saxby, David J; Singh, Parminder; Spiers, Libby; Tran, Phong; Wrigley, Tim V; Hunter, David J

    2017-09-26

    Femoroacetabular impingement syndrome (FAI), a hip disorder affecting active young adults, is believed to be a leading cause of hip osteoarthritis (OA). Current management approaches for FAI include arthroscopic hip surgery and physiotherapy-led non-surgical care; however, there is a paucity of clinical trial evidence comparing these approaches. In particular, it is unknown whether these management approaches modify the future risk of developing hip OA. The primary objective of this randomised controlled trial is to determine if participants with FAI who undergo hip arthroscopy have greater improvements in hip cartilage health, as demonstrated by changes in delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) index between baseline and 12 months, compared to those who undergo physiotherapy-led non-surgical management. This is a pragmatic, multi-centre, two-arm superiority randomised controlled trial comparing hip arthroscopy to physiotherapy-led management for FAI. A total of 140 participants with FAI will be recruited from the clinics of participating orthopaedic surgeons, and randomly allocated to receive either surgery or physiotherapy-led non-surgical care. The surgical intervention involves arthroscopic FAI surgery from one of eight orthopaedic surgeons specialising in this field, located in three different Australian cities. The physiotherapy-led non-surgical management is an individualised physiotherapy program, named Personalised Hip Therapy (PHT), developed by a panel to represent the best non-operative care for FAI. It entails at least six individual physiotherapy sessions over 12 weeks, and up to ten sessions over six months, provided by experienced musculoskeletal physiotherapists trained to deliver the PHT program. The primary outcome measure is the change in dGEMRIC score of a ROI containing both acetabular and femoral head cartilages at the chondrolabral transitional zone of the mid-sagittal plane between baseline and

  6. Changes in well-being and quality of life in a randomized trial comparing dynamic psychotherapy and pharmacotherapy for major depressive disorder.

    Science.gov (United States)

    Zilcha-Mano, Sigal; Dinger, Ulrike; McCarthy, Kevin S; Barrett, Marna S; Barber, Jacques P

    2014-01-01

    Major depressive disorder (MDD) is associated with a decrease in quality of life (QOL) and well-being. Therefore, researchers are increasingly complementing traditional symptom measurements with QOL and well-being assessments in order to broaden the evaluation of treatment outcomes. The current prospective study investigated the effectiveness of supportive-expressive therapy (SET), antidepressant medication (MED) and placebo (PBO) in improving QOL and well-being in patients with MDD. Data from a randomized controlled trial (trial registration: NCT00043550) comparing SET, MED and PBO for the treatment of depression (N=156) were analyzed. Outcome measures addressed patients' QOL and physical and mental well-being. Changes in outcomes were assessed across and between treatments using linear mixed models. Across treatments, patients showed significant improvement in QOL and mental and physical health measures, as well as a reduction in interpersonal distress and depressive and anxiety symptoms (p≤.002 for all measures). Those changes were not only the products of a decrease in depressive symptoms, but also predicted subsequent reduction in symptoms. No significant differences were found between the three treatment conditions. The limitation is the study's moderate sample size. Current treatments for depression significantly improve patients' QOL and well-being. No significant differences were found between the three conditions examined in this study. The current study highlights the role of well-being in predicting subsequent symptomatic change. © 2013 Published by Elsevier B.V.

  7. Prolactinoma and hyperprolactinaemia: a transcultural comparative study between Germany as a western, liberal, industrialised country and Syria as an oriental society with a strong Islamic tradition.

    Science.gov (United States)

    Kann, Peter Herbert; Juratli, Nour; Kabalan, Younes

    2010-10-01

    Prolactinomas and hyperprolactinaemia cause hypogonadism and impairment of sexual and reproductive function. In this transcultural study, clinical characteristics of prolactinoma/hyperprolactinaemia were compared between a liberal, western, industrialised country and a more traditional, Islamic, oriental society. Sixty-two Syrian patients with hyperprolactinaemia were compared to 62 German patients with hyperprolactinaemia. In Syria and Germany, prolactinoma and hyperprolactinaemia were more frequent in females than in males (Syria 87% females; Germany 63% females). Prolactinomas were larger in males, males were older at diagnosis in both countries. Recorded clinical symptoms were comparable, even if culturally determined differences in spontaneous reporting of and asking for symptoms might be considered. The average age of the Syrian patients at diagnosis of hyperprolactinaemia was more than 6 years lower than in the German cohort (33.4 ± 10.4 vs. 39.7 ± 17.6 years). In Germany, a variety of therapeutic regimens were applied. In Syria, bromocriptine was prescribed exclusively. The differences may be attributed to culturally determined differences in sexual and reproductive behaviour, i.e. sexual intercourses of young, unmarried girls and women in association to the use of oral contraceptives regulating the menstrual cycle, maternal age at first delivery and birth frequency. Exclusive prescription of bromocriptine in Syria may be associated to limited resources and the safety of bromocriptine during pregnancy.

  8. Del Ajedrez a Starcraft. Análisis comparativo de juegos tradicionales y videojuegos From Chess to StarCraft. A Comparative Analysis of Traditional Games and Videogames

    Directory of Open Access Journals (Sweden)

    Óliver Pérez Latorre

    2012-03-01

    Full Text Available Desde su origen histórico, los juegos han planteado dramatizaciones sobre actividades fundamentales para la humanidad, como la siembra y recolección agrícola (juegos de mancala, la guerra (ajedrez o la construcción (puzzles, pero los juegos más populares sobre un mismo tipo de actividad varían de forma significativa en función del lugar y la época a la que pertenecen. En este sentido, el análisis comparado entre juegos tradicionales y videojuegos puede aportarnos una mirada particular y valiosa para profundizar en nuestra comprensión sobre la cultura popular de nuestro tiempo. ¿Qué rasgos distintivos presenta en los videojuegos de estrategia la dramatización de la guerra, en comparación con el ajedrez?, ¿qué distingue a las principales metáforas videolúdicas sobre la actividad de construcción de los puzzles tradicionales?... El objetivo de este artículo es abordar este tipo de cuestiones, a través de un análisis comparativo de la significación de juegos tradicionales y videojuegos populares. Los fundamentos teórico/metodológicos del trabajo se encuentran en la Historia del Juego, la Teoría del Diseño de Juegos y la Teoría de la Significación del Videojuego. Los resultados revelan elementos distintivos significativos entre los juegos tradicionales y algunos de los videojuegos más populares, y permiten verificar el interés de un modelo de análisis concebido para este estudio. Finalmente, en las conclusiones se reflexiona sobre la relación entre la significación de los videojuegos analizados y aspectos distintivos de la cultura contemporánea.From their historical origins games have provided us with dramatic models of the fundamental activities of humankind, such as sowing and harvesting (mancala games, war (chess and construction (puzzles. However, games based on the same activity change significantly depending on the place and time they belong to, and therefore a comparative analysis between traditional games and

  9. Employment and paid work among participants in a randomized controlled trial comparing diacetylmorphine and hydromorphone.

    Science.gov (United States)

    Nikoo, Mohammadali; Vogel, Marc; Choi, Fiona; Song, Michael J; Burghardt, Jensen; Zafari, Zafar; Tabi, Katarina; Frank, Anastasia; Barbic, Skye; Schütz, Christian; Jang, Kerry; Krausz, Michael

    2018-04-12

    Employment is one of the less studied but a significant outcome of medication-assisted treatment. Thus, we aimed to explore employment outcomes of medication-assisted treatment with hydromorphone (HDM) or diacetylmorphine (DAM). The secondary aim was to estimate characteristics of this population as well as treatment-related factors associated with these outcomes. This was a secondary analysis of a randomized, double blind controlled trial. A total of 102 and 100 participants were randomized to receive injectable DAM or HDM for 6 months respectively. In stage 2, 144 participants were randomized again to receive either oral or injectable forms of the medication they received for another 6 months. Participants were interviewed at 5 timepoints: before and 3, 6, 9 and 12 months after treatment assignment. Generalized estimating equations (GEE) with a logit link was fitted to determine factors related to paid work in the past 30 days. Mean age of participants was 44.3 (SD = 9.6) and 59 (29.2%) participants were men. At each timepoint, 6-8 (3.6%-4.1%) participants reported employment in the past 30 days and 40 to 52 (19.7%-26.7%) reported minimum 1 day of paid work. University or college education [OR = 2.12: 95% CI = (1.25, 3.62), P = 0.01] was significantly associated with paid work after adjustment for age, gender, treatment arms, timepoints, days receiving study treatment, physical health, psychological health and crack cocaine use in the past 30 days. The rate of employment was lower among participants of this study compared to similar studies on heroin-assisted treatment. Higher education was associated with increased odds of paid work. A large gap exists between employment rate and the proportion of participants who reported paid work. Supported employment and occupational therapy could optimize the employment outcomes of this population. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. A Randomized Clinical Trial Comparing Methotrexate and Mycophenolate Mofetil for Non-Infectious Uveitis

    Science.gov (United States)

    Rathinam, Sivakumar R; Babu, Manohar; Thundikandy, Radhika; Kanakath, Anuradha; Nardone, Natalie; Esterberg, Elizabeth; Lee, Salena M; Enanoria, Wayne TA; Porco, Travis C; Browne, Erica N; Weinrib, Rachel; Acharya, Nisha R

    2014-01-01

    Objective To compare the relative effectiveness of methotrexate and mycophenolate mofetil for non-infectious intermediate uveitis, posterior uveitis, or panuveitis. Design Multicenter, block-randomized, observer-masked clinical trial Participants Eighty patients with non-infectious intermediate, posterior or panuveitis requiring corticosteroid-sparing therapy at Aravind Eye Hospitals in Madurai and Coimbatore, India. Intervention Patients were randomized to receive 25mg weekly oral methotrexate or 1g twice daily oral mycophenolate mofetil and were monitored monthly for 6 months. Oral prednisone and topical corticosteroids were tapered. Main Outcome Measures Masked examiners assessed the primary outcome of treatment success, defined by achieving the following at 5 and 6 months: (1) ≤0.5+ anterior chamber cells, ≤0.5+ vitreous cells, ≤0.5+ vitreous haze and no active retinal/choroidal lesions in both eyes, (2) ≤ 10 mg of prednisone and ≤ 2 drops of prednisolone acetate 1% a day and (3) no declaration of treatment failure due to intolerability or safety. Additional outcomes included time to sustained corticosteroid-sparing control of inflammation, change in best spectacle-corrected visual acuity, resolution of macular edema, adverse events, subgroup analysis by anatomic location, and medication adherence. Results Forty-one patients were randomized to methotrexate and 39 to mycophenolate mofetil. A total of 67 patients (35 methotrexate, 32 mycophenolate mofetil) contributed to the primary outcome. Sixty-nine percent of patients achieved treatment success with methotrexate and 47% with mycophenolate mofetil (p=0.09). Treatment failure due to adverse events or tolerability was not significantly different by treatment arm (p=0.99). There were no statistically significant differences between treatment groups in time to corticosteroid-sparing control of inflammation (p=0.44), change in best spectacle-corrected visual acuity (p=0.68), and resolution of macular

  11. A randomized clinical trial comparing methotrexate and mycophenolate mofetil for noninfectious uveitis.

    Science.gov (United States)

    Rathinam, Sivakumar R; Babu, Manohar; Thundikandy, Radhika; Kanakath, Anuradha; Nardone, Natalie; Esterberg, Elizabeth; Lee, Salena M; Enanoria, Wayne T A; Porco, Travis C; Browne, Erica N; Weinrib, Rachel; Acharya, Nisha R

    2014-10-01

    To compare the relative effectiveness of methotrexate and mycophenolate mofetil for noninfectious intermediate uveitis, posterior uveitis, or panuveitis. Multicenter, block-randomized, observer-masked clinical trial. Eighty patients with noninfectious intermediate, posterior, or panuveitis requiring corticosteroid-sparing therapy at Aravind Eye Hospitals in Madurai and Coimbatore, India. Patients were randomized to receive 25 mg weekly oral methotrexate or 1 g twice daily oral mycophenolate mofetil and were monitored monthly for 6 months. Oral prednisone and topical corticosteroids were tapered. Masked examiners assessed the primary outcome of treatment success, defined by achieving the following at 5 and 6 months: (1) ≤0.5+ anterior chamber cells, ≤0.5+ vitreous cells, ≤0.5+ vitreous haze and no active retinal/choroidal lesions in both eyes, (2) ≤10 mg of prednisone and ≤2 drops of prednisolone acetate 1% a day, and (3) no declaration of treatment failure because of intolerability or safety. Additional outcomes included time to sustained corticosteroid-sparing control of inflammation, change in best spectacle-corrected visual acuity, resolution of macular edema, adverse events, subgroup analysis by anatomic location, and medication adherence. Forty-one patients were randomized to methotrexate and 39 to mycophenolate mofetil. A total of 67 patients (35 methotrexate, 32 mycophenolate mofetil) contributed to the primary outcome. Sixty-nine percent of patients achieved treatment success with methotrexate and 47% with mycophenolate mofetil (P = 0.09). Treatment failure from adverse events or tolerability was not different by treatment arm (P = 0.99). There were no differences between treatment groups in time to corticosteroid-sparing control of inflammation (P = 0.44), change in best spectacle-corrected visual acuity (P = 0.68), or resolution of macular edema (P = 0.31). There was no statistically significant difference in corticosteroid-sparing control of

  12. Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques.

    Science.gov (United States)

    Xu, Tian-Min; Zhang, Xiaoyun; Oh, Hee Soo; Boyd, Robert L; Korn, Edward L; Baumrind, Sheldon

    2010-11-01

    The objective of this pilot randomized clinical trial was to investigate the relative effectiveness of anchorage conservation of en-masse and 2-step retraction techniques during maximum anchorage treatment in patients with Angle Class I and Class II malocclusions. Sixty-four growing subjects (25 boys, 39 girls; 10.2-15.9 years old) who required maximum anchorage were randomized to 2 treatment techniques: en-masse retraction (n = 32) and 2-step retraction (n = 32); the groups were stratified by sex and starting age. Each patient was treated by a full-time clinic instructor experienced in the use of both retraction techniques at the orthodontic clinic of Peking University School of Stomatology in China. All patients used headgear, and most had transpalatal appliances. Lateral cephalograms taken before treatment and at the end of treatment were used to evaluate treatment-associated changes. Differences in maxillary molar mesial displacement and maxillary incisor retraction were measured with the before and after treatment tracings superimposed on the anatomic best fit of the palatal structures. Differences in mesial displacement of the maxillary first molar were compared between the 2 treatment techniques, between sexes, and between different starting-age groups. Average mesial displacement of the maxillary first molar was slightly less in the en-masse group than in the 2-step group (mean, -0.36 mm; 95% CI, -1.42 to 0.71 mm). The average mesial displacement of the maxillary first molar for both treatment groups pooled (n = 63, because 1 patient was lost to follow-up) was 4.3 ± 2.1 mm (mean ± standard deviation). Boys had significantly more mesial displacement than girls (mean difference, 1.3 mm; P <0.03). Younger adolescents had significantly more mesial displacement than older adolescents (mean difference, 1.3 mm; P <0.02). Average mesial displacement of the maxillary first molar with 2-step retraction was slightly greater than that for en-masse retraction, but the

  13. Comparative effectiveness of childhood obesity interventions in pediatric primary care: a cluster-randomized clinical trial.

    Science.gov (United States)

    Taveras, Elsie M; Marshall, Richard; Kleinman, Ken P; Gillman, Matthew W; Hacker, Karen; Horan, Christine M; Smith, Renata L; Price, Sarah; Sharifi, Mona; Rifas-Shiman, Sheryl L; Simon, Steven R

    2015-06-01

    Evidence of effective treatment of childhood obesity in primary care settings is limited. To examine the extent to which computerized clinical decision support (CDS) delivered to pediatric clinicians at the point of care of obese children, with or without individualized family coaching, improved body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and quality of care. We conducted a cluster-randomized, 3-arm clinical trial. We enrolled 549 children aged 6 to 12 years with a BMI at the 95% percentile or higher from 14 primary care practices in Massachusetts from October 1, 2011, through June 30, 2012. Patients were followed up for 1 year (last follow-up, August 30, 2013). In intent-to-treat analyses, we used linear mixed-effects models to account for clustering by practice and within each person. In 5 practices randomized to CDS, pediatric clinicians received decision support on obesity management, and patients and their families received an intervention for self-guided behavior change. In 5 practices randomized to CDS + coaching, decision support was augmented by individualized family coaching. The remaining 4 practices were randomized to usual care. Smaller age-associated change in BMI and the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures for obesity during the 1-year follow-up. At baseline, mean (SD) patient age and BMI were 9.8 (1.9) years and 25.8 (4.3), respectively. At 1 year, we obtained BMI from 518 children (94.4%) and HEDIS measures from 491 visits (89.4%). The 3 randomization arms had different effects on BMI over time (P = .04). Compared with the usual care arm, BMI increased less in children in the CDS arm during 1 year (-0.51 [95% CI, -0.91 to -0.11]). The CDS + coaching arm had a smaller magnitude of effect (-0.34 [95% CI, -0.75 to 0.07]). We found substantially greater achievement of childhood obesity HEDIS measures in the CDS arm (adjusted odds ratio, 2.28 [95% CI, 1

  14. Comparative prospective randomized trial: laparoscopic versus open common bile duct exploration

    Directory of Open Access Journals (Sweden)

    Vladimir Grubnik

    2011-06-01

    Full Text Available Introduction: Single-stage laparoscopic procedures for common bile duct (CBD stones are an alternative treatmentoption to two-stage endo-laparoscopic treatment and to open choledocholithotomy. Several reports have demonstratedthe feasibility, safety, efficiency and cost-effectiveness of laparoscopic techniques.Aim: To analyse the safety and benefits of laparoscopic compared to open common bile duct (CBD exploration.Material and methods: The prospective randomized trial included a total of 256 patients with CBD stones operated from2005 to 2009 in a single centre. The male/female ratio was 82/174, with a median age 62.3 ±5.8 years (range 27 to 87years. There were two groups of patients. Group I: laparoscopic CBD exploration (138 patients. Group II: open CBD exploration(118 patients. Patient comorbidity was assessed by means of the American Society of Anesthesiologists (ASA classification;ASA II – 109 patients, ASA III – 59 patients. Bile duct stones were visualized preoperatively by means of US examinationin 129 patients, by means of ERCP in 26 patients, and by magnetic resonance cholangiopancreatography (MRCPin 72 patients. Preoperative evaluation was done through medical history, biochemical tests and ultrasonography.Results: The mean duration of laparoscopic procedures was 82 min (range 40-160 min. The mean duration of openprocedures was 90 min (range 60-150 min. Mean blood loss was much lower in the laparoscopic group than in theopen group (20 ±2 v.s 285 ±27, p < 0.01. Postoperative complications were observed in 7 patients of the laparoscopicgroup and in 15 patients in the open group (p < 0.01. Laparoscopic common bile duct exploration was performedthrough a trans-cystic approach in 76 patients and via choledochotomy in 62 patients. The transcystic approach wassuccessful in 76 patients (74.5%. External drainage was used in 25 (32.8% patients with the transcystic approach.Conclusions: Laparoscopic CBD exploration can be performed with

  15. Short-term effects of a nicotine-free e-cigarette compared to a traditional cigarette in smokers and non-smokers.

    Science.gov (United States)

    Ferrari, Marco; Zanasi, Alessandro; Nardi, Elena; Morselli Labate, Antonio Maria; Ceriana, Piero; Balestrino, Antonella; Pisani, Lara; Corcione, Nadia; Nava, Stefano

    2015-10-12

    A few studies have assessed the short-term effects of low-dose nicotine e-cigarettes, while data about nicotine-free e-cigarettes (NF e-cigarettes) are scanty. Concerns have been expressed about the use of NF e-cigarettes, because of the high concentrations of propylene glycol and other compounds in the e-cigarette vapor. This laboratory-based study was aimed to compare the effects of ad libitum use of a NF e-cigarette or and a traditional cigarette for 5 min in healthy adult smokers (n = 10) and non-smokers (n = 10). The main outcome measures were pulmonary function tests, fraction of exhaled nitric oxide (FeNO) and fractional concentration of carbon monoxide (FeCO) in exhaled breath. The traditional cigarette induced statistically significant increases in FeCO in both smokers and non-smokers, while no significant changes were observed in FeNO. In non-smokers, the traditional cigarette induced a significant decrease from baseline in FEF75 (81 % ± 35 % vs 70.2 % ± 28.2 %, P = 0.013), while in smokers significant decreases were observed in FEF25 (101.3 % ± 16.4 % vs 93.5 % ± 31.7 %, P = 0.037), FEV1 (102.2 % ± 9.5 % vs 98.3 % ± 10 %, P = 0.037) and PEF (109.5 % ± 14.6 % vs 99.2 % ± 17.5 %, P = 0.009). In contrast, the only statistically significant effects induced by the NF e-cigarette in smokers were reductions in FEV1 (102.2 % ± 9.5 % vs 99.5 ± 7.6 %, P = 0.041) and FEF25 (103.4 % ± 16.4 % vs 94.2 % ± 16.2 %, P =  .014). The present study demonstrated that the specific brand of NF e-cigarette utilized did not induce any majoracute effects. In contrast, several studies have shown that both traditional cigarettes and nicotine-containing e-cigarettes have acute effects on lung function. Our study expands on previous observations on the effects of NF e-cigarettes, but also for the first time describes the changes induced by smoking one traditional cigarette in a group of never smokers. The short-term use of the specific brand of NF e-cigarette assessed

  16. Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer.

    Science.gov (United States)

    Clark, C H; Miles, E A; Urbano, M T Guerrero; Bhide, S A; Bidmead, A M; Harrington, K J; Nutting, C M

    2009-07-01

    The purpose of this study was to compare conventional radiotherapy with parotid gland-sparing intensity-modulated radiation therapy (IMRT) using the PARSPORT trial. The validity of such a trial depends on the radiotherapy planning and delivery meeting a defined standard across all centres. At the outset, many of the centres had little or no experience of delivering IMRT; therefore, quality assurance processes were devised to ensure consistency and standardisation of all processes for comparison within the trial. The pre-trial quality assurance (QA) programme and results are described. Each centre undertook exercises in target volume definition and treatment planning, completed a resource questionnaire and produced a process document. Additionally, the QA team visited each participating centre. Each exercise had to be accepted before patients could be recruited into the trial. 10 centres successfully completed the quality assurance exercises. A range of treatment planning systems, linear accelerators and delivery methods were used for the planning exercises, and all the plans created reached the standard required for participation in this multicentre trial. All 10 participating centres achieved implementation of a comprehensive and robust IMRT programme for treatment of head and neck cancer.

  17. A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus a traditional saline gauze dressing in the treatment of stage II pressure ulcers.

    Science.gov (United States)

    Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane

    2009-02-01

    Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers.

  18. Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: a randomized controlled trial.

    Science.gov (United States)

    Gharib, Nevein Mm; El-Maksoud, Gehan M Abd; Rezk-Allah, Soheir S

    2011-10-01

    To assess the effects of additional gait trainer assisted walking exercises on walking performance in children with hemiparetic cerebral palsy. A randomized controlled study. Paediatric physical therapy outpatient clinic. Thirty spastic hemiparetic cerebral palsied children of both sexes (10-13 years - 19 girls and 11 boys). Children were randomly assigned into two equal groups; experimental and control groups. Participants in both groups received a traditional physical therapy exercise programme. Those in the experimental group received additional gait trainer based walking exercises which aimed to improve walking performance. Treatment was provided three times per week for three successive months. Children received baseline and post-treatment assessments using Biodex Gait Trainer 2 assessment device to evaluate gait parameters including: average step length, walking speed, time on each foot (% of gait cycle) and ambulation index. Children in the experimental group showed a significant improvement as compared with those in the control group. The ambulation index was 75.53±7.36 (11.93 ± 2.89 change score) for the experimental group and 66.06 ± 5.48 (2.13 ± 4.43 change score) for the control group (t = 3.99 and P = 0.0001). Time of support for the affected side was 42.4 ± 3.37 (7 ± 2.20 change score) for the experimental group and 38.06 ± 4.63 (3.33 ± 6.25 change score) for the control group (t = 2.92 and P = 0.007). Also, there was a significant improvement in step length and walking speed in both groups. Gait trainer combined with traditional physiotherapy increase the chance of improving gait performance in children with spastic hemiparetic cerebral palsy.

  19. Expanding the Evidence Base: Comparing Randomized Controlled Trials and Observational Studies of Statins

    NARCIS (Netherlands)

    Atar, Dan; Ong, Seleen; Lansberg, Peter J.

    2015-01-01

    It is widely accepted that randomized controlled trials (RCTs) are the gold standard for demonstrating the efficacy of a given therapy (results under ideal conditions). Observational studies, on the other hand, can complement this by demonstrating effectiveness (results under real-world conditions).

  20. Explaining Feast or Famine in Randomized Field Trials: Medical Science and Criminology Compared.

    Science.gov (United States)

    Shepherd, Jonathan P.

    2003-01-01

    Discusses the contrast between the frequency of randomized clinical trials in the health sciences and the relative famine of such studies in criminology. Attributes this difference to the contexts in which research is done and the difference in the status of situational research in the two disciplines. (SLD)

  1. The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

    Directory of Open Access Journals (Sweden)

    Gerritsen Pieter G

    2009-09-01

    Full Text Available Abstract Background Anterior open treatment of the inguinal hernia with a tension free mesh has reduced the incidence of recurrence and direct postoperative pain. The Lichtenstein procedure rules nowadays as reference technique for hernia treatment. Not recurrences but chronic pain is the main postoperative complication in inguinal hernia repair after Lichtenstein's technique. Preliminary experiences with a soft mesh placed in the preperitoneal space showed good results and less chronic pain. Methods The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work and recurrence. Both groups will be evaluated. Success rate of hernia repair and complications will be measured as safeguard for quality. To demonstrate that inguinal hernia repair according to the transinguinal preperitoneal (TIPP technique reduces postoperative pain to Discussion The TULIP trial is aimed to show a reduction in postoperative chronic pain after anterior hernia repair according to the transinguinal preperitoneal (TIPP technique, compared to Lichtenstein. In our hypothesis the TIPP technique reduces chronic pain compared to Lichtenstein. Trial registration ISRCTN 93798494

  2. Systematic review and meta-analysis of published, randomized, controlled trials comparing suture anastomosis to stapled anastomosis for ileostomy closure.

    Science.gov (United States)

    Sajid, M S; Craciunas, L; Baig, M K; Sains, P

    2013-12-01

    The objective of this article is to systematically analyze the randomized, controlled trials comparing the effectiveness of suture anastomosis (SUA) versus stapled anastomosis (STA) in patients undergoing ileostomy closure. Randomized, controlled trials comparing the effectiveness of SUA versus STA in patients undergoing ileostomy closure were analyzed using RevMan(®), and combined outcomes were expressed as odds risk ratio (OR) and standardized mean difference (SMD). Four randomized, controlled trials that recruited 645 patients were retrieved from electronic databases. There were 327 patients in the STA group and 318 patients in the SUA group. There was significant heterogeneity among included trials. Operative time (SMD -1.02; 95 % CI -1.89, -0.15; z = 2.29; p infection, reoperation and readmission were similar following STA and SUA in patients undergoing ileostomy closure. Length of hospital stay was also similar between STA and SUA groups. In ileostomy closure, STA was associated with shorter operative time and lower risk of postoperative small bowel obstruction. However, STA and SUA were similar in terms of anastomotic leak, surgical site infection, readmission, reoperations and length of hospital stay.

  3. Comparative study of outcome measures and analysis methods for traumatic brain injury trials.

    Science.gov (United States)

    Alali, Aziz S; Vavrek, Darcy; Barber, Jason; Dikmen, Sureyya; Nathens, Avery B; Temkin, Nancy R

    2015-04-15

    Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a "super" dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data.

  4. Efficacy of Traditional Chinese Medicine in Treatment and Prophylaxis of Radiation-Induced Oral Mucositis in Patients Receiving Radiotherapy: A Randomized Controlled Trial.

    Science.gov (United States)

    Wang, Cong; Wang, Peiguo; Ouyang, Huaqiang; Wang, Jing; Sun, Lining; Li, Yanwei; Liu, Dongying; Jiang, Zhansheng; Wang, Bin; Pan, Zhanyu

    2018-06-01

    To estimate the efficacy of traditional Chinese medicine (Chining decoction, CHIN) for radiation-induced oral mucositis in patients with head and neck cancer. From May 2014 to December 2015, 70 consecutive patients were randomly assigned to receive CHIN (treatment group) or recombinant human epidermal growth factor (rhEGF) spray (control group) at a 1:1 ratio. CHIN was administered to treatment group from the first day of radiotherapy until the completion of radiotherapy. Simultaneously, the rhEGF spray was administered to control group on the oral mucosa of irradiated area. The clinical benefit was determined by gradation of mucositis (Common Terminology Criteria for Adverse Events v4.0), oral pain, and xerostomia (visual analysis scale) for each week during radiotherapy. Body mass index was evaluated before and after radiotherapy. Patients in the treatment group had prominent remission of oral pain and grade of mucositis on each observing point compared with those in control group ( P .05). CHIN presented an obvious advantage in preventing radiation-induced oral mucositis compared with rhEGF spray.

  5. Generation of Chimeric “ABS Nanohemostat” Complex and Comparing Its Histomorphological In Vivo Effects to the Traditional Ankaferd Hemostat in Controlled Experimental Partial Nephrectomy Model

    Directory of Open Access Journals (Sweden)

    Emre Huri

    2013-01-01

    Full Text Available Purpose. Using the classical Ankaferd Blood Stopper (ABS solution to create active hemostasis during partial nephrectomy (PN may not be so effective due to insufficient contact surface between the ABS hemostatic liquid agent and the bleeding area. In order to broaden the contact surface, we generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. Materials and Methods. In order to generate ABS nanohemostat, a positively charged Peptide Amphiphile (PA molecule was synthesized by using solid phase peptide synthesis. For animal experiments, 24 Wistar rats were divided into the following 4 groups: Group 1: control; Group 2: conventional PN with only 0.5 ml Ankaferd hemostat; Group 3: conventional PN with ABS + peptide gel; Group 4: conventional PN with only 0.5 ml peptide solution. Results. Mean warm ischemia times (WITs were 232.8 ± 56.3, 65.6±11.4, 75.5± 17.2, and 58.1±17.6 seconds in Group 1 to Group 4, respectively. Fibrosis was not different among the groups, while inflammation was detected to be significantly different in G3 and G4. Conclusions. ABS nanohemostat has comparable hemostatic efficacy to the traditional Ankaferd hemostat in the partial nephrectomy experimental model. Elucidation of the cellular and tissue effects of this chimeric compound may establish a catalytic spark and open new avenues for novel experimental and clinical studies in the battlefield of hemostasis.

  6. OPTIMUM: a protocol for a multicentre randomised controlled trial comparing Out Patient Talc slurry via Indwelling pleural catheter for Malignant pleural effusion vs Usual inpatient Management.

    Science.gov (United States)

    Sivakumar, P; Douiri, A; West, A; Rao, D; Warwick, G; Chen, T; Ahmed, L

    2016-10-18

    The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis. OPTIMUM is currently open for any centres interested in collaborating in this study. OPTIMUM is a multicentre non-blinded randomised controlled trial. Patients with a diagnosis of MPE will be identified and screened for eligibility. Consenting participants will be randomised 1:1 either to an outpatient ambulatory pathway using IPCs and talc pleurodesis or standard inpatient treatment with chest drain and talc pleurodesis as per British Thoracic Society guidelines. The primary outcome measure is global health-related QoL at 30 days measured using the EORTC QLQ-C30 questionnaire. Secondary outcome measures include breathlessness and pain measured using a 100 mm Visual Analogue Scale and health-related QoL at 60 and 90 days. A sample size of 142 patients is needed to demonstrate a clinically significant difference of 8 points in global health status at 30 days, for an 80% power and a 5% significance level. The study has been approved by the NRES Committee South East Coast-Brighton and Sussex (reference 15/LO/1018). The trial results will be published in peer-reviewed journals and presented at scientific conferences. UKCRN19615 and ISRCTN15503522; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. A randomized controlled trial comparing split and subunit influenza vaccines in adults in Colombia

    Directory of Open Access Journals (Sweden)

    A. Morales

    2003-06-01

    Full Text Available In a two-center, comparative trial, 344 adults were randomly assigned to receive a single dose of inactivated split-virion (Imovax Gripeâ or sub-unit (Agrippal S1â influenza vaccine (1999-2000 formulations. For analysis, study groups were subdivided into adult (18-60 years old and elderly (over 60 years subjects. Blood was drawn immediately before and one month after vaccination, safety was evaluated using a blind-observer design based on reporting of solicited and unsolicited adverse events. Both vaccines were very well tolerated, had similar reactogenicity profiles, and elicited fewer reports of reactions in elderly individuals. Post-vaccination Imovax Gripeâ induced seroprotective antibody titers against the three vaccine strains in 94-99% of adults and 88-97% of elderly subjects, compared with 88-100% and 88-98%, respectively, of those given Agrippal S1â. In conclusion, the split-virion and sub-unit influenza vaccines had similar safety and reactogenicity profiles, and elicited satisfactory immunity in adult and elderly subjects. However, higher post-vaccination geometric mean titer (GMT values in response to the B strain were seen with the split vaccine Imovax Gripeâ, giving it a better overall immunogenicity.En un ensayo comparativo realizado en dos centros, se asignaron de manera aleatoria 344 adultos para recibir una dosis de vacuna contra la gripe de virus fraccionado inactivado (Imovax Gripeâ o de vacuna de subunidades (Agrippal S1â (formulaciones 1999-2000. Para el análisis, los grupos estudiados fueron subdivididos en adultos (18-60 años y ancianos (más de 60 años. La sangre fue extraída justo antes y un mes después de la vacunación. La inocuidad fue evaluada utilizando un informe sobre reacciones adversas, usando un diseño de observador a ciegas. Ambas vacunas fueron muy bien toleradas, con perfiles de reactogenicidad similares y desarrollaron escasas reacciones adversas en los individuos ancianos. La vacunación con

  8. Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Traditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis. Methods and design In a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ≥40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy

  9. Cost analysis of magnetically controlled growing rods compared with traditional growing rods for early-onset scoliosis in the US: an integrated health care delivery system perspective

    Science.gov (United States)

    Polly, David W; Ackerman, Stacey J; Schneider, Karen; Pawelek, Jeff B; Akbarnia, Behrooz A

    2016-01-01

    Purpose Traditional growing rod (TGR) for early-onset scoliosis (EOS) is effective but requires repeated invasive surgical lengthenings under general anesthesia. Magnetically controlled growing rod (MCGR) is lengthened noninvasively using a hand-held magnetic external remote controller in a physician office; however, the MCGR implant is expensive, and the cumulative cost savings have not been well studied. We compared direct medical costs of MCGR and TGR for EOS from the US integrated health care delivery system perspective. We hypothesized that over time, the MCGR implant cost will be offset by eliminating repeated TGR surgical lengthenings. Methods For both TGR and MCGR, the economic model estimated the cumulative costs for initial implantation, lengthenings, revisions due to device failure, surgical-site infections, device exchanges (at 3.8 years), and final fusion, over a 6-year episode of care. Model parameters were estimated from published literature, a multicenter EOS database of US institutions, and interviews. Costs were discounted at 3.0% annually and represent 2015 US dollars. Results Of 1,000 simulated patients over 6 years, MCGR was associated with an estimated 270 fewer deep surgical-site infections and 197 fewer revisions due to device failure compared with TGR. MCGR was projected to cost an additional $61 per patient over the 6-year episode of care compared with TGR. Sensitivity analyses indicated that the results were sensitive to changes in the percentage of MCGR dual rod use, months between TGR lengthenings, percentage of hospital inpatient (vs outpatient) TGR lengthenings, and MCGR implant cost. Conclusion Cost neutrality of MCGR to TGR was achieved over the 6-year episode of care by eliminating repeated TGR surgical lengthenings. To our knowledge, this is the first cost analysis comparing MCGR to TGR – from the US provider perspective – which demonstrates the efficient provision of care with MCGR. PMID:27695352

  10. Radiographic evaluation of acute distal radius fracture stability: A comparative cadaveric study between a thermo-formable bracing system and traditional fiberglass casting.

    Science.gov (United States)

    Santoni, Brandon G; Aira, Jazmine R; Diaz, Miguel A; Kyle Stoops, T; Simon, Peter

    2017-08-01

    Distal radius fractures are common musculoskeletal injuries and many can be treated non-operatively with cast immobilization. A thermo-formable brace has been developed for management of such fractures, but no data exist regarding its comparative stabilizing efficacy to fiberglass casting. A worst-case distal radius fracture was created in 6 cadaveric forearms. A radiolucent loading fixture was created to apply cantilever bending/compression loads ranging from 4.5N to 66.7N across the simulated fracture in the: (1) non-stabilized, (2) braced; and (3) casted forearms, each forearm serving as its own control. Fracture fragment translations and rotations were measured radiographically using orthogonal radiographs and a 2D-3D, CT-based transformation methodology. Under 4.5N of load in the non-stabilized condition, average sagittal plane rotation and 3D center of mass translation of the fracture fragment were 12.3° and 5.3mm, respectively. At the 4.5N load step, fragment rotation with the brace (avg. 0.0°) and cast (0.1°) reduced sagittal plane rotation compared to the non-stabilized forearm (Pthermo-formable brace stabilized the fracture in a manner that was not radiographically or biomechanically different from traditional fiberglass casting. Study results support the use of the thermo-formable brace clinically. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation.

    Science.gov (United States)

    Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E D

    2017-05-01

    Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team.

  12. Is a comparative clinical trial for breast cancer tumor markers to monitor disease recurrence warranted? A value of information analysis.

    Science.gov (United States)

    Thariani, Rahber; Henry, Norah Lynn; Ramsey, Scott D; Blough, David K; Barlow, Bill; Gralow, Julie R; Veenstra, David L

    2013-05-01

    Breast cancer tumor markers are used by some clinicians to screen for disease recurrence risk. Since there is limited evidence of benefit, additional research may be warranted. To assess the potential value of a randomized clinical trial of breast tumor marker testing in routine follow-up of high-risk, stage II-III breast cancer survivors. We developed a decision-analytic model of tumor marker testing plus standard surveillance every 3-6 months for 5 years. The expected value of sample information was calculated using probabilistic simulations and was a function of: the probability of selecting the optimal monitoring strategy with current versus future information; the impact of choosing the nonoptimal strategy; and the size of the population affected. The value of information for a randomized clinical trial involving 9000 women was US$214 million compared with a cost of US$30-60 million to conduct such a trial. The probability of making an alternate, nonoptimal decision and choosing testing versus no testing was 32% with current versus future information from the trial. The impact of a nonoptimal decision was US$2150 and size of population impacted over 10 years was 308,000. The value of improved information on overall survival was US$105 million, quality of life US$37 million and test performance US$71 million. Conducting a randomized clinical trial of breast cancer tumor markers appears to offer a good societal return on investment. Retrospective analyses to assess test performance and evaluation of patient quality of life using tumor markers may also offer valuable areas of research. However, alternative investments may offer even better returns in investments and, as such, the trial concept deserves further study as part of an overall research-portfolio evaluation.

  13. Postpartum perineal reapir performed by midwives: A randomised trial comparing two suture techniques for perineal repair leaving the skin unsutured

    DEFF Research Database (Denmark)

    Kindberg, Sara; Misan, Stehouwer; Hvidman, Lone

    2008-01-01

    Postpartum perineal repair performed by midwives: A randomised trial comparing two suture techniques leaving the skin unsutured. Objective      To compare a continuous suture technique to interrupted stitches using inverted knots for postpartum perineal repair of second-degree lacerations...... and episiotomies.   Design          A double blind randomised controlled trial.   Setting          A Danish university hospital with more than 4800 deliveries annually.   Population   400 healthy primiparous women with a vaginal delivery at term.   Method         Randomisation was computer-controlled. Structured...... healing, patient satisfaction, dyspareunia or need for resuturing. The continuous suture technique was significantly faster (15 min. vs. 17 min, p=0.03) and less suture material was used (1 vs. 2 packets, pskin unsutured...

  14. Informed consent from cognitively impaired persons participating in research trials: comparative law observations.

    Science.gov (United States)

    Petrini, Carlo

    2011-01-01

    This article addresses the ethical requirements to be considered when conducting clinical trials involving human subjects whose mental condition limits their ability to understand the information and to express fully autonomous and informed consent. It does not address other categories of vulnerable persons, such as children, or advanced directives concerning end-of-life care. There are many ethical issues entailed in clinical trials involving subjects with mental disabilities: how to obtain informed consent, balancing risks and benefits, balancing individual benefits with collective scientific and social interests, legal representation and many more. This article focuses on the issues surrounding the concept of minimal risk and the relationship between informed consent and risk. These issues are addressed with particular emphasis on the regulations adopted by the European Union and the federal government of the United States of America. The conclusion proposes a list of working criteria.

  15. Treatment of secondary hyperparathyroidism in haemodialysis patients: a randomised clinical trial comparing paricalcitol and alfacalcidol

    DEFF Research Database (Denmark)

    Hansen, Ditte; Brandi, Lisbet; Rasmussen, Knud

    2009-01-01

    BACKGROUND: Secondary hyperparathyroidism is a common feature in patients with chronic kidney disease. Its serious clinical consequences include renal osteodystrophy, calcific uremic arteriolopathy, and vascular calcifications that increase morbidity and mortality.Reduced synthesis of active vita...... in the risk of cardiovascular mortality depending on which vitamin D analog that are used. This has potential major importance for this group of patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT00469599....... vitamin D contributes to secondary hyperparathyroidism. Therefore, this condition is managed with activated vitamin D. However, hypercalcemia and hyperphosphatemia limit the use of activated vitamin D.In Denmark alfacalcidol is the primary choice of vitamin D analog.A new vitamin D analog, paricalcitol...... and hyperphosphatemia are associated with increased cardiovascular mortality in patients with chronic kidney disease.If there is any difference in the ability of these two vitamin D analogs to decrease the secondary hyperparathyroidism without causing hypercalcemia and hyperphosphatemia, there may also be a difference...

  16. Informed consent from cognitively impaired persons participating in research trials: comparative law observations

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2011-12-01

    Full Text Available This article addresses the ethical requirements to be considered when conducting clinical trials involving human subjects whose mental condition limits their ability to understand the information and to express fully autonomous and informed consent. It does not address other categories of vulnerable persons, such as children, or advanced directives concerning end-of-life care. There are many ethical issues entailed in clinical trials involving subjects with mental disabilities: how to obtain informed consent, balancing risks and benefits, balancing individual benefits with collective scientific and social interests, legal representation and many more. This article focuses on the issues surrounding the concept of minimal risk and the relationship between informed consent and risk. These issues are addressed with particular emphasis on the regulations adopted by the European Union and the federal government of the United States of America. The conclusion proposes a list of working criteria.

  17. Reducing Trunk Compensation in Stroke Survivors: A Randomized Crossover Trial Comparing Visual and Force Feedback Modalities.

    Science.gov (United States)

    Valdés, Bulmaro Adolfo; Schneider, Andrea Nicole; Van der Loos, H F Machiel

    2017-10-01

    To investigate whether the compensatory trunk movements of stroke survivors observed during reaching tasks can be decreased by force and visual feedback, and to examine whether one of these feedback modalities is more efficacious than the other in reducing this compensatory tendency. Randomized crossover trial. University research laboratory. Community-dwelling older adults (N=15; 5 women; mean age, 64±11y) with hemiplegia from nontraumatic hemorrhagic or ischemic stroke (>3mo poststroke), recruited from stroke recovery groups, the research group's website, and the community. In a single session, participants received augmented feedback about their trunk compensation during a bimanual reaching task. Visual feedback (60 trials) was delivered through a computer monitor, and force feedback (60 trials) was delivered through 2 robotic devices. Primary outcome measure included change in anterior trunk displacement measured by motion tracking camera. Secondary outcomes included trunk rotation, index of curvature (measure of straightness of hands' path toward target), root mean square error of hands' movement (differences between hand position on every iteration of the program), completion time for each trial, and posttest questionnaire to evaluate users' experience and system's usability. Both visual (-45.6% [45.8 SD] change from baseline, P=.004) and force (-41.1% [46.1 SD], P=.004) feedback were effective in reducing trunk compensation. Scores on secondary outcome measures did not improve with either feedback modality. Neither feedback condition was superior. Visual and force feedback show promise as 2 modalities that could be used to decrease trunk compensation in stroke survivors during reaching tasks. It remains to be established which one of these 2 feedback modalities is more efficacious than the other as a cue to reduce compensatory trunk movement. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. A proposed framework for evaluating and comparing efficacy estimates in clinical trials of new rotavirus vaccines.

    Science.gov (United States)

    Neuzil, Kathleen M; Zaman, K; Victor, John C

    2014-08-11

    Oral rotavirus vaccines have yielded different point estimates of efficacy when tested in different populations. While population and environmental factors may account for these differences, study design characteristics should also be considered. We review the study design elements of rotavirus vaccine trials that may affect point estimates of efficacy, and propose a framework for evaluating new rotavirus vaccines. Copyright © 2014. Published by Elsevier Ltd.

  19. Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients: The SMILE Trial.

    Science.gov (United States)

    Sardella, Gennaro; Lucisano, Luigi; Garbo, Roberto; Pennacchi, Mauro; Cavallo, Erika; Stio, Rocco Edoardo; Calcagno, Simone; Ugo, Fabrizio; Boccuzzi, Giacomo; Fedele, Francesco; Mancone, Massimo

    2016-01-26

    A lack of clarity exists about the role of complete coronary revascularization in patients presenting with non-ST-segment elevation myocardial infarction. The aim of our study was to compare long-term outcomes in terms of major adverse cardiovascular and cerebrovascular events of 2 different complete coronary revascularization strategies in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease: 1-stage percutaneous coronary intervention (1S-PCI) during the index procedure versus multistage percutaneous coronary intervention (MS-PCI) complete coronary revascularization during the index hospitalization. In the SMILE (Impact of Different Treatment in Multivessel Non ST Elevation Myocardial Infarction Patients: One Stage Versus Multistaged Percutaneous Coronary Intervention) trial, 584 patients were randomly assigned in a 1:1 manner to 1S-PCI or MS-PCI. The primary study endpoint was the incidence of major adverse cardiovascular and cerebrovascular events, which were defined as cardiac death, death, reinfarction, rehospitalization for unstable angina, repeat coronary revascularization (target vessel revascularization), and stroke at 1 year. The occurrence of the primary endpoint was significantly lower in the 1-stage group (1S-PCI: n = 36 [13.63%] vs. MS-PCI: n = 61 [23.19%]; hazard ratio [HR]: 0.549 [95% confidence interval (CI): 0.363 to 0.828]; p = 0.004). The 1-year rate of target vessel revascularization was significantly higher in the MS-PCI group (1S-PCI: n = 22 [8.33%] vs. MS-PCI: n = 40 [15.20%]; HR: 0.522 [95% CI: 0.310 to 0.878]; p = 0.01; p log-rank = 0.013). When the analyses were limited to cardiac death (1S-PCI: n = 9 [3.41%] vs. MS-PCI: n = 14 [5.32%]; HR: 0.624 [95% CI: 0.270 to 1.441]; p = 0.27) and myocardial infarction (1S-PCI: n = 7 [2.65%] vs. MS-PCI: n = 10 [3.80%]; HR: 0.678 [95% CI: 0.156 to 2.657]; p = 0.46), no significant differences were observed between groups. In multivessel

  20. A combination of subcuticular suture and sterile Micropore tape compared with conventional interrupted sutures for skin closure. A controlled trial.

    Science.gov (United States)

    Taube, M.; Porter, R. J.; Lord, P. H.

    1983-01-01

    We have conducted a controlled trial to compare skin closure using conventional interrupted sutures with a combination of subcuticular suture and sterile Micropore tape in 169 patients undergoing appendicectomy, inguinal herniorrhaphy, or saphenofemoral ligation. We have found that the combination technique consistently gives a better cosmetic result and that the tape acts well as a dressing, is convenient, and is well tolerated by patients. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6344732

  1. Science-Technology-Society literacy in college non-majors biology: Comparing problem/case studies based learning and traditional expository methods of instruction

    Science.gov (United States)

    Peters, John S.

    This study used a multiple response model (MRM) on selected items from the Views on Science-Technology-Society (VOSTS) su