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Sample records for european randomized study

  1. The European Randomized Study of Screening for Prostate Cancer – Prostate Cancer Mortality at 13 Years of Follow-up

    PubMed Central

    Schröder, Fritz H.; Hugosson, Jonas; Roobol, Monique J.; Tammela, Teuvo L.J.; Zappa, Marco; Nelen, Vera; Kwiatkowski, Maciej; Lujan, Marcos; Määttänen, Lissa; Lilja, Hans; Denis, Louis J.; Recker, Franz; Paez, Alvaro; Bangma, Chris H.; Carlsson, Sigrid; Puliti, Donella; Villers, Arnauld; Rebillard, Xavier; Hakama, Matti; Stenman, Ulf-Hakan; Kujala, Paula; Taari, Kimmo; Aus, Gunnar; Huber, Andreas; van der Kwast, Theo; van Schaik R, Ron H.N.; de Koning, Harry J.; Moss, Sue M.; Auvinen, Anssi

    2015-01-01

    Background The European Randomized study of Screening for Prostate Cancer (ERSPC) is a randomized multi-center trial with a predefined centralized database, analysis plan and core age group (55–69 years) evaluating prostate-specific antigen (PSA) testing in eight European countries. Methods The present results are based on prostate cancer (PCa) incidence and mortality truncated at 9, 11, and 13 years of follow-up in the intervention arm (offered PSA testing) relative to the control arm. A secondary analysis corrected for selection bias due to non-participation was performed. Because of incomplete follow-up, only incidence and no mortality data at 9 years follow-up are reported for the French centers. Findings The rate ratio (RR) of PCa incidence between the intervention and control arms was 1.91 after 9 years (1.64 including France), 1.66 after 11 years and 1.57 after 13 years. The RR of PCa mortality was 0.85, 0.78 and 0.79 at 9, 11 and 13 years respectively (95% confidence interval 13-year 0.69–0.91, p = 0.001). This corresponds to a relative risk reduction of 21% and an absolute risk reduction of death from PCa at 13 years of 0.11 per 1,000 person-years or 1.28 per 1,000 men randomized, which is equivalent to one PCa death averted per 781 men invited for screening or one per 27 additional PCa detected. PCa mortality reduction in screened men after adjustment for non–participation was 27%. Interpretation This update of ERSPC confirms a substantial PCa mortality reduction due to PSA testing, with a substantially increased absolute effect at 13 years compared to findings after 9 and 11 years. Funding All sources of funding per center are indicated in the “Web extra material” section. Trial identification This trial is registered under Current Controlled Trials number: ISRCTN49127736. PMID:25108889

  2. European, randomized, phase 3 study of lisdexamfetamine dimesylate in children and adolescents with attention-deficit/hyperactivity disorder.

    PubMed

    Coghill, David; Banaschewski, Tobias; Lecendreux, Michel; Soutullo, Cesar; Johnson, Mats; Zuddas, Alessandro; Anderson, Colleen; Civil, Richard; Higgins, Nicholas; Lyne, Andrew; Squires, Liza

    2013-10-01

    This study evaluated the efficacy and safety of lisdexamfetamine dimesylate (LDX) compared with placebo in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Europe. Osmotic-release oral system methylphenidate (OROS-MPH) was included as a reference arm. Patients (6-17 years old) with a baseline ADHD Rating Scale version IV (ADHD-RS-IV) total score ≥ 28 were randomized (1:1:1) to dose-optimized LDX (30, 50, or 70 mg/day), OROS-MPH (18, 36, or 54 mg/day) or placebo for 7 weeks. Primary and key secondary efficacy measures were the investigator-rated ADHD-RS-IV and the Clinical Global Impressions-Improvement (CGI-I) rating, respectively. Safety assessments included treatment-emergent adverse events (TEAEs), electrocardiograms, and vital signs. Of 336 patients randomized, 196 completed the study. The difference between LDX and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -18.6 (95% confidence interval [CI]: -21.5 to -15.7) (p<0.001; effect size, 1.80). The difference between OROS-MPH and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -13.0 (95% CI: -15.9 to -10.2) (p<0.001; effect size, 1.26). The proportions (95% CI) of patients showing improvement (CGI-I of 1 or 2) at endpoint were 78% (70-86), 14% (8-21), and 61% (51-70) for LDX, placebo, and OROS-MPH. The most common TEAEs for LDX were decreased appetite, headache, and insomnia. Mean changes in vital signs were modest and consistent with the known profile of LDX. LDX was effective and generally well tolerated in children and adolescents with ADHD. PMID:23332456

  3. Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries: The ToyBox-Study

    PubMed Central

    Pinket, An-Sofie; Van Lippevelde, Wendy; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Cardon, Greet; Androutsos, Odysseas; Koletzko, Berthold; Moreno, Luis A.; Socha, Piotr; Iotova, Violeta; Manios, Yannis; De Craemer, Marieke

    2016-01-01

    Background Within the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers. Method A sample of 4964 preschoolers (4.7±0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed. Results Limited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores. Conclusion The ToyBox-intervention can provide the basis for the

  4. Detection rates of high-grade prostate cancer during subsequent screening visits. Results of the European Randomized Screening Study for Prostate Cancer.

    PubMed

    van der Kwast, Theodorus H; Ciatto, Stefano; Martikainen, Paula M; Hoedemaeker, Robert; Laurila, Marita; Pihl, Carl-Gustaph; Hugosson, Jonas; Neetens, Ingrid; Nelen, Vera; Di Lollo, Simonetta; Roobol, Monique J; Määtänen, Liisa; Santonja, Carlos; Moss, Sue; Schröder, Fritz H

    2006-05-15

    Screening for prostate cancer using prostate-specific antigen (PSA) tests has led to a stage and grade shift as compared to the pre-PSA era. Effectiveness of screening for prostate cancer should be manifested by a reduction in detection rate of aggressive cancers during subsequent screening. In 6 centers of the European Randomized Screening study for Prostate Cancer, a total of 58,710 men were tested for prostate cancer. Screening centers differed with regard to age-range, screening interval and biopsy indications. During the 2nd visit, the proportion of Gleason score 6 cancers increased from 62.5 to 75%, mainly at the expense of Gleason score 7 cancers. High-grade (Gleason score 8-10) cancer detection rates varied per screening center during the 1st visit from 5.1 to 41.1, and during the 2nd visit from 6.4 to 29.3/10,000 men. The overall detection rate of high-grade cancers showed a reduction during the 2nd visit from 26 to 12/10,000 men, an effect mainly attributable to the screening center with the highest cancer detection rate (i.e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range. PMID:16353141

  5. European randomized lung cancer screening trials: Post NLST.

    PubMed

    Field, John K; van Klaveren, Rob; Pedersen, Jesper H; Pastorino, Ugo; Paci, Eugino; Becker, Nikolauss; Infante, Maurizo; Oudkerk, Matthijs; de Koning, Harry J

    2013-10-01

    Overview of the European randomized lung cancer CT screening trials (EUCT) is presented with regard to the implementation of CT screening in Europe; post NLST. All seven principal investigators completed a questionnaire on the epidemiological, radiological, and nodule management aspects of their trials at August 2010, which included 32,000 people, inclusion of UKLS pilot trial will reach 36,000. An interim analysis is planned, but the final mortality data testing is scheduled for 2015. PMID:23893464

  6. European Collaboration on Low-dose Aspirin in Polycythemia Vera (ECLAP): a randomized trial.

    PubMed

    Landolfi, R; Marchioli, R

    1997-01-01

    Thrombotic complications characterize the clinical course of polycythemia vera (PV) and represent the main cause of morbidity and mortality. However, uncertainty still exists as to the benefit/risk ratio of aspirin prophylaxis in this setting. In vivo platelet biosynthesis of thromboxane A2 is enhanced and can be suppressed by low-dose aspirin in PV, thus providing a rationale for assessing the efficacy and safety of a low-dose aspirin regimen in these patients. The Gruppo Italiano Studio Policitemia Vera has recently performed a pilot study on 112 patients randomized to receive aspirin, 40 mg daily, or placebo and followed for 16 +/- 6 months (mean +/- SD). This study showed that low-dose aspirin is well tolerated in PV patients, and that a large-scale efficacy trial is feasible in this setting. In this article we report the protocol of the European Collaboration on Low-dose Aspirin in Polycythemia Vera (ECLAP) study, which is a randomized trial designed to assess the risk/benefit ratio of low-dose aspirin in PV. To estimate the size and the follow-up duration required for the ECLAP trial, a retrospective analysis of the clinical epidemiology of a large PV population has recently been completed by the Gruppo Italiano Studio Policitemia Vera. On this basis, approximately 3500 patients will be enrolled in the ECLAP study with a follow-up of 3 to 4 years. The uncertainty principle will be used as the main eligibility criterion: Polycythemic patients of any age, having no clear indication for or contraindication to aspirin treatment, will be randomized in a double-blind fashion to receive oral aspirin (100 mg daily) or placebo. According to current therapeutic recommendations, the basic treatment of randomized patients should be aimed at maintaining the hematocrit value < or = 45% in subjects aged < or = 50, and hematocrit < 45% as well as platelet count < 400 x 10(9)/L in patients aged > 50. Randomization will be stratified by participating center. The study is

  7. Improved relapse-free survival after autologous stem cell transplantation does not translate into better quality of life in chronic lymphocytic leukemia: lessons from the randomized European Society for Blood and Marrow Transplantation-Intergroup study.

    PubMed

    de Wreede, Liesbeth C; Watson, Maggie; van Os, Marleen; Milligan, Donald; van Gelder, Michel; Michallet, Mauricette; Dreger, Peter; Dearden, Claire E; Homewood, Janis; Dupuis, Jehan; Leporrier, Michel; Karas, Michal; Corront, Bernadette; Baerlocher, Gabriela M; Herr, Wolfgang; Choquet, Sylvain; Niederwieser, Dietger W; Sutton, Laurent; Kröger, Nicolaus; de Witte, Theo M; Schetelig On Behalf Of The Chronic Malignancies Working Party Of The Ebmt And The Uk Medical Research Council, Johannes

    2014-02-01

    In chronic lymphocytic leukemia (CLL) medical progress is driven by clinical studies with relapse-free survival (RFS) as the primary endpoint. The randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation (ASCT) to observation and demonstrated a substantial improvement of RFS without showing improved overall survival for the transplant arm. Here we report quality of life (QoL) information of the first 3 years following randomization from that study. The main objective was to assess the impact of treatment on QoL over time. Two secondary analyses were performed to further investigate the impact of ASCT and relapse on QoL. In the primary analysis, we demonstrate an adverse impact of ASCT on QoL which was largest at 4 months and continued throughout the first year after randomization. Further, we demonstrated a sustained adverse impact of relapse on QoL which worsened over time. Despite better disease control by ASCT the side effects thus turned the net effect towards inferior QoL in the first year and comparable QoL in the following 2 years after randomization. This study emphasizes the importance of information concerning QoL impacts when patients are counseled about treatments aimed at improving RFS in the absence of a survival benefit. PMID:24123244

  8. Study Offers Ways to Better European Education

    ERIC Educational Resources Information Center

    Cavanagh, Sean

    2006-01-01

    School systems that track students into certain classes and academic programs based on ability end up worsening disparities between high and low performers, according to a far-ranging report that offers recommendations for improving education across Europe. The study, commissioned by a branch of the European Union (EU), also found that bilingual…

  9. Contemporary European Studies: A Model for Interdisciplinary Studies.

    ERIC Educational Resources Information Center

    Dannerbeck, Francis J.

    1989-01-01

    Describes the University of South Carolina's (Columbia) Contemporary European Studies program, which drew on current course offerings and existing financial resources to provide study about post-French Revolution European languages, cultures, politics, history, geography, and economics. Options exist at many other institutions to create broadly…

  10. Survey of studies in European languages.

    NASA Astrophysics Data System (ADS)

    Sen, S. N.

    The beginnings of the study in European languages of ancient Indian astronomy can hardly be fixed with any degree of certainty. Indian astronomy appears to have reached Europe through Arabic astronomical literature during the eleventh-thirteenth century. In this transmission Spain played a crucial part. With the revival of learning in Latin Europe, particularly during the active period of translation from Arabic into Latin, certain Hindu astronomical elements and tradition inevitably passed into Western Europe.

  11. The Physical Tourist. A European Study Course

    NASA Astrophysics Data System (ADS)

    Kortemeyer, Gerd; Westfall, Catherine

    2010-03-01

    We organized and led a European study course for American undergraduate university students to explore the early history of relativity and quantum theory. We were inspired by The Physical Tourist articles published in this journal on Munich, Bern, Berlin, Copenhagen, and Göttingen. We describe this adventure both for others wishing to teach such a course and for anyone wishing to walk in the footsteps of the physicists who revolutionized physics in the early decades of the twentieth century.

  12. World Studies in the European Classroom. Education and Culture.

    ERIC Educational Resources Information Center

    O'Connor, Edmund

    The study of world problems in secondary European schools is examined. The study reflects the concerns of a group of teachers from 15 European countries and from a range of disciplines who attended a course on "World Problems in the European Classroom" which was held at Lillehammer in July, 1979 as a contribution by Norway to the Council of…

  13. A European multicentre and open-label controlled randomized trial to evaluate the efficacy of Sequential treatment with TAcrolimus–Rituximab versus steroids plus cyclophosphamide in patients with primary MEmbranous Nephropathy: the STARMEN study

    PubMed Central

    Rojas-Rivera, Jorge; Fernández-Juárez, Gema; Ortiz, Alberto; Hofstra, Julia; Gesualdo, Loreto; Tesar, Vladimir; Wetzels, Jack; Segarra, Alfons; Egido, Jesus; Praga, Manuel

    2015-01-01

    Background Patients with primary membranous nephropathy (MN) and persistent nephrotic syndrome have a high risk of progression to end-stage renal disease. The Ponticelli protocol (steroids with alkylating agents) is the most effective immunosuppressive therapy for this condition, but it has severe adverse effects. Tacrolimus and rituximab have demonstrated efficacy for remission of nephrotic syndrome in MN with a safer profile. However, the published evidence is largely based on small or short-term observational studies, historical cohorts, comparisons with conservative therapy or clinical trials without appropriate control groups, and there is no head-to-head comparison with the Ponticelli protocol. Methods The STARMEN randomized clinical trial will compare the efficacy of sequential tacrolimus–rituximab therapy with a modified Ponticelli protocol (steroids plus cyclophosphamide). The trial will also evaluate the role of antibodies against the M-type phospholipase A2 receptor (anti-PLA2R) and other antibodies as markers of response to treatment and long-term prognosis. Results The trial has already started with 23 patients having been enrolled as of 1 April 2015, an estimated 21.7% of the estimated sample. PMID:26413273

  14. A European prospective, randomized placebo-controlled doubleblind Study on the efficacy and safety of Dr Michaels® (also branded as Soratinex®) product family for stable chronic plaque psoriasis.

    PubMed

    França, K; Hercogovấ, J; Fioranelli, M; Gianfaldoni, S; Chokoeva, A A; Tchernev, G; Wollina, U; Tirant, M; Novotny, F; Roccia, M G; Maximov, G K; Lotti, T

    2016-01-01

    Psoriasis is a chronic, inflammatory, recurrent, genetically determined dermatitis that affects the skin and joints. Many patients affected by this condition seek alternatives and complementary treatment options such as herbal medicines. In order to establish the safety of these products, trials, according to medical standards should be performed to provide the highest quality of data. The aim of this study was to assess the efficacy and safety of an Australian series of herbal skincare products [Dr. Michaels® (Soratinex®) skin-care products for psoriasis] for the management of stable chronic plaque psoriasis. We studied 142 patients (68 females and 74 males) with mild to moderate, stable, chronic plaque psoriasis and they were randomly assigned to either verum or control group. Exclusion criteria were: severe psoriasis, arthropathic psoriasis, intertriginous psoriasis, palmoplantar psoriasis, use of any antipsoriatic treatment and any medication which could influence or interfere with the course of the disease. Both groups consisted of a cleansing gel, an ointment and an oil blend (skin conditioner), packed in neutral bottles, used twice daily for all lesions except the scalp, for 8 weeks. As control products, we used compositions of well-known neutral ointments and medicinal bathing oil. Assessment, using the Psoriasis Activity Severity Index (PASI) scores, was done before treatment and after 2, 4, 6 and 8 weeks. Patient improvement was determined by the percentage reduction of the PASI scores. Statistical analysis was carried out using the Mann-Whitney-U Test with SPSS for Windows. Our investigation demonstrates that complementary methods can play a role in dermatologic therapy as long as they undergo standardised clinical trials and fulfil the basic requirements such as product safety and quality assurance. This study shows that Dr Michaels (Soratinex®) herbal skin-care products improve mild to moderate stable chronic plaque psoriasis significantly. PMID

  15. Discerning the Ancestry of European Americans in Genetic Association Studies

    PubMed Central

    Price, Alkes L; Butler, Johannah; Patterson, Nick; Capelli, Cristian; Pascali, Vincenzo L; Scarnicci, Francesca; Ruiz-Linares, Andres; Groop, Leif; Saetta, Angelica A; Korkolopoulou, Penelope; Seligsohn, Uri; Waliszewska, Alicja; Schirmer, Christine; Ardlie, Kristin; Ramos, Alexis; Nemesh, James; Arbeitman, Lori; Goldstein, David B

    2008-01-01

    European Americans are often treated as a homogeneous group, but in fact form a structured population due to historical immigration of diverse source populations. Discerning the ancestry of European Americans genotyped in association studies is important in order to prevent false-positive or false-negative associations due to population stratification and to identify genetic variants whose contribution to disease risk differs across European ancestries. Here, we investigate empirical patterns of population structure in European Americans, analyzing 4,198 samples from four genome-wide association studies to show that components roughly corresponding to northwest European, southeast European, and Ashkenazi Jewish ancestry are the main sources of European American population structure. Building on this insight, we constructed a panel of 300 validated markers that are highly informative for distinguishing these ancestries. We demonstrate that this panel of markers can be used to correct for stratification in association studies that do not generate dense genotype data. PMID:18208327

  16. Mineral Metabolism in European Children Living with a Renal Transplant: A European Society for Paediatric Nephrology/European Renal Association–European Dialysis and Transplant Association Registry Study

    PubMed Central

    Bonthuis, Marjolein; Busutti, Marco; Jager, Kitty J.; Baiko, Sergey; Bakkaloğlu, Sevcan; Battelino, Nina; Gaydarova, Maria; Gianoglio, Bruno; Parvex, Paloma; Gomes, Clara; Heaf, James G.; Podracka, Ludmila; Kuzmanovska, Dafina; Molchanova, Maria S.; Pankratenko, Tatiana E.; Papachristou, Fotios; Reusz, György; Sanahuja, Maria José; Shroff, Rukshana; Groothoff, Jaap W.; Schaefer, Franz; Verrina, Enrico

    2015-01-01

    Background and objectives Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal Association–European Dialysis and Transplant Association Registry to study the prevalence and potential determinants of mineral abnormalities, as well as the predictive value of a disturbed mineral level on graft survival in a large cohort of European pediatric renal transplant recipients. Design, setting, participants, & measurements This study included 1237 children (0–17 years) from 10 European countries, who had serum calcium, phosphorus, and parathyroid hormone measurements from 2000 onward. Abnormalities of mineral metabolism were defined according to European guidelines on prevention and treatment of renal osteodystrophy in children on chronic renal failure. Results Abnormal serum phosphorus levels were observed in 25% (14% hypophosphatemia and 11% hyperphosphatemia), altered serum calcium in 30% (19% hypocalcemia, 11% hypercalcemia), and hyperparathyroidism in 41% of the patients. A longer time since transplantation was associated with a lower risk of having mineral levels above target range. Serum phosphorus levels were inversely associated with eGFR, and levels above the recommended targets were associated with a higher risk of graft failure independently of eGFR. Conclusions Abnormalities in mineral metabolism are common after pediatric renal transplantation in Europe and are associated with graft dysfunction. PMID:25710805

  17. Effectiveness study of atropine for progressive myopia in Europeans

    PubMed Central

    Polling, J R; Kok, R G W; Tideman, J W L; Meskat, B; Klaver, C C W

    2016-01-01

    Purpose Randomized controlled trials have shown the efficacy of atropine for progressive myopia, and this treatment has become the preferred pattern for this condition in Taiwan. This study explores the effectiveness of atropine 0.5% treatment for progressive high myopia and adherence to therapy in a non-Asian country. Methods An effectiveness study was performed in Rotterdam, the Netherlands. Overall 77 children (mean age 10.3 years±2.3), of European (n=53), Asian (n=18), and African (n=6) descent with progressive myopia were prescribed atropine 0.5% eye drops daily. Both parents and children filled in a questionnaire regarding adverse events and adherence to therapy. A standardized eye examination including cycloplegic refraction and axial length was performed at baseline and 1, 4, and 12 months after initiation of therapy. Results Mean spherical equivalent at baseline was −6.6D (±3.3). The majority (60/77, 78%) of children adhered to atropine treatment for 12 months; 11 of the 17 children who discontinued therapy did so within 1 month after the start of therapy. The most prominent reported adverse events were photophobia (72%), followed by reading problems (38%), and headaches (22%). The progression rate of spherical equivalent before treatment (−1.0D/year±0.7) diminished substantially during treatment (−0.1D/year±0.7) compared to those who ceased therapy (−0.5D/year±0.6; P=0.03). Conclusions Despite the relatively high occurrence of adverse events, our study shows that atropine can be an effective and sustainable treatment for progressive high myopia in Europeans. PMID:27101751

  18. Effectiveness study of atropine for progressive myopia in Europeans.

    PubMed

    Polling, J R; Kok, R G W; Tideman, J W L; Meskat, B; Klaver, C C W

    2016-07-01

    PurposeRandomized controlled trials have shown the efficacy of atropine for progressive myopia, and this treatment has become the preferred pattern for this condition in Taiwan. This study explores the effectiveness of atropine 0.5% treatment for progressive high myopia and adherence to therapy in a non-Asian country.MethodsAn effectiveness study was performed in Rotterdam, the Netherlands. Overall 77 children (mean age 10.3 years±2.3), of European (n=53), Asian (n=18), and African (n=6) descent with progressive myopia were prescribed atropine 0.5% eye drops daily. Both parents and children filled in a questionnaire regarding adverse events and adherence to therapy. A standardized eye examination including cycloplegic refraction and axial length was performed at baseline and 1, 4, and 12 months after initiation of therapy.ResultsMean spherical equivalent at baseline was -6.6D (±3.3). The majority (60/77, 78%) of children adhered to atropine treatment for 12 months; 11 of the 17 children who discontinued therapy did so within 1 month after the start of therapy. The most prominent reported adverse events were photophobia (72%), followed by reading problems (38%), and headaches (22%). The progression rate of spherical equivalent before treatment (-1.0D/year±0.7) diminished substantially during treatment (-0.1D/year±0.7) compared to those who ceased therapy (-0.5D/year±0.6; P=0.03).ConclusionsDespite the relatively high occurrence of adverse events, our study shows that atropine can be an effective and sustainable treatment for progressive high myopia in Europeans. PMID:27101751

  19. Teaching European Studies Online: The Challenge of Quality Assurance

    ERIC Educational Resources Information Center

    Mihai, Alexandra

    2009-01-01

    This paper will be looking into the issue of quality assurance in online learning from the perspective of the e-learning tool developed by the Institute for European Studies in Brussels--the E-modules. The E-modules have been designed with the purpose of offering a structured and interactive way of learning how the European Union functions. As…

  20. [Comparative study of 5 European tables of food composition (study of European tables of food composition)].

    PubMed

    García González, J

    1990-01-01

    A comparative study has been made of the following nutritional data base: (A) C.S.I.C. (Spain); (B) Deutsche Forschungsanstalt für Lebensmittel Chemie, Garching; (C) INSERM (France); (D) Geigy; (E) Wander. The following values were researched: calorie, protein, carbohydrate, fiber, calcium, iron, magnesium, Vit. B1, Vit B2, Niacin, Folic Acid, Vit. B12 and Vit. C. In order to assess the use of these tables under different conditions, the following were researched: 1) A group of 10 essential representative foods. 2) A group of 25 foods corresponding to a 24-hour count of what can be considered a standard diet. 3) Data obtained from a food survey (24-hour count) applied to 72, 13-year-old students at a Barcelona public school (winter 1988). In this case, the Spanish data base was used as reference. Computerized data processing, especially variation coefficient studies revealed that macronutrients correlated well with the different data bases. On the other hand, the greatest differences were observed among micronutrients, especially vitamin B12, niacin, folic acid, calcium and particularly fiber. The role different national data bases may play within the context of a more integrated european system was assessed. PMID:2078596

  1. Study Assistance in Ten European Countries: Overview and Conceptual Framework.

    ERIC Educational Resources Information Center

    Johansson, Olof; Ricknell, Lars

    Fundamental features of the financial aid systems for college students in 10 European countries are described, as are the theoretical framework and research topics of the study on which this report is based. The study is intended to determine the per capita degree of subsidization in each country; to describe the effects of the financial aid…

  2. Entrepreneurial Training: A Comparative Study across Fifteen European Countries

    ERIC Educational Resources Information Center

    Matricano, Diego

    2014-01-01

    This paper arises from the contents of the Lisbon Strategy, a set of cooperation policies stressing the role of education and training. The findings from a comparative study of the influence that entrepreneurial training--classified as formal or informal--can have on start-up expectations are analysed. The study covers fifteen European countries…

  3. European Curriculum Studies No. 3: Biology.

    ERIC Educational Resources Information Center

    Saunders, A.

    The Committee for General and Technical Education of the Council of Europe has initiated several projects to study, compare and evaluate curriculum materials used in the member nations. This publication, a result of such attempts, was prepared after making a survey of the status of biology teaching at the upper secondary school level in 19 member…

  4. European Union Students Studying in English Higher Education Institutions

    ERIC Educational Resources Information Center

    Morris, Marian; Rutt, Simon

    2008-01-01

    This study aimed to identify the pathways, intentions and relevant perceptions of (non-UK) European Union (EU) students entering English higher education. It sought to identify why students wished to obtain an English HE qualification, their attitudes towards the uptake and repayment of tuition fee loans and their future career plans. Drawing on…

  5. European and Canadian Studies of Loneliness among Seniors

    ERIC Educational Resources Information Center

    Perlman, Daniel

    2004-01-01

    This article provides a commentary on a set of five other articles reporting European and Canadian studies of loneliness among seniors. It places those works involving Canadian, Dutch, Finnish, and Welsh samples in the larger context of research on loneliness; offers reflections on the methods and findings reported in the articles; and addresses…

  6. Ethnic Heritage Studies: Northern European Foods. Experimental Unit.

    ERIC Educational Resources Information Center

    Freepartner, Susan

    This teaching guide focuses on the Northern European food heritage. It is part of the Louisville Area Ethnic Heritage Studies Project described in ED 150 043. The materials are designed to foster communication across intercultural/ethnic lines. The objective of this unit is to gain familiarity with and appreciate foods from Scandinavia, the Soviet…

  7. Ethnic Heritage Studies: Southern European Foods. Experimental Unit.

    ERIC Educational Resources Information Center

    Freepartner, Susan

    This teaching guide focuses on the Southern European food heritage. It is part of the Louisville Area Ethnic Heritage Studies Project described in ED 150 043. The project materials are designed to foster communication across intercultural/ethnic lines. The objective of this unit is to gain familiarity with and appreciate foods from Spain, France,…

  8. Teacher Behavior and Student Outcomes: Results of a European Study

    ERIC Educational Resources Information Center

    Panayiotou, Anastasia; Kyriakides, Leonidas; Creemers, Bert P. M.; McMahon, Léan; Vanlaar, Gudrun; Pfeifer, Michael; Rekalidou, Galini; Bren, Matevž

    2014-01-01

    This study investigates the extent to which the factors included in the dynamic model of educational effectiveness are associated with student achievement gains in six different European countries. At classroom level, the dynamic model refers to eight factors relating to teacher behavior in the classroom: orientation, structuring, questioning,…

  9. Calculating statistical power in Mendelian randomization studies.

    PubMed

    Brion, Marie-Jo A; Shakhbazov, Konstantin; Visscher, Peter M

    2013-10-01

    In Mendelian randomization (MR) studies, where genetic variants are used as proxy measures for an exposure trait of interest, obtaining adequate statistical power is frequently a concern due to the small amount of variation in a phenotypic trait that is typically explained by genetic variants. A range of power estimates based on simulations and specific parameters for two-stage least squares (2SLS) MR analyses based on continuous variables has previously been published. However there are presently no specific equations or software tools one can implement for calculating power of a given MR study. Using asymptotic theory, we show that in the case of continuous variables and a single instrument, for example a single-nucleotide polymorphism (SNP) or multiple SNP predictor, statistical power for a fixed sample size is a function of two parameters: the proportion of variation in the exposure variable explained by the genetic predictor and the true causal association between the exposure and outcome variable. We demonstrate that power for 2SLS MR can be derived using the non-centrality parameter (NCP) of the statistical test that is employed to test whether the 2SLS regression coefficient is zero. We show that the previously published power estimates from simulations can be represented theoretically using this NCP-based approach, with similar estimates observed when the simulation-based estimates are compared with our NCP-based approach. General equations for calculating statistical power for 2SLS MR using the NCP are provided in this note, and we implement the calculations in a web-based application. PMID:24159078

  10. Lung Function Monitoring; A Randomized Agreement Study

    PubMed Central

    Berntsen, Sveinung; Stølevik, Solvor B.; Mowinckel, Petter; Nystad, Wenche; Stensrud, Trine

    2016-01-01

    Objective: To determine the agreement between devices and repeatability within devices of the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flow at 50% of FVC (FEF50) values measured using the four spirometers included in the study. Methods: 50 (24 women) participants (20-64 years of age) completed maximum forced expiratory flow manoeuvres and measurements were performed using the following devices: MasterScreen, SensorMedics, Oxycon Pro and SpiroUSB. The order of the instruments tested was randomized and blinded for both the participants and the technicians. Re-testing was conducted on a following day within 72 hours at the same time of the day. Results: The devices which obtained the most comparable values for all lung function variables were SensorMedics and Oxycon Pro, and MasterScreen and SpiroUSB. For FEV1, mean difference was 0.04 L (95% confidence interval; -0.05, 0.14) and 0.00 L (-0.06, 0.06), respectively. When using the criterion of FVC and FEV1 ≤ 0.150 L for acceptable repeatability, 67% of the comparisons of the measured lung function values obtained by the four devices were acceptable. Overall, Oxycon Pro obtained most frequently values of the lung function variables with highest precision as indicated by the coefficients of repeatability (CR), followed by MasterScreen, SensorMedics and SpiroUSB (e.g. min-max CR for FEV1; 0.27-0.46). Conclusion: The present study confirms that measurements obtained by the same device at different times can be compared; however, measured lung function values may differ depending on spirometers used. PMID:27583055

  11. Use of Social Media by Western European Hospitals: Longitudinal Study

    PubMed Central

    Berben, Sivera AA; Samsom, Melvin; Engelen, Lucien JLPG; Schoonhoven, Lisette

    2012-01-01

    Background Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals increasingly use social media, but it is unknown whether and how Western European hospitals use social media. Objective To identify to what extent Western European hospitals use social media. Methods In this longitudinal study, we explored the use of social media by hospitals in 12 Western European countries through an Internet search. We collected data for each country during the following three time periods: April to August 2009, August to December 2010, and April to July 2011. Results We included 873 hospitals from 12 Western European countries, of which 732 were general hospitals and 141 were university hospitals. The number of included hospitals per country ranged from 6 in Luxembourg to 347 in Germany. We found hospitals using social media in all countries. The use of social media increased significantly over time, especially for YouTube (n = 19, 2% to n = 172, 19.7%), LinkedIn (n =179, 20.5% to n = 278, 31.8%), and Facebook (n = 85, 10% to n = 585, 67.0%). Differences in social media usage between the included countries were significant. Conclusions Social media awareness in Western European hospitals is growing, as well as its use. Social media usage differs significantly between countries. Except for the Netherlands and the United Kingdom, the group of hospitals that is using social media remains small. Usage of LinkedIn for recruitment shows the awareness of the potential of social media. Future research is needed to investigate how social media lead to improved health

  12. The European Atherosclerosis Research Study (EARS): design and objectives.

    PubMed

    1994-06-01

    The European Atherosclerosis Research Study--EARS--is a multicentre collaborative project sponsored by the European Community. Its main objective is to study, in young people, the biological expression of a paternal history of premature acute myocardial infarction (AMI) and the relative share of heredity and environment in this expression. In 14 centres in 11 European countries, the offspring of fathers who suffered from a documented AMI before the age of 55 years (cases) are compared with age- and sex-matched control individuals. Genetic variables (restriction fragment length polymorphisms of candidate genes), lifestyle variables and biochemical variables that are known or suspected to play a role in the development of coronary heart disease (CHD), are studied. The cultural and ethnic diversity within Europe allows a thorough investigation of the relative importance and the potential interactions of genetics and environment in the pathogenesis of CHD. A standardized core methodology and centralized storage of blood samples with particular types of analyses systematically carried out in one or a few specialized laboratories, from a strong basis for valid cross-cultural analyses. The results of this study will offer new clues for the modelling of individual risk for developing CHD. PMID:7960370

  13. Mental Health Services in Pilot Study Areas: Report on a European Study.

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    The World Health Organization (WHO) conducted a study to collect data on mental health resources of pilot areas within several European countries. This report presents data from the study and provides a detailed and reliable description of the development of mental health services within the WHO European Region. Part I of the report describes the…

  14. A Study of Head Start Effectiveness Using a Randomized Design.

    ERIC Educational Resources Information Center

    Abbott-Shim, Martha; Lambert, Richard; McCart, Frances

    Although an extensive body of literature exists on the impact of Head Start, very few studies have used an experimental design with random assignment, a key methodological component needed to increase the weight of evaluation findings. This study used a randomized design with a wide range of outcomes related to school readiness to assess the…

  15. Theoretical studies of breakdown in random media

    SciTech Connect

    Duxbury, P.M.

    1993-01-01

    Failure initiates in local regions of a material microstructure which are either especially weak, or which carry an especially large field. The size and location of these weak or hotspots'' depends on the microstructure, and is especially sensitive to microstructural disorder. Using model random microstructures, we have developed analytic and numerical tools to predict where failure initiates, its initiation field, and how it propagates from the initiation sites. We have found it useful to divide the failure process into a nucleation stage, in which damage occurs quite randomly throughout the material, a localisation stage, where a critical crack nucleates, and a catastrophic failure stage during which an unstable crack propagates through the material. Results are being compared with experiments on: Highly porous materials (porous glass, and porous gold); dielectric breakdown of metal loaded insulators (e.g. aluminum in poly-ethyelene) and; the critical current of superconductors containing cracks (Nb and Nb[sub 3]Ge). This report summarises our efforts in these areas.

  16. Effects of a Web-Based Personalized Intervention on Physical Activity in European Adults: A Randomized Controlled Trial

    PubMed Central

    Celis-Morales, Carlos; Fallaize, Rosalind; Macready, Anna L; Kolossa, Silvia; Woolhead, Clara; O'Donovan, Clare B; Forster, Hannah; Navas-Carretero, Santiago; San-Cristobal, Rodrigo; Lambrinou, Christina-Paulina; Moschonis, George; Surwillo, Agnieszka; Godlewska, Magdalena; Goris, Annelies; Hoonhout, Jettie; Drevon, Christian A; Manios, Yannis; Traczyk, Iwona; Walsh, Marianne C; Gibney, Eileen R; Brennan, Lorraine; Martinez, J Alfredo; Lovegrove, Julie A; Gibney, Michael J; Daniel, Hannelore; Mathers, John C; Saris, Wim HM

    2015-01-01

    Background The high prevalence of physical inactivity worldwide calls for innovative and more effective ways to promote physical activity (PA). There are limited objective data on the effectiveness of Web-based personalized feedback on increasing PA in adults. Objective It is hypothesized that providing personalized advice based on PA measured objectively alongside diet, phenotype, or genotype information would lead to larger and more sustained changes in PA, compared with nonpersonalized advice. Methods A total of 1607 adults in seven European countries were randomized to either a control group (nonpersonalized advice, Level 0, L0) or to one of three personalized groups receiving personalized advice via the Internet based on current PA plus diet (Level 1, L1), PA plus diet and phenotype (Level 2, L2), or PA plus diet, phenotype, and genotype (Level 3, L3). PA was measured for 6 months using triaxial accelerometers, and self-reported using the Baecke questionnaire. Outcomes were objective and self-reported PA after 3 and 6 months. Results While 1270 participants (85.81% of 1480 actual starters) completed the 6-month trial, 1233 (83.31%) self-reported PA at both baseline and month 6, but only 730 (49.32%) had sufficient objective PA data at both time points. For the total cohort after 6 months, a greater improvement in self-reported total PA (P=.02) and PA during leisure (nonsport) (P=.03) was observed in personalized groups compared with the control group. For individuals advised to increase PA, we also observed greater improvements in those two self-reported indices (P=.006 and P=.008, respectively) with increased personalization of the advice (L2 and L3 vs L1). However, there were no significant differences in accelerometer results between personalized and control groups, and no significant effect of adding phenotypic or genotypic information to the tailored feedback at month 3 or 6. After 6 months, there were small but significant improvements in the objectively

  17. Random sampling of the Central European bat fauna reveals the existence of numerous hitherto unknown adenoviruses.

    PubMed

    Vidovszky, Márton; Kohl, Claudia; Boldogh, Sándor; Görföl, Tamás; Wibbelt, Gudrun; Kurth, Andreas; Harrach, Balázs

    2015-12-01

    From over 1250 extant species of the order Chiroptera, 25 and 28 are known to occur in Germany and Hungary, respectively. Close to 350 samples originating from 28 bat species (17 from Germany, 27 from Hungary) were screened for the presence of adenoviruses (AdVs) using a nested PCR that targets the DNA polymerase gene of AdVs. An additional PCR was designed and applied to amplify a fragment from the gene encoding the IVa2 protein of mastadenoviruses. All German samples originated from organs of bats found moribund or dead. The Hungarian samples were excrements collected from colonies of known bat species, throat or rectal swab samples, taken from live individuals that had been captured for faunistic surveys and migration studies, as well as internal organs of dead specimens. Overall, 51 samples (14.73%) were found positive. We detected 28 seemingly novel and six previously described bat AdVs by sequencing the PCR products. The positivity rate was the highest among the guano samples of bat colonies. In phylogeny reconstructions, the AdVs detected in bats clustered roughly, but not perfectly, according to the hosts' families (Vespertilionidae, Rhinolophidae, Hipposideridae, Phyllostomidae and Pteropodidae). In a few cases, identical sequences were derived from animals of closely related species. On the other hand, some bat species proved to harbour more than one type of AdV. The high prevalence of infection and the large number of chiropteran species worldwide make us hypothesise that hundreds of different yet unknown AdV types might circulate in bats. PMID:26599097

  18. European education on natural disasters - a textbook study

    NASA Astrophysics Data System (ADS)

    Komac, B.; Zorn, M.; Ciglič, R.

    2013-05-01

    Present is the role of formal education on natural disasters in Europe. To ensure a uniform overview, the study used secondary-school geography textbooks from the collection of textbooks at the Georg Eckert Institute for International Textbook Research in Braunschweig, Germany. Altogether, more than 160 textbooks from 36 European countries were examined in order to investigate how much their content (pages, text, figures) is related to natural-disasters topics, and to find out which types of hazards are presented more often. In the research it was also analyzed which disaster events are frequently used as an example.

  19. The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group.

    PubMed

    Cooper, C; O'Neill, T; Silman, A

    1993-01-01

    Vertebral fractures are recognised as a hallmark of osteoporosis, yet little is known of their epidemiology. This deficiency limits accurate characterisation of the public health importance of osteoporosis. Assessment of the impact of vertebral fractures has been hampered by the absence of formal criteria for identifying fractures on a thoracolumbar radiograph. Initial methods relying upon subjective radiological assessments have given way to morphometric measurements of vertebral heights, with deformities defined according to various algorithms. These methods have been used in a series of studies performed in Rochester, MN, to determine the incidence, outcome, and time trends of vertebral deformities. The results suggest a prevalence rate of vertebral deformity of 25.3 per 100 Rochester women aged 50 years and over (95% CI, 22.3-28.2), with an estimated incidence of 17.8 per 1,000 person-years. The incidence of clinically diagnosed vertebral fractures among women in the same population was 5.3 per 1,000 person-years, suggesting that around 30% of such deformities in women receive clinical attention. Morphometric measurement on the radiographs of women with clinically diagnosed fractures revealed that 80% had grade 2 ( > 4 SD) deformities. Comparable data on the occurrence and health impact of vertebral deformities throughout Europe are urgently required. The European Vertebral Osteoporosis Study (EVOS) is a multicentre epidemiological study that aims to address this issue. It is designed as a radiographic prevalence study in 34 European centres.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8110529

  20. A numerical study of the 3D random interchange and random loop models

    NASA Astrophysics Data System (ADS)

    Barp, Alessandro; Barp, Edoardo Gabriele; Briol, François-Xavier; Ueltschi, Daniel

    2015-08-01

    We have studied numerically the random interchange model and related loop models on the three-dimensional cubic lattice. We have determined the transition time for the occurrence of long loops. The joint distribution of the lengths of long loops is Poisson-Dirichlet with parameter 1 or \\frac{1}{2}.

  1. Ethics teaching in European veterinary schools: a qualitative case study.

    PubMed

    Magalhães-Sant'Ana, M

    2014-12-13

    Veterinary ethics is recognised as a relevant topic in the undergraduate veterinary curriculum. However, there appears to be no widely agreed view on which contents are best suited for veterinary ethics teaching and there is limited information on the teaching approaches adopted by veterinary schools. This paper provides an inside perspective on the diversity of veterinary ethics teaching topics, based on an in-depth analysis of three European veterinary schools: Copenhagen, Lisbon and Nottingham. The case study approach integrated information from the analysis of syllabi contents and interviews with educators (curricular year 2010-2011). These results show that the curriculum of veterinary ethics is multidimensional and can combine a wide range of scientific, regulatory, professional and philosophical subjects, some of which may not be explicitly set out in the course descriptors. A conceptual model for veterinary ethics teaching is proposed comprising prominent topics included within four overarching concepts: animal welfare science, laws/regulations, professionalism, and theories/concepts. It is intended that this work should inform future curriculum development of veterinary ethics in European schools and assist ethical deliberation in veterinary practice. PMID:25185106

  2. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study.

    PubMed

    Boffano, Paolo; Roccia, Fabio; Zavattero, Emanuele; Dediol, Emil; Uglešić, Vedran; Kovačič, Žiga; Vesnaver, Aleš; Konstantinović, Vitomir S; Petrović, Milan; Stephens, Jonny; Kanzaria, Amar; Bhatti, Nabeel; Holmes, Simon; Pechalova, Petia F; Bakardjiev, Angel G; Malanchuk, Vladislav A; Kopchak, Andrey V; Galteland, Pål; Mjøen, Even; Skjelbred, Per; Koudougou, Carine; Mouallem, Guillaume; Corre, Pierre; Løes, Sigbjørn; Lekven, Njål; Laverick, Sean; Gordon, Peter; Tamme, Tiia; Akermann, Stephanie; Karagozoglu, K Hakki; Kommers, Sofie C; Forouzanfar, Tymour

    2015-01-01

    The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres. The most frequently observed fracture involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures. Condylar fractures were the most commonly observed mandibular fracture. The results of the EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe, with trauma cases caused by assaults and falls now outnumbering those due to road traffic accidents. The progressive ageing of the European population, in addition to strict road and work legislation may have been responsible for this change. Men are still the most frequent victims of maxillofacial injuries. PMID:25457465

  3. Improving Balance in Subacute Stroke Patients: A Randomized Controlled Study

    ERIC Educational Resources Information Center

    Goljar, Nika; Burger, Helena; Rudolf, Marko; Stanonik, Irena

    2010-01-01

    The aim of the study was to compare the efficacy of balance training in a balance trainer, a newly developed mechanical device for training balance, with conventional balance training in subacute stroke patients. This was a randomized controlled study. Fifty participants met the inclusion criteria and 39 finished the study. The participants were…

  4. Drug use in children: cohort study in three European countries

    PubMed Central

    Verhamme, Katia M C; Nicolosi, Alfredo; Murray, Macey L; Neubert, Antje; Caudri, Daan; Picelli, Gino; Sen, Elif Fatma; Giaquinto, Carlo; Cantarutti, Luigi; Baiardi, Paola; Felisi, Maria-Grazia; Ceci, Adriana; Wong, Ian C K

    2008-01-01

    Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs. PMID:19029175

  5. Multi-instrumental study of the ionosphere in European region

    NASA Astrophysics Data System (ADS)

    Zakharenkova, I.; Krankowski, A.; Cherniak, I.; Rothkaehl, H.

    2013-12-01

    We present the techniques for the investigation of the spatial-temporal structure of the mid-latitude ionosphere on the base of comprehensive analysis of multi-instrumental satellite and ground-based measurements and demonstrates their application at several case study results. For our analysis we used the ionospheric data provided by European ionosondes network (DIAS), as well as GNSS TEC observations. Manually scaled ionosondes' data are used as a benchmark in our study. Two-dimensional maps of vertical TEC over Europe are created using IGS and EUREF permanent networks. These maps have spatial resolution of 1 deg and temporal resolution of 1 h, for investigation of ionosphere response on special events (geomagnetic storms, solar eclipses, etc) there is possibility to create TEC maps with 5-10 min resolution. The high temporal resolution maps give the possibility to study of spatial gradients of electron density. Joint analysis of GPS TEC and FORMOSAT-3/COSMIC radio occultation data allows us to extract and estimate electron content corresponded to the ionosphere (its bottom and topside parts) and the plasmasphere (h>700 km) for different conditions. Several case-studies of geomagnetic storms were analyzed in order to estimate changes and redistribution of electron content between ionosphere and plasmasphere over Europe. The obtained results were compared with TEC, IEC and PEC estimates retrieved by IRI-Plas Model that has the plasmasphere extension up to 20,000 km (GPS orbit). As a new data source there will be new ionospheric sounding station, located in European mid-latitudes in Olsztyn, Poland, that will start its operation at the end of 2013. One of the possible user of ionospheric products is represented by LOFAR (LOw Frequency Array), a new fully digital radio telescope designed for frequencies between 30 MHz and 240 MHz. To the summer of 2015 three new LOFAR stations will be installed in Poland: Lazy (East of Krakow), Borowiec near Poznan and Baldy near

  6. A study on evaluation of random failure in building facilities

    SciTech Connect

    Tanaka, Takehiro; Gotoh, Shigeru

    1998-12-31

    Estimation of the mean time between failures (hereinafter termed MTBF) for random failure is a well-known part of equipment engineering, but no discussion of MTBF presently exists in connection with building equipment. Close examination of the interval estimation of MTBF is indispensable in establishing maintenance periods for building automation and other systems. In this study, an investigation of MTBF estimation for random failure is made using field data of building equipment operations, and a comparison of results is conducted by applying two methods of interval estimation. The study touches upon the relationship of the results achieved by the Bayesian approach with the assessed values of practical operations. The authors employ simulation of a maximum-likelihood method with the Bayesian method in estimating the failure rate and then analyze it by using the data of building equipment and devices for a period of random failure. These results suggest the most suitable and practical way of MTBF estimation for actual maintenance sites.

  7. ADAPTIVE MATCHING IN RANDOMIZED TRIALS AND OBSERVATIONAL STUDIES

    PubMed Central

    van der Laan, Mark J.; Balzer, Laura B.; Petersen, Maya L.

    2014-01-01

    SUMMARY In many randomized and observational studies the allocation of treatment among a sample of n independent and identically distributed units is a function of the covariates of all sampled units. As a result, the treatment labels among the units are possibly dependent, complicating estimation and posing challenges for statistical inference. For example, cluster randomized trials frequently sample communities from some target population, construct matched pairs of communities from those included in the sample based on some metric of similarity in baseline community characteristics, and then randomly allocate a treatment and a control intervention within each matched pair. In this case, the observed data can neither be represented as the realization of n independent random variables, nor, contrary to current practice, as the realization of n/2 independent random variables (treating the matched pair as the independent sampling unit). In this paper we study estimation of the average causal effect of a treatment under experimental designs in which treatment allocation potentially depends on the pre-intervention covariates of all units included in the sample. We define efficient targeted minimum loss based estimators for this general design, present a theorem that establishes the desired asymptotic normality of these estimators and allows for asymptotically valid statistical inference, and discuss implementation of these estimators. We further investigate the relative asymptotic efficiency of this design compared with a design in which unit-specific treatment assignment depends only on the units’ covariates. Our findings have practical implications for the optimal design and analysis of pair matched cluster randomized trials, as well as for observational studies in which treatment decisions may depend on characteristics of the entire sample. PMID:25097298

  8. Spaceflight studies of tropisms in the European Modular Cultivation System

    NASA Astrophysics Data System (ADS)

    Kiss, J. Z.; Correll, M. J.; Edelmann, R. E.

    Phototropism and gravitropism play key roles in the oriented growth of roots in flowering plants. In blue or white light, roots exhibit negative phototropism, but red light induces positive phototropism in Arabidopsis roots. The blue-light response is controlled by the phototropins while the red-light response is mediated by the phytochrome family of photoreceptors. In order to better characterize root phototropism, we plan to perform experiments in microgravity so that this tropism can be more effectively studied without the interactions with the gravity response. Our experiments are to be performed on the European Modular Cultivation System (EMCS), which provides an incubator, lighting system, and high resolution video that are on a centrifuge palette. These experiments will be performed at μ g, 1g (control) and fractional g-levels. In order to ensure success of this mission on the International Space Station (ISS), we have been performing ground-based studies on growth, phototropism, and gravitropism in experimental unique equipment (EUE) that was designed for our experiments that will use Arabidopsis seedlings. Currently, the EMCS and our EUE are scheduled for launch on space shuttle mission STS-121. This project should provide insight into how the blue-light and red-light signaling systems interact with each other, and also with the gravisensing system.

  9. Cognitive Behavioral Principles within Group Mentoring: A Randomized Pilot Study

    ERIC Educational Resources Information Center

    Jent, Jason F.; Niec, Larissa N.

    2009-01-01

    This study evaluated the effectiveness of a group mentoring program that included components of empirically supported mentoring and cognitive behavioral techniques for children served at a community mental health center. Eighty-six 8- to 12-year-old children were randomly assigned to either group mentoring or a wait-list control group. Group…

  10. A Systematic Review of Randomized Controlled Studies of Art Therapy

    ERIC Educational Resources Information Center

    Maujean, Annick; Pepping, Christopher A.; Kendall, Elizabeth

    2014-01-01

    This review article examines current knowledge about the efficacy of art therapy based on the findings of 8 randomized controlled trials (RCTs) conducted with adult populations from 2008-2013 that met a high standard of rigor. Of these studies, all but one reported beneficial effects of art therapy. Review findings suggest that art therapy may…

  11. Building Kindergartners' Number Sense: A Randomized Controlled Study

    ERIC Educational Resources Information Center

    Jordan, Nancy C.; Glutting, Joseph; Dyson, Nancy; Hassinger-Das, Brenna; Irwin, Casey

    2012-01-01

    Math achievement in elementary school is mediated by performance and growth in number sense during kindergarten. The aim of the present study was to test the effectiveness of a targeted small-group number sense intervention for high-risk kindergartners from low-income communities. Children were randomly assigned to 1 of 3 groups (n = 44 in each…

  12. What Does a Random Line Look Like: An Experimental Study

    ERIC Educational Resources Information Center

    Turner, Nigel E.; Liu, Eleanor; Toneatto, Tony

    2011-01-01

    The study examined the perception of random lines by people with gambling problems compared to people without gambling problems. The sample consisted of 67 probable pathological gamblers and 46 people without gambling problems. Participants completed a number of questionnaires about their gambling and were then presented with a series of random…

  13. Recent Extremes in European Climate: Assessment, Case Studies and Impacts

    NASA Astrophysics Data System (ADS)

    Yiou, P.; Vautard, R.; D'Andrea, F.; Cattiaux, J.; Naveau, P.; Ciais, P.; Garnier, E.

    2008-12-01

    During the last centuries and up to the present decade, extreme climate events have certainly had larger economic impacts than any trend of temperature in Europe. In addition to an intrinsic scientific interest, their study is thus essential for society. One of the challenges of their investigation is that, depending on their definition, extreme climate events potentially have a behavior that is not connected to the secular temperature trend in a simple fashion. This presentation will review the statistical assessments of extremes in Europe, focusing on surface temperature, precipitation, and their connections with large-scale features of the atmospheric circulation. In particular, the questions of modeling their severity and frequency will be discussed in the first part of the presentation. I will then give two kinds of examples of European climate extremes: summer heatwaves and droughts, and winter warm waves. The mechanisms leading to such phenomena will be explored, and I will examine some of the impacts on the biosphere that were recently observed. In order to provide a long term perspective of those events, examples of historical droughts in France will be presented and connected with proxy records of temperature. It appears that the mechanisms that are favored for present-day climate might still have been valid during the past centuries. To conclude, new challenges for dynamical and statistical modeling will be explored.

  14. Mendelian randomization studies of biomarkers and type 2 diabetes

    PubMed Central

    Abbasi, Ali

    2015-01-01

    Many biomarkers are associated with type 2 diabetes (T2D) risk in epidemiological observations. The aim of this study was to identify and summarize current evidence for causal effects of biomarkers on T2D. A systematic literature search in PubMed and EMBASE (until April 2015) was done to identify Mendelian randomization studies that examined potential causal effects of biomarkers on T2D. To replicate the findings of identified studies, data from two large-scale, genome-wide association studies (GWAS) were used: DIAbetes Genetics Replication And Meta-analysis (DIAGRAMv3) for T2D and the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) for glycaemic traits. GWAS summary statistics were extracted for the same genetic variants (or proxy variants), which were used in the original Mendelian randomization studies. Of the 21 biomarkers (from 28 studies), ten have been reported to be causally associated with T2D in Mendelian randomization. Most biomarkers were investigated in a single cohort study or population. Of the ten biomarkers that were identified, nominally significant associations with T2D or glycaemic traits were reached for those genetic variants related to bilirubin, pro-B-type natriuretic peptide, delta-6 desaturase and dimethylglycine based on the summary data from DIAGRAMv3 or MAGIC. Several Mendelian randomization studies investigated the nature of associations of biomarkers with T2D. However, there were only a few biomarkers that may have causal effects on T2D. Further research is needed to broadly evaluate the causal effects of multiple biomarkers on T2D and glycaemic traits using data from large-scale cohorts or GWAS including many different genetic variants. PMID:26446360

  15. Site Selection for the European ELT: working package included in the European FP6 ``ELT design study'' contract

    NASA Astrophysics Data System (ADS)

    Muñoz-Tuñón, C.; Sarazin, M.; Vernin, J.

    2007-10-01

    The site selection for the future European Large Telescope (E-ELT) is a key issue within the European proposal funded by the European Union (EU), within the ``ELT design study'' proposal. The organization, working scheme and baseline frameworks are reviewed. For the definition of the working package WP12000 ``Site Characterization'', important use has been done of previous work in the definition of techniques and tools for the study of the atmosphere above observing sites. We have also taken advantage of the number of data already available which have naturally defined a ranking among the known places which have also been taken as a base line for pre-selecting the candidate sites. The work will last 4 years, it started in 2005 and is organized in subtasks, working packages WP, whose main objectives are the following: WP12100: to characterize two top astronomical sites (ORM and North-Paranal) and to explore three other alternatives (Macon in Argentina, Izaña in Spain and Aklim in Morocco) suitable to install an ELT under the best conditions (Dome C is been currently under investigation, and no particular effort will be put in this site, but rather its atmospheric properties will be compared to the above mentioned sites). WP12200 is dedicated to design, build and operate a set of standard equipment in all the sites and to perform long term campaign. WP12300 will investigate wavefront properties over large baselines (50-100 m) corresponding to the size of the future ELT, as well as the fine characterization of the optical turbulence within the boundary layer. A similar plan is being carried out by the Thirty Meter Telescope (TMT) site selection team. For the sake of saving resources (budget and people), the TMT preselected sites (all in the American Continent) are not included in our European study.

  16. European Studies as Answer to Allan Bloom's "The Closing of the American Mind."

    ERIC Educational Resources Information Center

    Macdonald, Michael H.

    European studies can provide a solution to several of the issues raised in Allan Bloom's "The Closing of the American Mind." European studies pursue the academic quest for what is truth, what is goodness, and what is beauty. In seeking to answer these questions, the Greeks were among the first to explore many of humanity's problems and their…

  17. Randomized or fixed order for studies of behavioral syndromes?

    PubMed Central

    2013-01-01

    There is a growing interest among behavioral ecologists in behavioral syndromes and animal personality. Studies of behavioral syndromes repeatedly measure the same individuals to quantify within-individual consistency and between-individual variation in behavior. Often these studies measure behavior in different contexts or in different behavioral assays to determine whether individual differences in behavior in one context are related to behavior in other contexts, that is, a behavioral syndrome. For studies of behavioral syndromes, there is not universal agreement about whether it is preferable to randomize the order of different assays or to administer them in a fixed order. Here, I articulate the advantages and disadvantages of testing in a randomized or fixed order and offer some recommendations according to the goals and power of the experiment. In general, studies using within-subjects designs that are primarily interested in mean-level differences between treatments should randomize the order that individuals experience different treatments. Under certain conditions, studies of behavioral syndromes should also administer the assays in a randomized order, but only if the study is sufficiently powerful to statistically account for carryover and period effects. If the experimenter is interested in behavioral syndromes that are caused by carryovers, it is often preferable to test in a fixed order. If the experimenter wants to guard against carryovers, but the experiment is not sufficiently powerful to account for carryover and period effects, then a compromise is to test in a fixed order, but to test individuals in the context that is most likely to affect subsequent behavior last. PMID:27307687

  18. An integrated lithospheric study targeting the Holy Cross Mountains of the Eastern European Trans-European Suture Zone in Poland

    NASA Astrophysics Data System (ADS)

    Averill, M.; Bond, T.; Sroda, P.; Keller, G.; Miller, K.

    2003-04-01

    The Trans-European Suture Zone (TESZ) in Eastern Europe, of which the TTZ is a portion, marks the boundary between Phanerozoic Western European terrains with the Precambrian Eastern European Craton (EEC). The nature of this suture is known primarily from geophysical studies. Seismic velocity and gravity models indicate changes of crustal thickness from 28-35 km to 42-47 km across the TTZ (Teisseyre-Tornquist Zone) from the Paleozoic Platform of Western Europe to the Eastern European Craton. Tectonic models suggest the presence of a Precambrian/Early Paleozoic passive margin beneath the TTZ. The Holy Cross Mountains in southeastern Poland represent an anomalous crustal block whose origin and interaction with the EEC is largely unknown. The subject of this study is the origin and tectonic evolution of this and adjacent crustal blocks in relation to the eastern TESZ and EEC. We have employed a technique to integrate industry acquired well and reflection data, as well as refraction data from the CELEBRATION 2000, POLONAISE '97 and TTZ seismic experiments. We used well check shot surveys from wells and CDP (common depth point) stacking velocities from reflection surveys in addition to refraction data as data input to a 3-D tomographic inversion. Gravity, magnetics, drilling and geologic data support an integrated interpretation of the output velocity model for this region. Gravity modeling based on geologic and velocity model constraints indicate an incomplete docking of Variscan terranes along the EEC margin with deformation of the Paleozoic margin strata associated with uplift in the Holy Cross Mountains region.

  19. Job insecurity and health: A study of 16 European countries

    PubMed Central

    László, Krisztina D.; Pikhart, Hynek; Kopp, Mária S.; Bobak, Martin; Pajak, Andrzej; Malyutina, Sofia; Salavecz, Gyöngyvér; Marmot, Michael

    2010-01-01

    Although the number of insecure jobs has increased considerably over the recent decades, relatively little is known about the health consequences of job insecurity, their international pattern, and factors that may modify them. In this paper, we investigated the association between job insecurity and self-rated health, and whether the relationship differs by country or individual-level characteristics. Cross-sectional data from 3 population-based studies on job insecurity, self-rated health, demographic, socioeconomic, work-related and behavioural factors and lifetime chronic diseases in 23,245 working subjects aged 45–70 years from 16 European countries were analysed using logistic regression and meta-analysis. In fully adjusted models, job insecurity was significantly associated with an increased risk of poor health in the Czech Republic, Denmark, Germany, Greece, Hungary, Israel, the Netherlands, Poland and Russia, with odds ratios ranging between 1.3 and 2.0. Similar, but not significant, associations were observed in Austria, France, Italy, Spain and Switzerland. We found no effect of job insecurity in Belgium and Sweden. In the pooled data, the odds ratio of poor health by job insecurity was 1.39. The association between job insecurity and health did not differ significantly by age, sex, education, and marital status. Persons with insecure jobs were at an increased risk of poor health in most of the countries included in the analysis. Given these results and trends towards increasing frequency of insecure jobs, attention needs to be paid to the public health consequences of job insecurity. PMID:20060634

  20. Coproducing European Integration Studies: Infrastructures and Epistemic Movements in an Interdisciplinary Field

    ERIC Educational Resources Information Center

    Pfister, Thomas

    2015-01-01

    This paper is interested in the interdisciplinary characteristics of European integration studies. It explores how the institutional and intellectual, internal and external boundaries of this interdisciplinary field are shaped. For this purpose, it discusses two interlocking dynamics that are most important: on the one hand, the European Union…

  1. A large-scale study of the random variability of a coding sequence: a study on the CFTR gene.

    PubMed

    Modiano, Guido; Bombieri, Cristina; Ciminelli, Bianca Maria; Belpinati, Francesca; Giorgi, Silvia; Georges, Marie des; Scotet, Virginie; Pompei, Fiorenza; Ciccacci, Cinzia; Guittard, Caroline; Audrézet, Marie Pierre; Begnini, Angela; Toepfer, Michael; Macek, Milan; Ferec, Claude; Claustres, Mireille; Pignatti, Pier Franco

    2005-02-01

    Coding single nucleotide substitutions (cSNSs) have been studied on hundreds of genes using small samples (n(g) approximately 100-150 genes). In the present investigation, a large random European population sample (average n(g) approximately 1500) was studied for a single gene, the CFTR (Cystic Fibrosis Transmembrane conductance Regulator). The nonsynonymous (NS) substitutions exhibited, in accordance with previous reports, a mean probability of being polymorphic (q > 0.005), much lower than that of the synonymous (S) substitutions, but they showed a similar rate of subpolymorphic (q < 0.005) variability. This indicates that, in autosomal genes that may have harmful recessive alleles (nonduplicated genes with important functions), genetic drift overwhelms selection in the subpolymorphic range of variability, making disadvantageous alleles behave as neutral. These results imply that the majority of the subpolymorphic nonsynonymous alleles of these genes are selectively negative or even pathogenic. PMID:15536480

  2. Mendelian randomization study of body mass index and colorectal cancer risk

    PubMed Central

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike; Chang-Claude, Jenny; Rudolph, Anja; Slattery, Martha L.; Chan, Andrew T.; Locke, Adam E.; Kahali, Bratati; Justice, Anne E.; Pers, Tune H.; Gallinger, Steven; Hayes, Richard B; Baron, John A.; Caan, Bette J.; Ogino, Shuji; Berndt, Sonja I.; Chanock, Stephen J.; Casey, Graham; Haile, Robert W.; Du, Mengmeng; Harrison, Tabitha A.; Thornquist, Mark; Duggan, David J.; Le Marchand, Loïc; Lindor, Noralane M.; Seminara, Daniela; Song, Mingyang; Wu, Kana; Thibodeau, Stephen N.; Cotterchio, Michelle; Win, Aung Ko; Jenkins, Mark A.; Hopper, John L.; Ulrich, Cornelia M.; Potter, John D.; Newcomb, Polly A.; Hoffmeister, Michael; Brenner, Hermann; White, Emily; Hsu, Li; Campbell, Peter T.

    2015-01-01

    Background High body mass index (BMI) is consistently linked to increased risk of colorectal cancer (CRC) for men, whereas the association is less clear for women. As risk estimates from observational studies may be biased and/or confounded, we conducted a Mendelian randomization study to estimate the causal association between BMI and CRC. Methods We used data from 10,226 CRC cases and 10,286 controls of European ancestry. The Mendelian randomization analysis used a weighted genetic risk score, derived from 77 genome-wide association study identified variants associated with higher BMI, as an instrumental variable (IV). We compared the IV odds ratio (IV-OR) with the OR obtained using a conventional covariate-adjusted analysis. Results Individuals carrying greater numbers of BMI-increasing alleles had higher CRC risk (per weighted allele OR, 1.31; 95% confidence interval [CI], 1.10–1.57). Our IV estimation results support the hypothesis that genetically influenced BMI is directly associated with risk for CRC (IV-OR per 5 kg/m2, 1.50; 95% CI, 1.13–2.01). In the sex-specific IV analyses higher BMI was associated with higher risk of CRC among women (IV-OR per 5 kg/m2, 1.82; 95% CI, 1.26–2.61). For men, genetically influenced BMI was not associated with CRC (IV-OR per 5 kg/m2, 1.18; 95% CI, 0.73–1.92). Conclusions High BMI was associated with increased CRC risk for women. Whether abdominal obesity, rather than overall obesity, is a more important risk factor for men requires further investigation. Impact Overall, conventional epidemiologic and Mendelian randomization studies suggest a strong association between obesity and the risk of CRC. PMID:25976416

  3. A Mendelian Randomization Study of Plasma Homocysteine and Multiple Myeloma.

    PubMed

    Xuan, Yang; Li, Xiao-Hong; Hu, Zhong-Qian; Teng, Zhi-Mei; Hu, Dao-Jun

    2016-01-01

    Observational studies have demonstrated an association between elevated homocysteine (Hcy) level and risk of multiple myeloma (MM). However, it remains unclear whether this relationship is causal. We conducted a Mendelian randomization (MR) study to evaluate whether genetically increased Hcy level influences the risk of MM. We used the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism as an instrumental variable, which affects the plasma Hcy levels. Estimate of its effect on plasma Hcy level was based on a recent genome-wide meta-analysis of 44,147 individuals, while estimate of its effect on MM risk was obtained through meta-analysis of case-control studies with 2,092 cases and 4,954 controls. By combining these two estimates, we found that per one standard-deviation (SD) increase in natural log-transformed plasma Hcy levels conferred a 2.67-fold increase in risk for MM (95% confidence interval (CI): 1.12-6.38; P = 2.7 × 10(-2)). Our study suggests that elevated Hcy levels are causally associated with an increased risk of developing MM. Whether Hcy-lowering therapy can prevent MM merits further investigation in long-term randomized controlled trials (RCTs). PMID:27126524

  4. A Mendelian Randomization Study of Plasma Homocysteine and Multiple Myeloma

    PubMed Central

    Xuan, Yang; Li, Xiao-Hong; Hu, Zhong-Qian; Teng, Zhi-Mei; Hu, Dao-Jun

    2016-01-01

    Observational studies have demonstrated an association between elevated homocysteine (Hcy) level and risk of multiple myeloma (MM). However, it remains unclear whether this relationship is causal. We conducted a Mendelian randomization (MR) study to evaluate whether genetically increased Hcy level influences the risk of MM. We used the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism as an instrumental variable, which affects the plasma Hcy levels. Estimate of its effect on plasma Hcy level was based on a recent genome-wide meta-analysis of 44,147 individuals, while estimate of its effect on MM risk was obtained through meta-analysis of case-control studies with 2,092 cases and 4,954 controls. By combining these two estimates, we found that per one standard-deviation (SD) increase in natural log-transformed plasma Hcy levels conferred a 2.67-fold increase in risk for MM (95% confidence interval (CI): 1.12–6.38; P = 2.7 × 10−2). Our study suggests that elevated Hcy levels are causally associated with an increased risk of developing MM. Whether Hcy-lowering therapy can prevent MM merits further investigation in long-term randomized controlled trials (RCTs). PMID:27126524

  5. Random matrix study for a three-terminal chaotic device

    SciTech Connect

    Martínez-Argüello, A. M.; Castaño, E.; Martínez-Mares, M.

    2014-01-14

    We perform a study based on a random-matrix theory simulation for a three-terminal device, consisting of chaotic cavities on each terminal. We analyze the voltage drop along one wire with two chaotic mesoscopic cavities, connected by a perfect conductor, or waveguide, with one open mode. This is done by means of a probe, which also consists of a chaotic cavity that measure the voltage in different configurations. Our results show significant differences with respect to the disordered case, previously considered in the literature.

  6. Neuropsychological Outcome of Children Treated for Standard Risk Medulloblastoma in the PNET4 European Randomized Controlled Trial of Hyperfractionated Versus Standard Radiation Therapy and Maintenance Chemotherapy

    SciTech Connect

    Câmara-Costa, Hugo; Resch, Anika; Kieffer, Virginie; Lalande, Clémence; Poggi, Geraldina; Kennedy, Colin; Bull, Kim; Calaminus, Gabriele; Grill, Jacques; Doz, François; Rutkowski, Stefan; Massimino, Maura; Kortmann, Rolf-Dieter; Lannering, Birgitta; Dellatolas, Georges; Chevignard, Mathilde

    2015-08-01

    Purpose: In the European HIT-SIOP PNET4 randomized controlled trial, children with standard risk medulloblastoma were allocated to hyperfractionated radiation therapy (HFRT arm, including a partially focused boost) or standard radiation therapy (STRT arm), followed, in both arms, by maintenance chemotherapy. Event-free survival was similar in both arms. Previous work showed that the HFRT arm was associated with worse growth and better questionnaire-based executive function, especially in children <8 years of age at diagnosis. Therefore, the aim of this study was to compare performance-based cognitive outcomes between treatment arms. Methods and Materials: Neuropsychological data were collected prospectively in 137 patients. Using the Wechsler Intelligence Scales, Kaufman Assessment Battery for Children, and Raven's Progressive Matrices, we estimated full-scale intelligence quotient (FSIQ) and, when available, verbal IQ (VIQ), performance IQ (PIQ), working memory index (WMI), and processing speed index (PSI). Results: Among the 137 participants (HFRT arm n=71, STRT arm n=66, 63.5% males), mean (±SD) ages at diagnosis and assessment respectively were 9.3 (±3.2) years of age (40.8% < 8 years of age at diagnosis) and 14.6 (±4.3) years of age. Mean (±SD) FSIQ was 88 (±19), and mean intergroup difference was 3.88 (95% confidence interval: −2.66 to 10.42, P=.24). No significant differences were found in children >8 years of age at diagnosis. In children <8 years of age at diagnosis, a marginally significant trend toward higher VIQ was found in those treated in the HFRT arm; a similar trend was found for PSI but not for PIQ, WMI, or FSIQ (mean intergroup differences were: 12.02 for VIQ [95% CI: 2.37-21.67; P=.02]; 3.77 for PIQ [95% CI: −5.19 to 12.74; P>.10]; 5.20 for WMI [95% CI: −2.07 to 12.47; P>.10]; 10.90 for PSI [95% CI: −1.54 to 23.36; P=.08]; and 5.28 for FSIQ [95% CI: −4.23 to 14.79; P>.10]). Conclusions: HFRT was associated with marginally

  7. Smoking reduces fecundity: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity.

    PubMed

    Bolumar, F; Olsen, J; Boldsen, J

    1996-03-15

    Several studies published within the past 10 years indicate that smoking reduces fecundity, but not all studies have found this effect, and smoking cessation is not used routinely in infertility treatment in Europe. The present study was designed to examine male and female smoking at the start of a couple's waiting time to a planned pregnancy. Two types of samples were used: population-based samples of women aged 25-44 years who were randomly selected in different countries from census registers and electoral rolls, in which the unit of analysis was the couple; and pregnancy-based samples of pregnant women (at least 20 weeks' pregnant) who were consecutively recruited during prenatal care visits, in which the unit of analysis was a pregnancy. More than 4,000 couples were included in each sample, and 10 different regions in Europe took part in data collection. The data were collected between August 1991 and February 1993 by personal interview in all population-based samples and in all but three regions of the pregnancy sample, where self-administered questionnaires were used. The results based on the population sample showed a remarkably coherent association between female smoking and subfecundity in each individual country and in all countries together, both with the first pregnancy (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.1, at the upper level of exposure) and during the most recent waiting time to pregnancy (OR = 1.6, 95% CI 1.3-2.1). Results based on the pregnancy sample were similar (OR = 1.7, 95% CI 1.3-2.3). No significant association was found with male smoking (in the population sample, OR = 0.9, 95% CI 0.7-1.1 (first pregnancy) and OR = 1.0, 95% CI 0.9-1.3 (most recent waiting time); in the pregnancy sample, OR = 0.9, 95% CI 0.7-1.1). The fecundity distribution among smokers appeared to be shifted toward longer waiting times without a change in the shape of the distribution. Women who have difficulty conceiving should try to stop smoking

  8. Essential elements of treatment: a comparative study between European and American therapeutic communities for addiction.

    PubMed

    Goethals, Ilse; Soyez, Veerle; Melnick, Gerald; De Leon, George; Broekaert, Eric

    2011-01-01

    The purpose of this study was to investigate whether European and American therapeutic communities (TCs) for addiction, both traditional and modified, share a common perspective on what is essential in treatment using the Survey of Essential Elements Questionnaire (SEEQ). The European sample (N = 19) was gathered in 2009. For the American sample (N = 19), we used previously published research data. Despite comparable perspectives, European traditional TCs (N = 11) scored significantly higher than their American predecessors (N = 11) on four SEEQ domains. Cluster differences were more pronounced in Europe than in America. PMID:21235341

  9. A Comparative Study of Randomized Constraint Solvers for Random-Symbolic Testing

    NASA Technical Reports Server (NTRS)

    Takaki, Mitsuo; Cavalcanti, Diego; Gheyi, Rohit; Iyoda, Juliano; dAmorim, Marcelo; Prudencio, Ricardo

    2009-01-01

    The complexity of constraints is a major obstacle for constraint-based software verification. Automatic constraint solvers are fundamentally incomplete: input constraints often build on some undecidable theory or some theory the solver does not support. This paper proposes and evaluates several randomized solvers to address this issue. We compare the effectiveness of a symbolic solver (CVC3), a random solver, three hybrid solvers (i.e., mix of random and symbolic), and two heuristic search solvers. We evaluate the solvers on two benchmarks: one consisting of manually generated constraints and another generated with a concolic execution of 8 subjects. In addition to fully decidable constraints, the benchmarks include constraints with non-linear integer arithmetic, integer modulo and division, bitwise arithmetic, and floating-point arithmetic. As expected symbolic solving (in particular, CVC3) subsumes the other solvers for the concolic execution of subjects that only generate decidable constraints. For the remaining subjects the solvers are complementary.

  10. Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study.

    PubMed

    Ozkurt, Seçil; Dönmez, Arif; Zeki Karagülle, M; Uzunoğlu, Emel; Turan, Mustafa; Erdoğan, Nergis

    2012-07-01

    We aimed to evaluate the effectiveness of balneotherapy in fibromyalgia management. Fifty women with fibromyalgia under pharmacological treatment were randomly assigned to either the balneotherapy (25) or the control (25) group. Four patients from the balneotherapy group and one patient from the control group left the study after randomization. The patients in the balneotherapy group (21) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center. The patients in the control group (24) continued to have their medical treatment and routine daily life. An investigator who was blinded to the study arms assessed the patients. All patients were assessed four times; at the beginning of the study, at the end of the 2nd week, the 1st month, and the 3rd month after balneotherapy. Outcome measures of the study were pain intensity, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), patient's global assessment, investigator's global assessment, SF-36 scores, and tender point count. Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity, FIQ, Beck Depression Inventory, patient's global assessment, investigator's global assessment scores, and tender point count as compared to the control group. The superiority of balneotherapy lasted up to the end of the 3rd month, except for the Beck Depression Inventory score and the investigator's global assessment score. Significant improvements were observed in PF, GH, and MH subscales of SF-36 during the study period in the balneotherapy group; however, no such improvement was observed in the control group. Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls. It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia. PMID:21461716

  11. Water Intake and Hydration Indices in Healthy European Adults: The European Hydration Research Study (EHRS)

    PubMed Central

    Malisova, Olga; Athanasatou, Adelais; Pepa, Alex; Husemann, Marlien; Domnik, Kirsten; Braun, Hans; Mora-Rodriguez, Ricardo; Ortega, Juan F.; Fernandez-Elias, Valentin E.; Kapsokefalou, Maria

    2016-01-01

    Hydration status is linked with health, wellness, and performance. We evaluated hydration status, water intake, and urine output for seven consecutive days in healthy adults. Volunteers living in Spain, Germany, or Greece (n = 573, 39 ± 12 years (51.1% males), 25.0 ± 4.6 kg/m2 BMI) participated in an eight-day study protocol. Total water intake was estimated from seven-day food and drink diaries. Hydration status was measured in urine samples collected over 24 h for seven days and in blood samples collected in fasting state on the mornings of days 1 and 8. Total daily water intake was 2.75 ± 1.01 L, water from beverages 2.10 ± 0.91 L, water from foods 0.66 ± 0.29 L. Urine parameters were: 24 h volume 1.65 ± 0.70 L, 24 h osmolality 631 ± 221 mOsmol/kg Η2Ο, 24 h specific gravity 1.017 ± 0.005, 24 h excretion of sodium 166.9 ± 54.7 mEq, 24 h excretion of potassium 72.4 ± 24.6 mEq, color chart 4.2 ± 1.4. Predictors for urine osmolality were age, country, gender, and BMI. Blood indices were: haemoglobin concentration 14.7 ± 1.7 g/dL, hematocrit 43% ± 4% and serum osmolality 294 ± 9 mOsmol/kg Η2Ο. Daily water intake was higher in summer (2.8 ± 1.02 L) than in winter (2.6 ± 0.98 L) (p = 0.019). Water intake was associated negatively with urine specific gravity, urine color, and urine sodium and potassium concentrations (p < 0.01). Applying urine osmolality cut-offs, approximately 60% of participants were euhydrated and 20% hyperhydrated or dehydrated. Most participants were euhydrated, but a substantial number of people (40%) deviated from a normal hydration level. PMID:27058557

  12. Water Intake and Hydration Indices in Healthy European Adults: The European Hydration Research Study (EHRS).

    PubMed

    Malisova, Olga; Athanasatou, Adelais; Pepa, Alex; Husemann, Marlien; Domnik, Kirsten; Braun, Hans; Mora-Rodriguez, Ricardo; Ortega, Juan F; Fernandez-Elias, Valentin E; Kapsokefalou, Maria

    2016-01-01

    Hydration status is linked with health, wellness, and performance. We evaluated hydration status, water intake, and urine output for seven consecutive days in healthy adults. Volunteers living in Spain, Germany, or Greece (n = 573, 39 ± 12 years (51.1% males), 25.0 ± 4.6 kg/m² BMI) participated in an eight-day study protocol. Total water intake was estimated from seven-day food and drink diaries. Hydration status was measured in urine samples collected over 24 h for seven days and in blood samples collected in fasting state on the mornings of days 1 and 8. Total daily water intake was 2.75 ± 1.01 L, water from beverages 2.10 ± 0.91 L, water from foods 0.66 ± 0.29 L. Urine parameters were: 24 h volume 1.65 ± 0.70 L, 24 h osmolality 631 ± 221 mOsmol/kg Η2Ο, 24 h specific gravity 1.017 ± 0.005, 24 h excretion of sodium 166.9 ± 54.7 mEq, 24 h excretion of potassium 72.4 ± 24.6 mEq, color chart 4.2 ± 1.4. Predictors for urine osmolality were age, country, gender, and BMI. Blood indices were: haemoglobin concentration 14.7 ± 1.7 g/dL, hematocrit 43% ± 4% and serum osmolality 294 ± 9 mOsmol/kg Η2Ο. Daily water intake was higher in summer (2.8 ± 1.02 L) than in winter (2.6 ± 0.98 L) (p = 0.019). Water intake was associated negatively with urine specific gravity, urine color, and urine sodium and potassium concentrations (p < 0.01). Applying urine osmolality cut-offs, approximately 60% of participants were euhydrated and 20% hyperhydrated or dehydrated. Most participants were euhydrated, but a substantial number of people (40%) deviated from a normal hydration level. PMID:27058557

  13. Humans cannot consciously generate random numbers sequences: Polemic study.

    PubMed

    Figurska, Małgorzata; Stańczyk, Maciej; Kulesza, Kamil

    2008-01-01

    It is widely believed, that randomness exists in Nature. In fact such an assumption underlies many scientific theories and is embedded in the foundations of quantum mechanics. Assuming that this hypothesis is valid one can use natural phenomena, like radioactive decay, to generate random numbers. Today, computers are capable of generating the so-called pseudorandom numbers. Such series of numbers are only seemingly random (bias in the randomness quality can be observed). Question whether people can produce random numbers, has been investigated by many scientists in the recent years. The paper "Humans can consciously generate random numbers sequences..." published recently in Medical Hypotheses made claims that were in many ways contrary to state of art; it also stated far-reaching hypotheses. So, we decided to repeat the experiments reported, with special care being taken of proper laboratory procedures. Here, we present the results and discuss possible implications in computer and other sciences. PMID:17888582

  14. Building Kindergartners’ Number Sense: A Randomized Controlled Study

    PubMed Central

    Jordan, Nancy C.; Glutting, Joseph; Dyson, Nancy; Hassinger-Das, Brenna; Irwin, Casey

    2015-01-01

    Math achievement in elementary school is mediated by performance and growth in number sense during kindergarten. The aim of the present study was to test the effectiveness of a targeted small group number sense intervention for high-risk kindergartners from low-income communities. Children were randomly assigned to one of three groups (n = 44 in each group): a number sense intervention group, a language intervention group, or a business as usual control group. Accounting for initial skill level in mathematical knowledge, children who received the number sense intervention performed better than controls at immediate post test, with meaningful effects on measures of number competencies and general math achievement. Many of the effects held eight weeks after the intervention was completed, suggesting that children internalized what they had learned. There were no differences between the language and control groups on any math-related measures. PMID:25866417

  15. Cognitive Behavioral Principles Within Group Mentoring: A Randomized Pilot Study

    PubMed Central

    JENT, JASON F.; NIEC, LARISSA N.

    2010-01-01

    This study evaluated the effectiveness of a group mentoring program that included components of empirically supported mentoring and cognitive behavioral techniques for children served at a community mental health center. Eighty-six 8- to 12-year-old children were randomly assigned to either group mentoring or a wait-list control group. Group mentoring significantly increased children’s reported social problem-solving skills and decreased parent-reported child externalizing and internalizing behavior problems after controlling for other concurrent mental health services. Attrition from the group mentoring program was notably low (7%) for children. The integration of a cognitive behavioral group mentoring program into children’s existing community mental health services may result in additional reductions in externalizing and internalizing behavior problems. PMID:20582243

  16. Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS).

    PubMed

    Matthis, C; Weber, U; O'Neill, T W; Raspe, H

    1998-01-01

    To study the association between vertebral deformities and subjective health outcome indicators, including back pain and disability, a cross-sectional survey with spinal radiographs and personal interviews was carried out in 36 study centres in 19 European countries on a total of 15,570 men and women aged 50-79 years (population-based stratified random samples). No interventions were done. The main outcome measures were the presence and intensity of current and previous back pain, functional capacity (ADL questionnaire) and overall subjective health. The presence and intensity of back pain and functional and health impairments varied within wide ranges with no obvious regional pattern. However, the associations between negative health outcomes and vertebral deformity were homogeneous between countries and between centres within countries. In logistic regression analyses weak but significant associations between the presence of vertebral deformities and various health indicators were demonstrated. The magnitude of the associations increased with severity and number of deformities. Compared with subjects without deformities those with low-grade deformities had no or only a weakly elevated risk for back pain, disability and impaired subjective health (odds ratios (OR) 1.2-1.3). The odds ratios increased for individuals with single severe deformities (OR 1.3-2.1) and were highest in those with multiple severe deformities (OR 1.7-4.2). The associations between vertebral deformities and negative health outcomes were stronger in men than in women. In this cross-sectional study radiologically assessed vertebral deformities were therefore weakly associated with both current and previous back pain as well as with functional and health impairments in both women and men. Multiple severe deformities were associated with severe and disabling back pain with stronger effects in men. PMID:10024907

  17. Recombinant Bile Salt-Stimulated Lipase in Preterm Infant Feeding: A Randomized Phase 3 Study

    PubMed Central

    Casper, Charlotte; Hascoet, Jean-Michel; Ertl, Tibor; Gadzinowski, Janusz S.; Carnielli, Virgilio; Rigo, Jacques; Lapillonne, Alexandre; Couce, María L.; Vågerö, Mårten; Palmgren, Ingrid; Timdahl, Kristina; Hernell, Olle

    2016-01-01

    Introduction Feeding strategies are critical for healthy growth in preterm infants. Bile salt-stimulated lipase (BSSL), present in human milk, is important for fat digestion and absorption but is inactivated during pasteurization and absent in formula. This study evaluated if recombinant human BSSL (rhBSSL) improves growth in preterm infants when added to formula or pasteurized breast milk. Patients and Methods LAIF (Lipase Added to Infant Feeding) was a randomized, double-blind, placebo-controlled phase 3 study in infants born before 32 weeks of gestation. The primary efficacy variable was growth velocity (g/kg/day) during 4 weeks intervention. Follow-up visits were at 3 and 12 months. The study was performed at 54 centers in 10 European countries. Results In total 415 patients were randomized (rhBSSL n = 207, placebo n = 208), 410 patients were analyzed (rhBSSL n = 206, placebo n = 204) and 365 patients were followed until 12 months. Overall, there was no significantly improved growth velocity during rhBSSL treatment compared to placebo (16.77 vs. 16.56 g/kg/day, estimated difference 0.21 g/kg/day, 95% CI [-0.40; 0.83]), nor were secondary endpoints met. However, in a predefined subgroup, small for gestational age infants, there was a significant effect on growth in favor of rhBSSL during treatment. The incidence of adverse events was higher in the rhBSSL group during treatment. Conclusions Although this study did not meet its primary endpoint, except in a subgroup of infants small for gestational age, and there was an imbalance in short-term safety, these data provide insights in nutrition, growth and development in preterm infants. Trial Registration ClinicalTrials.gov NCT01413581 PMID:27244221

  18. Randomized Study Combining Interferon & Glatiramer Acetate in Multiple Sclerosis

    PubMed Central

    Lublin, Fred D.; Cofield, Stacey S.; Cutter, Gary R.; Conwit, Robin; Narayana, Ponnada A.; Nelson, Flavia; Salter, Amber R.; Gustafson, Tarah; Wolinsky, Jerry S.

    2013-01-01

    Objective A double-blind, randomized, controlled study to determine if combined use of interferon beta-1a (IFN) 30ug IM weekly and glatiramer acetate (GA) 20mg daily is more efficacious than either agent alone in relapsing-remitting multiple sclerosis (RRMS). Methods 1008 participants were randomized and followed until the last participant enrolled completed 3 yrs. The primary endpoint was reduction in annualized relapse rate utilizing a strict definition of relapse. Secondary outcomes included time to confirmed disability, Multiple Sclerosis Functional Composite (MSFC) score and MRI metrics. Results Combination IFN + GA was not superior to the better of the single agents (GA) in risk of relapse. Both the combination therapy and GA were significantly better than IFN in reducing the risk of relapse. The Combination was not better than either agent alone in lessening confirmed EDSS progression or change in MSFC over 36 months. The combination was superior to either agent alone in reducing new lesion activity and accumulation of total lesion volumes. In a post hoc analysis, combination therapy resulted in a higher proportion of participants attaining disease activity free status (DAFS) compared to either single arm; driven by the MRI results. Interpretation Combining the two most commonly prescribed therapies for MS did not produce a significant clinical benefit over three years. An effect was seen on some MRI metrics. In a test of comparative efficacy, GA was superior to IFN in reducing the risk of exacerbation. The extension phase for CombiRx will address if the observed differences in MRI and DAFS findings predict later clinical differences. PMID:23424159

  19. Population-based geographic variations in DXA bone density in Europe: the EVOS Study. European Vertebral Osteoporosis.

    PubMed

    Lunt, M; Felsenberg, D; Adams, J; Benevolenskaya, L; Cannata, J; Dequeker, J; Dodenhof, C; Falch, J A; Johnell, O; Khaw, K T; Masaryk, P; Pols, H; Poor, G; Reid, D; Scheidt-Nave, C; Weber, K; Silman, A J; Reeve, J

    1997-01-01

    The purpose of this study was to investigate variations in bone density between 16 European populations, 13 of which were participants in the European Vertebral Osteoporosis Study (EVOS). Men and women aged 50-80 years were recruited randomly from local population registers, stratified in 5-year age bands. The other three centres recruited similarly. Random samples of 20-100% of EVOS subjects were invited for dual-energy X-ray absorptiometry (DXA) densitometry of the lumbar spine and/or proximal femur using Hologic, Lunar or Norland pencil beam machines or, in one centre, a Sopha fan-beam machine. Cross-calibration of the different machines was undertaken using the European Spine Phantom prototype (ESPp). Highly significant differences in mean bone density were demonstrated between centres, giving rise to between centre SDs in bone density that were about a quarter of a population SD. These differences persisted when centres using Hologic machines and centres using Lunar machines were considered separately. The centres were ranked differently according to whether male or female subjects were being considered and according to site of measurement (L2-4, femoral neck or femoral trochanter). As expected, bone mineral density (BMD) had a curvilinear relationship with age, and apparent rates of decrease slowed as age advanced past 50 years in both sexes. In the spine, not only did male BMD usually appear to increase with age, but there was a highly significant difference between centres in the age effect in both sexes, suggesting a variability in the impact of osteoarthritis between centres. Weight was consistently positively associated with BMD, but the effects of height and armspan were less consistent. Logarithmic transformation was needed to normalize the regressions of BMD on the independent variates, and after transformation, all sites except the femoral neck in females showed significant increases in SD with age. Interestingly, the effect of increasing weight was

  20. Non-fatal injuries in three Central and Eastern European urban population samples: the HAPIEE study

    PubMed Central

    Pikhart, Hynek; Pajak, Andrzej; Kubinova, Ruzena; Malyutina, Sofia; Peasey, Anne; Topor-Madry, Roman; Nikitin, Yuri; Marmot, Michael; Bobak, Martin

    2010-01-01

    Background: Despite high mortality from injuries and accidents, data on rates and distribution of non-fatal injuries in Central and Eastern European populations are scarce. Methods: Cross-sectional study of random population samples of 45–69-year-old men and women (n = 28 600) from Novosibirsk (Russia), Krakow (Poland) and six Czech towns, participating in the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study. Participants provided information on non-fatal injuries in the past 12 months, socio-economic characteristics, alcohol consumption and other covariates. Results: The period prevalence of non-fatal injuries in the last year among Czech, Russian and Polish men was 12.5, 9.4 and 5.3%, respectively; among women, the respective proportions were 9.9, 9.8 and 6.4%. Injury prevalence declined with age in men and increased with age in women. Higher injury prevalence was associated with being unmarried, material deprivation, higher drinking frequency and problem drinking. In the pooled data, the adjusted odds ratio (OR) for the highest versus lowest material deprivation category was 1.57 [95% confidence interval (CI) 1.38–1.79]; for problem drinking, the OR was 1.44 (95% CI 1.23–1.69). Alcohol did not mediate the link between socio-economic status and injury. Conclusion: Non-fatal injuries were associated with material deprivation, other socio-economic characteristics and with alcohol. These results not only underscore the universality of the inequality phenomenon, but also suggest that the mediating role of alcohol in social differentials in non-fatal injury remains an unresolved issue. PMID:19959615

  1. Body mass index and psychiatric disorders: a Mendelian randomization study

    PubMed Central

    Hartwig, Fernando Pires; Bowden, Jack; Loret de Mola, Christian; Tovo-Rodrigues, Luciana; Davey Smith, George; Horta, Bernardo Lessa

    2016-01-01

    Obesity is a highly prevalent risk factor for cardiometabolic diseases. Observational studies suggest that obesity is associated with psychiatric traits, but causal inference from such studies has several limitations. We used two-sample Mendelian randomization methods (inverse variance weighting, weighted median and MR-Egger regression) to evaluate the association of body mass index (BMI) with three psychiatric traits using data from the Genetic Investigation of Anthropometric Traits and Psychiatric Genomics consortia. Causal odds ratio estimates per 1-standard deviation increment in BMI ranged from 0.88 (95% CI: 0.62; 1.25) to 1.23 (95% CI: 0.65; 2.31) for bipolar disorder; 0.93 (0.78; 1.11) to 1.41 (0.87; 2.27) for schizophrenia; and 1.15 (95% CI: 0.92; 1.44) to 1.40 (95% CI: 1.03; 1.90) for major depressive disorder. Analyses removing potentially influential SNPs suggested that the effect estimates for depression might be underestimated. Our findings do not support the notion that higher BMI increases risk of bipolar disorder and schizophrenia. Although the point estimates for depression were consistent in all sensitivity analyses, the overall statistical evidence was weak. However, the fact that SNP-depression associations were estimated in relatively small samples reduced power to detect causal effects. This should be re-addressed when SNP-depression associations from larger studies become available. PMID:27601421

  2. Body mass index and psychiatric disorders: a Mendelian randomization study.

    PubMed

    Hartwig, Fernando Pires; Bowden, Jack; Loret de Mola, Christian; Tovo-Rodrigues, Luciana; Davey Smith, George; Horta, Bernardo Lessa

    2016-01-01

    Obesity is a highly prevalent risk factor for cardiometabolic diseases. Observational studies suggest that obesity is associated with psychiatric traits, but causal inference from such studies has several limitations. We used two-sample Mendelian randomization methods (inverse variance weighting, weighted median and MR-Egger regression) to evaluate the association of body mass index (BMI) with three psychiatric traits using data from the Genetic Investigation of Anthropometric Traits and Psychiatric Genomics consortia. Causal odds ratio estimates per 1-standard deviation increment in BMI ranged from 0.88 (95% CI: 0.62; 1.25) to 1.23 (95% CI: 0.65; 2.31) for bipolar disorder; 0.93 (0.78; 1.11) to 1.41 (0.87; 2.27) for schizophrenia; and 1.15 (95% CI: 0.92; 1.44) to 1.40 (95% CI: 1.03; 1.90) for major depressive disorder. Analyses removing potentially influential SNPs suggested that the effect estimates for depression might be underestimated. Our findings do not support the notion that higher BMI increases risk of bipolar disorder and schizophrenia. Although the point estimates for depression were consistent in all sensitivity analyses, the overall statistical evidence was weak. However, the fact that SNP-depression associations were estimated in relatively small samples reduced power to detect causal effects. This should be re-addressed when SNP-depression associations from larger studies become available. PMID:27601421

  3. Long-term particulate matter exposure and mortality: a review of European epidemiological studies

    PubMed Central

    2009-01-01

    Background Several studies considered the relation between long-term exposure to particulate matter (PM) and total mortality, as well as mortality from cardiovascular and respiratory diseases. Our aim was to provide a comprehensive review of European epidemiological studies on the issue. Methods We searched the Medline database for epidemiological studies on air pollution and health outcomes published between January 2002 and December 2007. We also examined the reference lists of individual papers and reviews. Two independent reviewers classified the studies according to type of air pollutant, duration of exposure and health outcome considered. Among European investigations that examined long-term PM exposure we found 4 cohort studies (considering total and cardiopulmonary mortality), 1 case-control study (considering mortality from myocardial infarction), and 4 ecologic studies (2 studies considering total and cardiopulmonary mortality and 2 studies focused on cardiovascular mortality). Results Measurement indicators of PM exposure used in European studies, including PM10, PM2.5, total suspended particulate and black smoke, were heterogeneous. This notwithstanding, in all analytic studies total mortality was directly associated with long-term exposure to PM. The excesses in mortality were mainly due to cardiovascular and respiratory causes. Three out of 4 ecologic studies found significant direct associations between PM indexes and mortality. Conclusion European studies on long-term exposure to PM indicate a direct association with mortality, particularly from cardiovascular and respiratory diseases. PMID:19995424

  4. Evaluation of exposure parameters in plain radiography: a comparative study with European guidelines.

    PubMed

    Lança, L; Silva, A; Alves, E; Serranheira, F; Correia, M

    2008-01-01

    Typical distribution of exposure parameters in plain radiography is unknown in Portugal. This study aims to identify exposure parameters that are being used in plain radiography in the Lisbon area and to compare the collected data with European references [Commission of European Communities (CEC) guidelines]. The results show that in four examinations (skull, chest, lumbar spine and pelvis), there is a strong tendency of using exposure times above the European recommendation. The X-ray tube potential values (in kV) are below the recommended values from CEC guidelines. This study shows that at a local level (Lisbon region), radiographic practice does not comply with CEC guidelines concerning exposure techniques. Further national/local studies are recommended with the objective to improve exposure optimisation and technical procedures in plain radiography. This study also suggests the need to establish national/local diagnostic reference levels and to proceed to effective measurements for exposure optimisation. PMID:18430717

  5. [Randomized field study of the etiology of strabismus concomitans].

    PubMed

    Aichmair, H; Grossmann, W; Aichmair, M; Bomze, I; Fröschl, K; Futschik, A; Theyer, I; Hirmann, E; Kautzky, I; Hafner, J

    1992-01-01

    After an introduction to the problems of binocular vision and an overview of the literature, the authors report on the reasons for undertaking this study and on its practical implications. Up to now, no other randomized study has been undertaken to our knowledge on children of this age group in such a large city as Vienna. All children in primary 3 classes in 20 out of the 256 elementary schools were examined ophthalmologically and orthoptically. It was found that hereditary factors are of statistically significant importance. Especially important for the ophthalmologist is also the statistically significant relation between the diagnosis poor range of fusion, poor fixation, incorrect Worth test for distance and/or proximity, and poor or lacking stereoscopic vision with the occurrence of strabism. The authors were astonished to find a remarkably high percentage of exophoria (58%), in contrast to esophoria (16%). It is interesting for prophylaxis and therapy that children originating from families where spectacles are worn, acted more cooperatively and tended to take the orders of the physician more seriously than those coming from families without eye problems. The promotion of genetic research related to squint and more counselling for couples wishing to have children or confronted with risk factor problems would be desirable, as well as the inclusion of more obligatory ophthalmological examinations in the mother-child medical "passport". PMID:1441555

  6. Inspiratory Resistance Improves Postural Tachycardia: A Randomized Study

    PubMed Central

    Gamboa, Alfredo; Paranjape, Sachin Y.; Black, Bonnie K.; Arnold, Amy C.; Figueroa, Rocío; Okamoto, Luis E.; Nwazue, Victor C.; Diedrich, Andre; Plummer, W. Dale; Dupont, William D.; Robertson, David; Raj, Satish R.

    2015-01-01

    Background The objective of this study is to determine the effect of inspiratory resistance through an impedance threshold device (ITD) on orthostatic tolerance in patients with postural tachycardia syndrome (POTS). We hypothesized that the ITD would result in greater negative intrathoracic pressure to enhance cardiac venous return, improve stroke volume, and reduce heart rate in these patients. Methods and Results We compared the effect of a sham device (sham, no resistance) versus an ITD (increased inspiratory resistance), in 26 POTS patients in a randomized, single-blind, crossover study. Hemodynamic assessments were performed at baseline while supine and during head-up tilt (HUT) to 70 degrees for 10 minutes. We did not find differences in baseline hemodynamic parameters between the ITD and sham devices. After 10 minutes of HUT, the heart rate was lower with the ITD versus sham device (102±4 versus 109±4 beat/min, respectively; p=0.003). The ITD also improved stroke volume compared with the sham device (35±2 versus 26±1 mL, p=0.006). Conclusions These findings suggest that increasing negative intrathoracic pressure with ITD breathing improves heart rate control in POTS patients during upright posture. PMID:25792354

  7. A Mendelian randomization study of testosterone and cognition in men

    PubMed Central

    Zhao, Jie V.; Lam, Tai Hing; Jiang, Chaoqiang; Cherny, Stacey S.; Liu, Bin; Cheng, Kar Keung; Zhang, Weisen; Leung, Gabriel M.; Schooling, C Mary

    2016-01-01

    Testosterone replacement for older men is increasingly common, with some observations suggesting a protective effect on cognitive function. We examined the association of endogenous testosterone with cognitive function among older men in a Mendelian randomization study using a separate-sample instrumental variable (SSIV) analysis estimator to minimize confounding and reverse causality. A genetic score predicting testosterone was developed in 289 young Chinese men from Hong Kong, based on selected testosterone-related single nucleotide polymorphisms (rs10046, rs1008805 and rs1256031). The association of genetically predicted testosterone with delayed 10-word recall score and Mini-Mental State Examination (MMSE) score was assessed at baseline and follow-up using generalized estimating equation among 4,212 older Chinese men from the Guangzhou Biobank Cohort Study. Predicted testosterone was not associated with delayed 10-word recall score (−0.02 per nmol/L testosterone, 95% confidence interval (CI) −0.06–0.02) or MMSE score (0.06, 95% CI −0.002–0.12). These estimates were similar after additional adjustment for age, education, smoking, use of alcohol, body mass index and the Framingham score. Our findings do not corroborate observed protective effects of testosterone on cognitive function among older men. PMID:26864717

  8. European adults' physical activity socio-demographic correlates: a cross-sectional study from the European Social Survey.

    PubMed

    Marques, Adilson; Martins, João; Peralta, Miguel; Catunda, Ricardo; Nunes, Luís Saboga

    2016-01-01

    Background. From a public health perspective, the study of socio-demographic factors related to physical activity is important in order to identify subgroups for intervention programs. Objective. This study aimed to identify the prevalence of, and the socio-demographic correlates related to, the achievement of recommended physical activity levels. Methods. Using data from the European Social Survey round 6, physical activity and socio-demographic characteristics were collected, in 2012, from 39,278 European adults (18,272 men, 21,006 women), aged 18-65 years, from 28 countries. The question of meeting physical activity guidelines was assessed using World Health Organization criteria. Results. A total of 64.50% (63.36% men, 66.49% women) attained physical activity recommended levels. The likelihood of attaining physical activity recommendations was higher in the 55-64 years age group (men: OR = 1.22, p < 0.05; women: OR = 1.66, p < 0.001), among those who had secondary education (men: OR = 1.28, p < 0.01; women: OR = 1.26, p < 0.05), among those who lived in rural areas (men: OR = 1.20, p < 0.001; women: OR = 1.10, p < 0.05), and among those who had three or more people living at home (men: OR = 1.40, p < 0.001; women: OR = 1.43, p < 0.001). On the other hand, attaining physical activity recommendations was negatively associated with being unemployed (men: OR = 0.70, p < 0.001; women: OR = 0.87, p < 0.05), being a student (OR = 0.56, p < 0.001; women: OR = 0.64, p < 0.01), being a retired person (men: OR = 0.86, p < 0.05) and with having a higher household income (OR = 0.80, p < 0.001; women: OR = 0.81, p < 0.01). Conclusions. This research helped clarify that, as the promotion of physical activity is critical to sustain health and prevent disease, socio-demographic factors are important to consider when planning the increase of physical activity. PMID:27280072

  9. European adults’ physical activity socio-demographic correlates: a cross-sectional study from the European Social Survey

    PubMed Central

    Martins, João; Peralta, Miguel; Catunda, Ricardo; Nunes, Luís Saboga

    2016-01-01

    Background. From a public health perspective, the study of socio-demographic factors related to physical activity is important in order to identify subgroups for intervention programs. Objective. This study aimed to identify the prevalence of, and the socio-demographic correlates related to, the achievement of recommended physical activity levels. Methods. Using data from the European Social Survey round 6, physical activity and socio-demographic characteristics were collected, in 2012, from 39,278 European adults (18,272 men, 21,006 women), aged 18–65 years, from 28 countries. The question of meeting physical activity guidelines was assessed using World Health Organization criteria. Results. A total of 64.50% (63.36% men, 66.49% women) attained physical activity recommended levels. The likelihood of attaining physical activity recommendations was higher in the 55–64 years age group (men: OR = 1.22, p < 0.05; women: OR = 1.66, p < 0.001), among those who had secondary education (men: OR = 1.28, p < 0.01; women: OR = 1.26, p < 0.05), among those who lived in rural areas (men: OR = 1.20, p < 0.001; women: OR = 1.10, p < 0.05), and among those who had three or more people living at home (men: OR = 1.40, p < 0.001; women: OR = 1.43, p < 0.001). On the other hand, attaining physical activity recommendations was negatively associated with being unemployed (men: OR = 0.70, p < 0.001; women: OR = 0.87, p < 0.05), being a student (OR = 0.56, p < 0.001; women: OR = 0.64, p < 0.01), being a retired person (men: OR = 0.86, p < 0.05) and with having a higher household income (OR = 0.80, p < 0.001; women: OR = 0.81, p < 0.01). Conclusions. This research helped clarify that, as the promotion of physical activity is critical to sustain health and prevent disease, socio-demographic factors are important to consider when planning the increase of physical activity. PMID:27280072

  10. Levodopa and executive performance in Parkinson's disease: a randomized study.

    PubMed

    Pascual-Sedano, Berta; Kulisevsky, Jaime; Barbanoj, Manel; García-Sánchez, Carmen; Campolongo, Antonia; Gironell, Alexandre; Pagonabarraga, Javier; Gich, Ignasi

    2008-09-01

    Parkinson's disease (PD) patients may experience fluctuations in executive performance after oral levodopa (LD). Their relationship with the pharmacokinetic profile of LD and with distinct cognitive processes associated with frontal-basal ganglia circuits is not well understood. In this randomized, double-blind, crossover study we plotted acute cognitive changes in 14 PD patients challenged with faster (immediate-release, IR) versus slower (controlled-release, CR) increases in LD plasma concentrations. We monitored motor status, LD plasma levels, and performance on four tasks of executive function (Wisconsin Card Sorting Test-WCST, Sternberg test, Stroop and Tower of Hanoi), 1 hr before and over +6 hr after IR and CR-LD dose. Analysis of variance demonstrated significant but divergent changes in the Sternberg (6-digit but not 2- and 4-digit) test: improvement after CR-LD and worsening after IR-LD. Marginal improvement (p = .085) was observed with CR-LD in the WCST, while no significant differences were seen for the Stroop or Tower of Hanoi tests. Executive-related performance after LD challenge may differ depending on the LD time-to-peak plasma concentration and specific task demands. A slower rise in LD levels appears to have a more favorable impact on more difficult working memory tests. These results require replication to determine their generalization. PMID:18764978

  11. Microbiota-based Signature of Gingivitis Treatments: A Randomized Study

    PubMed Central

    Huang, Shi; Li, Zhen; He, Tao; Bo, Cunpei; Chang, Jinlan; Li, Lin; He, Yanyan; Liu, Jiquan; Charbonneau, Duane; Li, Rui; Xu, Jian

    2016-01-01

    Plaque-induced gingivitis can be alleviated by various treatment regimens. To probe the impacts of various anti-gingivitis treatments on plaque microflora, here a double blinded, randomized controlled trial of 91 adults with moderate gingivitis was designed with two anti-gingivitis regimens: the brush-alone treatment and the brush-plus-rinse treatment. In the later group, more reduction in both Plaque Index (TMQHI) and Gingival Index (mean MGI) at Day 3, Day 11 and Day 27 was evident, and more dramatic changes were found between baseline and other time points for both supragingival plaque microbiota structure and salivary metabonomic profiles. A comparison of plaque microbiota changes was also performed between these two treatments and a third dataset where 50 subjects received regimen of dental scaling. Only Actinobaculum, TM7 and Leptotrichia were consistently reduced by all the three treatments, whereas the different microbial signatures of the three treatments during gingivitis relieve indicate distinct mechanisms of action. Our study suggests that microbiota based signatures can serve as a valuable approach for understanding and potentially comparing the modes of action for clinical treatments and oral-care products in the future. PMID:27094556

  12. Microbiota-based Signature of Gingivitis Treatments: A Randomized Study.

    PubMed

    Huang, Shi; Li, Zhen; He, Tao; Bo, Cunpei; Chang, Jinlan; Li, Lin; He, Yanyan; Liu, Jiquan; Charbonneau, Duane; Li, Rui; Xu, Jian

    2016-01-01

    Plaque-induced gingivitis can be alleviated by various treatment regimens. To probe the impacts of various anti-gingivitis treatments on plaque microflora, here a double blinded, randomized controlled trial of 91 adults with moderate gingivitis was designed with two anti-gingivitis regimens: the brush-alone treatment and the brush-plus-rinse treatment. In the later group, more reduction in both Plaque Index (TMQHI) and Gingival Index (mean MGI) at Day 3, Day 11 and Day 27 was evident, and more dramatic changes were found between baseline and other time points for both supragingival plaque microbiota structure and salivary metabonomic profiles. A comparison of plaque microbiota changes was also performed between these two treatments and a third dataset where 50 subjects received regimen of dental scaling. Only Actinobaculum, TM7 and Leptotrichia were consistently reduced by all the three treatments, whereas the different microbial signatures of the three treatments during gingivitis relieve indicate distinct mechanisms of action. Our study suggests that microbiota based signatures can serve as a valuable approach for understanding and potentially comparing the modes of action for clinical treatments and oral-care products in the future. PMID:27094556

  13. Mendelian randomization study of height and risk of colorectal cancer

    PubMed Central

    Thrift, Aaron P; Gong, Jian; Peters, Ulrike; Chang-Claude, Jenny; Rudolph, Anja; Slattery, Martha L; Chan, Andrew T; Esko, Tonu; Wood, Andrew R; Yang, Jian; Vedantam, Sailaja; Gustafsson, Stefan; Pers, Tune H; Baron, John A; Bezieau, Stéphane; Küry, Sébastien; Ogino, Shuji; Berndt, Sonja I; Casey, Graham; Haile, Robert W; Du, Mengmeng; Harrison, Tabitha A; Thornquist, Mark; Duggan, David J; Le Marchand, Loic; Lemire, Mathieu; Lindor, Noralane M; Seminara, Daniela; Song, Mingyang; Thibodeau, Stephen N; Cotterchio, Michelle; Win, Aung Ko; Jenkins, Mark A; Hopper, John L; Ulrich, Cornelia M; Potter, John D; Newcomb, Polly A; Schoen, Robert E; Hoffmeister, Michael; Brenner, Hermann; White, Emily; Hsu, Li; Campbell, Peter T

    2015-01-01

    Background: For men and women, taller height is associated with increased risk of all cancers combined. For colorectal cancer (CRC), it is unclear whether the differential association of height by sex is real or is due to confounding or bias inherent in observational studies. We performed a Mendelian randomization study to examine the association between height and CRC risk. Methods: To minimize confounding and bias, we derived a weighted genetic risk score predicting height (using 696 genetic variants associated with height) in 10 226 CRC cases and 10 286 controls. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for associations between height, genetically predicted height and CRC. Results: Using conventional methods, increased height (per 10-cm increment) was associated with increased CRC risk (OR = 1.08, 95% CI = 1.02–1.15). In sex-specific analyses, height was associated with CRC risk for women (OR = 1.15, 95% CI = 1.05–1.26), but not men (OR = 0.98, 95% CI = 0.92–1.05). Consistent with these results, carrying greater numbers of (weighted) height-increasing alleles (per 1-unit increase) was associated with higher CRC risk for women and men combined (OR = 1.07, 95% CI = 1.01–1.14) and for women (OR = 1.09, 95% CI = 1.01–1.19). There was weaker evidence of an association for men (OR = 1.05, 95% CI = 0.96–1.15). Conclusion: We provide evidence for a causal association between height and CRC for women. The CRC-height association for men remains unclear and warrants further investigation in other large studies. PMID:25997436

  14. The Statistical Power of the Cluster Randomized Block Design with Matched Pairs--A Simulation Study

    ERIC Educational Resources Information Center

    Dong, Nianbo; Lipsey, Mark

    2010-01-01

    This study uses simulation techniques to examine the statistical power of the group- randomized design and the matched-pair (MP) randomized block design under various parameter combinations. Both nearest neighbor matching and random matching are used for the MP design. The power of each design for any parameter combination was calculated from…

  15. Housing and Health in Europe: Preliminary Results of a Pan-European Study

    PubMed Central

    Bonnefoy, Xavier R.; Braubach, Matthias; Moissonnier, Brigitte; Monolbaev, Kubanychbek; Röbbel, Nathalie

    2003-01-01

    Objectives. The World Health Organization’s Regional Office for Europe has undertaken a large study to evaluate housing and health in 7 European cities. Methods. Survey tools were used to obtain information about housing and living conditions, health perception, and health status from a representative sample of the population in each city. Results. In Forli, Italy, the first city studied, preliminary findings indicate some important potential links between housing and health. Conclusions. These findings, when combined with those from the remaining European cities, will likely generate concrete recommendations for the allocation of resources to programs that can improve housing and health. PMID:12948980

  16. The European Research Elite: A Cross-National Study of Highly Productive Academics in 11 Countries

    ERIC Educational Resources Information Center

    Kwiek, Marek

    2016-01-01

    In this paper, we focus on a rare scholarly theme of highly productive academics, statistically confirming their pivotal role in knowledge production across 11 systems studied. The upper 10% of highly productive academics in 11 European countries studied (N = 17,211) provide on average almost half of all academic knowledge production. In contrast…

  17. Executive Coaching: Study of the Evolution of the Program at a Top European Business School

    ERIC Educational Resources Information Center

    Kim, Hyun Jung

    2011-01-01

    To understand how tensions caused by the multidisciplinary nature of executive coaching are perceived and overcome, this modified ethnographic study was conducted at an executive coaching program and leadership center at a prestigious European business school. This study is built on prolonged discussions on the role of psychology in executive…

  18. Maternal and infant health of Eastern Europeans in Bradford, UK: a qualitative study.

    PubMed

    Richards, Jessica; Kliner, Merav; Brierley, Shirley; Stroud, Laura

    2014-09-01

    This qualitative study aimed to investigate maternal and infant health needs within Eastern European populations in Bradford. Evidence suggested that migrants from Eastern Europe had poor maternal and child health and increased rates of infant mortality. Health visitors, community midwives and specialist voluntary workers were involved. Eleven interviews took place. They were semi-structured and analysed using a thematic approach. A number of health needs were identified in Eastern European populations, including high rates of smoking and poor diet. Wider determinants of health such as poverty and poor housing were cited as commonplace for Eastern European migrants. There were numerous cultural barriers to health, such as discrimination, mobility, cultural practices regarding age at pregnancy, and disempowerment of women. Lastly, access to health services was identified as a significant issue and this was impacting on staff working with this population. This study demonstrated the complexity and interaction of health and social factors and their influence on utilisation of health services. PMID:25286741

  19. European Space Agency studies of the solar probe

    NASA Technical Reports Server (NTRS)

    Roxburgh, I. W.

    1978-01-01

    The feasibility and scientific objectives of a solar probe were studied by a Mission Definition Group in 1975 and 1976. The orbit analysis program was developed and an extended study of the orbit analysis was done in 1977. The results of these studies are in the Report of the Mission Definition Study (1976) and an E.S.O.C. report (1978), and the reader is referred to these sources for greater details. In this report, only brief discussion on mission concept and objectives, satellite design, orbit, orbit analysis, are presented.

  20. Alcohol Use among Abused and Non-Abused Older Persons Aged 60-84 Years: An European Study

    ERIC Educational Resources Information Center

    Tredal, Ingrid; Soares, Joaquim J. F.; Sundin, Orjan; Viitasara, Eija; Melchiorre, Maria Gabriella; Torres-Gonzales, Francisco; Stankunas, Mindaugas; Lindert, Jutta; Ioannidi-Kapolou, Elisabeth; Barros, Henrique

    2013-01-01

    Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with…

  1. Generalization and dilution of association results from European GWAS in populations of non-European ancestry: the PAGE study.

    PubMed

    Carlson, Christopher S; Matise, Tara C; North, Kari E; Haiman, Christopher A; Fesinmeyer, Megan D; Buyske, Steven; Schumacher, Fredrick R; Peters, Ulrike; Franceschini, Nora; Ritchie, Marylyn D; Duggan, David J; Spencer, Kylee L; Dumitrescu, Logan; Eaton, Charles B; Thomas, Fridtjof; Young, Alicia; Carty, Cara; Heiss, Gerardo; Le Marchand, Loic; Crawford, Dana C; Hindorff, Lucia A; Kooperberg, Charles L

    2013-09-01

    The vast majority of genome-wide association study (GWAS) findings reported to date are from populations with European Ancestry (EA), and it is not yet clear how broadly the genetic associations described will generalize to populations of diverse ancestry. The Population Architecture Using Genomics and Epidemiology (PAGE) study is a consortium of multi-ancestry, population-based studies formed with the objective of refining our understanding of the genetic architecture of common traits emerging from GWAS. In the present analysis of five common diseases and traits, including body mass index, type 2 diabetes, and lipid levels, we compare direction and magnitude of effects for GWAS-identified variants in multiple non-EA populations against EA findings. We demonstrate that, in all populations analyzed, a significant majority of GWAS-identified variants have allelic associations in the same direction as in EA, with none showing a statistically significant effect in the opposite direction, after adjustment for multiple testing. However, 25% of tagSNPs identified in EA GWAS have significantly different effect sizes in at least one non-EA population, and these differential effects were most frequent in African Americans where all differential effects were diluted toward the null. We demonstrate that differential LD between tagSNPs and functional variants within populations contributes significantly to dilute effect sizes in this population. Although most variants identified from GWAS in EA populations generalize to all non-EA populations assessed, genetic models derived from GWAS findings in EA may generate spurious results in non-EA populations due to differential effect sizes. Regardless of the origin of the differential effects, caution should be exercised in applying any genetic risk prediction model based on tagSNPs outside of the ancestry group in which it was derived. Models based directly on functional variation may generalize more robustly, but the identification

  2. Medication use in European primary care patients with lower respiratory tract infection: an observational study

    PubMed Central

    Hamoen, Marleen; Broekhuizen, Berna DL; Little, Paul; Melbye, Hasse; Coenen, Samuel; Goossens, Herman; Butler, Chris C; Francis, Nick A; Verheij, Theo JM

    2014-01-01

    Background It is largely unknown what medication is used by patients with lower respiratory tract infection (LRTI). Aim To describe the use of self-medication and prescribed medication in adults presenting with LRTI in different European countries, and to relate self-medication to patient characteristics. Design and setting An observational study in 16 primary care networks in 12 European countries. Method A total of 2530 adult patients presenting with LRTI in 12 European countries filled in a diary on any medication used before and after a primary care consultation. Patient characteristics related to self-medication were determined by univariable and multivariable logistic regression analysis. Results The frequency and types of medication used differed greatly between European countries. Overall, 55.4% self-medicated before consultation, and 21.5% after consultation, most frequently with paracetamol, antitussives, and mucolytics. Females, non-smokers, and patients with more severe symptoms used more self-medication. Patients who were not prescribed medication during the consultation self-medicated more often afterwards. Self-medication with antibiotics was relatively rare. Conclusion A considerable amount of medication, often with no proven efficacy, was used by adults presenting with LRTI in primary care. There were large differences between European countries. These findings should help develop patient information resources, international guidelines, and international legislation concerning the availability of over-the-counter medication, and can also support interventions against unwarranted variations in care. In addition, further research on the effects of symptomatic medication is needed. PMID:24567621

  3. Conditions for Valid Empirical Estimates of Cancer Overdiagnosis in Randomized Trials and Population Studies.

    PubMed

    Gulati, Roman; Feuer, Eric J; Etzioni, Ruth

    2016-07-15

    Cancer overdiagnosis is frequently estimated using the excess incidence in a screened group relative to that in an unscreened group. However, conditions for unbiased estimation are poorly understood. We developed a mathematical framework to project the effects of screening on the incidence of relevant cancers-that is, cancers that would present clinically without screening. Screening advances the date of diagnosis for a fraction of preclinical relevant cancers. Which diagnoses are advanced and by how much depends on the preclinical detectable period, test sensitivity, and screening patterns. Using the model, we projected incidence in common trial designs and population settings and compared excess incidence with true overdiagnosis. In trials with no control arm screening, unbiased estimates are available using cumulative incidence if the screen arm stops screening and using annual incidence if the screen arm continues screening. In both designs, unbiased estimation requires waiting until screening stabilizes plus the maximum preclinical period. In continued-screen trials and population settings, excess cumulative incidence is persistently biased. We investigated this bias in published estimates from the European Randomized Study of Screening for Prostate Cancer after 9-13 years. In conclusion, no trial or population setting automatically permits unbiased estimation of overdiagnosis; sufficient follow-up and appropriate analysis remain crucial. PMID:27358266

  4. Uric Acid and Cardiovascular Events: A Mendelian Randomization Study.

    PubMed

    Kleber, Marcus E; Delgado, Graciela; Grammer, Tanja B; Silbernagel, Günther; Huang, Jie; Krämer, Bernhard K; Ritz, Eberhard; März, Winfried

    2015-11-01

    Obesity and diets rich in uric acid-raising components appear to account for the increased prevalence of hyperuricemia in Westernized populations. Prevalence rates of hypertension, diabetes mellitus, CKD, and cardiovascular disease are also increasing. We used Mendelian randomization to examine whether uric acid is an independent and causal cardiovascular risk factor. Serum uric acid was measured in 3315 patients of the Ludwigshafen Risk and Cardiovascular Health Study. We calculated a weighted genetic risk score (GRS) for uric acid concentration based on eight uric acid-regulating single nucleotide polymorphisms. Causal odds ratios and causal hazard ratios (HRs) were calculated using a two-stage regression estimate with the GRS as the instrumental variable to examine associations with cardiometabolic phenotypes (cross-sectional) and mortality (prospectively) by logistic regression and Cox regression, respectively. Our GRS was not consistently associated with any biochemical marker except for uric acid, arguing against pleiotropy. Uric acid was associated with a range of prevalent diseases, including coronary artery disease. Uric acid and the GRS were both associated with cardiovascular death and sudden cardiac death. In a multivariate model adjusted for factors including medication, causal HRs corresponding to each 1-mg/dl increase in genetically predicted uric acid concentration were significant for cardiovascular death (HR, 1.77; 95% confidence interval, 1.12 to 2.81) and sudden cardiac death (HR, 2.41; 95% confidence interval, 1.16 to 5.00). These results suggest that high uric acid is causally related to adverse cardiovascular outcomes, especially sudden cardiac death. PMID:25788527

  5. A randomized study of reinforcing ambulatory exercise in older adults

    PubMed Central

    Petry, Nancy M.; Andrade, Leonardo F.; Barry, Danielle; Byrne, Shannon

    2014-01-01

    Many older adults do not meet physical activity recommendations and suffer from health-related complications. Reinforcement interventions can have pronounced effects on promoting behavior change; this study evaluated the efficacy of a reinforcement intervention to enhance walking in older adults. Forty-five sedentary adults with mild to moderate hypertension were randomized to 12-week interventions consisting of pedometers and guidelines to walk 10,000 steps/day or that same intervention with chances to win $1-$100 prizes for meeting recommendations. Patients walked an average of about 4,000 steps/day at baseline. Throughout the intervention, participants in the reinforcement intervention met walking goals on 82.5% ± 25.8% of days versus 55.3% ± 37.1% of days in the control condition, p < .01. Even though steps walked increased significantly in both groups relative to baseline, participants in the reinforcement condition walked an average of about 2,000 more steps/day than participants in the control condition, p < .02. Beneficial effects of the reinforcement condition relative to the control condition persisted at a 24-week follow-up evaluation, p < .02, although steps/day were lower than during the intervention period in both groups. Participants in the reinforcement intervention also evidenced greater reductions in blood pressure and weight over time and improvements in fitness indices, ps < .05. This reinforcement-based intervention substantially increased walking and improved clinical parameters, suggesting that larger-scale evaluations of reinforcement-based interventions for enhancing active lifestyles in older adults are warranted. Ultimately, economic analyses may reveal reinforcement interventions to be cost-effective, especially in high-risk populations of older adults. PMID:24128075

  6. The Deckled Incision: Study Protocol for a Randomized Controlled Trial

    PubMed Central

    Lord, Sarah J; Ngo, Quan

    2016-01-01

    Background Scar visibility is multifactorial and skin closure technique is thought to play an important role. It is an established principle in plastic surgery that Z plasties generally reduce scar contracture by breaking up the lines of tension in a wound. As an extension of this principle, it is postulated that irregular “deckled” skin incisions made during tumor excision would produce aesthetically superior scars. Objective The primary objective of this study is to assess both the clinician and patient opinion of scar quality using the Patient and Observer Scar Assessment Scale (POSAS). Secondary objectives include the proportion of scars judged as good by the both the patient and clinician (less than or equal to 5 on the overall PSOAS scale), the number of adverse events, and the proportion of the scar visible at 1 meter. Methods The deckling study will be a patient-blinded, simple randomized controlled trial (RCT) at a single center institution. The two groups will be equally allocated on a 1:1 ratio into the control and treatment arms. All patients greater than 18 years of age undergoing a plastic surgery procedure involving excision of skin lesions will be enrolled. Any patients requiring re-excision through the wound or undergoing injectable corticosteroid therapy will be excluded. A total of 500 patients will be enrolled. The patients will be followed-up at 1 week, 3 months, and 6 months post-operatively. Results The study is expected to begin enrolment in August 2016. We anticipate that the deckling study group will have superior scar outcomes when compared to the straight line incision. From clinical experience this is especially true for lesions involving the face and in those areas of the skin that have undergone radiation therapy. The study will be funded by the Plastics and Reconstructive Surgery Department at St Vincent’s Hospital, Sydney, Australia. Ethics approval has been obtained for the study. Conclusion: We believe this will be an

  7. Evidence-based practice: reflections from five European case studies.

    PubMed

    Baeza, Juan I; Fraser, Alec; Boaz, Annette

    2014-01-01

    Background Evidence-based practice (EBP) is now the accepted orthodoxy in clinical practice and developed from evidence-based medicine. EBP is based on a specific type of evidence that is derived from studies based on randomised controlled trials (RCT). This type of evidence is suited to acute medical care and is more problematic for other clinicians such as nurses and therapists, particularly when they are situated within community or primary care settings. Setting Five stroke care services in England (2), Sweden (2) and Poland (1). Aims To reflect on the evidence gained from these case studies to shed light on various aspects of EBP. This paper focuses on three key issues: (1) the importance of context for evidence, (2) the nature of knowledge, and (3) professional hierarchies. Methods Five qualitative case studies into stroke care were carried out in England, Sweden and Poland. One hundred and twenty semi-structured interviews were carried out with a range of healthcare staff who provided specialised and non-specialised stroke care in acute, community and primary care between October 2010 and September 2011. Medical doctors, nurses and different therapists were included in the samples in all five case studies. For this paper, we reflect on some aspects of this work to illuminate the different interprofessional perspectives relating to EBP in stroke care. Results The lack of RCT-based evidence in the community and primary care sectors can lead to the clinicians working in these sectors being perceived as having a lower status. Clinicians use both tacit and encoded knowledge to guide their practice and there existed both intraand interprofessional tensions in these two types of knowledge. The professional hierarchy of stroke teams varies with national context and the role of the non-specialists is less valued in stroke care. PMID:25949726

  8. Obesity and Multiple Sclerosis: A Mendelian Randomization Study

    PubMed Central

    Davey Smith, George; Richards, J. Brent

    2016-01-01

    Background Observational studies have reported an association between obesity, as measured by elevated body mass index (BMI), in early adulthood and risk of multiple sclerosis (MS). However, bias potentially introduced by confounding and reverse causation may have influenced these findings. Therefore, we elected to perform Mendelian randomization (MR) analyses to evaluate whether genetically increased BMI is associated with an increased risk of MS. Methods and Findings Employing a two-sample MR approach, we used summary statistics from the Genetic Investigation of Anthropometric Traits (GIANT) consortium and the International MS Genetics Consortium (IMSGC), the largest genome-wide association studies for BMI and MS, respectively (GIANT: n = 322,105; IMSGC: n = 14,498 cases and 24,091 controls). Seventy single nucleotide polymorphisms (SNPs) were genome-wide significant (p < 5 x 10−8) for BMI in GIANT (n = 322,105) and were investigated for their association with MS risk in the IMSGC. The effect of each SNP on MS was weighted by its effect on BMI, and estimates were pooled to provide a summary measure for the effect of increased BMI upon risk of MS. Our results suggest that increased BMI influences MS susceptibility, where a 1 standard deviation increase in genetically determined BMI (kg/m2) increased odds of MS by 41% (odds ratio [OR]: 1.41, 95% CI 1.20–1.66, p = 2.7 x 10−5, I2 = 0%, 95% CI 0–29). Sensitivity analyses, including MR-Egger regression, and the weighted median approach provided no evidence of pleiotropic effects. The main study limitations are that, while these sensitivity analyses reduce the possibility that pleiotropy influenced our results, residual pleiotropy is difficult to exclude entirely. Conclusion Genetically elevated BMI is associated with risk of MS, providing evidence for a causal role for obesity in MS etiology. While obesity has been associated with many late-life outcomes, these findings suggest an important consequence of

  9. Intercultural Education in the European Context: Key Remarks from a Comparative Study

    ERIC Educational Resources Information Center

    Catarci, Marco

    2014-01-01

    The article focuses on some findings of a comparative study carried out by a network of scholars and researchers who are active in the field of intercultural education in the European context in the main "old immigration countries" (United Kingdom, France and Germany), "new immigration countries" (Italy, Spain and Greece) and…

  10. European Union Students Studying in English Higher Education Institutions. DIUS Research Report 08-09

    ERIC Educational Resources Information Center

    Morris, Marian; Rutt, Simon

    2008-01-01

    This study aimed to identify the pathways, intentions and relevant perceptions of (non-UK) European Union (EU) students entering English higher education. It sought to identify why students wished to obtain an English HE qualification, their attitudes towards the uptake and repayment of tuition fee loans and their future career plans. Drawing on…

  11. Pedometer Use in University Freshmen: A Randomized Controlled Pilot Study

    ERIC Educational Resources Information Center

    LeCheminant, James D.; Smith, John D.; Covington, N. Kay; Hardin-Renschen, Tracie; Heden, Tim

    2011-01-01

    Objectives: To describe activity patterns associated with a pedometer intervention in university freshmen and compare the intervention participants to controls for several health outcomes. Methods: Forty-six university freshmen were randomized to a group that wore a pedometer across the academic year with a goal of 10,000 steps/day or to a control…

  12. Laser surgery for Zenker's diverticulum: European combined study.

    PubMed

    Papaspyrou, Giorgos; Schick, Bernhard; Papaspyrou, Spyros; Wiegand, Susanne; Al Kadah, Basel

    2016-01-01

    Surgical intervention is the gold standard of treatment for Zenker's diverticulum. The aim of this study was to examine the role of laser surgery in a large number of patients with this pathological entity. The data of 91 consecutive patients treated due to Zenker's diverticulum with the aid of CO2 laser in three institutions (Homburg/Saar and Marburg, Germany/Athens, Greece) during the last 10 years were retrospectively analyzed. Parameters examined were sex, age, preoperative symptoms, length of operation and complications, revision surgery necessity and degree of patient satisfaction. All patients had a minimum follow-up of one year. Dysphagia was the most common preoperative symptom (78 %). The most common minor complication was dental injury (6.6 %), but a serious complication in form of emphysema was observed in only two patients (2.2 %). A surgical revision was necessary in 8 (8.8 %) of the treated patients. The majority of treated patients was free of symptoms (86.8 %), or presented mild symptoms (9.9 %) one year after intervention, and only three patients (3.3 %) were dissatisfied. Our study shows that laser treatment of Zenker's diverticulum is an efficient operative technique associated with low complications rates and significant improvement of patients' symptoms in most of the examined cases. PMID:25567345

  13. A collaborative European study of personal inhalable aerosol sampler performance.

    PubMed

    Kenny, L C; Aitken, R; Chalmers, C; Fabriès, J F; Gonzalez-Fernandez, E; Kromhout, H; Lidén, G; Mark, D; Riediger, G; Prodi, V

    1997-04-01

    Following the adoption of new international sampling conventions for inhalable, thoracic and respirable aerosol fractions, a working group of Comité Européen de Normalisation (CEN) drafted a standard for the performance of workplace aerosol sampling instruments. The present study was set up to verify the experimental, statistical and mathematical procedures recommended in the draft performance standard and to check that they could be applied to inhalable aerosol samplers. This was achieved by applying the tests to eight types of personal inhalable aerosol sampler commonly used for workplace monitoring throughout Europe. The study led to recommendations for revising the CEN draft standard, in order to simplify the tests and reduce their cost. However, some further work will be needed to develop simpler test facilities and methods. Several of the samplers tested were found to perform adequately with respect to the inhalable sampling convention, at least over a limited range of typical workplace conditions. In general the samplers were found to perform best in low external wind speeds, which are the test conditions thought to be closest to those normally found in indoor workplaces. The practical implementation of the CEN aerosol sampling conventions requires decisions on which sampling instruments to use, estimation of the likely impact that changing sampling methods could have on apparent exposures, and adjustment where necessary of exposure limit values. The sampler performance data obtained in this project were affected by large experimental errors, but are nevertheless a useful input to decisions on how to incorporate the CEN inhalable sampling convention into regulation, guidance and occupational hygiene practice. PMID:9155236

  14. Regional aspects of the energy crisis: East European case study

    SciTech Connect

    Merkin, V.O.

    1985-01-01

    The energy crisis occurring in Eastern Europe owes much to the Stalinist model of energy-intensive industrialization applied to a basically energy short region still partially isolated from the world energy market. Systemic factors are thus much more important than in the West. Due to this, solutions to the energy crisis in the East of Europe, be it through supply augmentation or conservation, belong as much in the sphere of politics and ideology as they do in the sphere of economics. The dissertation examines in a systematic manner the evolution and prospects of the energy economy in the region (Chapter 1), the present sectoral pattern of energy consumption (Chapter 2), and conversion (thermo-electric conversion in Chapter 3 and oil refining in Chapter 4). Four subsequent chapters are devoted to individual energy-consuming sectors such as industry, transportation, agriculture, and households. Finally, the potential and problems of energy conservation in Eastern Europe are analyzed in the context of broader economic policies and concerns of the states of the region. In the conclusion, topics in the energy economy of Eastern Europe requiring further study are outlined.

  15. An Integrated Study of the Holy Cross Mountains region of the Eastern European TESZ in Poland

    NASA Astrophysics Data System (ADS)

    Averill, M. G.; Bond, T.; Sroda, P.; Keller, G. R.; Miller, K.

    2002-12-01

    The Trans-European Suture Zone (TESZ) in Eastern Europe is an anomalous region marking the suture of Phanerozoic Western European terrains with the Precambrian Eastern European Craton (EEC). The nature of this suture is known primarily from geophysical studies. Seismic velocity and gravity models indicate changes of crustal thickness from 28-35 km to 42-47 km across the TTZ (Teisseyre-Tornquist Zone) from the Paleozoic Platform of Western Europe to the Eastern European Craton. Tectonic models suggest the presence of a Precambrian/Early Paleozoic passive margin beneath the TTZ. The Holy Cross Mountains in southeastern Poland represent an anomalous crustal block whose origin and interaction with the EEC is unknown. The subject of this study is the origin and tectonic evolution of this and adjacent crustal blocks in relation to the eastern TESZ and EEC. We have employed a technique to integrate industry acquired well and reflection data, as well as refraction data from the CELEBRATION 2000, POLONAISE '97 and TTZ experiments. We used well check shot surveys and CDP (common depth point) stacking velocities from reflection surveys in addition to refraction data as controls in a tomographic inversion. In turn, gravity, magnetics, drilling and geologic data is incorporated to support an integrated study of this region.

  16. Databases for Studies of Infrasound Propagation in the European Arctic

    NASA Astrophysics Data System (ADS)

    Gibbons, Steven J.; Ringdal, Frode

    2010-05-01

    Industrial and military sources in northern Fennoscandia and NW Russia generate both seismic and infrasound signals observed at regional distances. Similar seismic signals constrain origin times and explosion yield and, using correlation detectors at the ARCES array, have enabled us to detect and classify hundreds of events from a small number of sites. This has in turn provided superb datasets for infrasound propagation studies. The multi-channel waveform correlation procedure has even had considerable success in detecting closely spaced events when the signals from subsequent events show considerable differences. A post-processing system which examines the alignment of the single-channel cross-correlation traces allows for very low detection thresholds with low false alarm rates. Near-surface explosions at Hukkakero in northern Finland generate infrasound signals on the seismic sensors at ARCES, 175 km to the North, near to the edge of the classical "Zone of Silence". Many tropospheric phase observations can be predicted using ray-tracing given favourable winds at low altitudes. However, the vast majority of the observed infrasound signals - probably refracted from stratospheric heights - are not predicted by ray-tracing, warranting a re-evaluation of propagation models for these distances. In 2008, a mini-array of microbarographs, co-located with ARCES seismometers, also observed later signals probably refracted from thermospheric heights. These signals are more impulsive and of smaller amplitude than the more typically observed signals. A second site near the northern coast of the Kola Peninsula is approximately 250 km from ARCES to the West and Apatity to the South. Despite poor waveform similarity between events, multichannel correlation detectors assign confidently over 350 events over an 8 year period to this site. Infrasound is observed at ARCES for almost all events in the summer and almost no events in the winter, and is observed at Apatity for almost

  17. Randomized Controlled Studies and Alternative Designs in Outcome Studies: Challenges and Opportunities

    ERIC Educational Resources Information Center

    Shadish, William R.

    2011-01-01

    This article reviews several decades of the author's meta-analytic and experimental research on the conditions under which nonrandomized experiments can approximate the results from randomized experiments (REs). Several studies make clear that we can expect accurate effect estimates from the regression discontinuity design, though its statistical…

  18. A comparative study of psychophysical judgment of color reproductions on mobile displays between Europeans and Asians

    NASA Astrophysics Data System (ADS)

    Choi, Kyungah; Suk, Hyeon-Jeong

    2015-01-01

    The purpose of this study is to investigate the differences in the psychophysical judgment of mobile display color appearances between Europeans and Asians. A total of 50 participants, comprising 20 Europeans (9 French, 6 Swedish, 3 Norwegians, and 2 Germans) and 30 Asians (30 Koreans) participated in this experiment. A total of 18 display stimuli with different correlated color temperatures were presented, varying from 2,470 to 18,330 K. Each stimulus was viewed under 11 illuminants ranging from 2,530 to 19,760 K, while their illuminance was consistent around 500 lux. The subjects were asked to assess the optimal level of the display stimuli under different illuminants. In general, confirming the previous studies on color reproduction, we found a positive correlation in the correlated color temperatures between the illuminants and optimal displays. However, Europeans preferred a lower color temperature compared to Asians along the entire range of the illuminants. Two regression equations were derived to predict the optimal display color temperature (y) under varying illuminants (x) as follows: y = α + β*log(x), where α = -8770.37 and β = 4279.29 for European (R2 = 0.95, p < .05), and α = -16076.35 and β = 6388.41 for Asian (R2 = 0.85, p < .05). The findings provide the theoretical basis from which manufacturers can take a cultural-sensitive approach to enhancing their products' appeal in the global markets.

  19. 77 FR 5850 - Notice of Random Assignment Study To Evaluate Workforce Investment Act Adult and Dislocated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-06

    ... evaluation study period. On July 21, 2011 (76 FR 43729-43731), the Department solicited comments concerning... Employment and Training Administration Notice of Random Assignment Study To Evaluate Workforce Investment Act... interest to use a random assignment impact methodology for the study. This methodology will provide...

  20. Implementation and Operational Research: Computer-Assisted Intervention for Safer Sex in HIV-Positive Men Having Sex With Men: Findings of a European Randomized Multi-Center Trial

    PubMed Central

    Platteau, Tom; Bogner, Johannes; Buyze, Jozefien; Dec-Pietrowska, Joanna; Dias, Sonia; Newbury-Helps, John; Kocsis, Agnes; Mueller, Matthias; Rojas, Daniela; Stanekova, Danica; van Lankveld, Jacques; Colebunders, Robert

    2016-01-01

    Objective: Men who have sex with men (MSM) are the key population most affected by HIV in Europe. We performed the first European multicenter, simple-randomized parallel-group study to test the effectiveness of a theory-guided computer-assisted intervention to improve safer sex among HIV-positive men who have sex with men. Methods: Between February, 2011 and February, 2013, 112 participants were enrolled in 8 different European HIV-care settings. Intervention participants received 3 individual counseling sessions facilitated by trained service providers using computer-assisted tools. The control-group received sexual health advice delivered as part of regular HIV care. Outcome behavior (self-reported condom use at last intercourse; combined HIV transmission risk score), its influencing factors, and mediating variables were assessed at baseline, and at 3 and 6 months follow-up. Mixed effects models were used to compare primary outcomes (condom use at last intercourse, HIV transmission risk score), and mediation analysis to explore intervention effects. Results: Condom use at last intercourse increased more among intervention than control participants at 3 months follow-up (odds ratio of 3.83; P = 0.03), but not significantly at 6 months follow-up. Intervention participants reported a lower transmission risk at 3 months follow-up than controls (odds ratio compared with baseline of 11.53 and 1.28, respectively; P = 0.008), but this effect became nonsignificant at 6 months. Intervention effects were mediated by the proximal variables, self-efficacy to negotiate condom use and condom attitudes. Conclusions: This intervention showed short-term effectiveness. The intervention should be replicated in other settings, eventually investigating if booster-counseling sessions would yield a longer lasting effect. PMID:26866955

  1. Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

    PubMed

    van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

    2016-07-21

    Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. PMID:27472820

  2. European Non-Communicable Respiratory Disease Research, 2002-13: Bibliometric Study of Outputs and Funding

    PubMed Central

    Wright, John S. F.; Pallari, Elena; Sullivan, Richard

    2016-01-01

    This study was conducted in order to map European research in chronic respiratory diseases (CRDs). It was intended to assist the European Commission and other research funders to identify gaps and overlaps in their portfolios, and to suggest ways in which they could improve the effectiveness of their support and increase the impact of the research on patient care and on the reduction of the incidence of the CRDs. Articles and reviews were identified in the Web of Science on research in six non-communicable respiratory diseases that were published in 2002–13 from 31 European countries. They represented only 0.8% of biomedical research output but these diseases accounted for 4.7% of the European disease burden, as measured by Disability-Adjusted Life Years (DALYs), so the sub-field is seriously under-researched. Europe is prominent in the sub-field and published 56% of the world total, with the UK the most productive and publishing more than France and Italy, the next two countries, combined. Asthma and Chronic Obstructive Pulmonary Disease (COPD) were the diseases with the most publications and the highest citation rates. They also received the most funding, with around two acknowledgments per paper (in 2009–13), whereas cystic fibrosis and emphysema averaged only one. Just over 37% of papers had no specific funding and depended on institutional support from universities and hospitals. PMID:27111670

  3. European Non-Communicable Respiratory Disease Research, 2002-13: Bibliometric Study of Outputs and Funding.

    PubMed

    Begum, Mursheda; Lewison, Grant; Wright, John S F; Pallari, Elena; Sullivan, Richard

    2016-01-01

    This study was conducted in order to map European research in chronic respiratory diseases (CRDs). It was intended to assist the European Commission and other research funders to identify gaps and overlaps in their portfolios, and to suggest ways in which they could improve the effectiveness of their support and increase the impact of the research on patient care and on the reduction of the incidence of the CRDs. Articles and reviews were identified in the Web of Science on research in six non-communicable respiratory diseases that were published in 2002-13 from 31 European countries. They represented only 0.8% of biomedical research output but these diseases accounted for 4.7% of the European disease burden, as measured by Disability-Adjusted Life Years (DALYs), so the sub-field is seriously under-researched. Europe is prominent in the sub-field and published 56% of the world total, with the UK the most productive and publishing more than France and Italy, the next two countries, combined. Asthma and Chronic Obstructive Pulmonary Disease (COPD) were the diseases with the most publications and the highest citation rates. They also received the most funding, with around two acknowledgments per paper (in 2009-13), whereas cystic fibrosis and emphysema averaged only one. Just over 37% of papers had no specific funding and depended on institutional support from universities and hospitals. PMID:27111670

  4. Simulation and study of small numbers of random events

    NASA Technical Reports Server (NTRS)

    Shelton, R. D.

    1986-01-01

    Random events were simulated by computer and subjected to various statistical methods to extract important parameters. Various forms of curve fitting were explored, such as least squares, least distance from a line, maximum likelihood. Problems considered were dead time, exponential decay, and spectrum extraction from cosmic ray data using binned data and data from individual events. Computer programs, mostly of an iterative nature, were developed to do these simulations and extractions and are partially listed as appendices. The mathematical basis for the compuer programs is given.

  5. Use of National and International Growth Charts for Studying Height in European Children: Development of Up-To-Date European Height-For-Age Charts

    PubMed Central

    Bonthuis, Marjolein; van Stralen, Karlijn J.; Verrina, Enrico; Edefonti, Alberto; Molchanova, Elena A.; Hokken-Koelega, Anita C. S.; Schaefer, Franz; Jager, Kitty J.

    2012-01-01

    Background Growth charts based on data collected in different populations and time periods are key tools to assess children’s linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date European growth charts, and studied the effect of using different charts in a sample of growth retarded children. Methods and Findings In an international survey we obtained 18 unique national height-for-age charts from 28 European countries and compared them with charts from the World Health Organization (WHO), Euro-Growth reference, and Centers of Disease Control and Prevention (CDC). As an example, we obtained height data from 3,534 children with end-stage renal disease (ESRD) from 13 countries via the ESPN/ERA-EDTA registry, a patient group generally suffering from growth retardation. National growth charts showed a clear secular trend in height (mean height increased on average 0.6 cm/decade) and a North-South height gradient in Europe. For countries without a recent (>1990) national growth chart novel European growth charts were constructed from Northern and Southern European reference populations, reflecting geographic height differences in mean final height of 3.9 cm in boys and 3.8 cm in girls. Mean height SDS of 2- to 17-year-old ESRD patients calculated from recent national or derived European growth charts (−1.91, 95% CI: −1.97 to −1.85) was significantly lower than when using CDC or WHO growth charts (−1.55, 95% CI: −1.61 to −1.49) (P<0.0001). Conclusion Differences between height-for-age charts may reflect true population differences, but are also strongly affected by the secular trend in height. The choice of reference charts substantially affects the clinical decision whether a child is considered short-for-age. Therefore, we advocate using recent national or European height-for-age charts derived from recent national data when monitoring growth

  6. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

    PubMed Central

    Dinis-Ribeiro, M.; Areia, M.; de Vries, A. C.; Marcos-Pinto, R.; Monteiro-Soares, M.; O'Connor, A.; Pereira, C.; Pimentel-Nunes, P.; Correia, R.; Ensari, A.; Dumonceau, J. M.; Machado, J. C.; Macedo, G.; Malfertheiner, P.; Matysiak-Budnik, T.; Megraud, F.; Miki, K.; O'Morain, C.; Peek, R. M.; Ponchon, T.; Ristimaki, A.; Rembacken, B.; Carneiro, F.; Kuipers, E. J.

    2012-01-01

    Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22198778

  7. Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study

    PubMed Central

    Fauconnier, Jérôme; Dickinson, Heather O; Beckung, Eva; Marcelli, Marco; McManus, Vicki; Michelsen, Susan I; Parkes, Jackie; Parkinson, Kathryn N; Thyen, Ute; Arnaud, Catherine

    2009-01-01

    Objectives To evaluate how involvement in life situations (participation) in children with cerebral palsy varies with type and severity of impairment and to investigate geographical variation in participation. Design Cross sectional study. Trained interviewers visited parents of children with cerebral palsy; multilevel multivariable regression related participation to impairments, pain, and sociodemographic characteristics. Setting Eight European regions with population registers of children with cerebral palsy; one further region recruited children from multiple sources. Participants 1174 children aged 8-12 with cerebral palsy randomly selected from the population registers, 743 (63%) joined in the study; the further region recruited 75 children. Main outcome measure Children’s participation assessed by the Life-H questionnaire covering 10 main areas of daily life. Scoring ignored adaptations or assistance required for participation. Results Children with pain and those with more severely impaired walking, fine motor skills, communication, and intellectual abilities had lower participation across most domains. Type of cerebral palsy and problems with feeding and vision were associated with lower participation for specific domains, but the sociodemographic factors examined were not. Impairment and pain accounted for up to a sixth of the variation in participation. Participation on all domains varied substantially between regions: children in east Denmark had consistently higher participation than children in other regions. For most participation domains, about a third of the unexplained variation could be ascribed to variation between regions and about two thirds to variation between individuals. Conclusions Participation in children with cerebral palsy should be assessed in clinical practice to guide intervention and assess its effect. Pain should be carefully assessed. Some European countries facilitate participation better than others, implying some countries

  8. "Governmentality" in the Origins of European Female PE and Sport: The Spanish Case Study (1883-1936)

    ERIC Educational Resources Information Center

    Garcia, Raul Sanchez; Herraiz, Antonio Rivero

    2013-01-01

    The purpose of the paper is twofold: (1) to contribute to the analysis of the origins of modern European female PE and sports from a power perspective, inspired by Foucault's work; and (2) to present a detailed analysis of female PE and sport in Spain (1883-1936) as a specific European case study. It is argued that these physical activities…

  9. Building Evaluation Capacity in Spain: A Case Study of Rural Development and Empowerment in the European Union

    ERIC Educational Resources Information Center

    Diaz-Puente, Jose M.; Yague, Jose L.; Afonso, Ana

    2008-01-01

    The development of European Community administrative authority has greatly influenced the development of an evaluation culture among the southern and central member states of the European Union. The present case study from Spain provides an example of this diffusion through the use of an empowerment evaluation approach to build evaluation capacity…

  10. Discrete Randomness in Discrete Time Quantum Walk: Study Via Stochastic Averaging

    NASA Astrophysics Data System (ADS)

    Ellinas, D.; Bracken, A. J.; Smyrnakis, I.

    2012-10-01

    The role of classical noise in quantum walks (QW) on integers is investigated in the form of discrete dichotomic random variable affecting its reshuffling matrix parametrized as a SU2)/U (1) coset element. Analysis in terms of quantum statistical moments and generating functions, derived by the completely positive trace preserving (CPTP) map governing evolution, reveals a pronounced eventual transition in walk's diffusion mode, from a quantum ballistic regime with rate O(t) to a classical diffusive regime with rate O(√{t}), when condition (strength of noise parameter)2 × (number of steps) = 1, is satisfied. The role of classical randomness is studied showing that the randomized QW, when treated on the stochastic average level by means of an appropriate CPTP averaging map, turns out to be equivalent to a novel quantized classical walk without randomness. This result emphasizes the dual role of quantization/randomization in the context of classical random walk.

  11. Changes in mortality inequalities over two decades: register based study of European countries

    PubMed Central

    Kulhánová, Ivana; Artnik, Barbara; Bopp, Matthias; Borrell, Carme; Clemens, Tom; Costa, Giuseppe; Dibben, Chris; Kalediene, Ramune; Lundberg, Olle; Martikainen, Pekka; Menvielle, Gwenn; Östergren, Olof; Prochorskas, Remigijus; Rodríguez-Sanz, Maica; Strand, Bjørn Heine; Looman, Caspar W N; de Gelder, Rianne

    2016-01-01

    Objective To determine whether government efforts in reducing inequalities in health in European countries have actually made a difference to mortality inequalities by socioeconomic group. Design Register based study. Data source Mortality data by level of education and occupational class in the period 1990-2010, usually collected in a census linked longitudinal study design. We compared changes in mortality between the lowest and highest socioeconomic groups, and calculated their effect on absolute and relative inequalities in mortality (measured as rate differences and rate ratios, respectively). Setting All European countries for which data on socioeconomic inequalities in mortality were available for the approximate period between years 1990 and 2010. These included Finland, Norway, Sweden, Scotland, England and Wales (data applied to both together), France, Switzerland, Spain (Barcelona), Italy (Turin), Slovenia, and Lithuania. Results Substantial mortality declines occurred in lower socioeconomic groups in most European countries covered by this study. Relative inequalities in mortality widened almost universally, because percentage declines were usually smaller in lower socioeconomic groups. However, as absolute declines were often smaller in higher socioeconomic groups, absolute inequalities narrowed by up to 35%, particularly among men. Narrowing was partly driven by ischaemic heart disease, smoking related causes, and causes amenable to medical intervention. Progress in reducing absolute inequalities was greatest in Spain (Barcelona), Scotland, England and Wales, and Italy (Turin), and absent in Finland and Norway. More detailed studies preferably using individual level data are necessary to identify the causes of these variations. Conclusions Over the past two decades, trends in inequalities in mortality have been more favourable in most European countries than is commonly assumed. Absolute inequalities have decreased in several countries, probably

  12. PROSPECTIVE RANDOMIZED STUDY COMPARING TWO ANESTHETIC METHODS FOR SHOULDER SURGERY

    PubMed Central

    Ikemoto, Roberto Yukio; Murachovsky, Joel; Prata Nascimento, Luis Gustavo; Bueno, Rogerio Serpone; Oliveira Almeida, Luiz Henrique; Strose, Eric; de Mello, Sérgio Cabral; Saletti, Deise

    2015-01-01

    Objective: To evaluate the efficacy of suprascapular nerve block in combination with infusion of anesthetic into the subacromial space, compared with interscalene block. Methods: Forty-five patients with small or medium-sized isolated supraspinatus tendon lesions who underwent arthroscopic repair were prospectively and comparatively evaluated through random assignation to three groups of 15, each with a different combination of anesthetic methods. The efficacy of postoperative analgesia was measured using the visual analogue scale for pain and the analgesic, anti-inflammatory and opioid drug consumption. Inhalation anesthetic consumption during surgery was also compared between the groups. Results: The statistical analysis did not find any statistically significant differences among the groups regarding anesthetic consumption during surgery or postoperative analgesic efficacy during the first 48 hours. Conclusion: Suprascapular nerve block with infusion of anesthetic into the subacromial space is an excellent alternative to interscalene block, particularly in hospitals in which an electrical nerve stimulating device is unavailable. PMID:27022569

  13. European project on osteoarthritis: design of a six-cohort study on the personal and societal burden of osteoarthritis in an older European population

    PubMed Central

    2013-01-01

    Background Osteoarthritis (OA), the most common form of arthritis, is a major contributor to functional impairment and loss of independence in older persons. The European Project on OSteoArthritis (EPOSA) is a collaborative study involving six European cohort studies on ageing. This project focuses on the personal and societal burden and its determinants of osteoarthritis. This paper describes the design of the project, and presents some descriptive analyses on selected variables across countries. Methods/design EPOSA is an observational study including pre-harmonized data from European cohort studies (Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom) on older community-dwelling persons aged 65 to 85 years. In total, 2942 persons were included in the baseline study with a mean age of 74.2 years (SD 5.1), just over half were women (51,9%). The baseline assessment was conducted by a face-to-face interview followed by a clinical examination. Measures included physical, cognitive, psychological and social functioning, lifestyle behaviour, physical environment, wellbeing and care utilisation. The clinical examination included anthropometry, muscle strength, physical performance and OA exam. A follow-up assessment was performed 12–18 months after baseline. Discussion The EPOSA study is the first population-based study including a clinical examination of OA, using pre-harmonized data across European countries. The EPOSA study provides a unique opportunity to study the determinants and consequences of OA in general populations of older persons, including both care-seeking and non care-seeking persons. PMID:23597054

  14. Air Pollution Exposure during Pregnancy and Childhood Autistic Traits in Four European Population-Based Cohort Studies: The ESCAPE Project

    PubMed Central

    Guxens, Mònica; Ghassabian, Akhgar; Gong, Tong; Garcia-Esteban, Raquel; Porta, Daniela; Giorgis-Allemand, Lise; Almqvist, Catarina; Aranbarri, Aritz; Beelen, Rob; Badaloni, Chiara; Cesaroni, Giulia; de Nazelle, Audrey; Estarlich, Marisa; Forastiere, Francesco; Forns, Joan; Gehring, Ulrike; Ibarluzea, Jesús; Jaddoe, Vincent W.V.; Korek, Michal; Lichtenstein, Paul; Nieuwenhuijsen, Mark J.; Rebagliato, Marisa; Slama, Rémy; Tiemeier, Henning; Verhulst, Frank C.; Volk, Heather E.; Pershagen, Göran; Brunekreef, Bert; Sunyer, Jordi

    2015-01-01

    Background Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. Objectives We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. Methods Ours was a collaborative study of four European population-based birth/child cohorts—CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides (NO2, NOx) and particulate matter (PM) with diameters of ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and between 2.5 and 10 μm (PMcoarse), and PM2.5 absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. Results A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-μg/m3 increase in NO2 pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. Conclusions Prenatal exposure to NO2 and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies. Citation Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, Porta D, Giorgis-Allemand L, Almqvist C, Aranbarri A, Beelen R, Badaloni C, Cesaroni G, de Nazelle A, Estarlich M, Forastiere F

  15. [The randomized study of efficiency of preoperative photodynamic].

    PubMed

    Akopov, A L; Rusanov, A A; Molodtsova, V P; Gerasin, A V; Kazakov, N V; Urtenova, M A; Chistiakov, I V

    2013-01-01

    The authors made a prospective randomized comparison of results of preoperative photodynamic therapy (PhT) with chemotherapy, preoperative chemotherapy in initial unresectable central non-small cell lung cancer in stage III. The efficiency and safety of preoperative therapy were estimated as well as the possibility of subsequent surgical treatment. The research included patients in stage IIIA and IIIB of central non-small cell lung cancer with lesions of primary bronchi and lower section of the trachea, which initially were unresectable, but potentially the patients could be operated on after preoperative treatment. The photodynamic therapy was performed using chlorine E6 and the light of wave length 662 nm. Since January 2008 till December 2011,42 patients were included in the research, 21 patients were randomized in the group for photodynamic therapy and 21--in group without PhT. These groups were compared according to their sex, age, stage of the disease and histological findings. After nonadjuvant treatment the remissions were reached in 19 (90%) patients of the group with PhT and in 16 (76%) patients without PhT and all the patients were operated on. The explorative operations were made on 3 patients out of 16 operated on in the group without PhT (19%). In the group PhT 14 pneumonectomies and 5 lobectomies were perfomed opposite 10 pneumonectomies and 3 lobectomies in group without PhT. The degree of radicalism of resection appears to be reliably higher in the group PhT (RO-89%, R1-11% as against RO-54%, R1-46% in group without PhT), p = 0.038. The preoperative endobronchial PhT conducted with chemotherapy was characterized by efficiency and safety, allowed the surgical treatment and elevated the degree of radicalism of this treatment in selected patients, initially assessed as unresectable. PMID:23808222

  16. Association Study for 26 Candidate Loci in Idiopathic Pulmonary Fibrosis Patients from Four European Populations

    PubMed Central

    Kishore, Amit; Žižková, Veronika; Kocourková, Lenka; Petrkova, Jana; Bouros, Evangelos; Nunes, Hilario; Loštáková, Vladimíra; Müller-Quernheim, Joachim; Zissel, Gernot; Kolek, Vitezslav; Bouros, Demosthenes; Valeyre, Dominique; Petrek, Martin

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF) affects lung parenchyma with progressing fibrosis. In this study, we aimed to replicate MUC5B rs35705950 variants and determine new plausible candidate variants for IPF among four different European populations. We genotyped 26 IPF candidate loci in 165 IPF patients from four European countries, such as Czech Republic (n = 41), Germany (n = 33), Greece (n = 40), France (n = 51), and performed association study comparing observed variant distribution with that obtained in a genetically similar Czech healthy control population (n = 96) described in our earlier data report. A highly significant association for a promoter variant (rs35705950) of mucin encoding MUC5B gene was observed in all IPF populations, individually and combined [odds ratio (95% confidence interval); p-value as 5.23 (8.94–3.06); 1.80 × 10−11]. Another non-coding variant, rs7934606 in MUC2 was significant among German patients [2.85 (5.05–1.60); 4.03 × 10−4] and combined European IPF cases [2.18 (3.16–1.50); 3.73 × 10−5]. The network analysis for these variants indicated gene–gene and gene–phenotype interactions in IPF and lung biology. With replication of MUC5B rs35705950 previously reported in U.S. populations of European descent and indicating other plausible polymorphic variants relevant for IPF, we provide additional reference information for future extended functional and population studies aimed, ideally with inclusion of clinical parameters, at identification of IPF genetic markers. PMID:27462317

  17. Testing Links between Childhood Positive Peer Relations and Externalizing Outcomes through a Randomized Controlled Intervention Study

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  18. PBL and Critical Thinking Disposition in Chinese Medical Students--A Randomized Cross-Sectional Study

    ERIC Educational Resources Information Center

    Du, XiangYun; Emmersen, Jeppe; Toft, Egon; Sun, Baozhi

    2013-01-01

    The purpose of this study was to explore the relationship of problem-based learning (PBL) and the development of critical thinking disposition (CT) and academic achievement in Chinese medical students using a cross-sectional randomized design. Medical students from China Medical University (CMU) were randomized to PBL or non-PBL teaching at the…

  19. Community-Based Prevention of Marital Dysfunction: Multilevel Modeling of a Randomized Effectiveness Study

    ERIC Educational Resources Information Center

    Laurenceau, Jean-Philippe; Stanley, Scott M.; Olmos-Gallo, Antonio; Baucom, Brian; Markham, Howard J.

    2004-01-01

    This study is a cluster randomized controlled trial of the Prevention and Relationship Enhancement Program (PREP; H. J. Markman, S. M. Stanley, & S. L. Blumberg, 2001). Fifty-seven religious organizations (ROs), consisting of 217 newlywed couples, were randomly assigned to 1 of 3 intervention conditions: PREP delivered by university clinicians…

  20. Patient organisations and the reimbursement process for medicines: an exploratory study in eight European countries

    PubMed Central

    2010-01-01

    Background Little is known about the role European patient organisations play in the process of deciding on reimbursement for medicines. Therefore we explore the current role of patient organisations in the process of reimbursement for medicines in Western Europe. We focus in particular on collaboration between patient organisations and the pharmaceutical industry in this respect. Methods Sixty-eight patient organisations representing seven medical conditions, from ten Western European countries, were asked to participate in the study. The participating organisations reported their experiences in a web-based questionnaire. Results Twenty-one patient organisations completed the questionnaire (response rate: 31%), of which ten (47.6%) demanded reimbursement for medicines. Organisations demanding reimbursement were larger than those not demanding reimbursement. The main aim of these organisations was to create better accessibility of medicines for patients. Most organisations limited themselves to single actions. Only two engaged in multiple actions. Almost all organisations had general policies on cooperation with the pharmaceutical industry, with autonomy as the key feature. The patient organisations said they were reasonably successful and almost always satisfied with their own role in the reimbursement process. Conclusion Our study has found that the role of European patient organisations in the reimbursement process still seems limited, especially for small patient organisations. PMID:20170557

  1. Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Reducing harm in drinking environments is a growing priority for European alcohol policy yet few studies have explored nightlife drinking behaviours. This study examines alcohol consumption and blood alcohol concentration (BAC) in drinking environments in four European cities. Methods A short questionnaire was implemented among 838 drinkers aged 16-35 in drinking environments in four European cities, in the Netherlands, Slovenia, Spain and the UK. Questions included self-reported alcohol use before interview and expected consumption over the remainder of the night. Breathalyser tests were used to measured breath alcohol concentration (converted to BAC) at interview. Results Most participants in the Dutch (56.2%), Spanish (59.6%) and British (61.4%) samples had preloaded (cf Slovenia 34.8%). In those drinking < 3 h at interview, there were no differences in BAC by gender or nationality. In UK participants, BAC increased significantly in those who had been drinking longer, reaching 0.13% (median) in females and 0.17% in males drinking > 5 h. In other nationalities, BAC increases were less pronounced or absent. High BAC (> 0.08%) was associated with being male, aged > 19, British and having consumed spirits. In all cities most participants intended to drink enough alcohol to constitute binge drinking. Conclusions Different models of drinking behaviour are seen in different nightlife settings. Here, the UK sample was typified by continued increases in inebriation compared with steady, more moderate intoxication elsewhere. With the former being associated with higher health risks, European alcohol policy must work to deter this form of nightlife. PMID:22151744

  2. Prenatal emotion management improves obstetric outcomes: a randomized control study

    PubMed Central

    Huang, Jian; Li, He-Jiang; Wang, Jue; Mao, Hong-Jing; Jiang, Wen-Ying; Zhou, Hong; Chen, Shu-Lin

    2015-01-01

    Introduction: Negative emotions can cause a number of prenatal problems and disturb obstetric outcomes. We determined the effectiveness of prenatal emotional management on obstetric outcomes in nulliparas. Methods: All participants completed the PHQ-9 at the baseline assessment. Then, the participants were randomly assigned to the emotional management (EM) and usual care (UC) groups. The baseline evaluation began at 31 weeks gestation and the participants were followed up to 42 days postpartum. Each subject in the EM group received an extra EM program while the participants in the UC groups received routine prenatal care and education only. The PHQ-9 and Edinburgh Postnatal Depression scale (EPDS) were used for assessment. Results: The EM group had a lower PHQ-9 score at 36 weeks gestation, and 7 and 42 days after delivery (P < 0.01), and a lower EPDS score 42 days postpartum (P < 0.05). The rate of cesarean section in the EM group was lower than the UC group (P < 0.01), and the cesarean section rate without a medical indication was lower (P < 0.01). The duration of the second stage of labor in the EM group was shorter than the UC group (P < 0.01). Conclusions: Prenatal EM intervention could control anxiety and depressive feelings in nulliparas, and improve obstetric outcomes. It may serve as an innovative approach to reduce the cesarean section rate in China. PMID:26309641

  3. A randomized RSA study concentrating especially on continuous migration.

    PubMed

    Molt, Mats; Ryd, Leif; Toksvig-Larsen, Sören

    2016-06-01

    Background and purpose - There is a general call for phased introduction of new implants, and one step in the introduction is an early evaluation of micromotion. We compared the micromotion in the Triathlon and its predecessor, the Duracon total knee prosthesis, concentrating especially on continuous migration over 5 years of follow-up. Patients and methods - 60 patients were randomized to receive either a cemented Triathlon total knee prosthesis or a cemented Duracon total knee prosthesis. 3-D tibial component migration was measured by radiostereometric analysis (RSA) at 3 months and at 1, 2, and 5 years. Results - There was no statistically significant difference in maximum total point motion (MTPM) between the 2 groups (p = 0.1). The mean MTPM at 5 years for the Duracon was 1.10 (SD 1.21) mm and for the Triathlon it was 0.66 (SD 0.38) mm. The numbers of continuously migrating prostheses were similar in the groups at the fifth year of follow-up; 6 of 21 prostheses in the Duracon group and 3 of 21 in the Triathlon group had migrated more than 0.3 mm between the second year and the fifth year of follow-up (p = 0.2). Interpretation - The Triathlon has a micromotion pattern similar to that of the Duracon total knee system at both short-term and medium-term follow-up, and may therefore, over time, show the same good long-term mechanical stability. PMID:27088580

  4. Study on MAX-MIN Ant System with Random Selection in Quadratic Assignment Problem

    NASA Astrophysics Data System (ADS)

    Iimura, Ichiro; Yoshida, Kenji; Ishibashi, Ken; Nakayama, Shigeru

    Ant Colony Optimization (ACO), which is a type of swarm intelligence inspired by ants' foraging behavior, has been studied extensively and its effectiveness has been shown by many researchers. The previous studies have reported that MAX-MIN Ant System (MMAS) is one of effective ACO algorithms. The MMAS maintains the balance of intensification and diversification concerning pheromone by limiting the quantity of pheromone to the range of minimum and maximum values. In this paper, we propose MAX-MIN Ant System with Random Selection (MMASRS) for improving the search performance even further. The MMASRS is a new ACO algorithm that is MMAS into which random selection was newly introduced. The random selection is one of the edgechoosing methods by agents (ants). In our experimental evaluation using ten quadratic assignment problems, we have proved that the proposed MMASRS with the random selection is superior to the conventional MMAS without the random selection in the viewpoint of the search performance.

  5. Identification of Serum Metabolites Associated With Incident Hypertension in the European Prospective Investigation into Cancer and Nutrition-Potsdam Study.

    PubMed

    Dietrich, Stefan; Floegel, Anna; Weikert, Cornelia; Pischon, Tobias; Boeing, Heiner; Drogan, Dagmar

    2016-08-01

    Metabolomics is a promising tool to gain new insights into early metabolic alterations preceding the development of hypertension in humans. We therefore aimed to identify metabolites associated with incident hypertension using measured data of serum metabolites of the European Prospective Investigation Into Cancer and Nutrition (EPIC)-Potsdam study. Targeted metabolic profiling was conducted on serum blood samples of a randomly drawn EPIC-Potsdam subcohort consisting of 135 cases and 981 noncases of incident hypertension, all of them being free of hypertension and not on antihypertensive therapy at the time of blood sampling. Mean follow-up was 9.9 years. A validated set of 127 metabolites was statistically analyzed with a random survival forest backward selection algorithm to identify predictive metabolites of incident hypertension taking into account important epidemiological hypertension risk markers. Six metabolites were identified to be most predictive for the development of hypertension. Higher concentrations of serine, glycine, and acyl-alkyl-phosphatidylcholines C42:4 and C44:3 tended to be associated with higher and diacyl-phosphatidylcholines C38:4 and C38:3 with lower predicted 10-year hypertension-free survival, although visualization by partial plots revealed some nonlinearity in the above associations. The identified metabolites improved prediction of incident hypertension when used together with known risk markers of hypertension. In conclusion, these findings indicate that metabolic alterations occur early in the development of hypertension. However, these alterations are confined to a few members of the amino acid or phosphatidylcholine metabolism, respectively. PMID:27245178

  6. Studies in astronomical time series analysis: Modeling random processes in the time domain

    NASA Technical Reports Server (NTRS)

    Scargle, J. D.

    1979-01-01

    Random process models phased in the time domain are used to analyze astrophysical time series data produced by random processes. A moving average (MA) model represents the data as a sequence of pulses occurring randomly in time, with random amplitudes. An autoregressive (AR) model represents the correlations in the process in terms of a linear function of past values. The best AR model is determined from sampled data and transformed to an MA for interpretation. The randomness of the pulse amplitudes is maximized by a FORTRAN algorithm which is relatively stable numerically. Results of test cases are given to study the effects of adding noise and of different distributions for the pulse amplitudes. A preliminary analysis of the optical light curve of the quasar 3C 273 is given.

  7. Safety and tolerability of dienogest in endometriosis: pooled analysis from the European clinical study program

    PubMed Central

    Strowitzki, Thomas; Faustmann, Thomas; Gerlinger, Christoph; Schumacher, Ulrike; Ahlers, Christiane; Seitz, Christian

    2015-01-01

    Background In four randomized, controlled, European trials, dienogest 2 mg once daily demonstrated significant efficacy for lesion reduction and reduction in pain intensity in endometriosis. We describe a pooled analysis of the safety and tolerability data from these trials to confirm and further characterize the safety profile of dienogest in the treatment of endometriosis. Methods All 332 women treated with dienogest 2 mg who participated in the four clinical trials were included in the pooled analyses for safety assessments, including adverse events, laboratory tests, vital signs, body weight, and bleeding patterns. Safety variables were analyzed using descriptive statistics. Results Pooled analyses of this large patient population confirmed that dienogest 2 mg is well tolerated, with a favorable safety profile extending over a period up to 65 weeks in women with endometriosis. The most common adverse drug reactions were headache, breast discomfort, depressed mood, and acne, each occurring in <10% of women. All these adverse events were generally of mild-to-moderate intensity and associated with low discontinuation rates. The bleeding pattern associated with dienogest 2 mg was well tolerated, and only two women (0.6%) reported bleeding events as the primary reason for premature discontinuation. Laboratory and vital sign assessments indicated no safety concerns for dienogest. Estradiol levels were maintained within the low-physiological range, in support of previous evidence indicating that dienogest 2 mg demonstrates therapeutic efficacy without inducing estradiol deficiency. Conclusion In this pooled analysis of 332 women with endometriosis, dienogest was well tolerated with a favorable safety profile extending over a period of up to 65 weeks. There is a paucity of randomized trial evidence to support the use of many treatments in endometriosis. These pooled analyses from four clinical trials of dienogest 2 mg represent a contribution to evidence-based medicine

  8. Random Telegraph Signal Amplitudes in Sub 100 nm (Decanano) MOSFETs: A 3D 'Atomistic' Simulation Study

    NASA Technical Reports Server (NTRS)

    Asenov, Asen; Balasubramaniam, R.; Brown, A. R.; Davies, J. H.; Saini, Subhash

    2000-01-01

    In this paper we use 3D simulations to study the amplitudes of random telegraph signals (RTS) associated with the trapping of a single carrier in interface states in the channel of sub 100 nm (decanano) MOSFETs. Both simulations using continuous doping charge and random discrete dopants in the active region of the MOSFETs are presented. We have studied the dependence of the RTS amplitudes on the position of the trapped charge in the channel and on the device design parameters. We have observed a significant increase in the maximum RTS amplitude when discrete random dopants are employed in the simulations.

  9. Risk factors for atrophic chronic gastritis in a European population: results of the Eurohepygast study

    PubMed Central

    2002-01-01

    Background and aims: The development of atrophic chronic gastritis (ACG) is multifactorial, involving environment as well as host responses to Helicobacter pylori infection. The aim of this study was to determine factors involved in ACG in a European dyspeptic population. Methods: Data concerning sociodemographics, social behaviour, biological aspects, diet, and virulence factors of H pylori strains were collected in a cross sectional study from 19 European centres in 14 countries. Dyspeptic H pylori positive patients with ACG or non-ACG (NACG) at histology were included. Anti-CagA antibodies were evaluated by two immunoblot tests and anti-VacA antibodies by one. Logistic regression models were constructed, and estimated odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated from the coefficients. Results: Of the 451 patients included in the study, 267 were analysed: 202 had NACG and 65 ACG. Mean age was 44.4 years and 63% were women. Risk factors for atrophy identified by multivariate analysis were: age over 60 years (OR 4.14, 95% CI 1.79–9.58), coffee consumption (OR 2.35, 95% CI 1.07–5.16), sedative consumption (OR 2.17, 95% CI 1.04–4.52), and harbouring anti-CagA and anti-VacA antibodies simultaneously (OR 3.09, 95% CI 1.26–7.56), while the odds were significantly reduced for those with an anxiety score of 6 or more (OR 0.45, 95% CI 0.21–0.99). Conclusion: The simultaneous presence of anti-CagA and anti-VacA antibodies enhanced the risk of ACG in European dyspeptic patients. Failure to discern diet and family history as risk factors for ACG may suggest that diet is homogeneous in Europe and that most of the risk factors for ACG identified so far are identical to risk factors for H pylori infection. PMID:12010878

  10. Associations of adiponectin with individual European ancestry in African Americans: the Jackson Heart Study

    PubMed Central

    Bidulescu, Aurelian; Choudhry, Shweta; Musani, Solomon K.; Buxbaum, Sarah G.; Liu, Jiankang; Rotimi, Charles N.; Wilson, James G.; Taylor, Herman A.; Gibbons, Gary H.

    2014-01-01

    Background: Compared with European Americans, African Americans (AAs) exhibit lower levels of the cardio-metabolically protective adiponectin even after accounting for adiposity measures. Because few studies have examined in AA the association between adiponectin and genetic admixture, a dense panel of ancestry informative markers (AIMs) was used to estimate the individual proportions of European ancestry (PEA) for the AAs enrolled in a large community-based cohort, the Jackson Heart Study (JHS). We tested the hypothesis that plasma adiponectin and PEA are directly associated and assessed the interaction with a series of cardio-metabolic risk factors. Methods: Plasma specimens from 1439 JHS participants were analyzed by ELISA for adiponectin levels. Using pseudo-ancestral population genotype data from the HapMap Consortium, PEA was estimated with a panel of up to 1447 genome-wide preselected AIMs by a maximum likelihood approach. Interaction assessment, stepwise linear and cubic multivariable-adjusted regression models were used to analyze the cross-sectional association between adiponectin and PEA. Results: Among the study participants (62% women; mean age 48 ± 12 years), the median (interquartile range) of PEA was 15.8 (9.3)%. Body mass index (BMI) (p = 0.04) and insulin resistance (p = 0.0001) modified the association between adiponectin and PEA. Adiponectin was directly and linearly associated with PEA (β = 0.62 ± 0.28, p = 0.03) among non-obese (n = 673) and insulin sensitive participants (n = 1141; β = 0.74 ± 0.23, p = 0.001), but not among those obese or with insulin resistance. No threshold point effect was detected for non-obese participants. Conclusions: In a large AA population, the individual proportion of European ancestry was linearly and directly associated with plasma adiponectin among non-obese and non insulin-resistant participants, pointing to the interaction of genetic and metabolic factors influencing adiponectin levels. PMID:24575123

  11. Low heel ultrasound parameters predict mortality in men: results from the European Male Ageing Study (EMAS)

    PubMed Central

    Pye, Stephen R.; Vanderschueren, Dirk; Boonen, Steven; Gielen, Evelien; Adams, Judith E.; Ward, Kate A.; Lee, David M.; Bartfai, György; Casanueva, Felipe F.; Finn, Joseph D.; Forti, Gianni; Giwercman, Aleksander; Han, Thang S.; Huhtaniemi, Ilpo T.; Kula, Krzysztof; Lean, Michael E.; Pendleton, Neil; Punab, Margus; Wu, Frederick C.; O'Neill, Terence W.

    2015-01-01

    Background: low bone mineral density measured by dual-energy x-ray absorptiometry is associated with increased mortality. The relationship between other skeletal phenotypes and mortality is unclear. The aim of this study was to determine the relationship between quantitative heel ultrasound parameters and mortality in a cohort of European men. Methods: men aged 40–79 years were recruited for participation in a prospective study of male ageing: the European Male Ageing Study (EMAS). At baseline, subjects attended for quantitative ultrasound (QUS) of the heel (Hologic—SAHARA) and completed questionnaires on lifestyle factors and co-morbidities. Height and weight were measured. After a median of 4.3 years, subjects were invited to attend a follow-up assessment, and reasons for non-participation, including death, were recorded. The relationship between QUS parameters (broadband ultrasound attenuation [BUA] and speed of sound [SOS]) and mortality was assessed using Cox proportional hazards model. Results: from a total of 3,244 men (mean age 59.8, standard deviation [SD] 10.8 years), 185 (5.7%) died during the follow-up period. After adjusting for age, centre, body mass index, physical activity, current smoking, number of co-morbidities and general health, each SD decrease in BUA was associated with a 20% higher risk of mortality (hazard ratio [HR] per SD = 1.2; 95% confidence interval [CI] = 1.0–1.4). Compared with those in higher quintiles (2nd–5th), those in the lowest quintile of BUA and SOS had a greater mortality risk (BUA: HR = 1.6; 95% CI = 1.1–2.3 and SOS: HR = 1.6; 95% CI = 1.2–2.2). Conclusion: lower heel ultrasound parameters are associated with increased mortality in European men. PMID:26162912

  12. Empirical Evidence of Study Design Biases in Randomized Trials: Systematic Review of Meta-Epidemiological Studies

    PubMed Central

    Page, Matthew J.; Higgins, Julian P. T.; Clayton, Gemma; Sterne, Jonathan A. C.; Hróbjartsson, Asbjørn; Savović, Jelena

    2016-01-01

    Objective To synthesise evidence on the average bias and heterogeneity associated with reported methodological features of randomized trials. Design Systematic review of meta-epidemiological studies. Methods We retrieved eligible studies included in a recent AHRQ-EPC review on this topic (latest search September 2012), and searched Ovid MEDLINE and Ovid EMBASE for studies indexed from Jan 2012-May 2015. Data were extracted by one author and verified by another. We combined estimates of average bias (e.g. ratio of odds ratios (ROR) or difference in standardised mean differences (dSMD)) in meta-analyses using the random-effects model. Analyses were stratified by type of outcome (“mortality” versus “other objective” versus “subjective”). Direction of effect was standardised so that ROR < 1 and dSMD < 0 denotes a larger intervention effect estimate in trials with an inadequate or unclear (versus adequate) characteristic. Results We included 24 studies. The available evidence suggests that intervention effect estimates may be exaggerated in trials with inadequate/unclear (versus adequate) sequence generation (ROR 0.93, 95% CI 0.86 to 0.99; 7 studies) and allocation concealment (ROR 0.90, 95% CI 0.84 to 0.97; 7 studies). For these characteristics, the average bias appeared to be larger in trials of subjective outcomes compared with other objective outcomes. Also, intervention effects for subjective outcomes appear to be exaggerated in trials with lack of/unclear blinding of participants (versus blinding) (dSMD -0.37, 95% CI -0.77 to 0.04; 2 studies), lack of/unclear blinding of outcome assessors (ROR 0.64, 95% CI 0.43 to 0.96; 1 study) and lack of/unclear double blinding (ROR 0.77, 95% CI 0.61 to 0.93; 1 study). The influence of other characteristics (e.g. unblinded trial personnel, attrition) is unclear. Conclusions Certain characteristics of randomized trials may exaggerate intervention effect estimates. The average bias appears to be greatest in trials of

  13. Occupational exposure to endocrine disruptors and lymphoma risk in a multi-centric European study

    PubMed Central

    Costas, L; Infante-Rivard, C; Zock, J-P; Van Tongeren, M; Boffetta, P; Cusson, A; Robles, C; Casabonne, D; Benavente, Y; Becker, N; Brennan, P; Foretova, L; Maynadié, M; Staines, A; Nieters, A; Cocco, P; de Sanjosé, S

    2015-01-01

    Background: Incidence rates of lymphoma are usually higher in men than in women, and oestrogens may protect against lymphoma. Methods: We evaluated occupational exposure to endocrine disrupting chemicals (EDCs) among 2457 controls and 2178 incident lymphoma cases and subtypes from the European Epilymph study. Results: Over 30 years of exposure to EDCs compared to no exposure was associated with a 24% increased risk of mature B-cell neoplasms (P-trend=0.02). Associations were observed among men, but not women. Conclusions: Prolonged occupational exposure to endocrine disruptors seems to be moderately associated with some lymphoma subtypes. PMID:25742473

  14. European Academies Advise on Gain-of-Function Studies in Influenza Virus Research

    PubMed Central

    Fears, Robin

    2015-01-01

    Gain-of-function (GoF) studies to understand factors affecting transmissibility of potentially pandemic pathogens are controversial. The European Academies Science Advisory Council (EASAC) recently published consensus recommendations relating to GoF research review and management on self-regulation and harmonization; bioethical considerations; benefit-risk assessment; biosafety, and biosecurity advisory options; and publication of sensitive information. A layered approach to integration of responsibilities must include conforming to the stringent rules and guidance already existing. Further commitment is essential to extend the debate on issues worldwide. PMID:26699646

  15. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study

    NASA Astrophysics Data System (ADS)

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Águeda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A.; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

  16. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.

    PubMed

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Agueda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries. PMID:23152194

  17. Eliminating Language Barriers Online at European Prisons (ELBEP): A Case-Study

    ERIC Educational Resources Information Center

    Barkan, M.; Toprak, E.; Kumtepe, A. T.; Kumtepe, E. Genc; Ataizi, M.; Pilanci, H.; Mutlu, M. E.; Kayabas, I.; Kayabas, B. Kip

    2011-01-01

    ELBEP (Eliminating Language Barriers in European Prisons Through Open and Distance Education Technology) is a multilateral project funded by the European Union (EU) Lifelong Learning, Grundtvig (Adult Education) Programme. It aims to overcome language/communication problems between prison staff and foreign inmates at European prisons via online…

  18. U.S. Taxation of Business: Relevance of the European Experience. German Studies Notes.

    ERIC Educational Resources Information Center

    McLure, Charles E., Jr.

    American and European business taxation policies are compared in this booklet. Topics discussed in the paper include effects of the corporation income tax, integration of income taxation, and the value added tax. Two major differences between the American and European systems are noted. First, European countries derive substantial portions of…

  19. Risk factors for vertebral deformities in men: relationship to number of vertebral deformities. European Vertebral Osteoporosis Study Group.

    PubMed

    Ismail, A A; O'Neill, T W; Cooper, C; Silman, A J

    2000-02-01

    Recent epidemiological studies suggest a similar overall prevalence of vertebral deformity in men to that in women, though the influence of increasing age on the prevalence of vertebral deformity is less marked in men. However, most affected men have only a single or two vertebral deformities, which may be unrelated to osteoporosis. The aim of this study was to examine the role of risk factors, previously demonstrated to be associated with vertebral osteoporosis in females, in men with single/dual deformities compared to those with multiple deformities. Age stratified random samples of men aged 50 years and over were recruited from population registers in 30 European centers as part of the European Vertebral Osteoporosis Study (EVOS). Subjects had a lateral spinal radiograph and the presence of vertebral deformity was determined using the McCloskey algorithm. Lifestyle and other risk factor data were obtained from an interviewer-administered questionnaire. In all 6937 men with a mean age of 64.4 (SD = 8.5) years were studied of whom 738 (10.6%) subjects had one or two deformities, and 109 (1.6%) subjects had three or more deformities. There was a marked increase in the prevalence of multiple vertebral deformities with increasing age, but only a modest effect of age on the prevalence of single deformities. Associations between various risk factors for osteoporosis and vertebral deformity were analyzed separately in men with single/dual vertebral deformity from those with three or more deformities using logistic regression. After adjustment for age, there were statistically significant associations between the following risk factors and multiple deformities: previous hip fracture (odds ratio [OR] 10.5), lack of regular physical activity (OR 2.9), low body mass (OR 2.5), and previous steroid use (OR 2.3). By contrast, there were only weak associations with these same variables in males with single/dual deformities and, apart from poor self-reported general health, all

  20. Anxiety Levels in People Who Stutter: A Randomized Population Study

    ERIC Educational Resources Information Center

    Craig, Ashley; Hancock, Karen; Tran, Yvonne; Craig, Magali

    2003-01-01

    The question of whether people who stutter are generally more anxious than people who do not stutter has not yet been resolved. One major methodological barrier to determining whether differences exist has been the type of stuttering sample used. Studies investigating anxiety levels of those who stutter have mostly assessed people referred to…

  1. Patterns of body size and adiposity among UK children of South Asian, black African–Caribbean and white European origin: Child Heart And health Study in England (CHASE Study)

    PubMed Central

    Nightingale, Claire M; Rudnicka, Alicja R; Owen, Chris G; Cook, Derek G; Whincup, Peter H

    2011-01-01

    Background The objective of this study was to examine adiposity patterns in UK South Asian, black African–Caribbean and white European children using a range of adiposity markers. A cross-sectional survey in London, Birmingham and Leicester primary schools was conducted. Weight, height, waist circumference, skinfold thickness values (biceps, triceps, subscapular and suprailiac) were measured. Fat mass was derived from bioimpedance; optimally height-standardized indices were derived for all adiposity markers. Ethnic origin was based on parental self-report. Multilevel models were used to obtain adjusted means and ethnic differences adjusted for gender, age, month, observer and school (fitted as a random effect). A total of 5887 children aged 9–10 years participated (response rate 68%), including 1345 white Europeans, 1523 South Asians and 1570 black African–Caribbeans. Results Compared with white Europeans, South Asians had a higher sum of all skinfolds and fat mass percentage, and their body mass index (BMI) was lower. South Asians were slightly shorter but use of optimally height-standardized indices did not materially affect these comparisons. At any given fat mass, BMI was lower in South Asians than white Europeans. In similar comparisons, black African–Caribbeans had a lower sum of all skinfolds but a higher fat mass percentage, and their BMI was higher. Black African–Caribbeans were markedly taller. Use of optimally height-standardized indices yielded markedly different findings; sum of skinfolds index was markedly lower, whereas fat mass index and weight-for-height index were similar. At any given fat mass, BMI was similar in black African–Caribbeans and white Europeans. Conclusions UK South Asian children have higher adiposity levels and black African–Caribbeans have similar or lower adiposity levels when compared with white Europeans. However, these differences are not well represented by comparisons based on BMI, which systematically

  2. Ethical and social issues in presymptomatic testing for Huntington's disease: a European Community collaborative study. European Community Huntington's Disease Collaborative Study Group.

    PubMed Central

    1993-01-01

    An analysis of social and ethical aspects of presymptomatic testing for Huntington's disease has been carried out, based on data on linked DNA markers, from four major testing centres in different European Community countries (Belgium, Italy, Netherlands, and United Kingdom). Information was available on 603 applicants, with 213 final results given, of which 32% gave an increased risk. A series of specific issues and problems were documented systematically for all applicants, results being given on frequency of occurrence and illustrated by individual case histories. The principal issues could be grouped as problems of inappropriate referral, problems involving relatives, and problems relating to disclosure of results. At least one important problem was encountered in 46% of applicants, emphasising the importance of expert counselling, preparation, and support of applicants, and of close liaison between clinical, counselling, and laboratory staff. The extensive and detailed information available for Huntington's disease from this and other studies will be of considerable value in relation to genetic testing for other late onset genetic disorders and will be even more relevant to Huntington's disease now that specific mutation analysis is possible for this disorder. PMID:8133502

  3. Hospital managers' need for information in decision-making--An interview study in nine European countries.

    PubMed

    Kidholm, Kristian; Ølholm, Anne Mette; Birk-Olsen, Mette; Cicchetti, Americo; Fure, Brynjar; Halmesmäki, Esa; Kahveci, Rabia; Kiivet, Raul-Allan; Wasserfallen, Jean-Blaise; Wild, Claudia; Sampietro-Colom, Laura

    2015-11-01

    Assessments of new health technologies in Europe are often made at the hospital level. However, the guidelines for health technology assessment (HTA), e.g. the EUnetHTA Core Model, are produced by national HTA organizations and focus on decision-making at the national level. This paper describes the results of an interview study with European hospital managers about their need for information when deciding about investments in new treatments. The study is part of the AdHopHTA project. Face-to-face, structured interviews were conducted with 53 hospital managers from nine European countries. The hospital managers identified the clinical, economic, safety and organizational aspects of new treatments as being the most relevant for decision-making. With regard to economic aspects, the hospital managers typically had a narrower focus on budget impact and reimbursement. In addition to the information included in traditional HTAs, hospital managers sometimes needed information on the political and strategic aspects of new treatments, in particular the relationship between the treatment and the strategic goals of the hospital. If further studies are able to verify our results, guidelines for hospital-based HTA should be altered to reflect the information needs of hospital managers when deciding about investments in new treatments. PMID:26362086

  4. The randomized shortened dental arch study: tooth loss.

    PubMed

    Walter, M H; Weber, A; Marré, B; Gitt, I; Gerss, J; Hannak, W; Hartmann, S; Heydecke, G; Huppertz, J; Jahn, F; Ludwig, A; Mundt, T; Kern, M; Klein, V; Pospiech, P; Stumbaum, M; Wolfart, S; Wöstmann, B; Busche, E; Böning, K; Luthardt, R G

    2010-08-01

    The evidence concerning the management of shortened dental arch (SDA) cases is sparse. This multi-center study was aimed at generating data on outcomes and survival rates for two common treatments, removable dental prostheses (RDP) for molar replacement or no replacement (SDA). The hypothesis was that the treatments lead to different incidences of tooth loss. We included 215 patients with complete molar loss in one jaw. Molars were either replaced by RDP or not replaced, according to the SDA concept. First tooth loss after treatment was the primary outcome measure. This event occurred in 13 patients in the RDP group and nine patients in the SDA group. The respective Kaplan-Meier survival rates at 38 months were 0.83 (95% CI: 0.74-0.91) in the RDP group and 0.86 (95% CI: 0.78-0.95) in the SDA group, the difference being non-significant. PMID:20400723

  5. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients.

    PubMed

    Pépin, J L; Krieger, J; Rodenstein, D; Cornette, A; Sforza, E; Delguste, P; Deschaux, C; Grillier, V; Lévy, P

    1999-10-01

    Effective compliance (time spent at the effective pressure) with nasal CPAP in obstructive sleep apnea has been reported to be poor. The aim of our study was to evaluate effective compliance in a large European multicenter study. One hundred twenty-one consecutive newly treated patients (initial apnea-hypopnea index [AHI] = 62.0 +/- 29. 5/h, AHI under CPAP = 6.4 +/- 8.1/h, CPAP pressure = 8.7 +/- 2.6 cm H(2)O, BMI = 33.1 +/- 6.8 kg/m(2)) were randomly allocated to a group with (MC(+)) (n = 58) or without (MC(-)) (n = 63) a control unit measuring effective compliance at 1, 2, and 3 mo, which was compared with the built-in time counter data. MC(+) data were 94 +/- 10, 98 +/- 5, and 96 +/- 9% of counter data at 1, 2, and 3 mo, respectively. Using criteria of regular use already reported in the literature (at least 4 h of nCPAP per day of use and nCPAP administered more than 70% of the days) we found 77, 82, and 79% compliant patients at 1, 2, and 3 mo, respectively, 79% of the patients meeting these criteria each month. Although there were no pulmonary functions or polysomnographic differences between the two subgroups, the compliant patients did report a greater improvement in minor symptoms. We found a close correlation between effective use of CPAP and the machine run time. The main result of our study was a higher effective compliance than previously reported, approximately 80% of the patients being regular users versus 46% in a previously published study. This may result from different technical and medical follow-up. PMID:10508797

  6. Sustaining international partnerships: the European Master of Science Programme in Occupational Therapy, a case study.

    PubMed

    Ilott, Irene; Kottorp, Anders; la Cour, Karen; van Nes, Fenna; Jonsson, Hans; Sadlo, Gaynor

    2013-06-01

    International partnerships are a mechanism for supporting the academic development of occupational therapy and promoting cultural competence. This case study describes the factors that have helped to sustain a post-qualifying programme implemented by five higher education institutions in Denmark, the Netherlands, Sweden, Switzerland and the UK since 1999. Data collection methods were documentary analysis and the reflections of a purposive sample of six key informants. Cohort and outcome data, from 193 students from 31 countries who enrolled between 1999 and 2011, are reported. Each cohort comprises students from an average of eight countries to optimize inter-cultural dialogue. Four factors support sustainability. These are 1) supportive professional European networks; 2) timeliness and alignment with European higher education policy; 3) partnership structures and processes that emphasize joint decision making and accountability; and 4) the stimulus and satisfaction associated with internationalization. The main limitations are considering the OT-EuroMaster as an intrinsic case study and using opportunistic data collection that undermines the rigor and transferability of the findings. Future opportunities include doctoral networks, transnational research and sharing our curricula design with other Regions to spread the collaborative, capacity building endeavours more widely. PMID:23559568

  7. Detecting Genetic Isolation in Human Populations: A Study of European Language Minorities

    PubMed Central

    Capocasa, Marco; Battaggia, Cinzia; Anagnostou, Paolo; Montinaro, Francesco; Boschi, Ilaria; Ferri, Gianmarco; Alù, Milena; Coia, Valentina; Crivellaro, Federica; Bisol, Giovanni Destro

    2013-01-01

    The identification of isolation signatures is fundamental to better understand the genetic structure of human populations and to test the relations between cultural factors and genetic variation. However, with current approaches, it is not possible to distinguish between the consequences of long-term isolation and the effects of reduced sample size, selection and differential gene flow. To overcome these limitations, we have integrated the analysis of classical genetic diversity measures with a Bayesian method to estimate gene flow and have carried out simulations based on the coalescent. Combining these approaches, we first tested whether the relatively short history of cultural and geographical isolation of four “linguistic islands” of the Eastern Alps (Lessinia, Sauris, Sappada and Timau) had left detectable signatures in their genetic structure. We then compared our findings to previous studies of European population isolates. Finally, we explored the importance of demographic and cultural factors in shaping genetic diversity among the groups under study. A combination of small initial effective size and continued genetic isolation from surrounding populations seems to provide a coherent explanation for the diversity observed among Sauris, Sappada and Timau, which was found to be substantially greater than in other groups of European isolated populations. Simulations of micro-evolutionary scenarios indicate that ethnicity might have been important in increasing genetic diversity among these culturally related and spatially close populations. PMID:23418562

  8. Consumer perceptions of beef healthiness: results from a qualitative study in four European countries

    PubMed Central

    2010-01-01

    Background Consumer perception of the healthiness of beef is an important determinant of beef consumption. However, little is known about how consumers perceive the healthiness of beef. The aim of this study is to shed light on the associations between beef and health. Methods Eight focus group discussions were conducted in four European countries (France, UK, Germany, Spain), each consisting of seven to nine participants. A content analysis was performed on the transcripts of these discussions. Results Although beef was generally perceived as healthful, focus group participants expected positive as well as negative effects of beef consumption on their health. Labelled, branded, fresh and lean beef were perceived as signalling healthful beef, in contrast with further processed and packaged beef. Consumers felt that their individual choices could make a difference with respect to the healthiness of beef consumed. Focus group participants were not in favour of improving beef healthiness during processing, but rather focussed on appropriate consumption behaviour and preparation methods. Conclusions The individual responsibility for health implies that consumers should be able to make correct judgements about how healthful their food is. However, the results of this study indicate that an accurate assessment of beef healthiness is not always straightforward. The presented results on consumer perceptions of beef healthiness provide insights into consumer decision making processes, which are important for the innovation and product differentiation in the European beef sector, as well as for public health policy decisions related to meat consumption in general and beef consumption in particular. PMID:20550647

  9. Study on 2D random medium inversion algorithm based on Fuzzy C-means Clustering theory

    NASA Astrophysics Data System (ADS)

    Xu, Z.; Zhu, P.; Gu, Y.; Yang, X.; Jiang, J.

    2015-12-01

    Abstract: In seismic exploration for metal deposits, the traditional seismic inversion method based on layered homogeneous medium theory seems difficult to inverse small scale inhomogeneity and spatial variation of the actual medium. The reason is that physical properties of actual medium are more likely random distribution rather than layered. Thus, it is necessary to investigate a random medium inversion algorithm. The velocity of 2D random medium can be described as a function of five parameters: the background velocity (V0), the standard deviation of velocity (σ), the horizontal and vertical autocorrelation lengths (A and B), and the autocorrelation angle (θ). In this study, we propose an inversion algorithm for random medium based on the Fuzzy C-means Clustering (FCM) theory, whose basic idea is that FCM is used to control the inversion process to move forward to the direction we desired by clustering the estimated parameters into groups. Our method can be divided into three steps: firstly, the three parameters (A, B, θ) are estimated from 2D post-stack seismic data using the non-stationary random medium parameter estimation method, and then the estimated parameters are clustered to different groups according to FCM; secondly, the initial random medium model is constructed with clustered groups and the rest two parameters (V0 and σ) obtained from the well logging data; at last, inversion of the random medium are conducted to obtain velocity, impedance and random medium parameters using the Conjugate Gradient Method. The inversion experiments of synthetic seismic data show that the velocity models inverted by our algorithm are close to the real velocity distribution and the boundary of different media can be distinguished clearly.Key words: random medium, inversion, FCM, parameter estimation

  10. Molecular analysis of anaplastic oligodendroglial tumors in a prospective randomized study: A report from EORTC study 26951.

    PubMed

    Kouwenhoven, Mathilde C M; Gorlia, Thierry; Kros, Johan M; Ibdaih, Ahmed; Brandes, Alba A; Bromberg, Jacolien E C; Mokhtari, Karima; van Duinen, Sjoerd G; Teepen, Johannes L; Wesseling, Pieter; Vandenbos, Fanny; Grisold, Wolfgang; Sipos, László; Mirimanoff, Rene; Vecht, Charles J; Allgeier, Anouk; Lacombe, Denis; van den Bent, Martin J

    2009-12-01

    Recent studies have shown that the clinical outcome of anaplastic oligodendroglial tumors is variable, but also that the histological diagnosis is subject to interobserver variation. We investigated whether the assessment of 1p/19q codeletion, polysomy of chromosome 7, epidermal growth factor receptor (EGFR) gene amplification (EGFR(amp)), and loss of chromosome 10 or 10q offers additional prognostic information to the histological diagnosis and would allow molecular subtyping. For this study, we used the clinical data and tumor samples of the patients included in multicenter prospective phase III European Organisation for Research and Treatment of Cancer (EORTC) study 26951 on the effects of adjuvant procarbazine, chloroethyl cyclohexylnitrosourea (lomustine), and vincristine chemotherapy in anaplastic oligodendroglial tumors. Fluorescence in situ hybridization was used to assess copy number aberrations of chromosome 1p, 19q, 7, 10, and 10q and EGFR. Three different analyses were performed: on all included patients based on local pathology diagnosis, on the patients with confirmed anaplastic oligodendroglial tumors on central pathology review, and on this latter group but after excluding anaplastic oligoastrocytoma (AOA) with necrosis. As a reference set for glioblastoma multiforme (GBM), patients from the prospective randomized phase III study on GBM (EORTC 26981) were used as a benchmark. In 257 of 368 patients, central pathology review confirmed the presence of an anaplastic oligodendroglial tumor. Tumors with combined 1p and 19q loss (1p(loss)19q(loss)) were histopathologically diagnosed as anaplastic oligodendroglioma, were more frequently located in the frontal lobe, and had a better outcome. Anaplastic oligodendroglial tumors with EGFR(amp) were more frequently AOA, were more often localized outside the frontal lobe, and had a survival similar to that for GBM. Survival of patients with AOA harboring necrosis was in a similar range as for GBM, while patients

  11. Molecular analysis of anaplastic oligodendroglial tumors in a prospective randomized study: A report from EORTC study 26951

    PubMed Central

    Kouwenhoven, Mathilde C.M.; Gorlia, Thierry; Kros, Johan M.; Ibdaih, Ahmed; Brandes, Alba A.; Bromberg, Jacolien E.C.; Mokhtari, Karima; van Duinen, Sjoerd G.; Teepen, Johannes L.; Wesseling, Pieter; Vandenbos, Fanny; Grisold, Wolfgang; Sipos, László; Mirimanoff, Rene; Vecht, Charles J.; Allgeier, Anouk; Lacombe, Denis; van den Bent, Martin J.

    2009-01-01

    Recent studies have shown that the clinical outcome of anaplastic oligodendroglial tumors is variable, but also that the histological diagnosis is subject to interobserver variation. We investigated whether the assessment of 1p/19q codeletion, polysomy of chromosome 7, epidermal growth factor receptor (EGFR) gene amplification (EGFRamp), and loss of chromosome 10 or 10q offers additional prognostic information to the histological diagnosis and would allow molecular subtyping. For this study, we used the clinical data and tumor samples of the patients included in multicenter prospective phase III European Organisation for Research and Treatment of Cancer (EORTC) study 26951 on the effects of adjuvant procarbazine, chloroethyl cyclohexylnitrosourea (lomustine), and vincristine chemotherapy in anaplastic oligodendroglial tumors. Fluorescence in situ hybridization was used to assess copy number aberrations of chromosome 1p, 19q, 7, 10, and 10q and EGFR. Three different analyses were performed: on all included patients based on local pathology diagnosis, on the patients with confirmed anaplastic oligodendroglial tumors on central pathology review, and on this latter group but after excluding anaplastic oligoastrocytoma (AOA) with necrosis. As a reference set for glioblastoma multiforme (GBM), patients from the prospective randomized phase III study on GBM (EORTC 26981) were used as a benchmark. In 257 of 368 patients, central pathology review confirmed the presence of an anaplastic oligodendroglial tumor. Tumors with combined 1p and 19q loss (1ploss19qloss) were histopathologically diagnosed as anaplastic oligodendroglioma, were more frequently located in the frontal lobe, and had a better outcome. Anaplastic oligodendroglial tumors with EGFRamp were more frequently AOA, were more often localized outside the frontal lobe, and had a survival similar to that for GBM. Survival of patients with AOA harboring necrosis was in a similar range as for GBM, while patients with

  12. Impact of the Training on the Compliance and Persistence of Weekly Bisphosphonate Treatment in Postmenopausal Osteoporosis: A Randomized Controlled Study

    PubMed Central

    Tüzün, Şansın; Akyüz, Gülseren; Eskiyurt, Nurten; Memiş, Asuman; Kuran, Banu; İçağasıoğlu, Afitap; Sarpel, Tunay; Özdemir, Ferda; Özgirgin, Neşe; Günaydın, Rezzan; Çakçı, Aytül; Yurtkuran, Merih

    2013-01-01

    Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2nd, 5th, 8th, and 11th months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3rd, 6th, 9th, and 12th months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire.. Of 448 patients (mean age 62.4±7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7±25.4 vs. 34.0

  13. A randomized trial of hydroxyurea versus VP16 in adult chronic myelomonocytic leukemia. Groupe Français des Myélodysplasies and European CMML Group.

    PubMed

    Wattel, E; Guerci, A; Hecquet, B; Economopoulos, T; Copplestone, A; Mahé, B; Couteaux, M E; Resegotti, L; Voglova, V; Foussard, C; Pegourié, B; Michaux, J L; Deconinck, E; Stoppa, A M; Mufti, G; Oscier, D; Fenaux, P

    1996-10-01

    We performed a randomized study of hydroxyurea (HY) versus VP16 in advanced chronic myelomonocytic leukemia (CMML) patients with CMML (according to French-American-British group criteria) and either documented visceral involvement (excluding liver and spleen infiltration) or at least 2 of the following: (1) neutrophils > 16 x 10(9)/I (2) Hemoglobin < 10 g/dL (3) platelets < 100 x 10(9)/L (4) marrow blasts > 5% (5) spleen > 5 cm below costal margin were eligible for this trial. Initial dosage was 1 g/d for HY and 150 mg/week for VP16, orally (doubled in case of visceral involvement). Doses were scheduled to be escalated up to HY 4 g/d and VP16 600 mg/week in the absence of response, and finally adjusted to maintain white blood cells (WBCs) between 5 and 10 x 10(9)/L. Crossing over was scheduled only in case of life threatening visceral involvement or major progression. The major endpoint of the study was survival. The study was closed on first interim analysis that showed a superiority of HY over VP16, after inclusion of 105 pts (HY arm: 53, VP16 arm: 52). Results of the second interim analysis, performed 7 months later, are presented here. Median age was 71 (range 38 to 91), median WBC count 20.10(9)/L (range 10 to 187). Thirteen pts had visceral involvement (3 serous effusions, 8 cutaneous infiltrations, 1 kidney, 1 bone infiltrations). Initial characteristics were similar in the HY and VP16 groups. Median follow up was 11 months in both groups (range 1 to 43+). Response to treatment was seen in 60% of the pts in the HY group, versus 36%, respectively, in the VP16 group (P = .02). Time to response was significantly shorter in the HY group (2.1 v 3.5 months, in the VP16 group, P = .003) and response duration was significantly longer in the HY group (median 24 v 9 months, in the VP16 group, P = .0004). The response rate of patients with visceral involvement was 3 out of 7 in the VP16 arm versus 5 out of 6 in the HY group. Three of the 10 pts crossed over from HY to

  14. Determinants of glycemic control in youth with type 2 diabetes at randomization in the TODAY study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to investigate insulin sensitivity and secretion indices and determinants of glycemic control in youth with recent-onset type 2 diabetes (T2DM) at randomization in the TODAY study, the largest study of youth with T2DM to date. We examined estimates of insulin sensitivit...

  15. A European research infrastructure for the aerosol study on a continental scale: EARLINET-ASOS

    NASA Astrophysics Data System (ADS)

    Amodeo, Aldo; Pappalardo, Gelsomina; Bösenberg, Jens; Ansmann, Albert; Apituley, Arnoud; Alados-Arboledas, Lucas; Balis, Dimitris; Böckmann, Christine; Chaikovsky, Anatoly; Comeron, Adolfo; Freudenthaler, Volker; Gustaffson, Ove; Hansen, Georg; Mitev, Valentin; Nicolae, Doina; Papayannis, Alexandros; Perrone, Maria Rita; Pietruczuk, Aleksander; Pujadas, Manuel; Putaud, Jean-Philippe; Ravetta, Francois; Rizi, Vincenzo; Simeonov, Valentin; Spinelli, Nicola; Stoyanov, Dimitar; Trickl, Thomas; Wiegner, Matthias

    2007-10-01

    The present knowledge of the aerosol distribution is not sufficient to estimate the aerosol influence on global and regional environmental conditions and climate. This observational gap can be closed by using advanced laser remote sensing. EARLINET (European Aerosol Research Lidar Network) is the first aerosol lidar network, established in 2000, with the main goal to provide a comprehensive, quantitative, and statistically significant database for the aerosol distribution on a continental scale. EARLINET is a coordinated network of European stations (25 at present) using advanced lidar methods for the vertical profiling of aerosols. The network activity is based on simultaneous scheduled measurements, a rigorous quality assurance program addressing both instruments and evaluation algorithms, and a standardised data exchange format. Further observations are performed to monitor special events. EARLINET-ASOS (Advanced Sustainable Observation System) is a five year EC Project started in 2006, based on the EARLINET infrastructure. The main objectives are: to make EARLINET a world-leading instrument for the observation of the 4-D aerosol distribution on continental scale; to foster aerosol-related process studies, validation of satellite sensors, model development and validation, assimilation of aerosol data into operational models; and to build a comprehensive climatology of the aerosol distribution.

  16. General Practitioners Recognizing Alcohol Dependence: A Large Cross-Sectional Study in 6 European Countries

    PubMed Central

    Rehm, Jürgen; Allamani, Allaman; Vedova, Roberto Della; Elekes, Zsuzsanna; Jakubczyk, Andrzej; Landsmane, Inga; Manthey, Jakob; Moreno-España, José; Pieper, Lars; Probst, Charlotte; Snikere, Sigita; Struzzo, Pierluigi; Voller, Fabio; Wittchen, Hans-Ulrich; Gual, Antoni; Wojnar, Marcin

    2015-01-01

    PURPOSE Although alcohol dependence causes marked mortality and disease burden in Europe, the treatment rate is low. Primary care could play a key role in reducing alcohol-attributable harm by screening, brief interventions, and initiating or referral to treatment. This study investigates identification of alcohol dependence in European primary care settings. METHODS Assessments from 13,003 general practitioners, and 9,098 interviews (8,476 joint number of interviewed patients with a physician’s assessment) were collected in 6 European countries. Alcohol dependence, comorbidities, and health service utilization were assessed by the general practitioner and independently using the Composite International Diagnostic Interview (CIDI) and other structured interviews. Weighted regression analyses were used to compare the impact of influencing variables on both types of diagnoses. RESULTS The rate of patients being identified as alcohol dependent by the CIDI or a general practitioner was about equally high, but there was not a lot of overlap between cases identified. Alcohol-dependent patients identified by a physician were older, had higher rates of physicial comorbidity (liver disease, hypertension), and were socially more marginalized, whereas average consumption of alcohol and mental comorbidity were equally high in both groups. CONCLUSION General practitioners were able to identify alcohol dependence, but the cases they identified differed from cases identified using the CIDI. The role of the CIDI as the reference standard should be reexamined, as older alcohol-dependent patients with severe comorbidities seemed to be missed in this assessment. PMID:25583889

  17. Nuclear waste incineration and accelerator aspects from the European PDS-XADS study

    NASA Astrophysics Data System (ADS)

    Mueller, Alex C.

    2005-04-01

    In the context of general environmental concerns, the issue of waste from nuclear power plants is a question of actual interest. Here fundamental research in Nuclear Science may have great potential impact on society and on the longer-term future. In contrast to certain non-scientifically voiced opininos, it is clear, from basic facts of Nuclear Science, that e.g. fast neutrons can transmute long-lived radio-toxic components of the spent fuel into short-lived species. Because of the flexibility and control needed for the transmutation of large quantities of nuclear waste with a high content of minor actinides, one could favor for a transmuter reactor a sub-critical system, where the needed additional neutrons come from an external source, i.e. a high-energy proton accelerator producing spallation neutrons. In the European context, a roadmap for this technology was developped by a technical expert group. Consecutive to this, the European project PDS-XADS has been launched, as a preliminary design study for an Accelerator-Driven System. Here we shall report the conclusions for the layout of the accelerator and the associated beam-line to the reactor. The technical options have been chosen with the reliability of the accelerator as prime design criterion.

  18. An European historical reconstruction of sea surface dynamics (waves and storm surge) for coastal impact studies

    NASA Astrophysics Data System (ADS)

    Menendez, Melisa; Perez, Jorge; Cid, Alba; Castanedo, Sonia; Losada, Inigo; Medina, Raul; Mendez, Fernando

    2015-04-01

    Despite their outstanding relevance in coastal processes, a study of the sea surface dynamics due to atmospheric wind and pressure variations are rather limited in comparison with the mean sea level rise. Data of waves and surges along the European region are scarce and in-homogeneous, not only in terms of spatial coverage but also in terms of temporal coverage. This study presents two databases focused on a historical reconstruction of: (i) the wind-generated waves (GOW) and (ii) the meteorological sea level component (GOS). The GOW and GOS datasets cover the whole European coast (North Atlantic, North Sea, Baltic Sea, Mediterranean Sea and Black Sea) at high-spatial resolution from 1979 to present. The meteorological sea level component (storm surge) has been generated by the Regional Ocean Model System (ROMS). To take into account non-linear interactions between tides and surges, both dynamics were simulated jointly. Final results of meteorological component of sea level were obtained by subtracting the astronomical tide from the simulated sea surface. The model was set-up for Europe using an orthogonal grid, with a horizontal resolution ranging between 3.5 to 11 km. A spatial domain of approximately 5 km was used for the Black Sea. Local coastal waves can be the integrated result of the ocean surface over a large region of influence. GOW-Europe is designed from a multigrid approach based on the overlapping of two-way nested domains. The coarser spatial resolution along the European coast of GOW is 15 km. The generation and propagation of the sea surface waves of GOW-Europe are simulated with the model WAVEWATCH III v4.18. Effects of non-linear wave-wave interactions, whitecapping and depth-induced refraction are considered in the propagation model. In order to validate GOW and GOS over Europe with available observations, an exhaustive comparison with in-situ and remote measurements was developed. In-situ buoys and tide-gauges are used to compare hourly time

  19. The quality of control groups in non-randomized studies published in Journal of Hand Surgery

    PubMed Central

    Johnson, Shepard P.; Malay, Sunitha; Chung, Kevin C.

    2016-01-01

    Purpose To evaluate control group selection in non-randomized studies published in the Journal of Hand Surgery American (JHS). Methods We reviewed all papers published in JHS in 2013 to identify studies that used non-randomized control groups. Data collected included type of study design and control group characteristics. We then appraised studies to determine if authors discussed confounding and selection bias and how they controlled for confounding. Results Thirty-seven non-randomized studies were published in JHS in 2013. The source of control was either the same institution as the study group, a different institution, a database, or not provided in the manuscript. Twenty-nine (78%) studies statistically compared key characteristics between control and study group. Confounding was controlled with matching, exclusion criteria, or regression analysis. Twenty-two (59%) papers explicitly discussed the threat of confounding and 18(49%) identified sources of selection bias. Conclusions In our review of non-randomized studies published in JHS, papers had well-defined controls that were similar to the study group, allowing for reasonable comparisons. However, we identified substantial confounding and bias that were not addressed as explicit limitations, which might lead the reader to overestimate the scientific validity of the data. Clinical relevance Incorporating a brief discussion of control group selection in scientific manuscripts should help readers interpret the study more appropriately. Authors, reviewers, and editors should strive to address this component of clinical importance. PMID:25447000

  20. Fire Regime and Land Abandonment in European Russia: Case Study of Smolensk Oblast

    NASA Astrophysics Data System (ADS)

    Krylov, A.; McCarty, J. L.; Potapov, P.; Turubanova, S.; Prishchepov, A. V.; Manisha, A.; Romanenkov, V.; Rukhovitch, D.; Koroleva, P.; Hansen, M.

    2014-12-01

    Fires in anthropogenically-dominated landscapes are generally attributed to ecosystem management, agriculture, and policy drivers. In European Russia, fire mainly occurring on agricultural lands, wetlands, and abandoned lands. In the agricultural practice in Russia prescribed fires are believed to increase pasture and hay productivity, suppress trees and shrub expansion, and reduce fire hazards, with fire frequency fire dependent on land use and agricultural practices. The large-scale socio-economic transition since the fall of the Soviet Union has led to changes in land use and land management, including land abandonment and changing agricultural practices. In June 2014, an extensive field campaign was completed in the Smolensk Oblast, located approximately two hundred kilometers west of Moscow on the border with Belarus. Our field sampling was based on circa 1985 Landsat-based forest cover map (Potapov et al., 2014). Points were randomly selected from the non-forested class of the 1985 classification, prior to the collapse of the Soviet Union. Of total field collects, 55% points were sampled on land in either early or late stage of abandonment, 15% from actively cropped fields, and 30% from hay or pasture. Fire frequency was calculated for the 108 field points using 1 km Moderate Resolution Imaging Spectroradiometer (MODIS) active fire data for years 2000-2014. Also we calculated percent of points burned in spring 2014 using 30 m Landsat 8 Operational Land Imager (OLI) data to derive burn scars. Actively cropped fields had lowest burn frequency while abandoned lands - early and late stage abandonment - had highest frequency. Fire frequency was significantly higher on wet soils than dry soils, with no relationship between fire frequency and tree canopy cover. We hypothesize, higher fire frequency on abandoned lands was likely due to greater fuel loads and because of traditional belief in rural Russia that fire is efficient way to suppress tree and shrub expansion.

  1. Field study analysis of the influences of deworming regimens and housing conditions on parasites and sperm output in 21 European boar studs.

    PubMed

    Schulze, Martin; Ammon, Christian; Nürnberg, Gerd; Rüdiger, Karin; Jung, Markus; Demeler, Janina

    2016-03-01

    The current study reports the parasitological results of a quality control audit in 21 European boar studs. Field investigations were performed over a 2-year period (2012-2013) during the winter and spring. From each stud, an average of 30 (range, 25-33) individual faecal samples and ejaculates from 615 randomly selected Pietrain boars were analysed. Statistical analysis revealed a significant effect (P < 0.0001) of deworming regimen (DR) × age class of boar (A) and housing condition (H) × A on the presence of parasites. A second model indicated a significant effect (P = 0.0262) of DR × H × A on the presence of parasites. Sperm output was significantly affected (P < 0.0001) by the DR. Based on this study, recommendations for deworming AI boars are proposed. PMID:26831176

  2. Plain packaging of cigarettes and smoking behavior: study protocol for a randomized controlled study

    PubMed Central

    2014-01-01

    Background Previous research on the effects of plain packaging has largely relied on self-report measures. Here we describe the protocol of a randomized controlled trial investigating the effect of the plain packaging of cigarettes on smoking behavior in a real-world setting. Methods/Design In a parallel group randomization design, 128 daily cigarette smokers (50% male, 50% female) will attend an initial screening session and be assigned plain or branded packs of cigarettes to smoke for a full day. Plain packs will be those currently used in Australia where plain packaging has been introduced, while branded packs will be those currently used in the United Kingdom. Our primary study outcomes will be smoking behavior (self-reported number of cigarettes smoked and volume of smoke inhaled per cigarette as measured using a smoking topography device). Secondary outcomes measured pre- and post-intervention will be smoking urges, motivation to quit smoking, and perceived taste of the cigarettes. Secondary outcomes measured post-intervention only will be experience of smoking from the cigarette pack, overall experience of smoking, attributes of the cigarette pack, perceptions of the on-packet health warnings, behavior changes, views on plain packaging, and the rewarding value of smoking. Sex differences will be explored for all analyses. Discussion This study is novel in its approach to assessing the impact of plain packaging on actual smoking behavior. This research will help inform policymakers about the effectiveness of plain packaging as a tobacco control measure. Trial registration Current Controlled Trials ISRCTN52982308 (registered 27 June 2013). PMID:24965551

  3. GREATER KUDU (TRAGELAPHUS STREPSICEROS) MORTALITY IN EUROPEAN ZOOLOGICAL INSTITUTIONS: A RETROSPECTIVE STUDY.

    PubMed

    Leclerc, Antoine; Lamglait, Benjamin; Petit, Thierry; Roman, Yannick; Jebram, Joerg

    2016-06-01

    A questionnaire was sent to 39 European institutions holding greater kudus (Tragelaphus strepsiceros), in order to determine the causes of captive greater kudu mortality. All reported macroscopic lesions and histopathologic observations, as well as other information regarding individuals that died, were analyzed to determine the most affected body systems and causes of death. Overall response rate was 31%, and 131 individuals were included in the study. The most frequently affected body systems were the digestive system (47%), respiratory system (38%), musculoskeletal system (37%), and cardiovascular system (32%). Most frequent causes of death were infectious diseases (27%) and trauma/accidents (18%); the cause was undetermined in 28% of cases. Nutrition-related disorders were difficult to assess, but results highlight possible nutritional imbalances. This retrospective study represents the first overview of greater kudu mortality in a captive population. PMID:27468026

  4. Feasibility Study of the Superconducting Gravity Gradiometer (SGG) Flight Test on the European Retrievable Carrier (EURECA)

    NASA Technical Reports Server (NTRS)

    1991-01-01

    A study was performed to determine the feasibility of conducting a flight test of the Superconducting Gravity Gradiometer (SGG) Experiment Module on one of the reflights of the European Retrievable Carrier (EURECA). EURECA was developed expressly to accommodate space science experimentation, while providing a high quality microgravity environment. As a retrievable carrier, it offers the ability to recover science experiments after a nominal six months of operations in orbit. The study concluded that the SGG Experiment Module can be accommodated and operated in a EURECA reflight mission. It was determined that such a flight test would enable the verification of the SGG Instrument flight performance and validate the design and operation of the Experiment Module. It was also concluded that a limited amount of scientific data could be obtained on this mission.

  5. The Richer, the Happier? An Empirical Investigation in Selected European Countries

    ERIC Educational Resources Information Center

    Seghieri, Chiara; Desantis, Gustavo; Tanturri, Maria Letizia

    2006-01-01

    This study analyses the relationship between subjective and objective measures of well-being in selected European countries using the data of the European Community Household Panel (ECHP). In the first part of the paper, we develop a random-effect ordered probit model, separately for each country, relating the subjective measure of income…

  6. Associations between early body mass index trajectories and later metabolic risk factors in European children: the IDEFICS study.

    PubMed

    Börnhorst, Claudia; Tilling, Kate; Russo, Paola; Kourides, Yannis; Michels, Nathalie; Molnár, Denés; Rodríguez, Gerado; Moreno, Luis A; Krogh, Vittorio; Ben-Shlomo, Yoav; Ahrens, Wolfgang; Pigeot, Iris

    2016-05-01

    Faster growth seems to be a common factor in several hypotheses relating early life exposures to subsequent health. This study aims to investigate the association between body mass index (BMI) trajectories during infancy/childhood and later metabolic risk in order to identify sensitive periods of growth affecting health. In a first step, BMI trajectories of 3301 European children that participated in the multi-centre Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) study were modelled using linear-spline mixed-effects models. The estimated random coefficients indicating initial subject-specific BMI and rates of change in BMI over time were used as exposure variables in a second step and related to a metabolic syndrome (MetS) score and its single components based on conditional regression models (mean age at outcome assessment: 8.5 years). All exposures under investigation, i.e. BMI at birth, rates of BMI change during infancy (0 to <9 months), early childhood (9 months to <6 years) and later childhood (≥6 years) as well as current BMI z-score were significantly associated with the later MetS score. Associations were strongest for the rate of BMI change in early childhood (1.78 [1.66; 1.90]; β estimate and 99 % confidence interval) and current BMI z-score (1.16 [0.96; 1.38]) and less pronounced for BMI at birth (0.62 [0.47; 0.78]). Results slightly differed with regard to the single metabolic factors. Starting from birth rapid BMI growth, especially in the time window of 9 months to <6 years, is significantly related to later metabolic risk in children. Much of the associations of early BMI growth may further be mediated through the effects on subsequent BMI growth. PMID:26297214

  7. Intravenous amifostine during chemoradiotherapy for head-and-neck cancer: A randomized placebo-controlled phase III study

    SciTech Connect

    Buentzel, Jens . E-mail: jens.buentzel@shk-ndh.de; Micke, Oliver; Adamietz, Irenaus A.; Monnier, Alain; Glatzel, Michael; Vries, Alexander de

    2006-03-01

    Purpose: Clinical trials demonstrated the efficacy and safety of intravenous (i.v.) or subcutaneous (s.c.) amifostine for reducing xerostomia and mucositis after radiotherapy or radiochemotherapy for head-and-neck cancer. This randomized, double-blinded, placebo-controlled, phase III study evaluated the efficacy and safety of i.v. amifostine during radiochemotherapy for head-and-neck cancer. Methods and Materials: Patients from European and American study centers received i.v. amifostine 300 mg/m{sup 2} (n = 67) or placebo (n = 65) before carboplatin 70 mg/m{sup 2} and radiotherapy on Days 1 to 5 and 21 to 25, and i.v. amifostine 200 mg/m{sup 2} or placebo before radiotherapy on other days. Results: Toxicity incidences were (amifostine, placebo, p value): Grade 2 or higher acute xerostomia (39%, 34%, 0.715), Grade 3 or higher acute mucositis (39%, 22%, 0.055), Grade 2 or higher late xerostomia (37%, 24%, 0.235), and Grade 3 or higher treatment-related adverse events (42%, 20%, 0.008). One-year rates of locoregional failure, progression-free survival, and overall survival were not significantly different between treatments. Conclusions: The used amifostine doses were not able to reduce the toxicity of simultaneous radiochemotherapy for head-and-neck cancer. The safety of amifostine and the lack of tumor protection were consistent with previous studies.

  8. Application of random effects to the study of resource selection by animals.

    PubMed

    Gillies, Cameron S; Hebblewhite, Mark; Nielsen, Scott E; Krawchuk, Meg A; Aldridge, Cameron L; Frair, Jacqueline L; Saher, D Joanne; Stevens, Cameron E; Jerde, Christopher L

    2006-07-01

    1. Resource selection estimated by logistic regression is used increasingly in studies to identify critical resources for animal populations and to predict species occurrence. 2. Most frequently, individual animals are monitored and pooled to estimate population-level effects without regard to group or individual-level variation. Pooling assumes that both observations and their errors are independent, and resource selection is constant given individual variation in resource availability. 3. Although researchers have identified ways to minimize autocorrelation, variation between individuals caused by differences in selection or available resources, including functional responses in resource selection, have not been well addressed. 4. Here we review random-effects models and their application to resource selection modelling to overcome these common limitations. We present a simple case study of an analysis of resource selection by grizzly bears in the foothills of the Canadian Rocky Mountains with and without random effects. 5. Both categorical and continuous variables in the grizzly bear model differed in interpretation, both in statistical significance and coefficient sign, depending on how a random effect was included. We used a simulation approach to clarify the application of random effects under three common situations for telemetry studies: (a) discrepancies in sample sizes among individuals; (b) differences among individuals in selection where availability is constant; and (c) differences in availability with and without a functional response in resource selection. 6. We found that random intercepts accounted for unbalanced sample designs, and models with random intercepts and coefficients improved model fit given the variation in selection among individuals and functional responses in selection. Our empirical example and simulations demonstrate how including random effects in resource selection models can aid interpretation and address difficult assumptions

  9. Anthropometric measurements and vertebral deformities. European Vertebral Osteoporosis Study (EVOS) Group.

    PubMed

    Johnell, O; O'Neill, T; Felsenberg, D; Kanis, J; Cooper, C; Silman, A J

    1997-08-15

    To investigate the association between anthropometric indices and morphometrically determined vertebral deformity, the authors carried out a cross-sectional study using data from the European Vertebral Osteoporosis Study (EVOS), a population-based study of vertebral osteoporosis in 36 European centers from 19 countries. A total of 16,047 EVOS subjects were included in this analysis, of whom 1,973 subjects (915 males, 1,058 females) (12.3%) aged 50 years or over had one or more vertebral deformities ("cases"). The cases were compared with the 14,074 subjects (6,539 males, 7,535 females) with morphometrically normal spines ("controls"). Data were collected on self-reported height at age 25 years and minimum weight after age 25 years, as well as on current measured height and weight. Body mass index (BMI) and height and weight change were calculated from these data. The relations between these variables and vertebral deformity were examined separately by sex with logistic regression adjusting for age, smoking, and physical activity. In females, there was a significant trend of decreasing risk with increasing quintile of current weight, current BMI, and weight gain since age 25 years. In males, subjects in the lightest quintile for these measures were at increased risk but there was no evidence of a trend. An ecologic analysis by country revealed a negative correlation between mean BMI and the prevalence of deformity in females but not in males. The authors conclude that low body weight is associated with presence of vertebral deformity. PMID:9270407

  10. Correlations Between Cutaneous Malignant Melanoma and Other Cancers: An Ecological Study in Forty European Countries

    PubMed Central

    Serrano, Pablo Fernandez-Crehuet; Serrano, Jose Luis Fernandez-Crehuet; Allam, Mohamed Farouk; Navajas, Rafael Fernandez-Crehuet

    2016-01-01

    Background: The presence of noncutaneous neoplasms does not seem to increase the risk of cutaneous malignant melanoma; however, it seems to be associated with the development of other hematological, brain, breast, uterine, and prostatic neoplasms. An ecological transversal study was conducted to study the geographic association between cutaneous malignant melanoma and 24 localizations of cancer in forty European countries. Methods: Cancer incidence rates were extracted from GLOBOCAN database of the International Agency for Research on Cancer. We analyzed the age-adjusted and gender-stratified incidence rates for different localizations of cancer in forty European countries and calculated their correlation using Pearson's correlation test. Results: In males, significant correlations were found between cutaneous malignant melanoma with testicular cancer (r = 0.83 [95% confidence interval (CI): 0.68–0.89]), myeloma (r = 0.68 [95% CI: 0.46–0.81]), prostatic carcinoma (r = 0.66 [95% CI: 0.43–0.80]), and non-Hodgkin lymphoma (NHL) (r = 0.63 [95% CI: 0.39–0.78]). In females, significant correlations were found between cutaneous malignant melanoma with breast cancer (r = 0.80 [95% CI: 0.64–0.88]), colorectal cancer (r = 0.72 [95% CI: 0.52–0.83]), and NHL (r = 0.71 [95% CI: 0.50–0.83]). Conclusions: These correlations call to conduct new studies about the epidemiology of cancer in general and cutaneous malignant melanoma risk factors in particular. PMID:27217938

  11. The effect of spiritual retreat on nurses' spirituality: a randomized controlled study.

    PubMed

    Bay, Paul S; Ivy, Steven S; Terry, Colin L

    2010-01-01

    This study tested whether two 1-day retreats focused on spiritual self-care would positively change nurse participants' spirituality. A total of 199 critical care nurses were accepted into this study; 87 were randomized to receive the retreat intervention. All 199 nurses were tested preretreat, 1 month and 6 months postretreat. Retreat participants demonstrated increased spirituality. PMID:20421752

  12. Supervised Home Training of Dialogue Skills in Chronic Aphasia: A Randomized Parallel Group Study

    ERIC Educational Resources Information Center

    Nobis-Bosch, Ruth; Springer, Luise; Radermacher, Irmgard; Huber, Walter

    2011-01-01

    Purpose: The aim of this study was to prove the efficacy of supervised self-training for individuals with aphasia. Linguistic and communicative performance in structured dialogues represented the main study parameters. Method: In a cross-over design for randomized matched pairs, 18 individuals with chronic aphasia were examined during 12 weeks of…

  13. Increasing Parent Involvement in Youth HIV Prevention: A Randomized Caribbean Study

    ERIC Educational Resources Information Center

    Baptiste, Donna R.; Kapungu, Chisina; Miller, Steve; Crown, Laurel; Henry, David; Da Costa Martinez, Dona; Jo-Bennett, Karen

    2009-01-01

    This article presents preliminary findings of a randomized HIV prevention study in Trinidad and Tobago in the Caribbean. The study centers on a family HIV workshop aimed at strengthening parenting skills that are empirically linked to reducing adolescent HIV exposure and other sexual risks. These skills include parental monitoring; educating youth…

  14. A Proof of Concept, Phase II Randomized European Trial, on the Efficacy of ALF-5755, a Novel Extracellular Matrix-Targeted Antioxidant in Patients with Acute Liver Diseases

    PubMed Central

    Nalpas, Bertrand; Ichaï, Philippe; Jamot, Laure; Carbonell, Nicolas; Rudler, Marika; Mathurin, Philippe; Durand, François; Gerken, Guido; Manns, Michael; Trautwein, Christian; Larrey, Dominique; Radenne, Sylvie; Duvoux, Christophe; Leroy, Vincent; Bernuau, Jacques; Faivre, Jamila; Moniaux, Nicolas; Bréchot, Christian; Amouyal, Gilles; Amouyal, Paul; Samuel, Didier

    2016-01-01

    Objective No efficient medical treatment is available for severe acute hepatitis (SAH) except N-acetylcysteine for acetaminophen-induced acute liver failure. The human C-type lectin Reg3α, referred to as ALF-5755, improved survival in an animal model of acute liver failure and was well tolerated in a phase 1 trial in humans. We performed a phase 2a trial of ALF5755 in non-acetaminophen induced SAH. Design double-blind, randomized, placebo-controlled study. The primary end-point was the improvement in the coagulation protein synthesis assessed by the change of Prothrombin (PR) during the 72 hours following treatment initiation calculated as PRH0 minus PRH72 divided by 72 (PR slope H0H72). Intention to treat (ITT) and per-protocol (PP) analysis of the entire group and the Hepatitis B virus (HBV)/AIH (auto-immune hepatitis) sub-group were done separately. Results 57 patients were included. Twenty-eight received ALF-5755, 29 the placebo. Etiologies were: Hepatitis A (n = 10), HBV (n = 13), AIH (n = 9), drug-induced (n = 8), other (n = 17). On the whole group, nor the PR slope H0H72 (0.18±0.31 vs 0.25±0.32), nor the transplant-free survival rate at day 21 (75 vs 86%) differed between groups. Conversely, in the HBV-AIH subgroup, in which ALF was more severe, PR slope H0-H72 was higher in the ALF-5755 arm, the difference being significant in PP analysis (0.048±0.066 vs -0.040±0.099, p = 0.04); the median length of hospitalization was lower in the ALF-5755 group (8 vs 14 days, p = 0.02). Conclusion ALF-5755 was not efficient in a ITT analysis performed on the whole sample; however it led to a significant, although moderate, clinical benefit in a PP analysis of the sub-group of patients with HBV or AIH related SAH. As HBV is the major cause of SAH in Asia and Africa and AIH a growing cause, this study emphasizes the need to pursuit the evaluation of this novel medical treatment of SAH. Trial Registration ClinicalTrials.gov NCT01318525 PMID:26983031

  15. Differences in Energy Balance-Related Behaviours in European Preschool Children: The ToyBox-Study

    PubMed Central

    De Craemer, Marieke; Lateva, Mina; Iotova, Violeta; De Decker, Ellen; Verloigne, Maïté; De Bourdeaudhuij, Ilse; Androutsos, Odysseas; Socha, Piotr; Kulaga, Zbigniew; Moreno, Luis; Koletzko, Berthold; Manios, Yannis; Cardon, Greet

    2015-01-01

    Background The aim of the current study was to compare levels of energy balance-related behaviours (physical activity, sedentary behaviour, and dietary behaviours (more specifically water consumption, sugar-sweetened beverage consumption and unhealthy snacking)) in four- to six-year-old preschoolers from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) within the ToyBox cross-sectional study. Methods A sample of 4,045 preschoolers (4.77 ± 0.43 years; 52.2% boys) had valid physical activity data (steps per day), parents of 8,117 preschoolers (4.78 ± 0.46 years; 53.0% boys) completed a parental questionnaire with questions on sedentary behaviours (television viewing, computer use, and quiet play), and parents of 7,244 preschoolers (4.77 ± 0.44 years; 52.0% boys) completed a food frequency questionnaire with questions on water consumption, sugar-sweetened beverage consumption and unhealthy snacking. Results The highest levels of physical activity were found in Spain (12,669 steps/day on weekdays), while the lowest levels were found in Bulgaria and Greece (9,777 and 9,656 steps/day on weekdays, respectively). German preschoolers spent the least amount of time in television viewing (43.3 min/day on weekdays), while Greek preschoolers spent the most time in television viewing (88.5 min/day on weekdays). A considerable amount of time was spent in quiet play in all countries, with the highest levels in Poland (104.9 min/day on weekdays), and the lowest levels in Spain (60.4 min/day on weekdays). Belgian, German, and Polish preschoolers had the lowest intakes of water and the highest intakes of sugar-sweetened beverages. The intake of snacks was the highest in Belgian preschoolers (73.1 g/day) and the lowest in Greek preschoolers (53.3 g/day). Conclusions Across six European countries, differences in preschoolers’ energy balance-related behaviours were found. Future interventions should target European preschoolers’ energy balance

  16. Studying snow cover in European Russia with the use of remote sensing methods

    NASA Astrophysics Data System (ADS)

    Telegina, A. A.

    2015-05-01

    Satellite data are used to study water balance in large river basins in the East European Plain. For this purpose, the accuracy of estimates of snow water equivalent (SWE) based on microwave remote sensing data was evaluated through the comparison of these data with SWE measurements in open and forested areas. The errors of the SWE estimates, evaluated as their relative root-mean-square deviations from the measured values, are maximal in the Northern Dvina basin (53%); for the Oka and Don river basins, the errors are 35 and 33%, respectively. The main problems of remote sensing for northern river basins occur due to the thick canopy and the high snowpack, whose height exceeds the penetration depth. For the southern regions and midland river basins, a priority problem is due to the presence of liquid water in the snowpack during thaws.

  17. Investigating the effects of ICT on innovation and performance of European hospitals: an exploratory study.

    PubMed

    Arvanitis, Spyros; Loukis, Euripidis N

    2016-05-01

    Hospitals are making big investments in various types of ICT, so it is important to investigate their effects on innovation and performance. This paper presents an empirical study in this direction, based on data for 743 hospitals from 18 European countries. We specified and estimated econometrically five equations: one for product innovation, one for process innovation and three equations for the three different dimensions of (ICT-enabled) hospital performance. All five equations included various ICT-related variables reflecting ICT infrastructure and a series of important ICT applications, some of them hospital-specific, and some others of general business use, and also ICT personnel (viewed as a kind of 'soft' ICT investment), while the performance equations also included the two innovation measures. PMID:25822165

  18. Cosmic radiation and cancer mortality among airline pilots: results from a European cohort study (ESCAPE).

    PubMed

    Langner, I; Blettner, M; Gundestrup, M; Storm, H; Aspholm, R; Auvinen, A; Pukkala, E; Hammer, G P; Zeeb, H; Hrafnkelsson, J; Rafnsson, V; Tulinius, H; De Angelis, G; Verdecchia, A; Haldorsen, T; Tveten, U; Eliasch, H; Hammar, N; Linnersjö, A

    2004-02-01

    Cosmic radiation is an occupational risk factor for commercial aircrews. In this large European cohort study (ESCAPE) its association with cancer mortality was investigated on the basis of individual effective dose estimates for 19,184 male pilots. Mean annual doses were in the range of 2-5 mSv and cumulative lifetime doses did not exceed 80 mSv. All-cause and all-cancer mortality was low for all exposure categories. A significant negative risk trend for all-cause mortality was seen with increasing dose. Neither external and internal comparisons nor nested case-control analyses showed any substantially increased risks for cancer mortality due to ionizing radiation. However, the number of deaths for specific types of cancer was low and the confidence intervals of the risk estimates were rather wide. Difficulties in interpreting mortality risk estimates for time-dependent exposures are discussed. PMID:14648170

  19. Genetically Predicted Body Mass Index and Breast Cancer Risk: Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

    PubMed Central

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou; Michailidou, Kyriaki; Bolla, Manjeet K.; Wang, Qin; Garcia-Closas, Montserrat; Milne, Roger L.; Schmidt, Marjanka K.; Chang-Claude, Jenny; Dunning, Allison; Bojesen, Stig E.; Ahsan, Habibul; Aittomäki, Kristiina; Andrulis, Irene L.; Anton-Culver, Hoda; Beckmann, Matthias W.; Beeghly-Fadiel, Alicia; Benitez, Javier; Bogdanova, Natalia V.; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Brand, Judith; Brauch, Hiltrud; Brenner, Hermann; Brüning, Thomas; Burwinkel, Barbara; Casey, Graham; Chenevix-Trench, Georgia; Couch, Fergus J.; Cross, Simon S.; Czene, Kamila; Dörk, Thilo; Dumont, Martine; Fasching, Peter A.; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Fostira, Florentia; Gammon, Marilie; Giles, Graham G.; Guénel, Pascal; Haiman, Christopher A.; Hamann, Ute; Hooning, Maartje J.; Hopper, John L.; Jakubowska, Anna; Jasmine, Farzana; Jenkins, Mark; John, Esther M.; Johnson, Nichola; Jones, Michael E.; Kabisch, Maria; Knight, Julia A.; Koppert, Linetta B.; Kosma, Veli-Matti; Kristensen, Vessela; Le Marchand, Loic; Lee, Eunjung; Li, Jingmei; Lindblom, Annika; Lubinski, Jan; Malone, Kathi E.; Mannermaa, Arto; Margolin, Sara; McLean, Catriona; Meindl, Alfons; Neuhausen, Susan L.; Nevanlinna, Heli; Neven, Patrick; Olson, Janet E.; Perez, Jose I. A.; Perkins, Barbara; Phillips, Kelly-Anne; Pylkäs, Katri; Rudolph, Anja; Santella, Regina; Sawyer, Elinor J.; Schmutzler, Rita K.; Seynaeve, Caroline; Shah, Mitul; Shrubsole, Martha J.; Southey, Melissa C.; Swerdlow, Anthony J.; Toland, Amanda E.; Tomlinson, Ian; Torres, Diana; Truong, Thérèse; Ursin, Giske; Van Der Luijt, Rob B.; Verhoef, Senno; Whittemore, Alice S.; Winqvist, Robert; Zhao, Hui; Zhao, Shilin; Hall, Per; Simard, Jacques; Kraft, Peter; Hunter, David; Easton, Douglas F.; Zheng, Wei

    2016-01-01

    Background Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or environmental factors. Methods We applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated genetically predicted BMI in association with breast cancer risk using individual-level data from the Breast Cancer Association Consortium (BCAC) (cases  =  46,325, controls  =  42,482). We further evaluated the association between genetically predicted BMI and breast cancer risk using summary statistics from 16,003 cases and 41,335 controls from the Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) Project. Because most studies measured BMI after cancer diagnosis, we could not conduct a parallel analysis to adequately evaluate the association of measured BMI with breast cancer risk prospectively. Results In the BCAC data, genetically predicted BMI was found to be inversely associated with breast cancer risk (odds ratio [OR]  =  0.65 per 5 kg/m2 increase, 95% confidence interval [CI]: 0.56–0.75, p = 3.32 × 10−10). The associations were similar for both premenopausal (OR   =   0.44, 95% CI:0.31–0.62, p  =  9.91 × 10−8) and postmenopausal breast cancer (OR  =  0.57, 95% CI: 0.46–0.71, p  =  1.88 × 10−8). This association was replicated in the data from the DRIVE consortium (OR  =  0.72, 95% CI: 0.60–0.84, p   =   1.64 × 10−7). Single marker analyses identified 17 of the 84 BMI-associated single nucleotide polymorphisms (SNPs) in association with breast cancer risk at p

  20. Hardy-Weinberg Equilibrium Testing of Biological Ascertainment for Mendelian Randomization Studies

    PubMed Central

    Rodriguez, Santiago; Gaunt, Tom R.

    2009-01-01

    Mendelian randomization (MR) permits causal inference between exposures and a disease. It can be compared with randomized controlled trials. Whereas in a randomized controlled trial the randomization occurs at entry into the trial, in MR the randomization occurs during gamete formation and conception. Several factors, including time since conception and sampling variation, are relevant to the interpretation of an MR test. Particularly important is consideration of the “missingness” of genotypes that can be originated by chance, genotyping errors, or clinical ascertainment. Testing for Hardy-Weinberg equilibrium (HWE) is a genetic approach that permits evaluation of missingness. In this paper, the authors demonstrate evidence of nonconformity with HWE in real data. They also perform simulations to characterize the sensitivity of HWE tests to missingness. Unresolved missingness could lead to a false rejection of causality in an MR investigation of trait-disease association. These results indicate that large-scale studies, very high quality genotyping data, and detailed knowledge of the life-course genetics of the alleles/genotypes studied will largely mitigate this risk. The authors also present a Web program (http://www.oege.org/software/hwe-mr-calc.shtml) for estimating possible missingness and an approach to evaluating missingness under different genetic models. PMID:19126586

  1. Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and heart failure.

    PubMed

    Jordan, Jens; Toplak, Hermann; Grassi, Guido; Yumuk, Volkan; Kotsis, Vasilios; Engeli, Stefan; Cuspidi, Cesare; Nilsson, Peter M; Finer, Nick; Doehner, Wolfram

    2016-09-01

    Obese individuals are more likely to develop heart failure. Yet, once heart failure is established, the impact of overweight and obesity on prognosis and survival is unclear. The purpose of this joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension is to provide an overview on the current scientific literature on obesity and heart failure in terms of prognosis, mechanisms, and clinical management implications. Moreover, the document identifies open questions that ought to be addressed. The need for more tailored weight management recommendations in heart failure will be emphasized and, in line with the emerging evidence, aims to distinguish between primary disease and secondary outcome prevention. In the primary prevention of heart failure, it appears prudent advising obese individuals to lose or achieve a healthy body weight, especially in those with risk factors such as hypertension or type 2 diabetes. However, there is no evidence from clinical trials to guide weight management in overweight or obese patients with established heart failure. Prospective clinical trials are strongly encouraged. PMID:27488547

  2. Fostering Self-Regulated Learning through the European Language Portfolio: An Embedded Mixed Methods Study

    ERIC Educational Resources Information Center

    Ziegler, Nicholas Allan

    2014-01-01

    The European Language Portfolio (ELP) is an alternative assessment used in foreign language classes throughout Europe to support and record language learning. Directly linked to the Common European Framework of Reference for Languages (Council of Europe, 2001) proficiency guidelines, it is designed to achieve an ambitious dual goal: document…

  3. Towards a European Academic Labour Market?: Some Lessons Drawn from Empirical Studies on Academic Mobility

    ERIC Educational Resources Information Center

    Musselin, Christine

    2004-01-01

    In Europe, academic mobility has a long tradition which began with the birth of the European universities in the middle ages. Recently, European policies were strongly oriented towards the promotion of student and academic mobility and the creation of research networks and projects within Europe. Nevertheless, academic labour markets in Europe…

  4. Studies in Business Administration in the European Higher Education Area: A Comparative Analysis in Europe

    ERIC Educational Resources Information Center

    Cavero Rubio, José Antonio; Mullor, Javier Reig; Martín, Agustín Pérez

    2015-01-01

    On signing the Bologna declaration in 1999, European countries committed themselves to addressing the reforms necessary for adapting their university education to the European Higher Education Area. This modification process culminated in 2010, and this research aims to analyse the degree of divergence that currently exists in each course subject…

  5. Renal Athersosclerotic reVascularization Evaluation (RAVE Study): Study protocol of a randomized trial [NCT00127738

    PubMed Central

    Tobe, Sheldon W; Atri, M; Perkins, N; Pugash, R; Bell, Chaim M

    2007-01-01

    Background It is uncertain whether patients with renal vascular disease will have renal or mortality benefit from re-establishing renal blood flow with renal revascularization procedures. The RAVE study will compare renal revascularization to medical management for people with atherosclerotic renal vascular disease (ARVD) and the indication for revascularization. Patients will be assessed for the standard nephrology research outcomes of progression to doubling of creatinine, need for dialysis, and death, as well as other cardiovascular outcomes. We will also establish whether the use of a new inexpensive, simple and available ultrasound test, the renal resistance index (RRI), can identify patients with renal vascular disease who will not benefit from renal revascularization procedures[1]. Methods/design This single center randomized, parallel group, pilot study comparing renal revascularization with medical therapy alone will help establish an infrastructure and test the feasibility of answering this important question in clinical nephrology. The main outcome will be a composite of death, dialysis and doubling of creatinine. Knowledge from this study will be used to better understand the natural history of patients diagnosed with renal vascular disease in anticipation of a Canadian multicenter trial. Data collected from this study will also inform the Canadian Hypertension Education Program (CHEP) Clinical Practice Guidelines for the management of Renal and Renal Vascular Disease. The expectation is that this program for ARVD, will enable community based programs to implement a comprehensive guidelines based diagnostic and treatment program, help create an evidence based approach for the management of patients with this condition, and possibly reduce or halt the progression of kidney disease in these patients. Discussion Results from this study will determine the feasibility of a multicentered study for the management of renovascular disease. PMID:17257413

  6. Study of seismic events in the Central Part of East European Platform

    NASA Astrophysics Data System (ADS)

    Gorbunova, Ella; Sanina, Irina; Ivanchenko, Galina; Nesterkina, Margarita; Konstantinovskaya, Natalya

    2015-04-01

    A measurement system for location seismic events in the Central Part of East European Platform is situated within the Mikhnevo Geophysical Observatory of the RAS Institute of Geospheres Dynamics and consists of 12 seismic stations. One vertical station is located in the center of the group in a shaft tunnel. The other stations are located on the periphery in three concentric circles and are almost equally spaced with regard to the terrain to ensure full azimuth coverage to the maximum extent possible. The unique array identifies events with a magnitude up to 3 at the distances until 1000 km within the Central Part of East European platform. Most of the events recorded by the Mikhnevo array at a distance of 60-500 km are man-made events represented by explosions in quarries during the development of mineral deposits. Long-term seismic records of explosions in quarries have been processed for the period from 2004 to 2014 to generate a database containing standard waveforms for each quarry. Some events of unknown origin appear in the records for this period; these do not correspond to the identified seismic forms for explosions in known quarries. Epicenter coordinates for these events do not match the coordinates of the known quarries. A cosmotectonic map of the Central Part of East European Platform was compiled during the studies using the LESSA software package (Lineament Extraction and Stripe Statistical Analysis) and data on the deep crustal structure, which made it possible to define the morphostructural plan and evaluate the geodynamic conditions in the area. The deep basement structure through the sedimentary cover is expressed in the surface texture of the area under study. The region's neotectonics is closely related to the history of deep structures, in particular, aulacogens extending in different directions, which may show in the contemporary morphostructural plan, mainly as inversion and partially inherited forms. Out of events of unknown nature

  7. Tissue segmentation of computed tomography images using a Random Forest algorithm: a feasibility study.

    PubMed

    Polan, Daniel F; Brady, Samuel L; Kaufman, Robert A

    2016-09-01

    There is a need for robust, fully automated whole body organ segmentation for diagnostic CT. This study investigates and optimizes a Random Forest algorithm for automated organ segmentation; explores the limitations of a Random Forest algorithm applied to the CT environment; and demonstrates segmentation accuracy in a feasibility study of pediatric and adult patients. To the best of our knowledge, this is the first study to investigate a trainable Weka segmentation (TWS) implementation using Random Forest machine-learning as a means to develop a fully automated tissue segmentation tool developed specifically for pediatric and adult examinations in a diagnostic CT environment. Current innovation in computed tomography (CT) is focused on radiomics, patient-specific radiation dose calculation, and image quality improvement using iterative reconstruction, all of which require specific knowledge of tissue and organ systems within a CT image. The purpose of this study was to develop a fully automated Random Forest classifier algorithm for segmentation of neck-chest-abdomen-pelvis CT examinations based on pediatric and adult CT protocols. Seven materials were classified: background, lung/internal air or gas, fat, muscle, solid organ parenchyma, blood/contrast enhanced fluid, and bone tissue using Matlab and the TWS plugin of FIJI. The following classifier feature filters of TWS were investigated: minimum, maximum, mean, and variance evaluated over a voxel radius of 2 (n) , (n from 0 to 4), along with noise reduction and edge preserving filters: Gaussian, bilateral, Kuwahara, and anisotropic diffusion. The Random Forest algorithm used 200 trees with 2 features randomly selected per node. The optimized auto-segmentation algorithm resulted in 16 image features including features derived from maximum, mean, variance Gaussian and Kuwahara filters. Dice similarity coefficient (DSC) calculations between manually segmented and Random Forest algorithm segmented images from 21

  8. European survey of fertility and pregnancy in women with Crohn's disease: a case control study by European collaborative group.

    PubMed Central

    Mayberry, J F; Weterman, I T

    1986-01-01

    Two hundred and seventy five patients with Crohn's disease from five countries were interviewed. Each patient was matched with a control of the same age. Of the 275 women with Crohn's disease 224 had been married at some time compared with 208 controls. The mean age at marriage was 23 years. Diagnosis of Crohn's disease was made five years later and the survey was conducted on average 16 years after marriage. Cases and controls had a similar obstetric study before diagnosis. After diagnosis there was a significant reduction in the number of children born to patients (0.4) compared with controls (0.7). Crohn's disease did not increase the rate of miscarriage or Caesarean section but prematurity was more common in patients (16%) than controls (7%). The site of disease at diagnosis did not affect these findings. Medical advice against pregnancy may be partly responsible for this reduction in fertility, but patients practised contraception less than controls and a significantly greater proportion of these (42%) failed to become pregnant compared with controls (28%). Crohn's disease results in subfertility. PMID:3732892

  9. Perceived Indoor Environment and Occupants' Comfort in European "Modern" Office Buildings: The OFFICAIR Study.

    PubMed

    Sakellaris, Ioannis A; Saraga, Dikaia E; Mandin, Corinne; Roda, Célina; Fossati, Serena; de Kluizenaar, Yvonne; Carrer, Paolo; Dimitroulopoulou, Sani; Mihucz, Victor G; Szigeti, Tamás; Hänninen, Otto; de Oliveira Fernandes, Eduardo; Bartzis, John G; Bluyssen, Philomena M

    2016-01-01

    Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers' comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants' comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 "modern" office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants' comfort. The highest association with occupants' overall comfort was found for "noise", followed by "air quality", "light" and "thermal" satisfaction. Analysis of detailed parameters revealed that "noise inside the buildings" was highly associated with occupants' overall comfort. "Layout of the offices" was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building's location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants. PMID:27120608

  10. Perceived Indoor Environment and Occupants’ Comfort in European “Modern” Office Buildings: The OFFICAIR Study

    PubMed Central

    Sakellaris, Ioannis A.; Saraga, Dikaia E.; Mandin, Corinne; Roda, Célina; Fossati, Serena; de Kluizenaar, Yvonne; Carrer, Paolo; Dimitroulopoulou, Sani; Mihucz, Victor G.; Szigeti, Tamás; Hänninen, Otto; de Oliveira Fernandes, Eduardo; Bartzis, John G.; Bluyssen, Philomena M.

    2016-01-01

    Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers’ comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants’ comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 “modern” office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants’ comfort. The highest association with occupants’ overall comfort was found for “noise”, followed by “air quality”, “light” and “thermal” satisfaction. Analysis of detailed parameters revealed that “noise inside the buildings” was highly associated with occupants’ overall comfort. “Layout of the offices” was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building’s location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants. PMID:27120608

  11. The media and cancer: education or entertainment? An ethnographic study of European cancer journalists

    PubMed Central

    Aggarwal, Ajay; Batura, Rekha; Sullivan, Richard

    2014-01-01

    The media plays a vital role in informing the public about new developments in cancer research and influencing cancer policy. This is no easy task, in view of the myriad of trials and wonder drugs that purport to be the ‘magic bullet’. However, misrepresentation can have profound consequences. In this qualitative study, we sought to understand the interaction between the media and cancer through the perspective of European science journalists by defining their attitudes towards current cancer research and challenges faced when reporting science news. A total of 67 respondents took part in this online survey, which was distributed by the European CanCer Organisation (ECCO) to all its media contacts between June and September 2013. Fifty-three per cent had over 20 years experience in reporting science news stories. The respondents utilised a number of media formats, including newsprint, online services, and radio. Fifty per cent ranked public interest as the greatest influence on their selection of cancer research topics, followed by topicality. Respondents were conscious of being fed ambiguous and exaggerated results from trials by the research community. Sixty-five per cent of respondents would appreciate access to a forum of experts willing to provide comment on new research findings. Seventy per cent highlighted the importance of prompt responses from scientists and researchers during correspondence, and the need to have advance warning of new developments (49%). To conclude – coverage of cancer related issues and scientific advances require greater collaboration between the press and cancer healthcare community to provide both credibility and accountability for the health information disseminated. Key areas include a more precise definition of the research context and differentiation of absolute and relative risks, as well as individual and population risks and an informed discussion about the realities and limitations of cancer care and research. PMID

  12. What Affects Reintegration of Female Drug Users after Prison Release? Results of a European Follow-Up Study

    ERIC Educational Resources Information Center

    Zurhold, Heike; Moskalewicz, Jacek; Sanclemente, Cristina; Schmied, Gabriele; Shewan, David; Verthein, Uwe

    2011-01-01

    The main objective of this follow-up study is to explore factors influencing the success or failure of women in reintegrating after their release from prison. Female drug users in five European cities were tracked after being released from prison. Out of 234 female prisoners contacted in prisons, 59 were included in the follow-up study. Structured…

  13. A Study of Greek Teachers' Satisfaction with the Implementation of the European Pedagogical ICT License Pilot Course

    ERIC Educational Resources Information Center

    Mouzakis, Charalambos; Roussakis, Ioannis; Tsagarissianos, George

    2010-01-01

    The survey presented in this study examines Greek teachers' satisfaction with the implementation of the European Pedagogical Information and Communication Technology License (EPICT) pilot course. A total of 51 primary and secondary education teachers participated in the study that followed the pilot course concerning the integration of ICT in the…

  14. A Qualitative Assessment of Students' Experiences of Studying Music: A Spanish Perspective on the European Credit Transfer System (ECTS)

    ERIC Educational Resources Information Center

    Faubel, Jose Maria Esteve; Valero, Miguel Angel Molina; Stephens, Jonathan

    2009-01-01

    The purpose of this investigation is to evaluate whether or not the allocation of time proposed in the Music Study Guide, adapted from the Espacio Europeo de Educacion Superior (European Higher Education Area) guidelines, is consistent and adequate for students with a minimal musical knowledge. The data for this study arise from a…

  15. Propensity scores used for analysis of cluster randomized trials with selection bias: a simulation study.

    PubMed

    Leyrat, C; Caille, A; Donner, A; Giraudeau, B

    2013-08-30

    Cluster randomized trials (CRTs) are often prone to selection bias despite randomization. Using a simulation study, we investigated the use of propensity score (PS) based methods in estimating treatment effects in CRTs with selection bias when the outcome is quantitative. Of four PS-based methods (adjustment on PS, inverse weighting, stratification, and optimal full matching method), three successfully corrected the bias, as did an approach using classical multivariable regression. However, they showed poorer statistical efficiency than classical methods, with higher standard error for the treatment effect, and type I error much smaller than the 5% nominal level. PMID:23553813

  16. European Mitochondrial DNA Haplogroups and Metabolic Changes during Antiretroviral Therapy in AIDS Clinical Trials Group Study A5142

    PubMed Central

    Hulgan, Todd; Haubrich, Richard; Riddler, Sharon A.; Tebas, Pablo; Ritchie, Marylyn D.; McComsey, Grace A.; Haas, David W.; Canter, Jeffrey A.

    2010-01-01

    Background Mitochondrial DNA (mtDNA) influences metabolic diseases and perhaps antiretroviral therapy (ART) complications. We explored associations between European mtDNA haplogroups and metabolic changes among A5142 participants. Methods 757 ART-naïve subjects were randomized to one of three class-sparing ART regimens including efavirenz and/or lopinavir/ritonavir with or without nucleoside reverse transcriptase inhibitors (NRTIs). Non-randomized NRTIs included stavudine, tenofovir, or zidovudine, each with lamivudine. Fasting lipid profiles and whole-body dual-energy X-ray absorptiometry (DEXA) were performed. Nine European mtDNA haplogroups were determined for 231 self-identified non-Hispanic white subjects. Metabolic changes from baseline to 96 weeks were analyzed by haplogroup. Results Median age was 39 years, 9% were female, and 37%, 32%, and 30% were randomized to NRTI-containing regimens with either efavirenz or lopinavir/ritonavir, and an NRTI-sparing regimen respectively. Among NRTI-containing regimens, 51% included zidovudine, 28% tenofovir, and 21% stavudine. Compared with other haplogroups, mtDNA haplogroup I (N=10) had higher baseline non-HDL cholesterol (160 mg/dL [interquartile range 137–171] vs. 120 mg/dL [104–136]; p=0.005), a decrease in non-HDL cholesterol over 96 weeks (−14% [−20-+6] vs. +25% [+8-+51]; p<0.001), tended to have more baseline extremity fat, and had more extremity fat loss by DEXA (−13% [−31-+12] vs. +9% [−13-+26]; p=0.08) and lipoatrophy (50% vs. 20%; p=0.04). Haplogroup W (N=5; all randomized to NRTI-sparing regimens) had the greatest increase in extremity fat (+35.5% [+26.8 - +54.9]; P=0.02). Conclusions Lipids and extremity fat were associated with European mtDNA haplogroups in this HIV-infected population. These preliminary results suggest that mitochondrial genomics may influence metabolic parameters before and during ART. PMID:20871389

  17. A Randomized Controlled Trial Study of the ABRACADABRA Reading Intervention Program in Grade 1

    ERIC Educational Resources Information Center

    Savage, Robert S.; Abrami, Philip; Hipps, Geoffrey; Deault, Louise

    2009-01-01

    This study reports a randomized controlled trial evaluation of a computer-based balanced literacy intervention, ABRACADABRA (http://grover.concordia.ca/abra/version1/abracadabra.html). Children (N = 144) in Grade 1 were exposed either to computer activities for word analysis, text comprehension, and fluency, alongside shared stories (experimental…

  18. Teaching Third Graders about Real-Life Mathematical Problem Solving: A Randomized Controlled Study

    ERIC Educational Resources Information Center

    Fuchs, Lynn S.; Fuchs, Douglas; Finelli, Robin; Courey, Susan J.; Hamlett, Carol L.; Sones, Estelle M.; Hope, Susan K.

    2006-01-01

    The purpose of this study was to assess the effects of schema-broadening instruction (SBI), with and without explicit instruction in strategies for tackling the complexities involved in real-life (RL) math problems, on the math problem solving of third-grade students. Teachers (n = 30) were assigned randomly to 3 16-week conditions: control, SBI,…

  19. Medical Students' Comfort with Pregnant Women with Substance-Use Disorders: A Randomized Educational Study

    ERIC Educational Resources Information Center

    Albright, Brittany; Skipper, Betty; Riley, Shawne; Wilhelm, Peggy; Rayburn, William F.

    2012-01-01

    Objective: The study objective was to determine whether medical students' attendance at a rehabilitation residence for pregnant women with substance-use disorders yielded changes in their attitudes and comfort levels in providing care to this population. Methods: This randomized educational trial involved 96 consecutive medical students during…

  20. Assessing Sensitivity of Early Head Start Study Findings to Manipulated Randomization Threats

    ERIC Educational Resources Information Center

    Green, Sheridan

    2013-01-01

    Increasing demands for design rigor and an emphasis on evidence-based practice on a national level indicated a need for further guidance related to successful implementation of randomized studies in education. Rigorous and meaningful experimental research and its conclusions help establish a valid theoretical and evidence base for educational…

  1. A Randomized Control Study of Responsive Teaching with Young Turkish Children and Their Mothers

    ERIC Educational Resources Information Center

    Karaaslan, Ozcan; Diken, Ibrahim H.; Mahoney, Gerald

    2013-01-01

    A randomized control study was conducted to evaluate the effectiveness of responsive teaching (RT) with a sample of 19 Turkish preschool-age children with disabilities and their mothers over a 6-months period. RT is an early intervention curriculum that attempts to promote children's development by encouraging parents to engage in highly…

  2. Power and sample size calculations for Mendelian randomization studies using one genetic instrument.

    PubMed

    Freeman, Guy; Cowling, Benjamin J; Schooling, C Mary

    2013-08-01

    Mendelian randomization, which is instrumental variable analysis using genetic variants as instruments, is an increasingly popular method of making causal inferences from observational studies. In order to design efficient Mendelian randomization studies, it is essential to calculate the sample sizes required. We present formulas for calculating the power of a Mendelian randomization study using one genetic instrument to detect an effect of a given size, and the minimum sample size required to detect effects for given levels of significance and power, using asymptotic statistical theory. We apply the formulas to some example data and compare the results with those from simulation methods. Power and sample size calculations using these formulas should be more straightforward to carry out than simulation approaches. These formulas make explicit that the sample size needed for Mendelian randomization study is inversely proportional to the square of the correlation between the genetic instrument and the exposure and proportional to the residual variance of the outcome after removing the effect of the exposure, as well as inversely proportional to the square of the effect size. PMID:23934314

  3. Randomized Trial of Tapas Acupressure Technique® for Weight Loss Maintenance: Rationale and Study Design

    PubMed Central

    Gallison, Cherri; Lindberg, Nangel M.; DeBar, Lynn; Funk, Kristine; Ritenbaugh, Cheryl; Stevens, Victor J.

    2010-01-01

    Abstract Objectives The aim of this article is to present the rationale, study design, and methods of an ongoing randomized controlled trial assessing the efficacy of an energy psychology intervention, Tapas Acupressure Technique® (TAT®), to prevent weight regain following successful weight loss. Design This is a randomized controlled trial. Settings/location The study is being conducted at a large group-model health maintenance organization (HMO). Subjects The study subjects are adult members of an HMO. Interventions TAT is being compared to a self-directed social support comparison intervention. Outcome measures The primary outcome measure is weight-loss maintenance at 6 and 12 months postrandomization. Conclusions This randomized controlled trial will test the efficacy of an energy psychology intervention, TAT, by comparing it with a self-directed social support group intervention. This is, to our knowledge, the largest randomized controlled study to date of an energy psychology intervention. Positive findings would support the use of TAT as a tool to prevent weight regain following successful weight loss. PMID:20569037

  4. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    ERIC Educational Resources Information Center

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  5. Human norovirus inactivation in oysters by high hydrostatic pressure processing: A randomized double-blinded study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This randomized, double-blinded, clinical trial assessed the effect of high hydrostatic pressure processing (HPP) on genogroup I.1 human norovirus (HuNoV) inactivation in virus-seeded oysters when ingested by subjects. The safety and efficacy of HPP treatments were assessed in three study phases wi...

  6. The Random Forests Statistical Technique: An Examination of Its Value for the Study of Reading

    ERIC Educational Resources Information Center

    Matsuki, Kazunaga; Kuperman, Victor; Van Dyke, Julie A.

    2016-01-01

    Studies investigating individual differences in reading ability often involve data sets containing a large number of collinear predictors and a small number of observations. In this article, we discuss the method of Random Forests and demonstrate its suitability for addressing the statistical concerns raised by such data sets. The method is…

  7. Efficiency of a Care Coordination Model: A Randomized Study with Stroke Patients

    ERIC Educational Resources Information Center

    Claiborne, Nancy

    2006-01-01

    Objectives: This study investigated the efficiency of a social work care coordination model for stroke patients. Care coordination addresses patient care and treatment resources across the health care system to reduce risk, improve clinical outcomes, and maximize efficiency. Method: A randomly assigned, pre-post experimental design measured…

  8. Melatonin Treatment in Individuals with Intellectual Disability and Chronic Insomnia: A Randomized Placebo-Controlled Study

    ERIC Educational Resources Information Center

    Braam, W.; Didden, R.; Smits, M.; Curfs, L.

    2008-01-01

    Background: While several small-number or open-label studies suggest that melatonin improves sleep in individuals with intellectual disabilities (ID) with chronic sleep disturbance, a larger randomized control trial is necessary to validate these promising results. Methods: The effectiveness of melatonin for the treatment of chronic sleep…

  9. A Randomized, Controlled Study of Computer-Based Intervention in Middle School Struggling Readers

    ERIC Educational Resources Information Center

    Given, Barbara K.; Wasserman, John D.; Chari, Sharmila A.; Beattie, Karen; Eden, Guinevere F.

    2008-01-01

    The current study was conducted to test the premise that computer-based intervention that targets auditory temporal processing combined with language exercises (Fast ForWord[R]) is effective in remediating children with disorders of language and reading. Sixty-five middle school struggling readers were randomly assigned to one of five groups and…

  10. Do Formal Mentoring Programs Matter?: A Longitudinal Randomized Experimental Study of Women Healthcare Workers

    ERIC Educational Resources Information Center

    Marshall Egan, Toby; Rosser, Manda H.

    2004-01-01

    We report results from a pretest-posttest randomized experimental study comparing the impact of high versus low facilitation of formal mentoring programs on female healthcare workers' performance and attitudes. Results indicated increases in job performance, job satisfaction, and organizational commitment for mentoring program participants from…

  11. Supplemental Reading Strategy Instruction for Adolescents: A Randomized Trial and Follow-up Study

    ERIC Educational Resources Information Center

    Cantrell, Susan Chambers; Almasi, Janice F.; Rintamaa, Margaret; Carter, Janis C.

    2016-01-01

    In this study, the authors examine the impact of a yearlong supplemental reading course involving daily instruction in the learning strategies curriculum on lower achieving adolescent students' reading achievement and motivation. Using a multiple-cohort randomized treatment-control group design over 4 years, they compared achievement and…

  12. Efficacy of Virtual Patients in Medical Education: A Meta-Analysis of Randomized Studies

    ERIC Educational Resources Information Center

    Consorti, Fabrizio; Mancuso, Rosaria; Nocioni, Martina; Piccolo, Annalisa

    2012-01-01

    A meta-analysis was performed to assess the Effect Size (ES) from randomized studies comparing the effect of educational interventions in which Virtual patients (VPs) were used either as an alternative method or additive to usual curriculum versus interventions based on more traditional methods. Meta-analysis was designed, conducted and reported…

  13. Predictors of participation of adolescents with cerebral palsy: A European multi-centre longitudinal study

    PubMed Central

    Dang, Van Mô; Colver, Allan; Dickinson, Heather O.; Marcelli, Marco; Michelsen, Susan I.; Parkes, Jackie; Parkinson, Kathryn; Rapp, Marion; Arnaud, Catherine; Nystrand, Malin; Fauconnier, Jérôme

    2015-01-01

    We investigated whether childhood factors that are amenable to intervention (parenting stress, child psychological problems and pain) predicted participation in daily activities and social roles of adolescents with cerebral palsy (CP). We randomly selected 1174 children aged 8–12 years from eight population-based registers of children with CP in six European countries; 743 (63%) agreed to participate. One further region recruited 75 children from multiple sources. These 818 children were visited at home at age 8–12 years, 594 (73%) agreed to follow-up at age 13–17 years. We used the following measures: parent reported stress (Parenting Stress Index Short Form), their child's psychological difficulties (Strength and Difficulties Questionnaire) and frequency and severity of pain; either child or parent reported the child's participation (LIFE Habits questionnaire). We fitted a structural equation model to each of the participation domains, regressing participation in childhood and adolescence on parenting stress, child psychological problems and pain, and regressing adolescent factors on the corresponding childhood factors; models were adjusted for impairment, region, age and gender. Pain in childhood predicted restricted adolescent participation in all domains except Mealtimes and Communication (standardized total indirect effects β −0.05 to −0.18, 0.01 < p < 0.05 to p < 0.001, depending on domain). Psychological problems in childhood predicted restricted adolescent participation in all domains of social roles, and in Personal Care and Communication (β −0.07 to −0.17, 0.001 < p < 0.01 to p < 0.001). Parenting stress in childhood predicted restricted adolescent participation in Health Hygiene, Mobility and Relationships (β −0.07 to −0.18, 0.001 < p < 0.01 to p < 0.001). These childhood factors predicted adolescent participation largely via their effects on childhood participation; though in some domains early psychological

  14. Genome-wide association study of tanning phenotype in a population of European ancestry.

    PubMed

    Nan, Hongmei; Kraft, Peter; Qureshi, Abrar A; Guo, Qun; Chen, Constance; Hankinson, Susan E; Hu, Frank B; Thomas, Gilles; Hoover, Robert N; Chanock, Stephen; Hunter, David J; Han, Jiali

    2009-09-01

    We conducted a multistage genome-wide association study (GWAS) of tanning response after exposure to sunlight in over 9,000 men and women of European ancestry who live in the United States. An initial analysis of 528,173 single-nucleotide polymorphisms (SNPs) genotyped on 2,287 women identified LOC401937 (rs966321) on chromosome 1 as a novel locus highly associated with tanning ability, and we confirmed this association in 870 women controls from a skin cancer case-control study with joint P-value=1.6 x 10(-9). We further genotyped this SNP in two subsequent replication studies (one with 3,750 women and the other with 2,405 men). This association was not replicated in either of these two studies. We found that several SNPs reaching the genome-wide significance level are located in or adjacent to the loci previously known as pigmentation genes: MATP, IRF4, TYR, OCA2, and MC1R. Overall, these tanning ability-related loci are similar to the hair color-related loci previously reported in the GWAS of hair color. PMID:19340012

  15. Learning from failure - rationale and design for a study about discontinuation of randomized trials (DISCO study)

    PubMed Central

    2012-01-01

    Background Randomized controlled trials (RCTs) may be discontinued because of apparent harm, benefit, or futility. Other RCTs are discontinued early because of insufficient recruitment. Trial discontinuation has ethical implications, because participants consent on the premise of contributing to new medical knowledge, Research Ethics Committees (RECs) spend considerable effort reviewing study protocols, and limited resources for conducting research are wasted. Currently, little is known regarding the frequency and characteristics of discontinued RCTs. Methods/Design Our aims are, first, to determine the prevalence of RCT discontinuation for specific reasons; second, to determine whether the risk of RCT discontinuation for specific reasons differs between investigator- and industry-initiated RCTs; third, to identify risk factors for RCT discontinuation due to insufficient recruitment; fourth, to determine at what stage RCTs are discontinued; and fifth, to examine the publication history of discontinued RCTs. We are currently assembling a multicenter cohort of RCTs based on protocols approved between 2000 and 2002/3 by 6 RECs in Switzerland, Germany, and Canada. We are extracting data on RCT characteristics and planned recruitment for all included protocols. Completion and publication status is determined using information from correspondence between investigators and RECs, publications identified through literature searches, or by contacting the investigators. We will use multivariable regression models to identify risk factors for trial discontinuation due to insufficient recruitment. We aim to include over 1000 RCTs of which an anticipated 150 will have been discontinued due to insufficient recruitment. Discussion Our study will provide insights into the prevalence and characteristics of RCTs that were discontinued. Effective recruitment strategies and the anticipation of problems are key issues in the planning and evaluation of trials by investigators, Clinical

  16. Efficacy and safety of acupuncture for chronic dizziness: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Dizziness is one of the most challenging symptoms in medicine. No medication for dizziness in current use has well-established curative or prophylactic value or is suitable for long-term palliative use. Unconventional remedies, such as acupuncture, should be considered and scientifically evaluated. However, there has been relatively little evidence in randomized controlled clinical trials on acupuncture to treat chronic dizziness. The aim of our study is to evaluate the efficacy and safety of acupuncture in patients with dizziness. Methods/Design This trial is a randomized, single-blind, controlled study. A total of 80 participants will be randomly assigned to two treatment groups receiving acupuncture and sham acupuncture treatment, respectively, for 4 weeks. The primary outcome measures are the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS). Treatment will be conducted over a period of 4 weeks, at a frequency of two sessions per week. The assessment is at baseline (before treatment initiation), 4 weeks after the first acupuncture session, and 8 weeks after the first acupuncture session. Discussion The results from this study will provide clinical evidence on the efficacy and safety of acupuncture in patients with chronic dizziness. Trial registration International Standard Randomized Controlled Trial Number Register: ISRCTN52695239 PMID:24330810

  17. The RAZOR (randomized open vs robotic cystectomy) trial: study design and trial update.

    PubMed

    Smith, Norm D; Castle, Erik P; Gonzalgo, Mark L; Svatek, Robert S; Weizer, Alon Z; Montgomery, Jeffrey S; Pruthi, Raj S; Woods, Michael E; Tollefson, Matthew K; Konety, Badrinath R; Shabsigh, Ahmad; Krupski, Tracey; Barocas, Daniel A; Dash, Atreya; Quek, Marcus L; Kibel, Adam S; Parekh, Dipen J

    2015-02-01

    The purpose of the RAZOR (randomized open vs robotic cystectomy) study is to compare open radical cystectomy (ORC) vs robot-assisted RC (RARC), pelvic lymph node dissection (PLND) and urinary diversion for oncological outcomes, complications and health-related quality of life (HRQL) measures with a primary endpoint of 2-year progression-free survival (PFS). RAZOR is a multi-institutional, randomized, non-inferior, phase III trial that will enrol at least 320 patients with T1-T4, N0-N1, M0 bladder cancer with ≈160 patients in both the RARC and ORC arms at 15 participating institutions. Data will be collected prospectively at each institution for cancer outcomes, complications of surgery and HRQL measures, and then submitted to trial data management services Cancer Research and Biostatistics (CRAB) for final analyses. To date, 306 patients have been randomized and accrual to the RAZOR trial is expected to conclude in 2014. In this study, we report the RAZOR trial experimental design, objectives, data safety, and monitoring, and accrual update. The RAZOR trial is a landmark study in urological oncology, randomizing T1-T4, N0-N1, M0 patients with bladder cancer to ORC vs RARC, PLND and urinary diversion. RAZOR is a multi-institutional, non-inferiority trial evaluating cancer outcomes, surgical complications and HRQL measures of ORC vs RARC with a primary endpoint of 2-year PFS. Full data from the RAZOR trial are not expected until 2016-2017. PMID:25626182

  18. Acupoint Stimulation on Weight Reduction for Obesity: A Randomized Sham-Controlled Study.

    PubMed

    Yeh, Mei-Ling; Chu, Nain-Feng; Hsu, Man-Ying F; Hsu, Chin-Che; Chung, Yu-Chu

    2015-12-01

    Auricular acupoint stimulation has become a popular weight loss method. However, its efficacy for obesity treatment has not been fully studied. This study aimed to investigate the effect of a 10-week intervention of auricular electrical stimulation combined with auricular acupressure on weight reduction in obese outpatients. In this single-blind randomized sham-controlled study, 134 participants were randomly assigned to an experimental group receiving stimulation at true acupoints, or a sham group receiving stimulation delivered in the same manner but at sham acupoints. Each participant received nutrition counseling by a nutritionist weekly. The results showed significant differences in body mass index, blood pressure, total cholesterol, triglyceride, and leptin or adiponectin over time within the group, but not between the groups. This study could not exclude the effect of placebo and dietary consultation. Further study that adds a control group receiving no treatment is therefore needed to confirm the effects of auricular acupressure. PMID:25183702

  19. Active relatives and health-related physical fitness in European adolescents: the HELENA Study.

    PubMed

    Martín-Matillas, Miguel; Ortega, Francisco B; Ruiz, Jonatan R; Martínez-Gómez, David; Vicente-Rodríguez, Germán; Marcos, Ascensión; Béghin, Laurent; Kafatos, Anthony; González-Gross, Marcela; Zaccaria, Maria; Molnár, Dénes; De Henauw, Stefaan; Sjöström, Michael; Moreno, Luis A; Castillo, Manuel J

    2012-01-01

    High physical fitness in childhood and adolescence is positively associated with favourable health-related outcomes. Our aim was to examine the relationship between relatives' (father, mother, brother, sister, and best friend) physical activity engagement and encouragement on adolescents' physical fitness. Adolescents were part of the HELENA study, a multi-centre study conducted in 10 cities from nine European countries in 2006-2008. Participants were 3288 adolescents (48% boys, 52% girls) aged 12.5-17.5 years with valid data on at least one of the three fitness variables studied: muscular strength (standing long jump), speed/agility (4×10 m shuttle run), and cardiorespiratory fitness (20 m shuttle run). The adolescents reported their relatives' physical activity engagement and encouragement. Analysis of covariance showed that relatives' physical activity engagement (father, mother, brother, and best friend) was positively related to cardiorespiratory fitness (P < 0.05); and mother's and sisters' physical activity engagement were positively associated with higher muscular strength in adolescents (P < 0.05). Furthermore, father's physical activity encouragement was positively linked to physical fitness (all fitness components) in adolescents (P < 0.05). Interventions aimed at improving physical fitness in young people might be more successful when family members, particularly mothers and fathers, are encouraged to engage in physical activity and support adolescents' physical activity. PMID:22906183

  20. Associations between bicycling and carotid arterial stiffness in adolescents: The European Youth Hearts Study.

    PubMed

    Ried-Larsen, M; Grøntved, A; Østergaard, L; Cooper, A R; Froberg, K; Andersen, L B; Møller, N C

    2015-10-01

    The aim of the study was to investigate the associations between bicycling and carotid arterial stiffness, independent of objectively measured moderate-and-vigorous physical activity. This cross-sectional study included 375 adolescents (age 15.7 ± 0.4 years) from the Danish site of the European Youth Heart Study. Total frequency of bicycle usage was assessed by self-report, and carotid arterial stiffness was assessed using B-mode ultrasound. After adjusting for pubertal status, body height, and objectively measured physical activity and other personal lifestyle and demographic factors, boys using their bicycle every day of the week displayed a higher carotid arterial compliance {standard beta 0.47 [95% confidence interval (CI) 0.07-0.87]} and distension [standard beta 0.38 (95% CI -0.04 to 0.81)]. Boys using their bicycle every day of the week furthermore displayed a lower Young's elastic modulus [standard beta -0.48 (95% CI -0.91 to -0.06)]. Similar trends were observed when investigating the association between commuter bicycling and carotid arterial stiffness. These associations were not observed in girls. Our observations suggest that increasing bicycling in adolescence may be beneficial to carotid arterial health among boys. PMID:25156494

  1. Cross-cultural issues in space operations: A survey study among ground personnel of the European Space Agency

    NASA Astrophysics Data System (ADS)

    Sandal, Gro Mjeldheim; Manzey, Dietrich

    2009-12-01

    Today's space operations involve co-working of people with different ethnical, professional and organisational backgrounds. The aim of this study was to examine the implications of cultural diversity for efficient collaboration within the European Space Agency (ESA), and between ESA employees and representatives from other agencies. ESA employees from European countries ( N=576) answered to the CULT Ground Survey. The results showed that differences in relation to leadership and decision making were the most important issues thought to interfere with efficient co-working within ESA, and between ESA employees and colleagues from other agencies. Employees who collaborated with more than three nationalities within ESA indicated most challenges in co-working due to differences in compliance, behavioural norms and competitiveness. Challenges in co-working differed between agencies, and these differences were consistent with value differences in the national populations. The results may have applied value for training of European employees working in international space program teams.

  2. Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study

    PubMed Central

    2009-01-01

    Background Patients with obesity, diabetes, and chronic kidney disease (CKD) are generally physically inactive, have a high mortality rate, and may benefit from an exercise program. Methods We performed a 24-week randomized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes, obesity (body mass index [BMI] > 30 kg/m2), and stage 2-4 CKD (estimated glomerular filtration rate [eGFR] 15-90 mL/min/1.73 m2 with persistent proteinuria). Subjects randomized to exercise underwent thrice weekly aerobic training for 6 followed by 18 weeks of supervised home exercise. The primary outcome variable was change in proteinuria. Results Seven subjects randomized to exercise and 4 control subjects completed the study. Exercise training resulted in an increase in exercise duration during treadmill testing, which was accompanied by slight but insignificant decreases in resting systolic blood pressure and 24-hour proteinuria. Exercise did not alter GFR, hemoglobin, glycated hemoglobin, serum lipids, or C-reactive protein (CRP). Caloric intake and body weight and composition also did not change with exercise training. Conclusion Exercise training in obese diabetic patients with CKD is feasible and may have clinical benefits. A large-scale randomized controlled trial to determine the effects of exercise on renal functions, cardiovascular fitness, inflammation, and oxidative stress in diabetic patients with CKD is planned. PMID:20003224

  3. Random-diluted triangular plaquette model: Study of phase transitions in a kinetically constrained model

    NASA Astrophysics Data System (ADS)

    Franz, Silvio; Gradenigo, Giacomo; Spigler, Stefano

    2016-03-01

    We study how the thermodynamic properties of the triangular plaquette model (TPM) are influenced by the addition of extra interactions. The thermodynamics of the original TPM is trivial, while its dynamics is glassy, as usual in kinetically constrained models. As soon as we generalize the model to include additional interactions, a thermodynamic phase transition appears in the system. The additional interactions we consider are either short ranged, forming a regular lattice in the plane, or long ranged of the small-world kind. In the case of long-range interactions we call the new model the random-diluted TPM. We provide arguments that the model so modified should undergo a thermodynamic phase transition, and that in the long-range case this is a glass transition of the "random first-order" kind. Finally, we give support to our conjectures studying the finite-temperature phase diagram of the random-diluted TPM in the Bethe approximation. This corresponds to the exact calculation on the random regular graph, where free energy and configurational entropy can be computed by means of the cavity equations.

  4. Random-diluted triangular plaquette model: Study of phase transitions in a kinetically constrained model.

    PubMed

    Franz, Silvio; Gradenigo, Giacomo; Spigler, Stefano

    2016-03-01

    We study how the thermodynamic properties of the triangular plaquette model (TPM) are influenced by the addition of extra interactions. The thermodynamics of the original TPM is trivial, while its dynamics is glassy, as usual in kinetically constrained models. As soon as we generalize the model to include additional interactions, a thermodynamic phase transition appears in the system. The additional interactions we consider are either short ranged, forming a regular lattice in the plane, or long ranged of the small-world kind. In the case of long-range interactions we call the new model the random-diluted TPM. We provide arguments that the model so modified should undergo a thermodynamic phase transition, and that in the long-range case this is a glass transition of the "random first-order" kind. Finally, we give support to our conjectures studying the finite-temperature phase diagram of the random-diluted TPM in the Bethe approximation. This corresponds to the exact calculation on the random regular graph, where free energy and configurational entropy can be computed by means of the cavity equations. PMID:27078408

  5. Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

    PubMed

    Meize-Grochowski, Robin; Shuster, George; Boursaw, Blake; DuVal, Michelle; Murray-Krezan, Cristina; Schrader, Ron; Smith, Bruce W; Herman, Carla J; Prasad, Arti

    2015-01-01

    This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study. PMID:25784079

  6. Simulation of long term renewable energy feed-in for European power system studies

    NASA Astrophysics Data System (ADS)

    Kies, Alexander; Nag, Kabitri; von Bremen, Lueder; Lorenz, Elke; Heinemann, Detlev; Späth, Stephan

    2014-05-01

    Renewable energies already play a remarkable role in Europe as of today. It is expected that wind and solar amongst other renewables will contribute strongly to the future European energy generation. However, wind and solar generation facilities have due to the weather dependent nature of their resources highly fluctuating feed-in profiles. To overcome the mismatch between energy demand and generation it is important to study and understand the generation patterns and balancing potentials. The goal of the current work is to investigate how the feed-in time series from different renewable sources like on- and offshore wind, photovoltaic, solar thermal, wave, hydro, geothermal and biomass power and combination of them look like in an European power supply system . The work is part of the RESTORE 2050 project (BMU) that investigates the requirements for cross-country grid extensions, usage of storage technologies and capacities, the development of new balancing technologies and the conceptual design of the future energy market which is suitable for high generation percentages of solar and wind. High temporally and spatially resolved long term weather data from COSMO-EU, MERRA and Meteosat (MFG/MSG) satellite data has been used to simulate feed-in from several types of renewable energy sources on a 7 x 7 km grid covering Europe. For wind speeds MERRA reanalysis data has been statistically downscaled to account for orography. Generation was aggregated on the country level and production patterns and their variations in time of different resources were investigated for the years ranging from 2002 to 2012. In a first step the quality of the simulated feed in time series has been investigated by comparison to real observations of wind power and PV generation. Furthermore, some sensitivity studies with respect to underlying assumptions like spatial distribution of wind and PV capacities, the chosen hub-height and wind power curve have been done and will be presented. While

  7. Decompressive craniectomy in traumatic brain injury: the randomized multicenter RESCUEicp study (www.RESCUEicp.com).

    PubMed

    Hutchinson, P J; Corteen, E; Czosnyka, M; Mendelow, A D; Menon, D K; Mitchell, P; Murray, G; Pickard, J D; Rickels, E; Sahuquillo, J; Servadei, F; Teasdale, G M; Timofeev, I; Unterberg, A; Kirkpatrick, P J

    2006-01-01

    The RESCUEicp (Randomized Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of intracranial pressure) study has been established to determine whether decompressive craniectomy has a role in the management of patients with traumatic brain injury and raised intracranial pressure that does not respond to initial treatment measures. We describe the concept of decompressive craniectomy in traumatic brain injury and the rationale and protocol of the RESCUEicp study. PMID:16671415

  8. Chronic morbidity in women, namely in pregnancy. (Comparative study between West, Central and East European centres).

    PubMed

    Kukla, L; Bouchalova, M; Shkiriak-Nyzhnyk, Z; Chyslovska, N; Golding, J; Goodfellow, S; Ignatjeva, R

    2008-01-01

    18 chronic diseases were investigated in a population of 13,115 women living in six settings of West- (Avon UK, the Isle of Man), Central- (the Czech Republic and the Slovak Republic) and East-Europe (the Ukraine and Russia), that collaborate in the European Longitudinal Study of Pregnancy and Childhood (ELSPAC project). In prenatal questionnaires filled in after the first half of pregnancy, women reported 25,795 chronic diseases they ever suffered, out of them 11,188 having in present pregnancies. In the whole sample, lifelong prevalence was 11,2%, and prevalence in pregnancy 4,8% which means that 43,4% of all chronic diseases recurred in pregnancy. Up to mean age of 255 years in the whole sample, 39,6% women reported ever having indigestion, 29% back pains, 22,6% migraine, about 16% haemorrhoids, hay fever and eczema, about 10% varicose veins, anorexia nervosa, heavy depression and kidney diseases, over 5% rheumatism and 4% asthma. Less prevalent were infections of pelvic organs, febrile convulsions, joint inflammations, stomach ulcers, psoriasis and epilepsy. Lifetime prevalence of chronic diseases and their prevalence in pregnancy were the highest in the western zone and decreased eastwards, but recurrence grew in the opposite direction, being the highest in the eastern zone. The variation of each morbidity indicator is followed in all diseases between geographical zones as well as between individual study centres. PMID:18822844

  9. The European study of assisted reproduction families: family functioning and child development.

    PubMed

    Golombok, S; Brewaeys, A; Cook, R; Giavazzi, M T; Guerra, D; Mantovani, A; van Hall, E; Crosignani, P G; Dexeus, S

    1996-10-01

    Findings are presented of a European study (conducted in the UK, Italy, Spain and The Netherlands) of family relationships and the social and emotional development of children in families created as a result of the two most widely used reproductive technologies, in-vitro fertilization (IVF) and donor insemination (DI), in comparison with control groups of families with naturally conceived child and adoptive families. Mothers of children conceived by assisted reproduction expressed greater warmth towards their child, were more emotionally involved with their child, interacted more with their child and reported less stress associated with parenting than mothers who conceived their child naturally. Similarly, assisted reproduction fathers were found to interact more with their child and to contribute more to parenting than fathers with a naturally conceived child. With respect to the children themselves, no group differences were found for either the presence of psychological disorder or for children's perceptions of the quality of family relationships. The findings relating to the quality of parenting and the socio-emotional development of the children were similar in each of the four countries studied. PMID:8943550

  10. A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone

    PubMed Central

    Berardinelli, Francesco; Proietti, Silvia; Cindolo, Luca; Pellegrini, Fabrizio; Peschechera, Roberto; Derek, Hennessey; Dalpiaz, Orietta; Schips, Luigi; Giusti, Guido

    2016-01-01

    ABSTRACT Purpose The aim of this study was to describe the outcomes and the complications of retrograde intrarenal surgery (RIRS) for renal stones in a multi-institutional working group. Materials and Methods From 2012 to 2014, we conducted a prospective study including all RIRS performed for kidney stones in 4 European centers. Demographic information, disease characteristics, and perioperative and postoperative data were gathered. Patients and stone data, procedure characteristics, results and safety outcomes were analyzed and compared by descriptive statistics. Complications were reported using the standardized Clavien system. Results Three hundred and fifty-six patients underwent 377 RIRS with holmium laser lithotripsy for renal stones. The RIRS was completed in all patients with a mean operative time of 63.5 min. The stone-free status was confirmed endoscopically and through fluoroscopic imaging after the first procedure in 73.6%. The second procedure was performed in twenty patients (5.6%) achieving an overall stone free rate of 78.9%. The overall complication rate was 15.1%. Intra-operative and post-operative complications were seen in 24 (6.7%) and 30 (8.4%) cases, respectively. Conclusions RIRS is a minimally invasive procedure with good results in terms of stone-free and complications rate. PMID:27286110