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Sample records for follow-up site visits

  1. QL-10NEURO-ONCOLOGY TELEMEDICINE FOLLOW-UP VISITS

    PubMed Central

    Green, Richard; Woyshner, Emily

    2014-01-01

    We report our 18 month experience with the use of a videoconferencing system to perform neuro-oncology follow-up visits. The Neuro-oncology Program at the Kaiser Permanente-Los Angeles Medical center serves the majority of Kaiser HMO patients in the Southern California region. We installed a videoconferencing system (Cisco TelePresence EX90, Cisco Systems, San Jose, CA) in our office in Los Angeles and in a medical office building in Anaheim, CA at a distance of 35 miles. Established neuro-oncology patients from Orange County chose between in-person and remote visits. Patients were seated in an examination room and the neuro-oncology provider alerted by text page. A focused history and physical examination was performed, followed by desktop sharing of clinical and laboratory data using an electronic medical record (Epic Systems Corporation, Verona, WI) and of neuroimages (Phillips iSite PACS, Andover, MA). Patients were asked, but not required, to complete an anonymous online 16 question satisfaction survey after each visit. Visits were performed by either a neuro-oncologist (179) or a Physician's Assistant (12). Of the 191 visits, 174 included evaluation of neuroimaging and 77 included evaluation of response to ongoing chemotherapy. During 12 visits chemotherapy was initiated, and during 15 visits the chemotherapy regimen was changed based on imaging findings. One-hundred and eleven surveys (58% of visits) were completed. Patients reported a high level of satisfaction with the visits (average 9.6, on a 1-10 scale). The average estimated travel time saved was 118 minutes per visit. Four surveys reported technical problems and 1 indicated a preference for an in-person visit. No adverse events could be attributed to use of the telemedicine system. These data suggest that neuro-oncology follow-up visits can be practiced safely and effectively using a telemedicine system, with high levels of patient satisfaction.

  2. Routine follow-up visits after first-trimester induced abortion.

    PubMed

    Grossman, Daniel; Ellertson, Charlotte; Grimes, David A; Walker, Dilys

    2004-04-01

    Routine follow-up visits after abortion are intended to confirm that the abortion is complete and to diagnose and treat complications. Many clinicians also take advantage of the follow-up visit to provide general reproductive health care: discussing contraceptive plans and providing family planning services; diagnosing sexually transmitted infections; performing a Pap test or discussing abnormal Pap results. We reviewed the evidence related to the routine postabortion follow-up visit. Other than mifepristone medical abortion performed at 50 days of gestation or later and methotrexate medical abortion, we found little evidence that mandatory follow-up visits typically detect conditions that women themselves could not be taught to recognize. In addition, the natural history of the most severe complications after abortion-infection and unrecognized ectopic pregnancy-have time courses inconsistent with the usual timing of the follow-up visit. Costs associated with this visit can be great. These include travel expenses, lost wages, child-care expenses, privacy and emotional burdens for women, and scheduling disruptions and the related opportunity costs caused by "no-shows" for the provider. Follow-up appointments should be scheduled for those women likely to benefit from a physical examination. For the remainder of women, simple instructions and advice about detecting complications, possibly coupled with telephone follow-up, might suffice. Although arguably valuable in their own right, counseling, family planning services, or sexually transmitted infection diagnosis and treatment should not be so inflexibly bundled with postabortion care. Protocols that require in-person follow-up after abortion may not make the best use of a women's time or abilities, or of the medical system. PMID:15051567

  3. Predictors and Correlates of Follow-up Visit Adherence among Adolescents Receiving Laparoscopic Adjustable Gastric Banding

    PubMed Central

    Sysko, Robyn; Hildebrandt, Tom B.; Kaplan, Simona; Brewer, Stephanie K.; Zitsman, Jeffrey L.; Devlin, Michael J.

    2014-01-01

    Background Adherence behaviors have not been examined among adolescents undergoing laparoscopic adjustable gastric banding (LAGB). In addition, studies of youth receiving bariatric surgery have not considered the influence of psychopathology on postoperative adherence. Objective The purpose of this study was to evaluate predictors and correlates of adherence to post-surgery visits among a sample of adolescents undergoing LAGB. Setting Psychiatry Department, University Medical Center, United States. Methods Postoperative visits with surgical staff were analyzed over the two years following surgery (n= 101 adolescents). Growth mixture modeling examined trends in adherence. Results A three-class solution provided the best fit to the data. The classes from the final model were characterized by class 1 (61.6%) demonstrating high levels of adherence over the 24 months following LAGB, class 2 (28.5%) showing a more gradual decline in adherence, and class 3 (9.9%) with an accelerated decline in adherence. Higher levels of preoperative depressive symptoms and more preoperative episodes of loss of control over eating decreased the likelihood of adherence. Class 3 adolescents had significantly higher estimated 24-month body mass indices than Classes 1 or 2. Conclusions Variable patterns of follow-up visit adherence were identified among adolescents receiving LAGB, which were predicted by depressive symptoms and loss of control over eating. The trajectory characterized by a rapid decline in adherence to follow-up visits was also associated with less weight loss. PMID:25066443

  4. Why Mothers Accompany Adolescent and Young Adult Childhood Cancer Survivors to Follow-up Clinic Visits

    PubMed Central

    Doshi, Kinjal; Kazak, Anne E.; Hocking, Matthew C.; DeRosa, Branlyn Werba; Schwartz, Lisa A.; Hobbie, Wendy L.; Ginsberg, Jill P.; Deatrick, Janet

    2015-01-01

    Purpose Parents often accompany adolescent and young adult (AYA) pediatric cancer survivors to follow-up oncology clinic visits and remain involved in their care, although little is known about their reasons for doing so. Method This mixed methods (qualitativequantitative) study of 76 mothers of AYA survivors of childhood cancer uses content analysis and logistic regression to identify and explore reasons mothers provided for coming to the visit. Demographic and treatment data are examined as potentially explanatory factors. Results Ten reasons (in decreasing order of frequency) were derived: Concern for Childs Health and Well-Being, Practical Support, Transportation, Familial Experience, General Support, Companionship, Personal Interest in Follow-up Care, Characteristics of their Child, Emotional Support, and Parental Duty. The reasons were not related to demographic or treatment factors. Conclusion Mothers accompany AYAs to survivorship clinic for both maternal/family-focused and survivor-focused reasons that can be incorporated in survivorship and transition care to reflect ongoing communications among survivors, parents, and health care teams. PMID:24451909

  5. Physician follow-up visits after acute care hospitalization for elderly Medicare beneficiaries discharged to noninstitutional settings.

    PubMed

    Lin, Caroline Y; Barnato, Amber E; Degenholtz, Howard B

    2011-10-01

    The purpose of this study was to assess the effect of posthospital physician follow-up on readmissions in older adults. Physician follow-up visits after discharge have been promoted as a way to improve outcomes and reduce readmissions, but the evidence base for this recommendation is limited. A retrospective analysis of data from the Medicare Current Beneficiary Survey (MCBS) was conducted for 2001 to 2003. Data were extracted on elderly Medicare beneficiaries with an index hospitalization in 2002, and physician follow-up visits and readmissions within 90 days of discharge were identified. Analysis was conducted with multivariable logistic regression modeling to assess the independent effect on 90-day readmission of any physician follow-up, timing of physician follow-up, and follow-up with only primary care physicians. A generalized linear model was used to assess the effect of physician follow-up on total health expenditures. The analytical sample included 326 beneficiaries; 79% had a physician follow-up visit within 90 days, and 28% were readmitted within 90 days. In multivariable modeling, physician follow-up was negatively associated with 90-day readmissions (odds ratio=0.23, 95% confidence interval=0.13-0.43). Follow-up visits were protective against readmissions regardless of timing of visit and when restricted to those by primary care physicians. Having a follow-up visit was associated with approximately $10,000 lower annual health expenditures. In conclusion, physician follow-up protects against readmission after adjusting for important covariates and is associated with significantly lower expenditures. Future efforts should ensure that patients have adequate physician follow-up. PMID:21883117

  6. Replacing Ambulatory Surgical Follow-Up Visits With Mobile App Home Monitoring: Modeling Cost-Effective Scenarios

    PubMed Central

    Semple, John L; Coyte, Peter C

    2014-01-01

    Background Womens College Hospital (WCH) offers specialized surgical procedures, including ambulatory breast reconstruction in post-mastectomy breast cancer patients. Most patients receiving ambulatory surgery have low rates of postoperative events necessitating clinic visits. Increasingly, mobile monitoring and follow-up care is used to overcome the distance patients must travel to receive specialized care at a reduced cost to society. WCH has completed a feasibility study using a mobile app (QoC Health Inc, Toronto) that suggests high patient satisfaction and adequate detection of postoperative complications. Objective The proposed cost-effectiveness study models the replacement of conventional, in-person postoperative follow-up care with mobile app follow-up care following ambulatory breast reconstruction in post-mastectomy breast cancer patients. Methods This is a societal perspective cost-effectiveness analysis, wherein all costs are assessed irrespective of the payer. The patient/caregiver, health care system, and externally borne costs are calculated within the first postoperative month based on cost information provided by WCH and QoC Health Inc. The effectiveness of telemedicine and conventional follow-up care is measured as successful surgical outcomes at 30-days postoperative, and is modeled based on previous clinical trials containing similar patient populations and surgical risks. Results This costing assumes that 1000 patients are enrolled in bring-your-own-device (BYOD) mobile app follow-up per year and that 1.64 in-person follow-ups are attended in the conventional arm within the first month postoperatively. The total cost difference between mobile app and in-person follow-up care is $245 CAD ($223 USD based on the current exchange rate), with in-person follow-up being more expensive ($381 CAD) than mobile app follow-up care ($136 CAD). This takes into account the total of health care system, patient, and external borne costs. If we examine health care system costs alone, in-person follow-up is $38 CAD ($35 USD) more expensive than mobile app follow-up care over the first postoperative month. The baseline difference in effect is modeled to be zero based on clinical trials examining the effectiveness of telephone follow-up care in similar patient populations. An incremental cost-effectiveness ratio (ICER) is not reportable in this scenario. An incremental net benefit (INB) is reportable, and reflects merely the cost difference between the two interventions for any willingness-to-pay value (INB=$245 CAD). The cost-effectiveness of mobile app follow-up even holds in scenarios where all mobile patients attend one in-person follow-up. Conclusions Mobile app follow-up care is suitably targeted to low-risk postoperative ambulatory patients. It can be cost-effective from a societal and health care system perspective. PMID:25245774

  7. Follow up policy after treatment for Hodgkin's disease: too many clinic visits and routine tests? A review of hospital records.

    PubMed Central

    Radford, J. A.; Eardley, A.; Woodman, C.; Crowther, D.

    1997-01-01

    OBJECTIVE: To examine the effectiveness of routine clinic review in detecting relapse after treatment for Hodgkin's disease. DESIGN: Review of hospital records. SETTING: Regional centre for cancer treatment and research. SUBJECTS: 210 patients with Hodgkin's disease recruited to a chemotherapy trial protocol between 1984 and the end of 1990 who had achieved a complete or partial remission after treatment. MAIN OUTCOME MEASURES: The number of clinic visits made by patients over the period of observation, the number of relapses occurring during that time, and the route by which relapse was detected. RESULTS: The 210 patients generated 2512 outpatient reviews, and 37 relapses were detected. Thirty relapses (81%) were diagnosed in patients who described symptoms, which in 15 cases had resulted in an earlier appointment being arranged. In only four cases (11%; 95% confidence interval 4% to 25%) was relapse detected as a result of routine physical examination on investigation of a patient who did not have symptoms. CONCLUSIONS: Relapse of Hodgkin's disease after treatment is usually detected as a result of the investigation of symptoms rather than by routine screening of asymptomatic patients. It is therefore proposed that the frequency of routine follow up visits should be reduced and greater emphasis placed on patient education. This should underline the importance of symptoms and encourage patients to arrange an earlier appointment if these develop. PMID:9040326

  8. Visit-to-Visit Glucose Variability Predicts the Development of End-Stage Renal Disease in Type 2 Diabetes: 10-Year Follow-Up of Taiwan Diabetes Study.

    PubMed

    Yang, Ya-Fei; Li, Tsai-Chung; Li, Chia-Ing; Liu, Chiu-Shong; Lin, Wen-Yuan; Yang, Sing-Yu; Chiang, Jen-Huai; Huang, Chiu-Ching; Sung, Fung-Chang; Lin, Cheng-Chieh

    2015-11-01

    The purpose of this study was to examine the association of glucose variability using coefficient of variation of fasting plasma glucose (FPG-CV) and coefficient of variation of glycated hemoglobin (HbA1c-CV) to end-stage renal disease (ESRD) in 31,841 Chinese patients with type 2 diabetes.Patients with type 2 diabetes enrolled in National Diabetes Care Management Program, aged ?30 years, and free of ESRD (n?=?31,841) in January 1, 2002 to December 31, 2004 were included. Extended Cox proportional hazards regression models with competing risk of all-cause mortality were used to evaluate risk factors on ESRD incidence. Patients were followed till 2012.After a median follow-up period of 8.23 years, 1642 patients developed ESRD, giving a crude incidence rate of 6.27/1000 person-years (6.36 for men, 6.19 for women). After the multivariate adjustment, both FPG-CV and HbA1c-CV were independent predictors of ESRD with corresponding hazard ratios of 1.20 (95% confidence interval [CI] 1.01, 1.41), 1.24 (95% CI 1.05, 1.46) in HbA1c-CV from fourth to fifth quintile and 1.23 (95% CI 1.03, 1.47) in FPG-CV from fifth quintile.One-year visit-to-visit glucose variability expressed by FPG-CV and HbA1c-CV predicted development of ESRD in patients with type 2 diabetes, suggesting therapeutic strategies toward a goal to minimize glucose fluctuation. PMID:26554779

  9. The CACREP Site Visit Process

    ERIC Educational Resources Information Center

    Lee, Courtland C.

    2013-01-01

    An important step in the CACREP review process is the campus site visit. The visit involves a team, usually from comparable institutions, coming to a campus for a review of the counselor training program(s). The role of the team is to be the CACREP Board's representative on campus to verify the self-study. In this article, the author reviews

  10. The CACREP Site Visit Process

    ERIC Educational Resources Information Center

    Lee, Courtland C.

    2013-01-01

    An important step in the CACREP review process is the campus site visit. The visit involves a team, usually from comparable institutions, coming to a campus for a review of the counselor training program(s). The role of the team is to be the CACREP Board's representative on campus to verify the self-study. In this article, the author reviews…

  11. Outpatient Follow-Up Visit after Hospital Discharge Lowers Risk of Rehospitalization in Patients with Schizophrenia: A Nationwide Population-Based Study

    PubMed Central

    Lee, Seung Yup; Kim, Kyoung Hoon; Kim, Tae; Kim, Sun Min; Kim, Jong-Woo; Han, Changsu; Song, Ji Young

    2015-01-01

    Objective Non-adherence to medication is a recognized problem in psychiatric patients and may be one of the most challenging aspects of treatment for patients with schizophrenia. Failure of follow-up care after discharge greatly increases non-adherence to prescribed medications, relapse and rehospitalization. However, it is still unknown whether and how much outpatient follow-up visits can mitigate the risk of rehospitalization. Therefore we sought to investigate the continuity and effectiveness of outpatient care after inpatient discharge and its effect on rehospitalization of patients with schizophrenia. Methods Data were extracted from National Health Insurance Claim Database covering the period from 2007 through 2010. We identified 10,246 patients aged 18 years or older who were admitted in psychiatric facilities with the diagnosis of schizophrenia between January 1 and December 31 in 2007. The number of outpatient visits within 60 days after discharge from index admission was defined as the indicator for the continuous care and rehospitalization was inspected during the following 36-month period. Cox's proportional hazard model was used to examine the factors affecting the risk of rehospitalization including the number of outpatient visits, age, sex, comorbidities, antipsychotics, and characteristics of medical institution. Results We found that 12.7% (n=1,327) of the patients visited psychiatric outpatient department once within 60 days after hospital discharge, 34.8% (n=3,626) twice, and 27.8% (n=2,900) more than three times. Patients taking atypical antipsychotics showed higher proportion in 2 or more outpatient visits, whereas patients taking typical antipsychotics showed higher proportion in one or no outpatient visits. Cox hazard ratios of rehospitalization for the factor of 3 or more outpatient visits referenced to that of no follow-up visit were 0.567 (0.428-0.750, 95% confidence interval) within 90 days, 0.673 (0.574-0.789) within 180 days, 0.800 (0.713-0.898) within a year, 0.906 (0.824-0.997) within 2 years, and 0.993 (0.910-1.084) within 3 years. Conclusion Although continuous outpatient treatment is important for relapse prevention, patients with schizophrenia showed a low rate of outpatient visit as 62.6% of total patients in 2 or more visits within 60 days after discharge. Lack of follow-up treatment might lead to increase psychotic symptoms and raised risk of relapse and rehospitalization. Our data suggest that the number of outpatient visits within 60 days after discharge in patients with schizophrenia is an important indicator of rehospitalization within a year. Therefore, further efforts to examine factors affecting failure of outpatient follow-up after discharge are warranted. PMID:26508952

  12. Evaluative Site Visits: A Methodological Review

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Keiser, Nanette; Lavoie, Bethann

    2003-01-01

    Site visits are a commonly employed, but little discussed, evaluation procedure. Our purpose is to review the state of the art regarding site visits, as well as to catalyze a discussion of site visits centering on the question of whether or not existing practices constitute a set of methods or a methodology. We define evaluative site visits and

  13. Job Candidates' Views of Site Visits.

    ERIC Educational Resources Information Center

    Fink, Laurence S.; And Others

    1994-01-01

    Followed 62 Master of Business Administration students through job search involving 97 site visits to determine whether site visits changed perceptions of visited companies, attitudes toward those firms, and intentions to accept job offers. Findings suggest that organizations can improve recruitment success by paying attention to how site visits

  14. Site Guidelines for a "Making Middle Grades Work" Technical Review Visit

    ERIC Educational Resources Information Center

    Southern Regional Education Board, 2004

    2004-01-01

    The purpose of the Technical Review Visit (TRV) is to follow up on the actions taken to implement the recommendations indicated for each challenge in the most recent Technical Assistance Visit (TAV) report. This document provides the following: (1) Site Guidelines for the Making Middle Grades Work (MMGW) Technical Review Visit; (2) Site Checklist;

  15. 7 CFR 3015.94 - Site visits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Monitoring and Reporting Program Performance 3015.94 Site visits. The awarding agency shall make site visits as frequently as practicable to: (a) Review program... 7 Agriculture 15 2010-01-01 2010-01-01 false Site visits. 3015.94 Section 3015.94...

  16. 48 CFR 36.523 - Site visit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 36.523 Site visit. The contracting... (Construction), in solicitations which include the clauses at 52.236-2, Differing Site Conditions, and 52.236-3... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Site visit. 36.523...

  17. 48 CFR 36.523 - Site visit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 36.523 Site visit. The contracting... (Construction), in solicitations which include the clauses at 52.236-2, Differing Site Conditions, and 52.236-3... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Site visit. 36.523...

  18. A follow-up of cancer incidence among former Finnish dump site residents: 19992011

    PubMed Central

    Pukkala, Eero

    2014-01-01

    Background: In an analysis of the years 19761998, a 50% excess in cancer incidence was observed among residents in twelve blockhouses in Helsinki, Finland on a former dump area containing industrial and household waste. Objective: To assess cancer risk over a 13-year period 19992011 among residents formerly living in houses built on a dump area. Methods: All 1879 persons who ever lived in the former dump area were identified and the number of cancer cases in this population was obtained from the Finnish Cancer Registry. Results: After 5 years of residence at the dump site, the standardized incidence ratio of cancer (all sites combined) was 1.32 (95% CI: 0.941.79) in men and 0.53 (95% CI: 0.330.82) for women, in comparison with the general Helsinki population (19992011). No significant excess cancer risks were found. Conclusions: Residing on a former dump area was not found to result in an increased risk of cancer. PMID:25224807

  19. 2011 Mound Site Groundwater Plume Rebound Exercise and Follow-Up - 13440

    SciTech Connect

    Hooten, Gwendolyn; Cato, Rebecca; Lupton, Greg

    2013-07-01

    The Mound Site facility near Miamisburg, Ohio, opened in 1948 to support early atomic weapons programs. It grew into a research, development, and production facility performing work in support of the U.S. Department of Energy (DOE) weapons and energy programs. The plant was in operation until 1995. During the course of operation, an onsite landfill was created. The landfill was located over a finger of a buried valley aquifer, which is a sole drinking water source for much of the Miami Valley. In the 1980's, volatile organic compounds (VOCs) were discovered in groundwater at the Mound site. The site was placed on the National Priorities List on November 21, 1989. DOE signed a Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Federal Facility Agreement with the U.S. Environmental Protection Agency (EPA) and the Ohio Environmental Protection Agency. The agreement became effective in October 1990. The area that included the landfill was designated Operational Unit 1 (OU-1). In 1995, a Record of Decision was signed that called for the installation and operation of a pump and treatment (P and T) system in order to prevent the VOCs in OU-1 groundwater from being captured by the onsite water production wells. In addition to the P and T system, a soil vapor extraction (SVE) system was installed in 1997 to accelerate removal of VOCs from groundwater in the OU-1 area. The SVE system was successful in removing large amounts of VOCs and continued to operate until 2007, when the amount of VOCs removed became minimal. A rebound study was started in February 2003 to determine how the groundwater system and contaminants would respond to shutting down the P and T system. The rebound test was stopped in February 2004 because predetermined VOC threshold concentrations were exceeded down-gradient of the landfill. The P and T and SVE systems were restarted after the termination of the rebound test. In 2006, the remediation of the Mound site was completed and the site was declared to be protective of human health and the environment, as long as the institutional controls are observed. The institutional controls that apply to the OU-1 area include provisions that no soil be allowed to leave the site, no wells be installed for drinking water, and the site may be approved only for industrial use. The onsite landfill with the operating CERCLA remedy remained. However, the Mound Development Corporation lobbied Congress for funds to remediate the remaining onsite landfill to allow for property reuse. In 2007 DOE received funding from Congress to perform non-CERCLA removal actions at OU-1 to excavate the site sanitary landfill. In 2009, DOE received American Recovery and Reinvestment Act funding to complete the project. Excavation of the landfill occurred intermittently from 2006 through 2010 and the majority of the VOC source was removed; however, VOC levels near the P and T system remained greater than the EPA maximum contaminant levels (MCLs). Presently, groundwater is contained using two extraction wells to create a hydraulic barrier to prevent down-gradient migration of VOC-impacted groundwater. Since the primary contamination source has been removed, the feasibility of moving away from containment to a more passive remedy, namely monitored natural attenuation (MNA), is being considered. A second rebound study was started in June 2011. If contaminant and groundwater behavior met specific conditions during the study, MNA would be evaluated and considered as a viable alternative for the groundwater in the OU-1 area. From June through December 2011, the second rebound study evaluated the changes in VOC concentrations in groundwater when the P and T system was not in operation. As the study progressed, elevated concentrations of VOCs that exceeded predetermined trigger values were measured along the down-gradient boundary of the study area, and so the P and T system was restarted. It was determined that a discrete area with VOC concentrations greater than the MCLs was present in groundwater down-gradient of the extraction wells. The source was not identified, but the contamination was thought not to be caused by residually contaminated soil beneath the former landfill. The data collected so far supports the consideration of MNA as a viable alternative to hydraulic containment. Additional investigations are being performed to identify possible sources or pathways of VOCs in groundwater that may be contributing to the elevated VOC levels measured down-gradient of the extraction well system. Data from this additional investigation will be used to determine whether the VOCs detected down-gradient of the hydraulic boundary are the result of residual soil contamination, a previously unknown contribution of VOC-contaminated water entering the groundwater outside the capture zone of the extraction wells, or a pulse of VOC-contaminated groundwater from the OU-1 landfill that occurred during the rebound study. (authors)

  20. Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal: 2012 follow-up survey and use of skilled birth attendants

    PubMed Central

    Choulagai, Bishnu P.; Aryal, Umesh Raj; Shrestha, Binjwala; Vaidya, Abhinav; Onta, Sharad; Petzold, Max; Krettek, Alexandra

    2015-01-01

    Background Estimates of disease burden in Nepal are based on cross-sectional studies that provide inadequate epidemiological information to support public health decisions. This study compares the health and demographic indicators at the end of 2012 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) with the baseline conducted at the end of 2010. We also report on the use of skilled birth attendants (SBAs) and associated factors in the JD-HDSS at the follow-up point. Design We used a structured questionnaire to survey 3,505 households in the JD-HDSS, Bhaktapur, Nepal. To investigate the use of SBAs, we interviewed 434 women who had delivered a baby within the prior 2 years. We compared demographic and health indicators at baseline and follow-up and assessed the association of SBA services with background variables. Results Due to rising in-migration, the total population and number of households in the JD-HDSS increased (13,669 and 2,712 in 2010 vs. 16,918 and 3,505 in 2012). Self-reported morbidity decreased (11.1% vs. 7.1%, respectively), whereas accidents and injuries increased (2.9% vs. 6.5% of overall morbidity, respectively). At follow-up, the proportion of institutional delivery (93.1%) exceeded the national average (36%). Women who accessed antenatal care and used transport (e.g. bus, taxi, motorcycle) to reach a health facility were more likely to access institutional delivery. Conclusions High in-migration increased the total population and number of households in the JD-HDSS, a peri-urban area where most health indicators exceed the national average. Major morbidity conditions (respiratory diseases, fever, gastrointestinal problems, and bone and joint problems) remain unchanged. Further investigation of reasons for increased proportion of accidents and injuries are recommended for their timely prevention. More than 90% of our respondents received adequate antenatal care and used institutional delivery, but only 13.2% accessed adequate postnatal care. Availability of transport and use of antenatal care was associated positively with institutional delivery. PMID:26700175

  1. Effects of Home Visits by Paraprofessionals and by Nurses on Children: Age-Six and Nine Follow-Up of a Randomized Trial

    PubMed Central

    Olds, David L.; Holmberg, John R.; Donelan-McCall, Nancy; Luckey, Dennis W.; Knudtson, Michael D.; Robinson, JoAnn

    2014-01-01

    Objective To examine the impact of prenatal and infancy/toddler home visiting by paraprofessionals and by nurses on child development at child ages 6 and 9. Design Randomized controlled trial. Setting Public and private care settings in Denver, Colorado. Participants 735 low-income women and their first-born children; 85% of the mothers were unmarried, 47% Hispanic, 35% non-Hispanic white, 15% African-American, and 3% American Indian/Asian. Interventions Home visits provided from pregnancy through child age 2 delivered in one group by paraprofessionals and in the other by nurses. Primary Outcomes Reports of children's internalizing, externalizing, and total emotional/behavioral problems; tests of children's language, intelligence, attention, attention dysfunction, visual attention/task shifting, working memory, and academic achievement. We hypothesized that program effects on cognitive related outcomes would be more pronounced among children born to mothers with low psychological resources. We report paraprofessional-control and nurse-control differences with p-values <.10 given similar effects in a previous trial, earlier impacts in this trial, and limited statistical power. Results There were no significant paraprofessional effects on emotional/behavioral problems, but paraprofessional-visited children born to mothers with low psychological resources, compared to control group counterparts, exhibited fewer errors in visual attention/task switching at age 9 (ES=?0.30, p=.078). There were no statistically significant paraprofessional effects on other primary outcomes. Nurse-visited children were less likely to be classified as having total emotional/behavioral problems at age 6 (RR=0.45, p=.082), internalizing problems at age 9 (RR=0.44, p =.078), and dysfunctional attention at age 9 (RR=0.34, p=.070). Nurse-visited children born to low-resource mothers, compared to control-group counterparts, had better receptive language averaged over ages 2, 4, and 6 (ES = 0.30, p=.014), and sustained attention averaged over ages 4, 6, and 9 (ES = 0.36, p =.006). There were no significant nurse effects on externalizing problems, intellectual functioning, and academic achievement. Conclusions Children born to low-resource mothers visited by paraprofessionals exhibited improvement in visual attention/task switching. Nurse-visited children showed improved behavioral functioning, and those born to low-resource mothers benefited in language and attention, but did not improve in intellectual functioning and academic achievement. PMID:24296904

  2. 48 CFR 52.236-27 - Site Visit (Construction).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Site Visit (Construction....236-27 Site Visit (Construction). As prescribed in 36.523, insert a provision substantially the same as the following: Site Visit (Construction) (FEB 1995) (a) The clauses at 52.236-2, Differing...

  3. 48 CFR 52.236-27 - Site Visit (Construction).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Site Visit (Construction....236-27 Site Visit (Construction). As prescribed in 36.523, insert a provision substantially the same as the following: Site Visit (Construction) (FEB 1995) (a) The clauses at 52.236-2, Differing...

  4. Effectiveness of group psychotherapy for adult outpatients traumatized by abuse, neglect, and/or pregnancy loss: a multiple-site, pre-post-follow-up, naturalistic study.

    PubMed

    Simon, Witold; ?liwka, Piotr

    2012-04-01

    The New Experience for Survivors of Trauma (NEST) is a group psychotherapy intervention for clients traumatized by consequences of abuse, neglect, and pregnancy loss. This multiple site study is the first investigation of its effectiveness. Ninety outpatients from a naturalistic setting completed the Symptom Checklist and the Sense of Coherence questionnaire at baseline, end of treatment, and one-year follow-up. Effectiveness was tested with statistical significance, effect size, and clinical significance. Clients from the total sample as well as from the abortion subsample showed improvement at the end of treatment and at follow-up. Lack of a control group is balanced to some extent by the high ecological validity. The findings suggest that the NEST treatment may be beneficial for traumatized clients and call for further research. PMID:22468575

  5. 76 FR 76168 - Regulatory Site Visit Training Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-06

    ...The Food and Drug Administration's (FDA's) Center for Biologics Evaluation and Research (CBER) is announcing an invitation for participation in its Regulatory Site Visit Training Program (RSVP). This training program is intended to give CBER regulatory review, compliance, and other relevant staff an opportunity to visit biologics facilities. These visits are intended to allow CBER staff to......

  6. Prescribed Fire: The Influence of Site Visits on Citizen Attitudes

    ERIC Educational Resources Information Center

    Toman, Eric; Shindler, Bruce; Reed, Michelle

    2004-01-01

    This research employed a panel design to measure the effect of site visits on public perceptions of prescribed fire. On-site survey questions were devised to compare answers to a mail questionnaire previously completed by the same respondents. Questions were designed to examine how site visits influence public opinion and affect acceptance of…

  7. Prescribed Fire: The Influence of Site Visits on Citizen Attitudes

    ERIC Educational Resources Information Center

    Toman, Eric; Shindler, Bruce; Reed, Michelle

    2004-01-01

    This research employed a panel design to measure the effect of site visits on public perceptions of prescribed fire. On-site survey questions were devised to compare answers to a mail questionnaire previously completed by the same respondents. Questions were designed to examine how site visits influence public opinion and affect acceptance of

  8. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  9. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  10. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  11. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  12. 19 CFR 10.553 - Textile and apparel site visits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Textile and apparel site visits. 10.553 Section 10... Trade Agreement Origin Verifications and Determinations § 10.553 Textile and apparel site visits. (a... Textile Agreements (CITA), exclude from the territory of the United States textile or apparel...

  13. Expert Panel Reviews of Research Centers: The Site Visit Process

    ERIC Educational Resources Information Center

    Lawrenz, Frances; Thao, Mao; Johnson, Kelli

    2012-01-01

    Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research

  14. 48 CFR 52.237-1 - Site Visit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... performed on Government installations, unless the solicitation is for construction: Site Visit (APR 1984... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Site Visit. 52.237-1... AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.237-1...

  15. 48 CFR 52.237-1 - Site Visit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... performed on Government installations, unless the solicitation is for construction: Site Visit (APR 1984... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Site Visit. 52.237-1... AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.237-1...

  16. Corrections Education Evaluation System Project. Site Visit Report.

    ERIC Educational Resources Information Center

    Nelson, Orville; And Others

    Site visits to five correctional institutions in Wisconsin were conducted as part of the development of an evaluation model for the competency-based vocational education (CBVE) project for the Wisconsin Correctional System. The evaluators' perceptions of the CBVE system are presented with recommendations for improvement. Site visits were conducted

  17. Designing a Marketing Course with Field Site Visits

    ERIC Educational Resources Information Center

    Van Doren, Doris; Corrigan, Hope Bober

    2008-01-01

    A key goal of including field site visits in marketing courses is to give business students increased interaction with industry professionals and community leaders. Site visits give students a concrete idea of how different marketing disciplines work in the business world. Business students gain greater insight into a career in marketing from this

  18. Corrections Education Evaluation System Project. Site Visit Report.

    ERIC Educational Resources Information Center

    Nelson, Orville; And Others

    Site visits to five correctional institutions in Wisconsin were conducted as part of the development of an evaluation model for the competency-based vocational education (CBVE) project for the Wisconsin Correctional System. The evaluators' perceptions of the CBVE system are presented with recommendations for improvement. Site visits were conducted…

  19. Predictors of Cosmetic Outcome Following MammoSite Breast Brachytherapy: A Single-Institution Experience of 100 Patients With Two Years of Follow-Up

    SciTech Connect

    Dragun, Anthony E. . E-mail: dragun@radonc.musc.edu; Harper, Jennifer L.; Jenrette, Joseph M.; Sinha, Debajyoti; Cole, David J.

    2007-06-01

    Purpose: To identify the factors that predict for excellent cosmesis in patients who receive MammoSite breast brachytherapy (MBT). Methods and Materials: One hundred patients with Stage 0, I, or II adenocarcinoma of the breast underwent adjuvant therapy using MBT. A dose of 34 Gy, delivered in 10 fractions twice daily, was prescribed to 1-cm depth using {sup 192}Ir high-dose-rate brachytherapy. Patients were assessed for acute toxicity on the day of therapy completion, 4 weeks after therapy, and at least every 3 months by radiation, surgical, and/or medical oncologists. All available data were reviewed for documentation of cosmesis and rated using the Harvard Scale. All patients had a minimum follow-up of 6 months (median = 24 months). Results: Of 100 patients treated, 90 had adequate data and follow-up. Cosmesis was excellent in 62 (68.9%), good in 19 (21.1%), fair in 8 (8.9%), and poor in 1 (1.1%) patient. Using stepwise logistic regression, the factors that predicted for excellent cosmesis were as follows: the absence vs. presence of infection (p = 0.017), and the absence vs. presence of acute skin toxicity (p = 0.026). There was a statistically significant association between acute skin toxicity (present vs. absent) and balloon-to-skin distance (<8 vs. >8 mm, p = 0.001). Factors that did not predict for cosmesis were age, balloon placement technique, balloon volume, catheter days in situ, subcutaneous toxicity, and chemotherapy or hormonal therapy. Conclusions: The acute and late-term toxicity profiles of MBT have been acceptable. Cosmetic outcome is improved by proper patient selection and infection prevention.

  20. 48 CFR 52.236-27 - Site Visit (Construction).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Conditions, and 52.236-3, Site Investigation and Conditions Affecting the Work, will be included in any... to inspect the site where the work will be performed. (b) Site visits may be arranged during normal duty hours by contacting: Name: Address: Telephone: (End of provision) Alterate I (FEB 1995). If...

  1. Russian research capabilities: Findings of site visits

    SciTech Connect

    Wester, D.W.

    1994-02-01

    In June 1993, a proposal was presented to the International Environmental Institute (IEI) in Kennewick, Washington, to establish cooperation and coordination to further pursue the interests of the United States of America and the Republic of Russia in the application and promotion of environmental technology; characterization, treatment, handling, isolation, and disposal of hazardous and radioactive materials; conversion of defense sites to other purposes; and technology transfer, cooperative programs, joint technology development and contractual research. In response to this proposal, IEI and Pacific Northwest Laboratory (PNL) jointly provided funding to send Dr. Dennis W. Wester on a fact-finding mission to Novosibirsk, Moscow, and St. Petersburg, Russia. The trip covered a period of eight weeks, six of which were spent in Novosibirsk and adjoining or related cities and one of which was spent in each of Moscow and St. Petersburg. The general objectives of the trip were to establish a basis for cooperation between IEI and the Russian Academy of Sciences (RAS) for future coordination of mutual interests and objectives such as technology acquisition, development, demonstration, application, and commercialization; use of capabilities and assets developed by the U.S. Department of Energy (DOE) and the RAS; and expediting of cooperative agreements, personnel exchanges, joint ventures and other contractual relationships. The particular objectives of this trip were to evaluate the capabilities of the RAS to satisfy the technology needs associated with the cleanup of the Hanford Site and similar sites in the U.S. and to evaluate the expediency of establishing an IEI presence in Russia.

  2. Middle School Site Visit Report: Five Schools in Profile.

    ERIC Educational Resources Information Center

    Coleman, Mary Ruth; And Others

    This study examined schools which had successfully blended gifted education programs into middle school environments in order to provide outstanding services to gifted middle grades students, and sought to determine the factors that made this successful blending possible. Five sites were visited from a variety of settings and schools that used

  3. 75 FR 6404 - Regulatory Site Visit Training Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration (formerly Docket No. 2004N-0408) Regulatory Site Visit..., and gene therapies. CBER is committed to advancing the public health through innovative...

  4. 76 FR 4919 - Regulatory Site Visit Training Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Regulatory Site Visit Training Program AGENCY: Food and Drug..., vaccines, and cellular, tissue, and gene therapies. CBER is committed to advancing the public...

  5. Managing the Site Visit: Communication Issues and Strategies for the Internship Director.

    ERIC Educational Resources Information Center

    Ross, Roseanna G.

    For the internship site visit to be the most effective vehicle of evaluation for the director, and for open communication between intern and supervisor, the director must be aware of both the communicative relationship issues and the content of the interactions. In all six phases of the site visit--pre-site visit, site visit entry, intern…

  6. Hanford/Tomsk reciprocal site visit: Plutonium agreement compliance talks

    SciTech Connect

    Libby, R.A.; Sorenson, R.; Six, D.; Schiegel, S.C.

    1994-11-01

    The objective of the visit to Hanford Site was to: demonstrate equipment, technology, and methods for calculating Pu production, measuring integrated reactor power, and storing and safeguarding PuO{sub 2}; demonstrate the shutdown of Hanford production reactors; and foster openness and transparency of Hanford operations. The first day`s visit was an introduction to Hanford and a review of the history of the reactors. The second day consisted of discussions on the production reactors, reprocessing operations, and PuO{sub 2} storage. The group divided on the third day to tour facilities. Group A toured the N reactor, K-West reactor, K-West Basins, B reactor, and participated in a demonstration and discussion of reactor modeling computer codes. Group B toured the Hanford Pu Storage Facility, 200-East Area, N-cell (oxide loadout station), the Automated Storage Facility, and the Nondestructive Assay Measurement System. Group discussions were held during the last day of the visit, which included scheduling of a US visit to Russia.

  7. Follow up of phenylketonuria patients.

    PubMed

    Demirkol, M; Giżewska, M; Giovannini, M; Walter, J

    2011-01-01

    In recent years our understanding of the follow up policies for PKU has increased substantially. In particular, we now understand the importance of maintaining control of blood phenylalanine (phe) concentrations life-long to achieve the best long-term neuropsychological outcomes. The concordance with the follow up strategy remains a key challenge for the future, especially with respect to adolescents and young adults. The recent therapies could ease the burden of the dietary phe restriction for PKU patients and their families. The time may be right for revisiting the guidelines for follow up of PKU in order to address a number of important issues related to PKU management: promotion of breastfeeding to complementary feeding up to 2 years of age for prevention of early growth retardation and later overweight development, treatment advancements for metabolic control, blood phe and tyr variability, routine screening measures for nutritional biomarkers, neurocognitive and psychological assessments, bone pathology, understanding the challenges of compliance and transitioning into adulthood as an individual with PKU and addressing unmet needs in this population. PMID:22018725

  8. Follow-up of treated osteosarcoma patient

    PubMed Central

    Martins, Gisele Eiras; Perez, Stela Verzinhasse

    2012-01-01

    Objective To evaluate the value of post-treatment follow-up in osteosarcoma patients. Methods Data were collected through a clinical record, with socio-demographic and clinical data, and information relating to the medical appointment. Descriptive analysis of the data was carried out. The Chi-squared test was used to associate the independent variables with attendance at scheduled follow-up appointments. Results We found a recurrence in 59.6% of cases, of which 58% were lung related; 44% presented clinical complaints and arrived on the scheduled date of the appointment. There was no statistically significant association between the demographic characteristics and early attendance of follow-up visits. 81.3% of the cases who came for the appointment earlier than originally scheduled presented complaints compared to those who did not (p=0.005). Of the cases who presented recurrence, 12.9% attended an appointment late and those who did not present recurrence, 47.6% were late for the appointment (p=0.006). Conclusion It is seen that the patients who came for an earlier appointment presented more complaints and were associated with the positive result of the exams carried out. The patients who had recurrence and came for an earlier appointment did not present a statistically significant difference in recurrence-free survival. It was observed that distance was not a predominant factor in late attendance at appointments. Level of Evidence II, Retrospective Study. PMID:24453610

  9. Remotely operated excavator needs assessment/site visit summary

    SciTech Connect

    Straub, J.; Haller, S.; Worsley, R.; King, M.

    1992-12-02

    The Uranium in Soils Integrated Demonstration requested an assessment of soil excavation needs relative to soil remediation. The following list identifies the DOE sites assessed: Mound Laboratory, Paducah Gaseous Diffusion Plant, Portsmouth Gaseous Diffusion Plant, Nevada Test Site, Lawrence Livermore National Laboratory, Rocky Flats Plant, Los Alamos National Laboratory, Sandia National Laboratory, Idaho National Engineering Laboratory, Hanford Site, and Fernald Site. The reviewed sites fall into one or more of the following three categories: production, EPA National Priorities List, or CERCLA (superfund) designation. Only three of the sites appear to have the need for a remotely operated excavator rope. Hanford and Idaho Falls have areas of high-level radioactive contamination either buried or in/under buildings. The Fernald site has a need for remote operated equipment of different types. It is their feeling that remote equipment can be used to remove the health dangers to humans by removing them from the area. Most interviewees stated that characterization technologies needs are more immediate concern over excavation. In addition, the sites do not have similar geographic conditions which would aid in the development of a generic precision excavator. The sites visited were not ready to utilize or provide the required design information necessary to draft a performance specification. This creates a strong case against the development of one type of ROPE for use at these sites. Assuming soil characterization technology/methodology is improved sufficiently to allow accurate and real time field characterization then development of a precision excavator might be pursued based on FEMP needs, since the FEMP`s sole scope of work is remediation. The excavator could then be used/tested and then later modified for other sites as warranted.

  10. "Pacecare"--a computerized database for pacemaker follow-up.

    PubMed

    Strathmore, N; Mond, H; Hunt, D; Graham, D; Cowling, R; Hale, G; Pate, B

    1990-12-01

    A computerized database for pacemaker follow-up has been designed to run on IBM compatible hardware and to accept pulse generator and lead models of all manufacturers. Stored data includes patient, physician and implant details, indications for pacing, underlying rhythm, complications and management, program settings, and follow-up measurements. Typing is minimized by the use of "pop-up" lists and prepared pulse generator template displays. At each follow-up visit a patient's file is retrieved by surname or number, a visit record created, and measurements documented. As the template of the previous visit is used, recording of the clinic visit takes less than 1 minute. Changes in pacing rates (base or magnet), pulse widths, lead thresholds, lead impedance, and battery cell impedance can be displayed graphically for immediate recognition of end-of-life parameters or suspected malfunction. The program will print patient, implantation and clinic visit summary reports, clinic appointment lists, letters to patients, and annual reports. Two Melbourne hospitals have now entered over 3,600 patients into the database. Valuable information has been obtained regarding implantation details and trends with pulse generator and lead usage. Pacecare is a sophisticated, yet user friendly, computerized database for pacemaker follow-up. Recording of clinic visits is fast and changes in testing parameters can be recognized immediately. PMID:1704542

  11. Appraising the value of independent EIA follow-up verifiers

    SciTech Connect

    Wessels, Jan-Albert

    2015-01-15

    Independent Environmental Impact Assessment (EIA) follow-up verifiers such as monitoring agencies, checkers, supervisors and control officers are active on various construction sites across the world. There are, however, differing views on the value that these verifiers add and very limited learning in EIA has been drawn from independent verifiers. This paper aims to appraise how and to what extent independent EIA follow-up verifiers add value in major construction projects in the developing country context of South Africa. A framework for appraising the role of independent verifiers was established and four South African case studies were examined through a mixture of site visits, project document analysis, and interviews. Appraisal results were documented in the performance areas of: planning, doing, checking, acting, public participating and integration with other programs. The results indicate that independent verifiers add most value to major construction projects when involved with screening EIA requirements of new projects, allocation of financial and human resources, checking legal compliance, influencing implementation, reporting conformance results, community and stakeholder engagement, integration with self-responsibility programs such as environmental management systems (EMS), and controlling records. It was apparent that verifiers could be more creatively utilized in pre-construction preparation, providing feedback of knowledge into assessment of new projects, giving input to the planning and design phase of projects, and performance evaluation. The study confirms the benefits of proponent and regulator follow-up, specifically in having independent verifiers that disclose information, facilitate discussion among stakeholders, are adaptable and proactive, aid in the integration of EIA with other programs, and instill trust in EIA enforcement by conformance evaluation. Overall, the study provides insight on how to harness the learning opportunities arising from EIA follow-up through the appointment of independent verifiers. - Highlights: • A framework for appraising the role of independent verifiers is established. • The value added to EIA follow-up by independent verifiers in South Africa is documented. • Verifiers add most value when involved with screening, checking compliance, influencing decisions and community engagement. • Verifiers could be more creatively utilized in pre-construction preparation, giving feedback, and performance evaluation.

  12. The value of crime scene and site visitation by forensic psychologists and psychiatrists.

    PubMed

    Mohandie, Kris; Meloy, J Reid

    2013-05-01

    Site visits and crime scene visitation by forensic psychologists and psychiatrists may enhance the accuracy and credibility of their forensic work in criminal, civil, and other important contexts. This ethically sound technique of after-the-fact data collection and verification offers numerous potential benefits to the forensic mental health professional: clarifying the subject's actions, assessing the reliability of witness reports, identifying contextual determinants of behavior, and more fully illuminating subject motivation and decision-making. Limitations and suggested guidelines for conducting site visits are offered. Guidelines include preplanning, arranging for an informed guide to accompany and narrate the visit, and conducting the site visit prior to forensic examinations. PMID:23550941

  13. Efficacy and Utility of Phone Call Follow-up after Pediatric General Surgery versus Traditional Clinic Follow-up

    PubMed Central

    Fischer, Kevin; Hogan, Virginia; Jager, Alesha; von Allmen, Daniel

    2015-01-01

    Context: Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call. Objective: Compare a traditional in-person clinic postoperative visit with postoperative phone call follow-up regarding patient satisfaction, rate of successful follow-up, and clinic resource utilization in a large academic practice. Design: A retrospective review of charts of patients who underwent select surgical procedures, along with a review of the clinic schedule for the same time period. Main Outcome Measures: Efficacy, patient/family satisfaction, and impact on the clinic. Methods: Families were contacted by telephone two weeks after select surgical procedures to assess for complications and questions. Cohorts of patients six months before and six months after implementation were assessed for main outcome measures. Results: Before implementation, 55.5% of patients (427/769) who had one of the select surgical procedures were seen in the clinic postoperatively, and 62.6% (435/695) had a successful postoperative phone call follow-up. There were also 1090 overall scheduled postoperative appointments. Six months after implementation, overall postoperative appointments decreased 35.5% to 703. Overall, postoperative-scheduled visits decreased by 6% compared with new visits and other general follow-up visits, which each increased by 3%. A satisfaction survey revealed that 93% of patients (n = 231) were highly satisfied with the process. A hospital cost analysis suggested an 89% cost savings ($101.75 per patient for clinic visit vs $12.50 per patient for phone call follow-up). Conclusion: Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction. PMID:25663201

  14. Impact of Follow Up Counseling on Academic Performance and Persistence.

    ERIC Educational Resources Information Center

    Willett, Terrence

    This document reports on a study done at Gavilan College regarding counseling intervention for students that are subject to academic dismissal. The students that were studied were required to visit a dedicated follow up counselor prior to enrolling in classes in order to assist them in designing an achievable academic plan. The data gathered came

  15. 76 FR 79675 - Pomperaug Hydro Project Andrew Peklo III; Notice of Site Visit and Technical Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Pomperaug Hydro Project Andrew Peklo III; Notice of Site Visit and Technical... for the proposed Pomperaug Hydro Project (FERC No. 12790-001). The purpose of the site visit is...

  16. 77 FR 44675 - Agency Information Collection Activities; Submission for OMB Review; Comment Request: Site Visit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... Register on April 20, 2012 (77 FR 23764). Interested parties are encouraged to send comments to the OMB...: Site Visit Data Collection Request for American Recovery and Reinvestment Act Funded Grants; Job..., ``Site Visit Data Collection Request for American Recovery and Reinvestment Act funded Grants;...

  17. The LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim; Gomez, Edward; Greenstreet, Sarah

    2015-08-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter telescopes to four locations in the northern and southern hemispheres, with a planned network of twelve 1-meter telescopes at 6 locations. This network is very versatile and is designed to respond rapidly to target of opportunity events and also to perform long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of the nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). The telescope network has been fully operational since 2014 May, and observations are being executed remotely and robotically. Future expansion to sites in the Canary Islands and Tibet is planned for 2016.I am using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS) and PanSTARRS (PS1) and several hundred targets are now being followed-up per year. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists in order to improve the orbits, determine the light curves and rotation periods and improve the characterization. This will be extended to obtain more light curves of other NEOs which could be targets. Recent results have included the first period determinations for several of the Goldstone-targeted NEOs. We are in the process of building a NEO Portal which will allow professionals, amateurs and Citizen Scientists to plan, schedule and analyze NEO imaging and spectroscopy observations and data using the LCOGT Network and to act as a co-ordination hub for the NEO follow-up efforts.

  18. Determining Virtual Environment "Fit": The Relationship between Navigation Style in a Virtual Field Trip, Student Self-Reported Desire to Visit the Field Trip Site in the Real World, and the Purposes of Science Education

    ERIC Educational Resources Information Center

    Tutwiler, M. Shane; Lin, Ming-Chao; Chang, Chun-Yen

    2013-01-01

    In this study, a follow-up analysis of the data reported in Lin et al. ("Learn Media Technol." doi: 10.1080/17439884.2011.629660 , 2011), we investigated the relationship between student use of a virtual field trip (VFT) system and the probability of students reporting wanting to visit the national park site upon which the VFT was modeled,

  19. Determining Virtual Environment "Fit": The Relationship between Navigation Style in a Virtual Field Trip, Student Self-Reported Desire to Visit the Field Trip Site in the Real World, and the Purposes of Science Education

    ERIC Educational Resources Information Center

    Tutwiler, M. Shane; Lin, Ming-Chao; Chang, Chun-Yen

    2013-01-01

    In this study, a follow-up analysis of the data reported in Lin et al. ("Learn Media Technol." doi: 10.1080/17439884.2011.629660 , 2011), we investigated the relationship between student use of a virtual field trip (VFT) system and the probability of students reporting wanting to visit the national park site upon which the VFT was modeled,…

  20. Preliminary Report on the Impact of Follow Up Counseling on Academic Performance and Persistence.

    ERIC Educational Resources Information Center

    Willett, Terrence

    This study documents visits to a follow-up counselor at Gavilan College (California) beginning in the fall of 2000. Students on dismissal are required to visit a counselor prior to enrolling to assist them in designing an achievable academic plan. The goals of the follow-up counseling include: (1) helping students raise their grade point averages

  1. Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones

    PubMed Central

    Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M.

    2016-01-01

    Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique. PMID:26880900

  2. Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones.

    PubMed

    Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Lezoche, Giovanni; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M

    2016-01-01

    Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique. PMID:26880900

  3. Long-term follow-up of pediatric trachyonychia.

    PubMed

    Kumar, Monique G; Ciliberto, Heather; Bayliss, Susan J

    2015-01-01

    Pediatric trachyonychia is an acquired nail disease that can cause distress to families. It is a poorly understood disease, and long-term follow-up data are lacking. We present an institutional review of 11 children with isolated pediatric trachyonychia followed over time. Children with the diagnosis of pediatric trachyonychia were identified and invited to participate. Pictures were taken on follow-up and a questionnaire was answered. Exclusion criteria include having another diagnosis at the initial visit that causes nail dystrophy. Eleven patients with the diagnosis of pediatric trachyonychia were available for follow-up. The mean age of appearance was 2.7 years (range 2-7 yrs) and the average follow-up was 66 months (range 10-126 mos). Nine patients were treated with potent topical corticosteroids, one used only petrolatum, and one took vitamin supplements. One patient was found to have an additional skin and hair diagnosis of alopecia areata on follow-up. On follow-up, 82% noted improvement of the nails, whereas 18% noted no change. A majority of cases of pediatric trachyonychia are isolated and improve with time, regardless of treatment. PMID:25556756

  4. Visiting the Site of Death: Experiences of the Bereaved after the 2004 Southeast Asian Tsunami

    ERIC Educational Resources Information Center

    Kristensen, Pal; Tonnessen, Arnfinn; Weisaeth, Lars; Heir, Trond

    2012-01-01

    The authors examined how many bereaved relatives of Norwegian tourists who perished in the 2004 Southeast Asian Tsunami had visited the site of death and the most important outcome from the visit. We conducted in-depth interviews (n = 110) and used self-report questionnaires (Impact of Event Scale--Revised, Inventory of Complicated Grief, and…

  5. Visiting the Site of Death: Experiences of the Bereaved after the 2004 Southeast Asian Tsunami

    ERIC Educational Resources Information Center

    Kristensen, Pal; Tonnessen, Arnfinn; Weisaeth, Lars; Heir, Trond

    2012-01-01

    The authors examined how many bereaved relatives of Norwegian tourists who perished in the 2004 Southeast Asian Tsunami had visited the site of death and the most important outcome from the visit. We conducted in-depth interviews (n = 110) and used self-report questionnaires (Impact of Event Scale--Revised, Inventory of Complicated Grief, and

  6. Loss to follow-up matters.

    PubMed

    Murray, D W; Britton, A R; Bulstrode, C J

    1997-03-01

    Survival analysis of joint replacement relies on the assumption that surgical procedures in patients lost to follow-up have the same chance of failing as those in patients who continue to be assessed. Our study questions that assumption. During the 16-year follow-up of 2268 patients who had received total hip replacements 142 (6%) were lost to follow-up. The cumulative loss at 15 years was 20%. At their last assessment, patients who subsequently failed to attend for follow-up had significantly worse pain, range of movement and opinion of their progress (p < 0.001) and significantly worse radiological features than a matched control group (p < 0.01). Patients lost to follow-up have a worse outcome than those who continue to be assessed. Consequently, a survival analysis that does not take into account such patients is likely to give falsely optimistic results. It is therefore essential that vigorous attempts are made to minimise loss to follow-up, and that the rate of such loss is quoted. The overall loss to follow-up disguises the magnitude of the problem, which is best quantified by a cumulative rate of follow-up. The reliability of a study can be assessed by a loss-to-follow-up quotient, calculated by the number of failures: the lower the quotient the more reliable the data. Ideally, the quotient should be less than 1. PMID:9119852

  7. Follow-up Cost Study. TEX-SIS FOLLOW-UP SC5.

    ERIC Educational Resources Information Center

    Baugh, Ronald C.

    This report presents data on the costs of follow-up studies, based on 29 separate follow-up studies conducted by eight public community/junior colleges in Texas. The purpose of this study, conducted by Navarro College as a subcontractor of Project FOLLOW-UP, was to provide data and information regarding the cost of follow-up studies that would be…

  8. Towards sustainability assessment follow-up

    SciTech Connect

    Morrison-Saunders, Angus; North-West University ; Pope, Jenny; Integral Sustainability; Curtin University ; Bond, Alan; University of East Anglia ; Retief, Francois

    2014-02-15

    This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.

  9. Francoise, a Fifteen-Year Follow Up.

    ERIC Educational Resources Information Center

    Rondal, J. A.; Elbouz, M.; Ylieff, M.; Docquier, L.

    2003-01-01

    This paper reports on a 15-year follow-up of the linguistic and cognitive profile of a woman with standard trisomy 21 (Down syndrome). The follow-up found recent rapid deterioration in receptive and productive language skills. However, basic phonological and morphosyntactic skills are preserved. Her changing profile mirrors that found in aging

  10. Robotic Follow-Up for Human Exploration

    NASA Technical Reports Server (NTRS)

    Fong, Terrence; Bualat, Maria; Deans, Matthew C.; Adams, Byron; Allan, Mark; Altobelli, Martha; Bouyssounouse, Xavier; Cohen, Tamar; Flueckiger, Lorenzo; Garber, Joshua; Palmer, Elizabeth; Heggy, Essam; Jurgens, Frank; Kennedy, Tim; Kobayashi, Linda; Lee, Pascal; Lee, Susan Y.; Lees, David; Lundy, Mike; Park, Eric; Pedersen, Liam; Smith, Trey; To, Vinh; Utz, Hans; Wheeler, Dawn

    2010-01-01

    We are studying how "robotic follow-up" can improve future planetary exploration. Robotic follow-up, which we define as augmenting human field work with subsequent robot activity, is a field exploration technique designed to increase human productivity and science return. To better understand the benefits, requirements, limitations and risks associated with this technique, we are conducting analog field tests with human and robot teams at the Haughton Crater impact structure on Devon Island, Canada. In this paper, we discuss the motivation for robotic follow-up, describe the scientific context and system design for our work, and present results and lessons learned from field testing.

  11. Complications and follow up of subarachnoid hemorrhages.

    PubMed

    Danire, F; Gascou, G; Menjot de Champfleur, N; Machi, P; Leboucq, N; Riquelme, C; Ruiz, C; Bonaf, A; Costalat, V

    2015-01-01

    Complications of subarachnoid hemorrhage are the major life threatening and functional components of the follow up of a ruptured aneurysm. Knowing how to identify these is a key challenge. They vary in type throughout the postoperative follow up period. The aim of this article is firstly to list the main complications of the acute phase (rebleeding, acute hydrocephalus, acute ischemic injury and non-neurological complications), the subacute phase (vasospasm) and the chronic phase of subarachnoid hemorrhages: (chronic hydrocephalus and cognitive disorders) and to describe their major clinical and radiological features. Secondly, we describe the long-term follow up strategy for patients who have suffered a subarachnoid hemorrhage and have been treated endovascularly or by surgery. This follow up involves a combination of clinical consultations, cerebral MRI and at least one review angiogram. PMID:26119863

  12. Effective Delivery of Therapeutic Interventions: Findings from Four Site Visits

    ERIC Educational Resources Information Center

    Atkinson, Cathy; Squires, Garry; Bragg, Joanna; Wasilewski, David; Muscutt, Janet

    2013-01-01

    This project follows a survey into the role of UK educational psychologists (EPs) in delivering therapeutic interventions to children and young people. Four educational psychology services (EPSs) that identified themselves as providing effective therapeutic practice were selected on the basis of their qualitative responses to the survey. Site

  13. Understanding the Experience of CACREP On-Site Visiting Review Team Chairpersons

    ERIC Educational Resources Information Center

    Minor, Amanda J.

    2012-01-01

    Understanding the experience of CACREP on-site review team members provides insight into the phenomenon of four counselor educators who have each served as a CACREP on-site visiting review team chairperson a minimum of three times. In total, the participants had been within the counselor education field for approximately 95 years and active within…

  14. Understanding the Experience of CACREP On-Site Visiting Review Team Chairpersons

    ERIC Educational Resources Information Center

    Minor, Amanda J.

    2012-01-01

    Understanding the experience of CACREP on-site review team members provides insight into the phenomenon of four counselor educators who have each served as a CACREP on-site visiting review team chairperson a minimum of three times. In total, the participants had been within the counselor education field for approximately 95 years and active within

  15. Pharmacy Student and Preceptor Impressions of Faculty Liaison Visits to Experiential Training Sites.

    PubMed

    Wilbur, Kerry; Paiva, Maria; Black, Emily

    2015-11-25

    Objective. To characterize preceptor and student views about and experiences with faculty liaison visits to practice sites during clinical internships. Methods. A survey was administered at the conclusion of each of the first 3 academic years of a new postbaccalaureate doctor of pharmacy (PharmD) program. Results. Preceptors were satisfied overall with faculty liaison visits, while students initially were not; however, their perception increased in subsequent years. Students felt development of their patient care skills benefited, but less so their interpersonal communication skills. Each year, almost all preceptors indicated faculty liaison visits were helpful in developing and refining their mentorship skills. Conclusion. Faculty liaison visits provided a valuable opportunity to interact and support preceptors and students during advanced pharmacy internships in a nascent PharmD program. PMID:26839424

  16. Pharmacy Student and Preceptor Impressions of Faculty Liaison Visits to Experiential Training Sites

    PubMed Central

    Paiva, Maria; Black, Emily

    2015-01-01

    Objective. To characterize preceptor and student views about and experiences with faculty liaison visits to practice sites during clinical internships. Methods. A survey was administered at the conclusion of each of the first 3 academic years of a new postbaccalaureate doctor of pharmacy (PharmD) program. Results. Preceptors were satisfied overall with faculty liaison visits, while students initially were not; however, their perception increased in subsequent years. Students felt development of their patient care skills benefited, but less so their interpersonal communication skills. Each year, almost all preceptors indicated faculty liaison visits were helpful in developing and refining their mentorship skills. Conclusion. Faculty liaison visits provided a valuable opportunity to interact and support preceptors and students during advanced pharmacy internships in a nascent PharmD program. PMID:26839424

  17. Follow-up of differentiated thyroid carcinoma.

    PubMed

    Bournaud, C; Raverot, V

    2015-02-01

    The aim of follow-up of differentiated thyroid carcinoma (CTD) is the assessment of remission, and, in further steps, the early recognition of patients who develop a recurrence. Tools for the follow-up of CTD include the assessment of thyroglobulin and imaging procedures. Thyroglobulin (Tg) is a strong marker of persistent or recurrent disease, but it must be known that Tg antibodies may give falsely low Tg concentration. TSH stimulation, mainly by the mean of recombinant human TSH, improves the sensitivity of Tg determination. New highly sensitive assays may preclude the need for TSH stimulation, at least in some situations. In the last decades, (131)iodine whole body scan gave place to neck ultrasonography (US) as the most performing imaging procedure in the follow-up of CTD. Criteria to identify cervical lymph node suspect of metastasis have been described, and standardized procedures proposed. Finally, the proof of tumoral invasion is brought by cytological analysis of fine needle biopsies of suspicious lymph nodes. (18)FDG PET is a valuable tool for diagnosis and prognosis in metastatic patients, especially with negative (131)I WBS. Initial response to therapy, assessed by Tg determination and neck US, allows re-stratification of the risk of relapse. According to this "reassessed risk", adapted rhythms and modalities of follow-up have been recently proposed. PMID:26826480

  18. Facilitating Follow-Up in ELT INSET

    ERIC Educational Resources Information Center

    Waters, Alan

    2006-01-01

    There is evidence that ELT INSET does not always result in the desired level of "follow-up," i.e. impact on teachers' classroom practices. Nevertheless, little research appears to have been carried out concerning how the design of INSET systems affects such outcomes. This paper therefore attempts to throw light on some of the factors involved,

  19. Utah Project "Follow-Up." Interim Report.

    ERIC Educational Resources Information Center

    Cox, John A.

    Procedures and machinery were developed for a statewide, 5-year follow-up of high school and post-secondary vocational students for quality and cost effectiveness analysis purposes. The system calls for specific information about the student to be gathered while he is in school by means of a Student Exit Form. Information is accumulated on

  20. Follow-Up Research on Agoraphobics.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.

    In vivo exposure is the most commonly used and generally the most effective behavioral treatment for agoraphobia. Follow-up studies are difficult to interpret because additional treatment does not necessarily indicate relapse and non-treatment does not necessarily indicate non-relapse. Relapse rates are difficult to estimate because of lack of

  1. Cardiac Resynchronization Therapy Follow-up: Role of Remote Monitoring.

    PubMed

    Linde, Cecilia; Braunschweig, Frieder

    2015-12-01

    Cardiac resynchronization therapy (CRT) is increasingly used in heart failure treatment and management of these patients imposes significant challenges. Remote monitoring is becoming essential for CRT follow-up and allows close surveillance of device function and patient condition. It is helpful to reduce clinic visits, increase device longevity and provide early detection of device failure. Clinical effects include prevention of appropriate and inappropriate shocks and early detection of arrhythmias, such as atrial fibrillation. For modification of heart failure the addition of monitoring to CRT by means of device-based multiparameters may help to modify disease progression and improve survival. PMID:26596821

  2. Outpatient follow-up after traumatic injury: Challenges and opportunities

    PubMed Central

    Hansen, Luke; Shaheen, Aisha; Crandall, Marie

    2014-01-01

    Background: It has been shown that rates of ambulatory follow-up after traumatic injury are not optimal, but the association with insurance status has not been studied. Aims: To describe trauma patient characteristics associated with completed follow-up after hospitalization and to compare relative rates of healthcare utilization across payor types. Setting and Design: Single institution retrospective cohort study. Materials and Methods: We compared patient demographics and healthcare utilization behavior after discharge among trauma patients between April 1, 2005 and April 1, 2010. Our primary outcome of interest was outpatient provider contact within 2 months of discharge. Statistical Analysis: Multivariate logistic regression was used to determine the association between characteristics including insurance status and subsequent ambulatory and acute care. Results: We reviewed the records of 2906 sequential trauma patients. Patients with Medicaid and those without insurance were significantly less likely to complete scheduled outpatient follow-up within 2 months, compared to those with private insurance (Medicaid, OR 0.67, 95% CI 0.51-0.88; uninsured, OR 0.29, 95% CI 0.23-0.36). Uninsured and Medicaid patients were twice as likely as privately insured patients to visit the Emergency Department (ED) for any reason after discharge (uninsured patients (Medicaid, OR 2.6, 95% CI 1.50-4.53; uninsured, OR 2.10, 94% CI 1.31-3.36). Conclusion: We found marked differences between patients in scheduled outpatient follow-up and ED utilization after injury associated with insurance status; however, Medicaid seemed to obviate some of this disparity. Medicaid expansion may improve outpatient follow-up and affect patient outcome disparities after injury. PMID:25400385

  3. A retrospective follow-up study of body dysmorphic disorder#

    PubMed Central

    Phillips, Katharine A.; Grant, Jon E.; Siniscalchi, Jason M.; Stout, Robert; Price, Lawrence H.

    2006-01-01

    Background Although research on body dysmorphic disorder (BDD) is increasing, no follow-up studies of this disorders course of illness have been published. Methods The status of 95 outpatients with BDD treated in a clinical practice was assessed by chart review. Standard scales were used to rate subjects at baseline and the most recent clinic visit (mean duration of follow-up, 1.7 1.1; range, 0.56.4 years). Ratings were also done at 6-month intervals over the first 4 years of follow-up. Results Allowing for censoring, life table analysis estimated that the proportion of subjects who achieved full remission from BDD at the 6-month and/or 12-month assessment was 24.7%; the proportion who attained partial or full remission at 6 months and/or 12 months was 57.8%. After 4 years of follow-up, 58.2% had experienced full remission, and 83.8% had experienced partial or full remission, at one or more 6-month assessment points. Of those subjects who attained partial or full remission at one or more assessment points, 28.6% subsequently relapsed. Between baseline and the most recent assessment, BDD severity and functioning significantly improved: at the most recent assessment, 16.7% of subjects were in full remission, 37.8% were in partial remission, and 45.6% met full criteria for BDD. Greater severity of BDD symptoms and the presence of major depression or social phobia at baseline were associated with more severe BDD symptoms at study end point. All subjects received at least one medication trial, and 34.3% received some type of therapy during the follow-up period. Conclusions A majority of treated patients with BDD improved, although improvement was usually partial. Prospective longitudinal studies are needed to further elucidate the course of BDD. PMID:16122530

  4. School Site Visits for Community-Based Participatory Research on Healthy Eating

    PubMed Central

    Patel, Anisha I.; Bogart, Laura M.; Uyeda, Kimberly E.; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W.; Schuster, Mark A.

    2010-01-01

    Background School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. Methods In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Results Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and cost were obstacles to policy implementation. Conclusions Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods. PMID:19896033

  5. Appendix B: Site Visit Reports. Assessment of Research Needs for Coal Utilization

    SciTech Connect

    Penner, S.S.

    1983-05-01

    This section contains edited copies of site-visit and other reports prepared by CCAWG members. Some of the hand-out materials prepared by DOE contractors and others are included (without explication) to permit readers the construction of a coherent picture of work in progress.

  6. Female Faculty Members in University Chemistry Departments: Observations and Conclusions Based on Site Visits

    ERIC Educational Resources Information Center

    Chapman, Sally; Dixon, Felicia F.; Foster, Natalie; Kuck, Valerie J.; McCarthy, Deborah A.; Tooney, Nancy M.; Buckner, Janine P.; Nolan, Susan A.; Marzabadi, Cecilia H.

    2011-01-01

    Oral interviews in focus groups and written surveys were conducted with 877 men and women, including administrators, faculty members, postdoctoral associates, and graduate students, during one-day site visits to chemistry and chemical engineering departments at 28 Ph.D.-granting institutions. This report is a preliminary review of the perceptions

  7. Preparing for a Successful Psychiatry Residency Review Committee Site Visit: A Guide for New Training Directors

    ERIC Educational Resources Information Center

    Bhatia, Shashi K.; Bhatia, Subhash C.

    2005-01-01

    Objective: New residency training directors are often faced with multiple competing tasks such as meeting Accreditation Council for Graduate Medical Education (ACGME) Psychiatry Program Requirements and achieving successful completion of residency review committee (RRC) site visits. For many years, the authors have presented workshops on this

  8. Robotic Follow-up of Microlensing Events

    NASA Astrophysics Data System (ADS)

    Street, Rachel; Microlensing Project, RoboNet

    2009-05-01

    Several hundred galactic microlensing events are now routinely discovered every year, of which a few exhibit anomalous behavior due to the presence of an exoplanet orbiting the lensing body. Ground based follow-up of these events requires a co-ordinated observing program using network of telescopes observing around the clock. The RoboNet microlensing project is taking advantage of the robotic scheduling capabilities of LCOGT and the Liverpool Telescope to provide responsive photometric follow-up of carefully selected events. Currently LCOGT has two, 2m telescopes available via our network and are in the process of building and deploying networks of 1m and 0.4m telescopes. Once online, these facilities will provide 24hr coverage of microlensing events. Here we highlight results from the RoboNet Project to date and describe the software we have developed to optimize our response to planetary events.

  9. The LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim A.; Greenstreet, S.; Gomez, E.; Christensen, E.; Larson, S.

    2016-01-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter telescopes to four locations in the northern and southern hemispheres, with a planned network size of twelve 1-meter telescopes at 6 locations. This network is very versatile and is designed to respond rapidly to target of opportunity events and also to perform long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and additionally for the discovery of new objects. We are using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS) and PanSTARRS (PS1&2) and several hundred targets are now being followed per year. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists in order to improve the orbits, determine the light curves and rotation periods and improve the characterization. This will be extended to obtain more light curves of other NEOs which could be targets. Recent results have included the first period determinations for several of the Goldstone-targeted NEOs. We are in the process of building a NEO follow-up portal which will allow professionals, amateurs and Citizen Scientists to plan, schedule and analyze NEO imaging and spectroscopy observations and data using the LCOGT Network and to act as a co-ordination hub for the NEO follow-up efforts.

  10. Prompt GRB optical follow-up experiments

    SciTech Connect

    Park, H-S; Williams, G; Ables, E; Band, D; Barthelmy, S; Bionta, R; Cline, T; Gehrels, N; Hartmann, D; Hurley, K; Kippen, M; Nemiroff, R; Pereira, W; Porrata, R

    2000-11-13

    Gamma Ray Bursts (GRBs) are brief, randomly located, releases of gamma-ray energy from unknown celestial sources that occur almost daily. The study of GRBs has undergone a revolution in the past three years due to an international effort of follow-up observations of coordinates provided by Beppo/SAX and IPN GRB. These follow-up observations have shown that GRBs are at cosmological distances and interact with surrounding material as described by the fireball model. However, prompt optical counterparts have only been seen in one case and are therefore very rare or much dimmer than the sensitivity of the current instruments. Unlike later time afterglows, prompt optical measurements would provide information on the GRB progenitor. LOTIS is the very first automated and dedicated telescope system that actively utilizes the GRB Coordinates Network (GCN) and it attempts to measure simultaneous optical light curve associated with GRBs. After 3 years of running, LOTIS has responded to 75 GRB triggers. The lack of any optical signal in any of the LOTIS images places numerical limits on the surrounding matter density, and other physical parameters in the environment of the GRB progenitor. This paper presents LOTIS results and describes other prompt GRB follow-up experiments including the Super-LOTIS at Kitt Peak in Arizona.

  11. [Follow up of patients in chronic hemodialysis].

    PubMed

    Bares, C

    1979-03-01

    Stemming from the evident need of psychological aid for this patients and in order to alleviate the suffering that causes psychiatric syntoms which endanger the survival chances or even worsen a situation which is in itself discouraging, 102 cases were studied trying to determine the possible causes of pathological behavior. The bibliography on the subject was evaluated and the follow-up of the group from our own practice was described. The patients were followed-up with a psychosomatic approach considering each as a hole conducting periodical interviews and administering psychological treatment and drugs. Follow-up of the relatives was done according to necessity. It was observed that these patients need a high tolerance to frustration and to be able to establish a relation of close dependence with a relative and/or the physician. The greatest problem is in the adequate and proper handling of the agression generated by the characteristics of the treatment. The phsychological training of the specialists in hemodialysis and their contact with a team of psychiatrist is of great importance. All of the 22 patients that did not receive transplants presented depression reactions, 2 experienced sexual impotence and 4 were successful in their suicidal behaviours. PMID:547684

  12. [Guidelines for the follow up of patients with bronchopulmonary dysplasia].

    PubMed

    Pérez Tarazona, S; Rueda Esteban, S; Alfonso Diego, J; Barrio Gómez de Agüero, M I; Callejón Callejón, A; Cortell Aznar, I; de la Serna Blázquez, O; Domingo Miró, X; García García, M L; García Hernández, G; Luna Paredes, C; Mesa Medina, O; Moreno Galdó, A; Moreno Requena, L; Pérez Pérez, G; Salcedo Posadas, A; Sánchez Solís de Querol, M; Torrent Vernetta, A; Valdesoiro Navarrete, L; Vilella Sabaté, M

    2016-01-01

    Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD. PMID:26089228

  13. Determining Virtual Environment "Fit": The Relationship Between Navigation Style in a Virtual Field Trip, Student Self-Reported Desire to Visit the Field Trip Site in the Real World, and the Purposes of Science Education

    NASA Astrophysics Data System (ADS)

    Tutwiler, M. Shane; Lin, Ming-Chao; Chang, Chun-Yen

    2013-06-01

    In this study, a follow-up analysis of the data reported in Lin et al. (Learn Media Technol. doi: 10.1080/17439884.2011.629660, 2011), we investigated the relationship between student use of a virtual field trip (VFT) system and the probability of students reporting wanting to visit the national park site upon which the VFT was modeled, controlling for content knowledge and prior visits to the park. Students who were able to navigate the VFT in teams were more likely than their peers who had the system demonstrated by a teacher to want to visit the national park. In addition, students with higher pre-intervention content knowledge were more likely to want to visit the national park than their peers with lower pre-test scores, in both the teacher demonstration and student co-navigation conditions.

  14. Follow-up examinations: are multidrug-resistant tuberculosis patients in Uttar Pradesh, India, on track?

    PubMed Central

    Nagaraja, S. B.; Tripathy, J. P.; Sahu, S. K.; Parmar, M.; Rade, K.; Bhatnagar, S.; Ranjan, A.; Sachdeva, K. S.

    2015-01-01

    Setting: All multidrug-resistant tuberculosis (MDR-TB) patients who had completed 6 months of treatment under the Revised National Tuberculosis Control Programme (RNTCP) in Uttar Pradesh, the largest state in northern India. Objective: To determine the proportion of MDR-TB patients with regular follow-up examinations, and underlying provider and patient perspectives of follow-up services. Methods: A retrospective cohort study was undertaken involving record reviews of 64 eligible MDR-TB patients registered during AprilJune 2013 in 11 districts of the state. Patients and programme personnel from the selected districts were interviewed using a semi-structured questionnaire. Results: A total of 34 (53.1%) patients underwent follow-up sputum culture at month 3, 43 (67.2%) at month 4, 36 (56.3%) at month 5 and 37 (57.8%) at month 6. Themes associated with irregular follow-up that emerged from the interviews were multiple visits, long travel distances, shortages of equipment at the facility and lack of knowledge among patients regarding the follow-up schedule. Conclusion: The majority of the MDR-TB patients had irregular follow-up visits. Provider-related factors outweigh patient-related factors on the poor follow-up examinations. The programme should focus on the decentralisation of follow-up services and ensure logistics and patient-centred counselling to improve the regularisation of follow up. PMID:26400602

  15. Spectroscopic Follow Up of Kepler Planet Candidates

    NASA Astrophysics Data System (ADS)

    Latham, David W.; Cochran, W. D.; Marcy, G. W.; Buchhave, L.; Endl, M.; Isaacson, H.; Gautier, T. N.; Borucki, W. J.; Koch, D.; Kepler Team

    2010-01-01

    Spectroscopic follow-up observations play a crucial role in the confirmation and characterization of transiting planet candidates identified by Kepler. The most challenging part of this work is the determination of radial velocities with a precision approaching 1 m/s in order to derive masses from spectroscopic orbits. The most precious resource for this work is HIRES on Keck I, to be joined by HARPS-North on the William Herschel Telescope when that new spectrometer comes on line in two years. Because a large fraction of the planet candidates are in fact stellar systems involving eclipsing stars and not planets, our strategy is to start with reconnaissance spectroscopy using smaller telescopes, to sort out and reject as many of the false positives as possible before going to Keck. During the first Kepler observing season in 2009, more than 100 nights of telescope time were allocated for this work, using high-resolution spectrometers on the Lick 3.0-m Shane Telescope, the McDonald 2.7-m Reflector, the 2.5-m Nordic Optical Telescope, and the 1.5-m Tillinghast Reflector at the Whipple observatory. In this paper we will summarize the scope and organization of the spectroscopic follow-up observations, showing examples of the types of false positives found and ending with a presentation of the characteristics of a confirmed planet.

  16. NASA Audit Follow-up Handbook

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This NASA Audit Follow-up Handbook is issued pursuant to the requirements of the Office of Management and Budget (OMB) Circular A-50, Audit Follow-up, dated September 29, 1982. It sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for use when considering reports issued by the Office of Inspector General (OIG), other executive branch audit organizations, the Defense Contract Audit Agency (DCAA), and the General Accounting Office (GAO). It is intended to: specify principal roles; strengthen the procedures for management decisions (resolution) on audit findings and corrective action on audit report recommendations; emphasize the importance of monitoring agreed upon corrective actions to assure actual accomplishment; and foster the use of audit reports as effective tools of management. A flow chart depicting the NASA audit and management decision process is in Appendix A. This handbook is a controlled handbook issued in loose-leaf form and will be revised by page changes. Additional copies for internal use may be obtained through normal distribution channels.

  17. Follow-up Strategies in MEO Observations

    NASA Astrophysics Data System (ADS)

    Hinze, Andreas; Schildknecht, Thomas; Vananti, Alessandro; Herzog, Johannes

    The Medium Earth Orbit (MEO) region becomes increasingly populated as new navigation satellite constellations are deployed or existing constellations are replenished with new satel-lites. As a consequence a growing number of space debris including small size objects must be expected. The Astronomical Institute of the University of Bern (AIUB) performs survey campaigns to search for debris objects in MEO. The optical observations are performed with ESA's Zeiss 1-m telescope located at the Teide Observatory at Tenerife, Spain and with the 0.3-m ZimSMART telescope of the AIUB, located 10 km south of Bern, Switzerland. To char-acterize debris objects their orbits must be established and maintained over a sufficiently long time interval. For successful recovery of detected objects in the subsequent night after first detection a preliminary orbit has to be determined and further follow-up observations within the same night have to be carefully scheduled. In this paper we present the results of differ-ent observation strategies and discussing the quality of the orbits determined from the initial recovery observations and follow-up observations performed after different time intervals.

  18. Oligometastases Treated With Stereotactic Body Radiotherapy: Long-Term Follow-Up of Prospective Study

    SciTech Connect

    Milano, Michael T.; Katz, Alan W.; Zhang Hong; Okunieff, Paul

    2012-07-01

    Purpose: To analyze the long-term survival and tumor control outcomes after stereotactic body radiotherapy (SBRT) for metastases limited in number and extent. Methods and Materials: We prospectively analyzed the long-term overall survival (OS) and cancer control outcomes of 121 patients with five or fewer clinically detectable metastases, from any primary site, metastatic to one to three organ sites, and treated with SBRT. Freedom from widespread distant metastasis (FFDM) was defined as metastatic disease not amenable to local therapy (i.e., resection or SBRT). Prognostic variables were assessed using log-rank and Cox regression analyses. Results: For breast cancer patients, the median follow-up was 4.5 years (7.1 years for 16 of 39 patients alive at the last follow-up visit). The 2-year OS, FFDM, and local control (LC) rate was 74%, 52%, and 87%, respectively. The 6-year OS, FFDM, and LC rate was 47%, 36%, and 87%, respectively. From the multivariate analyses, the variables of bone metastases (p = .057) and one vs. more than one metastasis (p = .055) were associated with a fourfold and threefold reduced hazard of death, respectively. None of the 17 bone lesions from breast cancer recurred after SBRT vs. 10 of 68 lesions from other organs that recurred (p = .095). For patients with nonbreast cancers, the median follow-up was 1.7 years (7.3 years for 7 of 82 patients alive at the last follow-up visit). The 2-year OS, FFDM, and LC rate was 39%, 28%, and 74%, respectively. The 6-year OS, FFDM, and LC rate was 9%, 13%, and 65%, respectively. For nonbreast cancers, a greater SBRT target volume was significantly adverse for OS (p = .012) and lesion LC (p < .0001). Patients whose metastatic lesions, before SBRT, demonstrated radiographic progression after systemic therapy experienced significantly worse OS compared with patients with stable or regressing disease. Conclusions: Select patients with limited metastases treated with SBRT are long-term survivors. Future research should address the therapeutic benefit of SBRT for these patients.

  19. Follow-up of complex unresectable lymphangiomas.

    PubMed

    Heether, J; Whalen, T; Doolin, E

    1994-11-01

    Our purpose was to determine the natural history of unresectable lymphangiomas. From 1986-1992, 11 cases of unresectable lymphangiomas were seen in our institution (age 1 month to 14 years). Locations affected included cervical (8), mediastinal (6), and abdominal (3). Presenting symptoms included abdominal pain, respiratory problems, chylothorax, pleural effusions, and pneumococcal sepsis. Attempts at total excision were performed in all but one patient who had biopsy only. The tumor that could not be removed was then observed for the development of complications. Follow-up of these 11 patients ranged from 2 to 6 years. Two have completely regressed, five have stabilized, and four have required repeat operation. Of the five that have stabilized, none have developed complications such as infection or compression secondary to the mass. In an asymptomatic patient, it appears that the portion of the lymphangiomas remaining will regress or at least not progress, and no further resections were required. PMID:7978677

  20. [Follow-up after lung stereotactic radiotherapy].

    PubMed

    Waissi, W; Noël, G; Giraud, P

    2015-10-01

    Nowadays, bronchopulmonary stereotactic body radiotherapy is recommended as the standard of care in treating medically inoperable patients with curative intent according to guidelines of multiple organizations. Changes in lung density on computed tomography are common after stereotactic body radiotherapy and can confound the early detection of recurrence. Radiation-induced computed tomography lung changes after bronchopulmonary stereotactic body radiotherapy differ from those observed after conventionally fractionated radiotherapy. It is mandatory to standardize and simplify our clinical, radiological and functional evaluation criteria to better distinguish tumor progression and radiation-induced pneumonitis. We performed a literature review to describe post-stereotactic body radiotherapy findings on computed tomography and positron emission tomography, identify imaging characteristics that predict recurrence and propose a follow-up algorithm. PMID:26337472

  1. DISSS/PSDB - Personnel Security Database Modernization Project: Compilation of data gathered from DOE Operations Office`s site visits

    SciTech Connect

    Carpenter, R.; Sweeney, D.

    1995-03-15

    This document is a compilation of the information gathered from visits to the DOE Operations Offices. The purpose of these visits was to gather requirements for the modernization of the personnel security database. The initial phase of visits were to sites which had known local systems to augment CPCI. They were; Rocky Flats, Richland, Las Vegas, Savannah River, Oak Ridge, and Oakland. The second phase of site visits were to; Headquarters, Schenectady, Pittsburgh, Idaho Falls, Chicago, and Albuquerque. We also visited the NRC. At each site we reviewed the current clearance process in use at the field office. If the site had a local personnel security database (PSDB), we also reviewed the current PSDB processing. Each meeting was began with the a discussion on the purpose of the meeting and the background of the redesign effort.

  2. Predictors of donor follow-up after living donor liver transplantation.

    PubMed

    Brown, Robert S; Smith, Abigail R; Dew, Mary Amanda; Gillespie, Brenda W; Hill-Callahan, Peg; Ladner, Daniela P

    2014-08-01

    Donor safety in living liver donation is of paramount importance; however, information on long-term outcomes is limited by incomplete follow-up. We sought to ascertain factors that predicted postdonation follow-up in 456 living liver donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study. Completed donor follow-up was defined as physical, phone, or laboratory contact at a given time point. Univariate and multivariate mixed effects logistic regression models, using donor and recipient demographic and clinical data and donor quality-of-life data, were developed to predict completed follow-up. Ninety percent of the donors completed their follow-up in the first 3 months, and 83% completed their follow-up at year 1; rates of completed follow-up ranged from 57% to 72% in years 2 to 7 and from 41% to 56% in years 8 to 10. The probability of completed follow-up in the first year was higher for white donors [odds ratio (OR) = 3.27, 95% confidence interval (CI) = 1.25-8.58] but lower for donors whose recipients had hepatitis C virus or hepatocellular carcinoma (OR = 0.34, 95% CI = 0.17-0.69). After the first year, an older age at donation predicted more complete follow-up. There were significant center differences at all time points (OR range = 0.29-10.11), with center variability in both returns for in-center visits and the use of phone/long-distance visits. Donor follow-up in the first year after donation was excellent but decreased with time. Predictors of follow-up varied with the time since donation. In conclusion, adapting best center practices (enhanced through the use of telephones and social media) to maintain contact with donors represents a significant opportunity to gain valuable information about long-term donor outcomes. PMID:24824858

  3. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    PubMed Central

    Gogate, Parikshit; Patil, Shailbala; Kulkarni, Anil; Mahadik, Ashok; Tamboli, Rahin; Mane, Rekha; Borah, Rishiraj; Rao, G V

    2014-01-01

    Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts) who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a “barriers to follow-up” questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6%) had been regularly following up with any hospital, 209 (79.4%) had not. A total of 150 (57.3%) were boys and the average age was 13.23 years (Std Dev 5 yrs). Poor follow up was associated with the older age group (P < 0.001), less education of mother (P = 0.012), father's occupation (P = 0.031), how much money spent on travel (P = 0.033) and was it paid or free surgery (P = 0.001). It was not related to gender, numbers of children in family, ordinal status of child, and social strata. Distance and cost were major barriers, as was the inability of the eye care center to communicate the importance of follow up. A prospective follow-up visit showed that 93 children needed Nd: YAG LASER capsulotomy, 5 needed low vision aids, 4 contact lens, and 162 a change of spectacles. The average visual acuity improved in 150 (38.8%) eyes >1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up. PMID:24008794

  4. [Follow-up of pulmonary thromboembolism].

    PubMed

    Uresandi, Fernando; Iruin, Gemma; Gmez, Beatriz; Uresandi, Amaia

    2008-11-01

    The aims of follow-up of pulmonary thromboembolism (PTE) are to avoid recurrence and possible sequels, such as pulmonary hypertension and postthrombotic syndrome of the lower limbs. Recurrences are reduced by anticoagulant therapy. In most PTE triggered by a transitory risk factor, without additional risk factors, the duration of oral anticoagulant therapy (OAT) is well established. However, in at least half of all cases, the triggering factors are not clear, the risk of recurrence is higher, and the duration of OAT has not been well-defined. Consequently, the factors that increase the risk of recurrence should be identified and monitored. These factors include cancer, some thrombophilias, and recurrent PTE or deep veinous thrombosis (DVT). In the last few years, idiopathic etiology, residual venous thrombosis, and other factors such as persistent right ventricular dysfunction, have also been demonstrated to be markers of recurrence. In some patients, D-dimers also seem to predict the risk of recurrence. Finally, the duration of OAT will be defined by periodically weighing the risk of recurrence against hemorrhagic risk in each individual patient. Current evidence on the balance of risks indicates a tendency toward indefinite anticoagulation, especially in idiopathic PTE. Moreover, functional monitoring through echocardiography, at least in the first 2 years, is essential to detect pulmonary hypertension associated with chronic pulmonary thromboembolism. PMID:19087852

  5. Improving Lunar Exploration with Robotic Follow-up

    NASA Technical Reports Server (NTRS)

    Fong, T.; Bualat, M.; Deans, M.; Heggy E.; Helper, M.; Hodges, K.; Lee, P.

    2011-01-01

    We are investigating how augmenting human field work with subsequent robot activity can improve lunar exploration. Robotic "follow-up" might involve: completing geology observations; making tedious or long-duration measurements of a target site or feature; curating samples in-situ; and performing unskilled, labor-intensive work. To study this technique, we have begun conducting a series of lunar analog field tests at Haughton Crater (Canada). Motivation: In most field geology studies on Earth, explorers often find themselves left with a set of observations they would have liked to make, or samples they would have liked to take, if only they had been able to stay longer in the field. For planetary field geology, we can imagine mobile robots - perhaps teleoperated vehicles previously used for manned exploration or dedicated planetary rovers - being deployed to perform such follow-up activities [1].

  6. School District and Interagency Collaborative Services for Students At Risk in Utah: A Report of On-Site Visits.

    ERIC Educational Resources Information Center

    Utah State Office of Education, Salt Lake City.

    During 1992, on-site visits were made to the 40 school districts in Utah to determine the current status of At Risk needs and services for students. This report describes the findings from those visits; many of the findings are reported in list form. Part 1 of this report focuses on school district services for students at risk. It presents

  7. Antiphospholipid syndrome: five year follow up.

    PubMed Central

    Asherson, R A; Baguley, E; Pal, C; Hughes, G R

    1991-01-01

    Nineteen patients out of 250 subjects with antiphospholipid antibodies, who had initially presented to the lupus clinic at St Thomas's Hospital, London five or more years ago with a history of venous/arterial occlusions, were entered into the study. The patients were divided into two main groups: I those who remained well without any further thromboembolic complications (n = 10); II those who developed recurrent thrombotic events in the five year period (n = 9). The patients were followed up to determine the relation between the level or the isotype of the anticardiolipin antibodies, or both, to the recurrent thromboembolic events, and the effect of a variety of treatments (corticosteroids, immunosuppression, anticoagulation) in the prevention of further vascular occlusions. Lupus activity over the five year period varied considerably between the two groups--those in group I tending to be relatively inactive compared with those in group II. For some patients in group II thromboembolic events seemed to occur at the time of lupus activity. Antiphospholipid antibodies remained positive in all patients, the levels remaining fairly constant. Levels fell in only one patient in group I and in two in group II. Patients in group II had more systemic lupus erythematosus related disease than those in group I; most were receiving concomitant steroid and immunosuppressive therapy, but this did not seem to protect against the development of further occlusions. All patients were given anticoagulation treatment (warfarin/heparin) or salicylates (low dose aspirin 75 mg daily), or both. Patients with deep vein thromboses developed more complications during anticoagulation therapy than those with cerebrovascular symptoms. Problems in anticoagulation control and recurrent thromboses consequent on warfarin withdrawal despite the administration of subcutaneous heparin were responsible for complications in most patients in group II. PMID:1772297

  8. A Mobile Phone-Based, Community Health Worker Program for Referral, Follow-Up, and Service Outreach in Rural Zambia: Outcomes and Overview

    PubMed Central

    Sindano, Ntazana; Theis, Mathew; Zue, Cory; Joseph, Jessica; Chilengi, Roma; Chi, Benjamin H.; Stringer, Jeffrey S.A.; Chintu, Namwinga

    2014-01-01

    Abstract Background: Mobile health (m-health) utilizes widespread access to mobile phone technologies to expand health services. Community health workers (CHWs) provide first-level contact with health facilities; combining CHW efforts with m-health may be an avenue for improving primary care services. As part of a primary care improvement project, a pilot CHW program was developed using a mobile phone-based application for outreach, referral, and follow-up between the clinic and community in rural Zambia. Materials and Methods: The program was implemented at six primary care sites. Computers were installed at clinics for data entry, and data were transmitted to central servers. In the field, using a mobile phone to send data and receive follow-up requests, CHWs conducted household health surveillance visits, referred individuals to clinic, and followed up clinic patients. Results: From January to April 2011, 24 CHWs surveyed 6,197 households with 33,304 inhabitants. Of 15,539 clinic visits, 1,173 (8%) had a follow-up visit indicated and transmitted via a mobile phone to designated CHWs. CHWs performed one or more follow-ups on 74% (n=871) of active requests and obtained outcomes on 63% (n=741). From all community visits combined, CHWs referred 840 individuals to a clinic. Conclusions: CHWs completed all planned aspects of surveillance and outreach, demonstrating feasibility. Components of this pilot project may aid clinical care in rural settings and have potential for epidemiologic and health system applications. Thus, m-health has the potential to improve service outreach, guide activities, and facilitate data collection in Zambia. PMID:24926815

  9. Long-Term Follow-up Observation of the Safety, Immunogenicity, and Effectiveness of Gardasil™ in Adult Women

    PubMed Central

    Luna, Joaquin; Plata, Manuel; Gonzalez, Mauricio; Correa, Alfonso; Maldonado, Ivete; Nossa, Claudia; Radley, David; Vuocolo, Scott; Haupt, Richard M.; Saah, Alfred

    2013-01-01

    Background Previous analyses from a randomized trial in women aged 24–45 have shown the quadrivalent HPV vaccine to be efficacious in the prevention of infection, cervical intraepithelial neoplasia (CIN) and external genital lesions (EGL) related to HPV 6/11/16/18 through 4 years. In this report we present long term follow-up data on the efficacy, safety and immunogenicity of the quadrivalent HPV vaccine in adult women. Methods Follow-up data are from a study being conducted in 5 sites in Colombia designed to evaluate the long-term immunogenicity, effectiveness, and safety of the qHPV vaccine in women who were vaccinated at 24 to 45 years of age (in the original vaccine group during the base study [n = 684]) or 29 to 50 years of age (in the original placebo group during the base study [n = 651]). This analysis summarizes data collected as of the year 6 post-vaccination visit relative to day 1 of the base study (median follow-up of 6.26 years) from both the original base study and the Colombian follow-up. Results There were no cases of HPV 6/11/16/18-related CIN or EGL during the extended follow-up phase in the per-protocol population. Immunogenicity persists against vaccine-related HPV types, and no evidence of HPV type replacement has been observed. No new serious adverse experiences have been reported. Conclusions Vaccination with qHPV vaccine provides generally safe and effective protection from HPV 6-, 11-, 16-, and 18-related genital warts and cervical dysplasia through 6 years following administration to 24–45 year-old women. Trial Registration Clinicaltrials.gov NCT00090220 PMID:24391768

  10. Minimum 20-year follow-up results of Harrington rod fusion for idiopathic scoliosis.

    PubMed

    Mariconda, M; Galasso, O; Barca, P; Milano, C

    2005-11-01

    We evaluated the outcome of spinal fusion with a single Harrington distraction rod in patients with idiopathic scoliosis. At follow-up visits a minimum of 20 years post-surgery, we studied 24 patients who had been operated on by the same surgeon. The Scoliosis Research Society (SRS) Instrument and an additional questionnaire of our own, along with an invitation for a follow-up visit, were originally mailed to 28 consecutive patients of the surgeon. The SRS Instrument has seven domains dealing with back pain, general self-image, self-image after surgery, general function, function in terms of level of activity, function after surgery, and degree of satisfaction with the surgery. The length of time between surgery and the follow-up visit averaged 22.9 years (20.2-27.3). The mean age at surgery and follow-up were 15.8 (13-22) and 38.8 (35-48) years, respectively. Twenty-four patients sent back the completed questionnaires and 16 of them participated in the clinic and radiographic follow-up. To assess the meaning of the questionnaires' results, a control group of the same sex, age and geographic provenance was selected from our outpatients without scoliosis. The average follow-up score on the SRS Instrument for the patients was 100.8 (78-110). When we compared the study and control groups, no significant differences in the single SRS domain scores were observed. The mean Cobb angle and rib cage deformity before surgery were 70.46 degrees (40-120) and 36.4 mm (20-60 mm), respectively, whereas on follow-up they were 41.23 degrees (16-75) and 22.3 mm (5-50 mm), respectively. These long-term results lead us to consider Harrington fusion a procedure that produces a long-lasting high degree of self-reported post-operative satisfaction. PMID:15864669

  11. Longest follow-up of in situ working Bjork Shiley valve: 42-year follow-up.

    PubMed

    Soofi, Muhammad A; Ignaszewski, Maya T; Ashton, Thomas H; Miyagishima, Robert T

    2016-03-01

    The Bjork Shiley valve (BSV) is considered as the pioneer among modern disc valves, and eventually evolved into a reliable prosthesis after considerable research and multiple modifications. Various case reports have been published with follow-up of different types of BSV. We are reporting the longest follow-up ever published of a plano-convex type of BSV. Our patient's valve was implanted in 1973 due to a congenital bicuspid aortic valve with concomitant severe, symptomatic aortic stenosis, discovered at the age of 27. She presented with exertional dyspnoea, syncope and chest pain; however, her cardiovascular status remained stable and these symptoms abated after successful valve replacement at the age of 34. She is now 77 years old with no limitations in her activities and is able to walk a few miles most days of the week. Her echocardiograms throughout the decades have shown acceptable gradients across the aortic prosthesis without evidence of haemolysis. Our case report includes a summary of the patient with a discussion of the evidence that supports the durability of the original plano-convex BSV. PMID:26686528

  12. Language as a factor affecting follow-up compliance from the emergency department.

    PubMed

    Enguidanos, E R; Rosen, P

    1997-01-01

    We evaluated language (English vs. Spanish) as a variable in compliance with follow-up appointments from emergency department (ED) referrals and compared it with four other socioeconomic variables. Patients were interviewed on presentation to the ED. A follow-up interview was performed by phone 8 weeks later, after the scheduled referral date. We find that language is not a significant variable influencing follow-up compliance. Having a primary medical doctor prior to the ED visit was positively correlated with follow-up compliance and was the only significant socioeconomic variable irrespective of language ability. There was no significant correlation between English speaking and any of the socioeconomic variables. Among Spanish speakers, having a primary medical doctor and having some form of medical insurance were significantly correlated to compliance with referrals. PMID:9017480

  13. A delay differential equation model for dengue transmission with regular visits to a mosquito breeding site

    NASA Astrophysics Data System (ADS)

    Yaacob, Y.; Yeak, S. H.; Lim, R. S.; Soewono, E.

    2015-03-01

    Dengue disease has been known as one of widely transmitted vector-borne diseases which potentially affects millions of people throughout the world especially in tropical and sub-tropical countries. One of the main factors contributing in the complication of the transmission process is the mobility of people in which people may get infection in the places far from their home. Here we construct a delay differential equation model for dengue transmission in a closed population where regular visits of people to a mosquito breeding site out of their residency such as traditional market take place daily. Basic reproductive ratio of the system is obtained and depends on the ratio between the outgoing rates of susceptible human and infective human. It is shown that the increase of mobility with different variation of mobility rates may contribute to different level of basic reproductive ratio as well as different level of outbreaks.

  14. Outpatient Follow-Up versus 30-day Readmission among General and Vascular Surgery Patients: A Case for Redesigning Transitional Care

    PubMed Central

    Saunders, Richard Scott; Fernandes-Taylor, Sara; Rathouz, Paul J.; Saha, Sandeep; Wiseman, Jason T.; Havlena, Jeffrey; Matsumura, Jon; Kent, K. Craig

    2014-01-01

    Background The association between early outpatient follow-up and 30-day readmission has not been evaluated in any surgical population. Our study characterizes the relationship between outpatient follow-up and early readmissions among surgical patients. Methods We queried the medical record at a large, tertiary care institution (July 2008-December 2012) to determine rates of 30-day outpatient follow-up and readmission for general or vascular surgical procedures. Results The majority of discharges for general (84% of 7552) and vascular (75% of 2362) surgery had a follow-up visit before readmission or within 30 days of discharge. General surgery patients who were not readmitted had high rates of follow-up (88%) and received follow-up at approximately 2-weeks post-discharge (median time 11 days after discharge). In contrast, readmitted general surgery patients received first follow-up at one week (a median time of 8 days); 49% had follow-up. Vascular surgery patients showed a similar trend. Over half of patients readmitted after follow-up were readmitted within 24 hours of their most recent outpatient visit. Conclusions Current routine follow-up does not occur early enough to detect adverse events and prevent readmission. Early outpatient care may prevent readmission in some patients, but often serves as a conduit for readmission among patients already experiencing complications. PMID:25239351

  15. NHEXAS PHASE I MARYLAND STUDY--FOLLOW-UP QUESTIONNAIRE DATA

    EPA Science Inventory

    The Follow-up questionnaire data set contains information concerning the activities within the household during the sampling week. The information is from 402 follow-up questionnaires for 80 households across 6 cycles. The Follow-up Questionnaire specifically addressed the time ...

  16. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and...

  17. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Audit findings follow-up. 99.315 Section 99.315 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up...

  18. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit findings follow-up. 3052.315 Section 3052.315....315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all audit findings. As part of this responsibility, the auditee shall prepare a...

  19. Alberta Euthanasia Survey: 3-year follow-up.

    PubMed Central

    Verhoef, M J; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 to 1146 physicians who could be traced through the 1994 Medical Directory of the provincial college of physicians and surgeons; 25 questionnaires were returned because they could not be delivered. OUTCOME MEASURES: Physicians' opinions about (a) the morality of active euthanasia, (b) changes in the law to permit active euthanasia and (c) the practice of legalized euthanasia. RESULTS: Of the 1121 physicians sent a follow-up questionnaire 866 (77%) returned it completed. The responses of these same 866 physicians in 1991 provided a basis for comparison. Of the 866, 360 (42%) stated in the 1994 survey that it is sometimes right to practise active euthanasia; a similar proportion (384 [44%]) gave this response in 1991. However, other opinions changed significantly. In 1991, 250 of the respondents (29%) indicated that they would practise active euthanasia if it were legalized, as compared with 128 (15%) in 1994 (p < 0.01). In 1991, 429 (50%) of the respondents thought that the law should be changed to permit active euthanasia, as compared with 316 (37%) in 1994 (p < 0.01). Religious activity was the most important characteristic associated with changes in opinion. Despite the decrease in support for the practice and legalization of active euthanasia between 1991 and 1994, in both surveys at least 70% of those who responded to this question indicated that active euthanasia, if it were legalized, should be performed only by physicians and should be taught at medical sites. CONCLUSION: Alberta physicians' support for the practice and legalization of active euthanasia decreased considerably between 1991 and 1994. However, most physicians remain in favour of restricting active euthanasia, if it were legalized, to the medical profession. These results suggest a need for caution and deliberation when changes in the law concerning active euthanasia are examined. PMID:8837535

  20. Shillapoo Wildlife Area 2007 Follow-up HEP Report.

    SciTech Connect

    Ashley, Paul R.

    2008-03-01

    In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this document. Details and results of the HEP analysis are included in this report.

  1. Go ahead, visit those web sites, you can`t get hurt, can you?

    SciTech Connect

    Rothfuss, J.S.; Parrett, J.W.

    1997-02-01

    Browsing (surfing) the World Wide Web (the web) has exploded onto the Internet with an unprecedented popularity. Fueled by massive acceptance, the web client/server technology is leaping forward with a speed that competes with no other software technology. The primary force behind this phenomenon is the simplicity of the web browsing experience. People who have never touched a computer before can now perform sophisticated network tasks with a simple point-and-click. Unfortunately, this simplicity gives many, if not most, web wanderers the impression that the web browser is risk free, nothing more than a high powered television. This misconception is dangerous by creating the myth that a user visiting a web site is immune from subversive or malicious intent. While many want you to believe that surfing the web is as simple as using any other household appliance, it is not like surfing television channels, it is bi-directional. You can learn a lot of useful information from web sites. But, either directly or indirectly, others can also learn quite a bit about you. Of even more concern is a web sites` potential ability to exert control over the local computer. This paper tries to consolidate some of the current concerns that you should consider as you jump into the surf.

  2. The effect of long-term care and follow-up on complications in patients with external fixators.

    PubMed

    Cam, Rahsan; Korkmaz, Fatma Demir

    2014-02-01

    The present study aimed to determine the effect of long-term care and follow-up on complications in patients with external fixators. This study was conducted as a study research. The study sample included a total of 60 patients treated with external fixators for fractures, of whom 30 were in the control and 30 were in the study group. No intervention was made on the control group patients. The patients in the study group received external fixator pin site wound care, pin site massage and neurovascular follow-up. The study group patients were also given discharge training about external fixator pin site care two days before their discharge and were also provided with training manuals to guide their home care. Both groups were visited weekly at their homes to record their complications. Nine complications developed in eight patients (26.7%) in the study group, and 19 complications developed in 19 patients (63.3%) in the control group. Pin site infections were 11.6% of the total sample. The percentage for pin loosening, stiff joint, nerve and vessel injury and pain and swelling was 5%, 25%, 1.7% and 3.3%, respectively. PMID:24580979

  3. Klenot Project - Near Earth Objects Follow-Up Program

    NASA Astrophysics Data System (ADS)

    Tichý, Miloš; Tichá, Jana; Kočer, Michal

    2016-01-01

    NEO research is a great challenge just now - for science, for exploration and for planetary defence. Therefore NEO discoveries, astrometric follow-up, orbit computations as well as physical studies are of high interest both to science community and humankind. The KLENOT Project of the Klet Observatory, South Bohemia, Czech Republic pursued the confirmation, early follow-up, long-arc follow-up and recovery of Near Earth Objects since 2002. Tens of thousands astrometric measurements helped to make inventory of NEOs as well as to understand the NEO population. It ranked among the world most prolific professional NEO follow-up programmes during its first phase from 2002 to 2008. The fundamental improvement of the 1.06-m KLENOT Telescope was started in autumn 2008. The new computer controlled paralactic mount was built to substantially increase telescope-time efficiency, the number of observations, their accuracy and limiting magnitude. The testing observations of the KLENOT Telescope Next Generation (NG) were started in October 2011. The new more efficient CCD camera FLI ProLine 230 was installed in summer 2013. The original Klet Software Package has been continually upgraded over the past two decades of operation. Along with huge hardware changes we have decided for essential changes in software and the whole KLENOT work-flow. Using the current higher computing power available, enhancing and updating our databases and astrometry program, the core of our software package, will prove highly beneficial. Moreover, the UCAC4 as the more precise astrometric star catalog was implemented. The modernized KLENOT System was put into full operation in September 2013. This step opens new possibilities for the KLENOT Project, the long-term European Contribution to Monitoring and Cataloging Near Earth Objects. KLENOT Project Goals are confirmatory observations of newly discovered fainter NEO candidates, early follow-up of newly discovered NEOs, long-arc follow-up astrometry of NEOs in need of further data. The higher priority is given to Potentially Hazardous Asteroids (PHAs) and Virtual Impactors (VIs), recoveries of NEOs in the second opposition and also follow-up astrometry of radar or mission targets, special follow-up requests and follow-up astrometry of other unusual objects (comets, bright TNOs) including analysis of cometary features of suspected bodies, and also search for new asteroids, especially NEOs as well as other objects showing unusual motion. The KLENOT Telescope is located at the Klet Observatory, South Bohemia, Czech Republic (Central Europe), at geographical position: latitude 14° 17' 17'' E, longitude 48° 51' 48''N, elevation 1068 meters above sea level, in a rather dark site in the middle of the Protected Landscape Area Blanský les. Average number of clear nights per year about 120. Our IAU/MPC code is 246 KLENOT Project Advantages: • full observing time is dedicated to the KLENOT team • quick changes in an observing plan possible, even during an observing night • long-term NEO activities at Klet (since 1992) • experienced observers/measurers visually validate each moving object candidate • real-time processing of targeted objects KLENOT Next Generation Telescope technical data (since 2013): • new computer controlled paralactic mount • 1.06-m f/3 main mirror (Zeiss) • four lenses primary focus corrector • 1.06-m f/2.7 optical system • CCD camera FLI ProLine PL230 • chip e2v 2048 × 2048 pixels, pixel size 15 microns, Peltier cooling • FOV 37 × 37 arcminutes, image scale 1.1 arcseconds per pixel • limiting magnitude m V=21.5 mag. for 120-sec exposure time KLENOT Project First Phase Results(2002-2008) total of 52,658 astrometric measurements of 5,867 bodies, it contains: • 13,342 astrometric measurements of 1,369 NEAs (MPC,NEODys) • confirmation and astrometry of 623 NEAs from NEOCP (MPECs) • recoveries of 4 comets and 16 NEAs (including 196P/Tichý) • astrometry of 157 Virtual Impactors (CLOMON, SENTRY) • detection of cometary features of 34 bodies (IAUCs) • discovery of splitting of comet C/2004 S1 (Van Ness) • independent discovery of 4 fragments of comet 73P/S-W 3 • asteroid discoveries - 750 bodies • 3 NEOs - Apollo 2002 LK, Aten 2003 UT55, Apollo 2006 XR4, 1 JFA 2004 RT109 The first KLENOT Project Next Generation Results (since 2011) total of 10,054 astrometric measurements of 1,298 bodies, it contains: • 2,211 astrometric measurements of 263 NEAs(MPC,NEODys) • confirmation and astrometry of 143 NEAs from NEOCP (MPECs) • astrometry of 18 Virtual Impactors (CLOMON, SENTRY) • detection of cometary features of 5 bodies (IAUCs)

  4. The LCOGT near-Earth-object follow-up network

    NASA Astrophysics Data System (ADS)

    Lister, T.

    2014-07-01

    Las Cumbres Observatory Global Telescope (LCOGT) network is a planned homogeneous network that will eventually consist of over 35 telescopes at 6 locations in the northern and southern hemispheres [1]. This network is versatile and designed to respond rapidly to target of opportunity events and also to do long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make the LCOGT network ideal for follow-up and characterization of a wide range of solar-system objects (e.g. asteroids, Kuiper-belt objects, comets) and in particular near-Earth objects (NEOs). There are 3 classes to the telescope resources: 2-meter aperture, 1-meter aperture and 0.4-meter aperture. We have been operating our two 2-meter telescopes since 2005 and began a specific program of NEO follow-up for the Pan-STARRS survey in October 2010. The combination of all-sky access, large aperture, rapid response, robotic operation and good site conditions allows us to provide time-critical follow-up astrometry and photometry on newly discovered objects and faint objects as they recede from the Earth, allowing the orbital arc to be extended and preventing loss of objects. These telescope resources have greatly increased as LCOGT has completed the first phase of the deployment, designated as ''Version 1.0'', with the installation, commissioning and ongoing operation of nine 1-meter telescopes. These are distributed among four sites with one 1-meter at McDonald Observatory (Texas), three telescopes at Cerro Tololo (Chile), three telescopes at SAAO (South Africa) and the final two telescope at Siding Spring Observatory (Australia). In addition to the 1-meter network, the scheduling and control system for the two 2-meter telescopes have been upgraded and unified with that of the 1-meter network to provide a coherent robotic telescopic network. The telescope network is now operating and observations are being executed remotely and robotically. I am using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS) and Pan-STARRS (PS1) with additional targets coming from the NEOWISE satellite and the Palomar Transient Factory (PTF). Robotic observations of NEOs and other solar-system objects have been routinely carried out for several years on the 2-m and 1-m telescopes, with over 20,000 positional and magnitude measurements reported to the Minor Planet Center (MPC) in the last two years. We have developed software to automatically fetch candidates from Pan-STARRS and the MPC Confirmation Page, compute orbits and ephemerides, plan and schedule observations on the telescopes and retrieve the processed data [2]. The program is being expanded which will allow us to greatly increase the amount of survey discoveries that are followed-up, obtain accurate astrometry and provide important characterization data in the form of colors, lightcurves, rotation rates and spectra for NEOs. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects in order to improve the orbits and determine the rotation periods. Priority for follow-up is now given to the fainter and most southern targets on the Confirmation Page, objects that are scheduled for Goldstone/Arecibo radar targeting and those objects which could become potential mission destinations for spacecraft. This will be extended to obtain more light curves of other NEOs which could be Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) targets. With the increase in time available from the LCOGT 1-meter network and commissioning of low-resolution spectrographs on the 2-meter telescopes for moving objects, this will produce a large advance in capabilities for NEO follow-up and characterization. This will produce an unprecedented network for NEO follow-up, particularly in the Southern Hemisphere where there is currently a shortage of suitable facilities. We will continue to develop our software to take advantage of the increased resources and capabilities of the LCOGT Network.

  5. Follow-up skeletal survey use by child abuse pediatricians.

    PubMed

    Harper, Nancy S; Lewis, Terri; Eddleman, Sonja; Lindberg, Daniel M

    2016-01-01

    Skeletal survey is frequently used to identify occult fractures in young children with concern for physical abuse. Because skeletal survey is relatively insensitive for some abusive fractures, a follow-up skeletal survey (FUSS) may be undertaken at least 10-14 days after the initial skeletal survey to improve sensitivity for healing fractures. This was a prospectively planned secondary analysis of a prospective, observational study of 2,890 children who underwent subspecialty evaluation for suspected child physical abuse at 1 of 19 centers. Our objective was to determine variability between sites in rates of FUSS recommendation, completion and fracture identification among the 2,049 participants who had an initial SS. Among children with an initial skeletal survey, the rate of FUSS recommendation for sites ranged from 20% to 97%; the rate of FUSS completion ranged from 10% to 100%. Among sites completing at least 10 FUSS, rates of new fracture identification ranged from 8% to 28%. Among completed FUSS, new fractures were more likely to be identified in younger children, children with higher initial level of concern for abuse, and those with a fracture or cutaneous injury identified in the initial evaluation. The current variability in FUSS utilization is not explained by variability in occult fracture prevalence. Specific guidelines for FUSS utilization are needed. PMID:26342432

  6. A Global Review of Melanoma Follow-up Guidelines.

    PubMed

    Trotter, Shannon C; Sroa, Novie; Winkelmann, Richard R; Olencki, Thomas; Bechtel, Mark

    2013-09-01

    Early detection of a melanoma recurrence is a major concern for the clinician. However, the follow-up care of melanoma patients lacks a uniform approach. Different dermatological and oncological organizations have developed their own strategies of follow-up management that vary by specialty and methods of screening for recurrence. Some areas of controversy in the follow-up care of melanoma patients include providers of care, use of staging versus Breslow depth to determine follow-up, the role of imaging and laboratory tests, frequency and duration of physical exams, and psychological well-being. Studies have evaluated these aspects of follow-up management, but no consensus exists. However, it is essential for clinicians to collaborate between specialties for an effective, evidence-based approach to melanoma clinical follow-up care. PMID:24062870

  7. Carbon Nanotube and Nanofiber Exposure Assessments: An Analysis of 14 Site Visits.

    PubMed

    Dahm, Matthew M; Schubauer-Berigan, Mary K; Evans, Douglas E; Birch, M Eileen; Fernback, Joseph E; Deddens, James A

    2015-07-01

    Recent evidence has suggested the potential for wide-ranging health effects that could result from exposure to carbon nanotubes (CNT) and carbon nanofibers (CNF). In response, the National Institute for Occupational Safety and Health (NIOSH) set a recommended exposure limit (REL) for CNT and CNF: 1 g m(-3) as an 8-h time weighted average (TWA) of elemental carbon (EC) for the respirable size fraction. The purpose of this study was to conduct an industrywide exposure assessment among US CNT and CNF manufacturers and users. Fourteen total sites were visited to assess exposures to CNT (13 sites) and CNF (1 site). Personal breathing zone (PBZ) and area samples were collected for both the inhalable and respirable mass concentration of EC, using NIOSH Method 5040. Inhalable PBZ samples were collected at nine sites while at the remaining five sites both respirable and inhalable PBZ samples were collected side-by-side. Transmission electron microscopy (TEM) PBZ and area samples were also collected at the inhalable size fraction and analyzed to quantify and size CNT and CNF agglomerate and fibrous exposures. Respirable EC PBZ concentrations ranged from 0.02 to 2.94 g m(-3) with a geometric mean (GM) of 0.34 g m(-3) and an 8-h TWA of 0.16 g m(-3). PBZ samples at the inhalable size fraction for EC ranged from 0.01 to 79.57 g m(-3) with a GM of 1.21 g m(-3). PBZ samples analyzed by TEM showed concentrations ranging from 0.0001 to 1.613 CNT or CNF-structures per cm(3) with a GM of 0.008 and an 8-h TWA concentration of 0.003. The most common CNT structure sizes were found to be larger agglomerates in the 2-5 m range as well as agglomerates >5 m. A statistically significant correlation was observed between the inhalable samples for the mass of EC and structure counts by TEM (Spearman ? = 0.39, P < 0.0001). Overall, EC PBZ and area TWA samples were below the NIOSH REL (96% were <1 ?g m(-3) at the respirable size fraction), while 30% of the inhalable PBZ EC samples were found to be >1 ?g m(-3). Until more information is known about health effects associated with larger agglomerates, it seems prudent to assess worker exposure to airborne CNT and CNF materials by monitoring EC at both the respirable and inhalable size fractions. Concurrent TEM samples should be collected to confirm the presence of CNT and CNF. PMID:25851309

  8. Data Management and Site-Visit Monitoring of the Multi-Center Registry in the Korean Neonatal Network

    PubMed Central

    Choi, Chang Won

    2015-01-01

    The Korean Neonatal Network (KNN), a nationwide prospective registry of very-low-birth-weight (VLBW, < 1,500 g at birth) infants, was launched in April 2013. Data management (DM) and site-visit monitoring (SVM) were crucial in ensuring the quality of the data collected from 55 participating hospitals across the country on 116 clinical variables. We describe the processes and results of DM and SVM performed during the establishment stage of the registry. The DM procedure included automated proof checks, electronic data validation, query creation, query resolution, and revalidation of the corrected data. SVM included SVM team organization, identification of unregistered cases, source document verification, and post-visit report production. By March 31, 2015, 4,063 VLBW infants were registered and 1,693 queries were produced. Of these, 1,629 queries were resolved and 64 queries remain unresolved. By November 28, 2014, 52 participating hospitals were visited, with 136 site-visits completed since April 2013. Each participating hospital was visited biannually. DM and SVM were performed to ensure the quality of the data collected for the KNN registry. Our experience with DM and SVM can be applied for similar multi-center registries with large numbers of participating centers. PMID:26566353

  9. 76 FR 51022 - Juneau Hydropower, Inc.; Notice of Scoping Meeting and Site Visit and Soliciting Scoping Comments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Energy Regulatory Commission Juneau Hydropower, Inc.; Notice of Scoping Meeting and Site Visit and.... Applicant: Juneau Hydropower, Inc. d. Name of Project: Sweetheart Lake Hydroelectric Project. e. Location.... 791(a)-825(r). g. Applicant Contact: Duff Mitchell, Business Manager, Juneau Hydropower, Inc.,...

  10. 76 FR 38383 - Albany Engineering Corporation, Town of Stuyvesant, NY; Notice of Site Visit and Technical Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Albany Engineering Corporation, Town of Stuyvesant, NY; Notice of Site Visit and Technical Meeting On July 12, 2011, Office of Energy Projects staff will participate in a...

  11. A Study of Program Management Procedures in the Campus-Based and Basic Grant Programs. Site Visit Report.

    ERIC Educational Resources Information Center

    Ellis, Richard, Ed.; Puma, Michael, Ed.

    Site visits to a sample of 173 colleges, universities, vocational-technical schools, and other postsecondary institutions--conducted to examine the procedures used to manage federal Basic Educational Opportunity Grant (BEOG) and campus-based student financial assistance programs--are summarized. This report deals only with the conduct of the

  12. Impact of clinical follow-up and diagnostic testing on intervention for tetralogy of Fallot

    PubMed Central

    House, Aswathy Vaikom; Danford, David A; Spicer, Robert L; Kutty, Shelby

    2015-01-01

    Objective Our purpose was to evaluate yield of tools commonly advocated for surveillance of tetralogy of Fallot (TOF). Methods All patients (pts) with TOF, seen at any time from 1/2008 to 9/2013 in an academic cardiology practice were studied. At the first and each subsequent outpatient visit, the use of tools including history and physical (H&P), ECG, Holter (HOL), echocardiogram (Echo), MR or CT (MR-CT) and stress testing (STR) were noted. Recommendations for intervention (INT) and for time to next follow-up were recorded; rationale for each INT with attribution to one or more tools was identified. Results There were 213 pts (mean 11.5 years, 130 male) who had 916 visits, 123 of which (13.4%) were associated with 138 INTs (47 surgical, 54 catheter-mediated, 37 other medical). Recommended follow-up interval was 9.44±6.5 months, actual mean follow-up interval was 11.7 months. All 916 (100%) patient visits had a H&P which contributed to 47.2% of INT decisions. Echo was performed in 652 (71.2%) of visits, and contributed to 53.7% of INTs. MR-CT was obtained in 129 (14.1%) of visits, and contributed to 30.1% of INTs. ECG was applied in 137 (15%) visits, and contributed to 1.6% of INTs. HOL was obtained in 188 (20.5%) visits, and contributed to 11.3% of INTs. STR was performed at 101 (11%) of visits, and contributed to 8.9% of INTs. Conclusions INTs are common in repaired TOF, but when visits average every 11–12 months, most visits do not result in INT. H&P, Echo and HOL were the most frequently applied screens, and all frequently yielded relevant information to guide INT decisions. STR and MR/CT were applied as targeted testing and in this limited, non-screening role had high relevance for INT. There was low utilisation of ECG and major impact on INT was not demonstrated. Risk stratification in TOF may be possible, and could result in more efficient surveillance and targeted testing. PMID:25973212

  13. Improving patient follow-up after inpatient stay

    PubMed Central

    Wimble, Katie; Yeong, Keefai

    2012-01-01

    Abstract Follow-up is a vital part of ongoing patient safety. It allows for subsequent investigations to be checked and acted upon, encourages specialist review of patients and ensures that patients with chronic conditions receive the appropriate secondary care input. This study aims to highlight and quantify current problems with how follow-up arrangements are made within our hospital and provide a suitable solution to ensure that these problems are minimised. 20 sets of clinical notes were analysed for plans of follow-up and then compared with the discharge summaries produced. Hospital computer systems were used to find out which interventions happened, and when, to get the baseline data. A simple follow-up prompt sheet was introduced and a further 20 sets of notes were audited to complete the study. Patient follow-up improved after the introduction of a simple follow-up prompt sheet but highlighted the need for a complete change in the way follow up is arranged at our hospital. There is a need for an online system for requesting follow-up appointments in our hospital. This is vital given the 24 hour environment that we work in with many patients being discharged out of normal working hours. This is currently being discussed with management and we hope that the introduction will be imminent to improve the future safety of all patients.

  14. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Analysis and follow-up. 219.211 Section 219.211... Analysis and follow-up. (a) The laboratory designated in appendix B to this part undertakes prompt analysis... the railroad receives notification of the results of the toxicological analysis, any provision...

  15. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Analysis and follow-up. 219.211 Section 219.211... Analysis and follow-up. (a) The laboratory designated in appendix B to this part undertakes prompt analysis... the railroad receives notification of the results of the toxicological analysis, any provision...

  16. Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy.

    PubMed

    Epstein, Joel B; Epstein, Joshua D; Epstein, Matthew S; Oien, Hal; Truelove, Edmond L

    2008-01-01

    This study assessed the effectiveness of oral doxepin rinse for mucositis-related pain management in patients following 1 week of repeated dosing. Patients with oral mucositis due to head and neck radiation therapy or hematopoietic stem cell transplant (HSCT) were recruited to participate in a 1-week follow-up study. Subjects who gave informed consent rinsed with doxepin (5 ml) during the initial visit and were then told to use doxepin rinse over the next week as needed, three to six times per day, and return for a follow-up visit. At each visit, mucositis was scored using the Oral Mucositis Assessment Scale and oral pain was assessed using a visual analogue scale before and after rinsing. The use of a systemic analgesic was recorded, and side effects were documented. At the follow-up visit, subjects were also asked to retrospectively report average pain scores they experienced over the past week, 5 and 15 minutes following rinse. Nine subjects were enrolled in the study. Statistically significant reductions in pain scores were reported for 2 hours following doxepin rinse during the initial visit (p < .05). Patients recalled that their pain significantly dropped within 5 minutes of rinsing over the week of repeated dosing (p < .05). At the follow-up visit, subjects reported statistically significant pain reduction 5 minutes after doxepin rinsing (p < .05). These results indicate that doxepin rinsing continues to produce reduced intensity of pain levels over a 1-week span of repeated dosing. PMID:18402621

  17. Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

    SciTech Connect

    Ashley, Paul R.

    2008-01-01

    Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

  18. Providers of Follow-Up Care in a Population-Based Sample of Breast Cancer Survivors

    PubMed Central

    Friese, Christopher R.; Martinez, Kathryn A.; Abrahamse, Paul; Hamilton, Ann S.; Graff, John J.; Jagsi, Reshma; Griggs, Jennifer J.; Hawley, Sarah T.; Katz, Steven J.

    2014-01-01

    Purpose To describe which providers provide breast cancer survivorship care. Patients and Methods We conducted a longitudinal survey of non-metastatic breast cancer patients identified by the SEER registries of Los Angeles and Detroit. Multinomial logistic regression examined the adjusted odds of surgeon compared with a medical oncologist follow up or primary care provider compared with medical oncologist follow up, adjusting for age, race/ethnicity, insurance, tumor stage, receipt of chemotherapy, endocrine therapy use, and visit to a medical oncologist at the time of diagnosis. Results were weighted to account for sample selection and non-response. Results 844 women had invasive disease and received chemotherapy or endocrine therapy. 65.2% reported medical oncologists as their main care provider at four years, followed by PCP/other physicians (24.3%) and surgeons (10.5%). Black women were more likely to receive their follow-up care from surgeons (OR 2.47, 95% CI 1.165.27) or PCP/other physicians (OR 2.62, 95% CI 1.474.65) than medical oncologists. Latinas were more likely to report PCP/other physician follow up than medical oncologists (OR 2.33, 95% CI 1.154.73). Compared with privately-insured women, Medicaid recipients were more likely to report PCP/other physician follow up (OR 2.52, 95% CI 1.245.15). Women taking endocrine therapy four years after diagnosis were less likely to report surgeons or PCP/other physicians as their primary provider of breast cancer follow up care. Conclusions Different survivorship care patterns based on race/ethnicity and insurance status. Interventions are needed to inform patients and providers on the recommended sources of breast cancer follow up. PMID:24481682

  19. The transitioning from trials to extended follow-up studies

    PubMed Central

    Drye, Lea T.; Casper, Anne S.; Sternberg, Alice L.; Holbrook, Janet T.; Jenkins, Gabrielle; Meinert, Curtis L.

    2014-01-01

    Background Investigators may elect to extend follow-up of participants enrolled in a randomized clinical trial after the trial comes to its planned end. The additional follow-up may be initiated to learn about longer term effects of treatments including adverse events, costs related to treatment, or for reasons unrelated to treatment such as to observe the natural course of the disease using the established cohort from the trial. Purpose We examine transitioning from trials to extended follow-up studies when the goal of additional follow-up is to observe longer term treatment effects. Methods We conducted a literature search in selected journals from 2000–2012 to identify trials that extended follow-up for the purpose of studying longer term treatment effects and extracted information on the operational and logistical issues in the transition. We also draw experience from three trials coordinated by the Johns Hopkins Coordinating Centers that made transitions to extended followup: the Alzheimer’s Disease Anti-inflammatory Prevention Trial (ADAPT); Multicenter Uveitis Steroid Treatment (MUST) trial; and Childhood Asthma Management Program (CAMP). Results Transitions are not uncommon in multicenter clinical trials, even in trials that continued to the planned end of the trial. Transitioning usually necessitates new participant consents. If study infrastructure is not maintained during the transition, participants will be lost and re-establishing the staff and facilities will be costly. Merging data from the trial and follow-up study can be complicated by changes in data collection measures and schedules. Limitations Our discussion and recommendations are limited to issues that we have experienced in transitions from trials to follow-up studies. Discussion We discuss issues such as maintaining funding, IRB and consent requirements, contacting participants, and combining data from the trial and follow-up phases. We conclude with a list of recommendations to facilitate transitions from a trial to an extended follow-up study. PMID:25115882

  20. Long term follow up after inhalation of foreign bodies.

    PubMed Central

    Davies, H; Gordon, I; Matthew, D J; Helms, P; Kenney, I J; Lutkin, J E; Lenney, W

    1990-01-01

    The long term results of treatment of inhalation of foreign bodies in a district children's hospital and in a tertiary referral centre were reviewed by clinical assessment, chest radiography, and standard four view 81mKr ventilation/99mTc macroaggregated albumin perfusion imaging (V/Q lung scan). The overall incidence in the population served by the district hospital was roughly one in 14,000/year. Of the 12 children reviewed there, three had abnormal chest radiographs and four had abnormal V/Q scans as a result of inhalation of the foreign bodies. Of 21 children treated and reviewed at the referral centre, eight had abnormal chest radiographs, and 14 had abnormal V/Q lung scans. Three factors were assessed for prognostic importance: site of impaction, initial radiographic appearance, and time before removal. A child who had inhaled a foreign body into the left lung and who had collapse/consolidation on the initial chest radiograph was at greatest risk of long term complications. These children merit close follow up. PMID:2378520

  1. [Follow-up after radiotherapy of anal canal carcinoma].

    PubMed

    Meillan, N; Huguet, F; Peiffert, D

    2015-10-01

    Anal canal carcinoma is a rare and curable disease for which the standard of care is radiation therapy with concurrent 5-fluoro-uracil and mitomycine-based chemotherapy. Post-treatment follow-up however is rather poorly defined. This article offers a review of the various post-treatment surveillance options both for early diagnosis of relapse and care for late treatment effects. While follow-up remains mostly clinical, we will discuss morphologic (endorectal echoendoscopy, pelvic magnetic resonance imaging, tomodensitometry and positron emission tomography) and biologic (squamous cell carcinoma antigen and pathology) follow-up so as to determine their diagnostic and prognostic value. PMID:26323891

  2. Short-Term Follow-Up of Narcotic Addicts

    ERIC Educational Resources Information Center

    Swartz, June; Jabara, Raymond

    1974-01-01

    A follow-up questionnaire was mailed to 144 narcotic addict veterans approximately six months after termination from treatment at a multimodality drug program. It was found that 75 percent continued to use drugs, and 38 percent became readdicted. (Author)

  3. Surgery Patients Like Online Follow-Up, Study Finds

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_154881.html Surgery Patients Like Online Follow-up, Study Finds But sometimes ... over in-person care by a majority of patients who have routine, uncomplicated surgery, a new study ...

  4. Osteochondral resurfacing with proximal row carpectomy: 8-year follow-up.

    PubMed

    Fowler, John R; Tang, Peter C; Imbriglia, Joseph E

    2014-10-01

    Degenerative arthrosis of the proximal row remains a challenging problem for both patients and surgeons. Proximal row carpectomy is a motion-preserving treatment option, with studies documenting acceptable long-term outcomes. Proximal row carpectomy is an attractive option because there is no need for fusion to occur between the carpal bones, as in 4-corner fusion. As a result, laborers and smokers may be able to return to work more quickly. However, capitate chondrosis traditionally has been considered a contraindication to proximal row carpectomy. The goal of this study was to review the long-term follow-up of patients who underwent osteochondral resurfacing of capitate chondrosis performed in the same setting as proximal row carpectomy. Final follow-up was obtained in 5 of 8 (63%) patients at an average of 101 months (range, 99-102) after surgery. Grip strength improved at each time point, but wrist flexion and extension decreased. The average Mayo Wrist Score was 74 (range, 65-85) and remained stable or improved in all patients between the 18-month visit and the final visit. The Disabilities of the Arm, Shoulder and Hand (DASH) score was unchanged at final follow-up compared with 18-month follow-up (P=.7). This study found that osteochondral resurfacing of the capitate in the setting of proximal row carpectomy for patients with capitate chondrosis offers good outcomes compared with standard proximal row carpectomy in patients without capitate chondrosis on patient-directed outcome tools (DASH, Mayo Wrist Score) at long-term follow-up of 101 months. PMID:25275971

  5. Evaluating an outreach service for paediatric burns follow up.

    PubMed

    Cubitt, Jonathan J; Chesney, Amy; Brown, Liz; Nguyen, Dai Q

    2015-09-01

    Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged. PMID:26036205

  6. The impact of primary care physicians on follow-up care of underserved breast cancer survivors

    PubMed Central

    Maly, Rose C.; Liu, Yihang; Diamant, Allison L.; Thind, Amardeep

    2014-01-01

    Purpose To investigate the impact of primary care physicians (PCP) involvement in the receipt of follow-up cancer preventive care after a breast cancer (BC) diagnosis among a low-income population. Methods Multiple logistic regression analyses were performed to identify potential factors associated with receipt of cancer preventive care among 579 low-income women with breast cancer. The main outcome variables were receipt of annual mammography, Pap smear in the past 2 years, and ever had colonoscopy for those who were at least 50 years old, at 36 months after BC diagnosis. The main independent variable was provider visit type in the past 12 months. Results Women with a PCP visit only or both PCP and surgeon/cancer specialist visits in the past 12 months were more likely to have had annual mammography (AOR=2.67, P=0.109; AOR=2.20, P=0.0008, respectively), a Pap smear in the past 2 years (AOR=2.90, P=0.04; AOR=2.24, P=0.009, respectively) and colonoscopy (AOR=2.99, P=0.041; AOR=2.17, P=0.026, respectively) than those who only visited surgeons/cancer specialists. Indeed, women who only saw a PCP for their follow-up care had the highest odds ratio to receive each clinical care service. Conclusions PCPs involvement in the medical care of low-income BC survivors results in better follow-up cancer preventive care. Getting PCPs involved in cancer survivor care might be particularly pertinent for low-income populations because of lower costs and ease of access compared to cancer specialist-provided care. PMID:24204059

  7. Revisiting High School Visits

    ERIC Educational Resources Information Center

    Flagel, Andrew

    2012-01-01

    NACAC's anniversary is a great time to follow up on an article on high school visits, a topic of ongoing discussion in every admission and guidance office. The article highlights a variety of potential good outcomes that can be derived from collaborative interactions. Sadly, however, admission representatives are apt to be described by the

  8. Enhancing High School Reform: Lessons from Site Visits to Four Cities

    ERIC Educational Resources Information Center

    Brand, Betsy

    2005-01-01

    The American Youth Policy Forum (AYPF) took groups of national policymakers to visit effective and innovative high schools and to meet with reform-minded leaders as a way to become familiar with the challenges and possibilities of high school redesign. This report summarizes the best practices and policies that were successful in the transformed

  9. Mineral licks: motivational factors for visitation and accompanying disease risk at communal use sites of elk and deer.

    PubMed

    Lavelle, Michael J; Phillips, Gregory E; Fischer, Justin W; Burke, Patrick W; Seward, Nathan W; Stahl, Randal S; Nichols, Tracy A; Wunder, Bruce A; VerCauteren, Kurt C

    2014-12-01

    Free-ranging cervids acquire most of their essential minerals through forage consumption, though occasionally seek other sources to account for seasonal mineral deficiencies. Mineral sources occur as natural geological deposits (i.e., licks) or as anthropogenic mineral supplements. In both scenarios, these sources commonly serve as focal sites for visitation. We monitored 11 licks in Rocky Mountain National Park, north-central Colorado, using trail cameras to quantify daily visitation indices (DVI) and soil consumption indices (SCI) for Rocky Mountain elk (Cervus elaphus) and mule deer (Odocoileus hemionus) during summer 2006 and documented elk, mule deer, and moose (Alces alces) visiting licks. Additionally, soil samples were collected, and mineral concentrations were compared to discern levels that explain rates of visitation. Relationships between response variables; DVI and SCI, and explanatory variables; elevation class, moisture class, period of study, and concentrations of minerals were examined. We found that DVI and SCI were greatest at two wet, low-elevation licks exhibiting relatively high concentrations of manganese and sodium. Because cervids are known to seek Na from soils, we suggest our observed association of Mn with DVI and SCI was a likely consequence of deer and elk seeking supplemental dietary Na. Additionally, highly utilized licks such as these provide an area of concentrated cervid occupation and interaction, thus increasing risk for environmental transmission of infectious pathogens such as chronic wasting disease, which has been shown to be shed in the saliva, urine, and feces of infected cervids. PMID:24711146

  10. Timing of Discharge Follow-up for Acute Pulmonary Embolism: Retrospective Cohort Study

    PubMed Central

    Vinson, David R.; Ballard, Dustin W.; Huang, Jie; Rauchwerger, Adina S.; Reed, Mary E.; Mark, Dustin G.

    2015-01-01

    Introduction Historically, emergency department (ED) patients with pulmonary embolism (PE) have been admitted for several days of inpatient care. Growing evidence suggests that selected ED patients with PE can be safely discharged home after a short length of stay. However, the optimal timing of follow up is unknown. We hypothesized that higher-risk patients with short length of stay (<24 hours from ED registration) would more commonly receive expedited follow up (≤3 days). Methods This retrospective cohort study included adults treated for acute PE in six community EDs. We ascertained the PE Severity Index risk class (for 30-day mortality), facility length of stay, the first follow-up clinician encounter, unscheduled return ED visits ≤3 days, 5-day PE-related readmissions, and 30-day all-cause mortality. Stratifying by risk class, we used multivariable analysis to examine age- and sex-adjusted associations between length of stay and expedited follow up. Results The mean age of our 175 patients was 63.2 (±16.8) years. Overall, 93.1% (n=163) of our cohort received follow up within one week of discharge. Fifty-six patients (32.0%) were sent home within 24 hours and 100 (57.1%) received expedited follow up, often by telephone (67/100). The short and longer length-of-stay groups were comparable in age and sex, but differed in rates of low-risk status (63% vs 37%; p<0.01) and expedited follow up (70% vs 51%; p=0.03). After adjustment, we found that short length of stay was independently associated with expedited follow up in higher-risk patients (adjusted odds ratio [aOR] 3.5; 95% CI [1.0–11.8]; p=0.04), but not in low-risk patients (aOR 2.2; 95% CI [0.8–5.7]; p=0.11). Adverse outcomes were uncommon (<2%) and were not significantly different between the two length-of-stay groups. Conclusion Higher-risk patients with acute PE and short length of stay more commonly received expedited follow up in our community setting than other groups of patients. These practice patterns are associated with low rates of 30-day adverse events. PMID:25671009

  11. Factors Associated with Follow-Up Attendance among Rape Victims Seen in Acute Medical Care

    PubMed Central

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2016-01-01

    Objective Rape is associated with Posttraumatic Stress Disorder and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well-positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Method Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Results Of the 521 diverse female (n=476) and male (n=45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR=0.40, 95% CI=0.21-0.77), having a current mental illness (OR=0.25, 95% CI=0.13-0.49), and being assaulted in public (OR=0.50, 95% CI=0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR= 3.02 95% CI=1.86-4.91), a completed SANE examination (OR=2.97, 95% CI=1.84-4.81), and social support available to help cope with the assault (OR=3.54, 95% CI=1.76-7.11) were associated with an increased odds of attending the follow-up. Conclusions Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage among these patients is warranted and may require alternative models to engage these patients to support posttraumatic recovery. PMID:26168030

  12. Long-term follow-up of patients with candiduria.

    PubMed

    Revankar, S G; Hasan, M S; Revankar, V S; Sobel, J D

    2011-02-01

    Candiduria is commonly encountered in hospitalized patients, particularly those with indwelling urinary catheters. While risk factors and therapy are well described in previous studies, little is known about long-term outcomes and recurrence rates of candiduria. We studied 188 patients with candiduria in a retrospective chart review at a single institution from January 1999 to December 2000. Data were collected regarding risk factors and underlying disease, therapy, follow-up cultures until December 2003, and mortality. Ninety-one patients with at least one follow-up culture >1 month after the initial culture (range 2-48) were available for further study. In this group, patients receiving antifungal therapy for asymptomatic candiduria were paradoxically more likely to have subsequent positive urine cultures than patients who never received antifungal therapy. Six patients developed candidemia during follow-up, although in none was this considered to represent a consequence of candiduria. Mortality rate at the end of the follow-up period (mean of 18 months) was 43%, including one death attributed to candidemia. Therapy for candiduria does not appear to reduce candiduria recurrence rates through 48 months of follow-up and little evidence of treatment benefit was identified. PMID:20857164

  13. Radiological follow-up results of untreated anterior disc displacement without reduction in adults.

    PubMed

    Zhuo, Z; Cai, X Y

    2016-03-01

    The aim of this study was to assess the radiographic changes in untreated adults with bilateral anterior disc displacement without reduction. A cohort study was designed to compare the bone changes, effusion, disc configuration, and pseudo-disc changes on two magnetic resonance images obtained at least 24 months apart. Twenty-eight patients (22 female, six male) with a mean age of 33.1 years (range 20-57 years) were included. The mean interval between the initial visit and the follow-up visit was 36.2 months. At the initial visit, the frequencies of bone changes, effusion, disc deformation, and pseudo-disc changes were 51.79%, 35.71%, 100%, and 0%, respectively. At follow-up, the frequency of effusion had decreased significantly. The frequency of bone changes had increased significantly to 75%, but newly formed cortical bone was present in five condyles. All discs remained deformed. Pseudo-disc changes were detected in five joints. Over a long period of observation, there was a significant decrease in effusion and a significant increase in bone changes. However, some adaptive changes occurred. PMID:26682646

  14. Outpatient Follow-up and Secondary Prevention for Melanoma Patients

    PubMed Central

    Gamble, Ryan G.; Jensen, Daniel; Suarez, Andrea L.; Hanson, Anne H.; McLaughlin, Lauren; Duke, Jodi; Dellavalle, Robert P.

    2010-01-01

    Health care providers and their patients jointly participate in melanoma prevention, surveillance, diagnosis, and treatment. This paper reviews screening and follow-up strategies for patients who have been diagnosed with melanoma, based on current available evidence, and focuses on methods to assess disease recurrence and second primary occurrence. Secondary prevention, including the roles of behavioral modification and chemoprevention are also reviewed. The role of follow-up dermatologist consultation, with focused physical examinations complemented by dermatoscopy, reflectance confocal microscopy, and/or full-body mapping is discussed. Furthermore, we address the inclusion of routine imaging and laboratory assessment as components of follow-up and monitoring of advanced stage melanoma. The role of physicians in addressing the psychosocial stresses associated with a diagnosis of melanoma is reviewed. PMID:24281112

  15. Posttreatment Follow-Up of Brucellosis by PCR Assay

    PubMed Central

    Morata, Pilar; Queipo-Ortuo, Mara Isabel; Reguera, Jos Mara; Garca-Ordoez, Miguel Angel; Pichardo, Cristina; Colmenero, Juan de Dios

    1999-01-01

    In order to evaluate the usefulness of a peripheral blood PCR assay in the posttreatment follow-up of brucellosis, a cohort of 30 patients was studied by means of blood cultures, rose Bengal, seroagglutination, Coombs' antibrucella tests, and PCR assay at the time of diagnosis, at the end of treatment, and 2, 4, and 6 months later. Of the 29 patients whose PCR assays were initially positive, 28 (96.5%) were negative at the conclusion of the treatment. PCR was positive for the two patients who had relapses and negative for another four who had suspected but unconfirmed relapses. PCR was negative for 98.3% of the follow-up samples from those patients who had a favorable evolution. In conclusion, PCR appears to be a very useful technique, not only for the initial diagnosis of the disease, but also for posttreatment follow-up and the early detection of relapses. PMID:10565954

  16. Cancer Related Follow-up Care among Hispanic and non-Hispanic Childhood Cancer Survivors: The Project Forward Study

    PubMed Central

    Milam, Joel; Meeske, Kathleen; Slaughter, Rhona; Sherman-Bien, Sandra; Ritt-Olson, Anamara; Kuperberg, Aura; Freyer, David R.; Hamilton, Ann S.

    2014-01-01

    Background Follow-up care is critical for childhood cancer survivors (CCS) who are at high risk for co-morbidities and late effects of cancer treatments. Understanding factors associated with maintaining follow-up care is needed, especially for Hispanic CCS who are underrepresented in previous studies. Methods Risk and protective factors for receiving cancer-related follow-up care were examined among 193 Los Angeles County CCS diagnosed between 20002007 (54% Hispanic; mean age=19.9, SD=2.8; mean age at diagnosis=12.1, SD=3.0; mean years since diagnosis=7.8, SD=2.0). Self-report surveys assessed follow-up care, insurance status, demographics, clinical factors, and psychosocial risk (e.g., depression) and protective [e.g., self-efficacy (SE)] factors. Multivariable logistic regression was used to determine factors associated with previous (in prior 2 years) and intent for future cancer-related follow-up care. Results Seventy-three percent of CCS reported a cancer follow-up visit in the prior 2 years, which was positively associated (ps<.05) with having health insurance, White ethnicity (vs. Hispanic), younger age and greater treatment intensity. Sixty-nine percent reported intent for follow-up care in the next two years, which was positively associated (ps<.05) with having health insurance and greater SE. Conclusions Hispanics and older CCS are more likely to lack previous follow-up care. Because health insurance was strongly associated with both previous follow-up care and intent to seek care, recent changes in health coverage may improve follow-up among CCS. Interventions targeting improved SE may help increase intent to receive follow-up care for this population. PMID:25345867

  17. Diabetes after infectious hepatitis: a follow-up study.

    PubMed Central

    Oli, J M; Nwokolo, C

    1979-01-01

    Eleven patients (nine men, one woman, and one girl) aged 11-62 years who developed diabetes mellitus after an attack of infectious hepatitis during the Eastern Nigerian epidemic of 1970-2 were followed up for two to nine years. One patient aged 60 years remained diabetic after the original illness. In the remaining 10 patients the diabetes remitted after three to nine months (mean 6.7 months) but in four it recurred after a remission lasting one and a half to four years (mean 2.6 years). Results of this follow-up study seem to confirm that the pancreas is sometimes permanently damaged during infectious hepatitis. PMID:435884

  18. Popularity of less frequent follow up for breast cancer in randomised study: initial findings from the hotline study.

    PubMed Central

    Gulliford, T.; Opomu, M.; Wilson, E.; Hanham, I.; Epstein, R.

    1997-01-01

    OBJECTIVE: To compare the experiences of patients with breast cancer who were conventionally monitored with those in whom routine follow up was restricted to the time of mammography. DESIGN: Randomisation to conventional schedule of clinic visits or to visits only after mammography. Both cohorts received identical mammography and were invited to telephone for immediate appointments if they detected symptoms. SETTING: Combined breast clinic, Chelsea and Westminster Hospital. SUBJECTS: 211 eligible outpatients with a history of breast cancer. MAIN OUTCOME MEASURES: Acceptability of randomisation, interim use of telephone and general practitioner, satisfaction with allocation to follow up. RESULTS: Of 211 eligible patients, 196 (93%) opted for randomisation in the study. Of these, 55 were under 50 years, 78 were diagnosed fewer than five years before, 90 had stage T2-4 tumours, and 71 had involved axillary nodes. Patients who did not participate were more likely to be under 50 years, to be two to five years after diagnosis, and to have had aggressive primary disease. Twice as many patients in both groups expressed a preference for reducing rather than increasing follow up. No increased use of local practitioner services or telephone triage was apparent in the cohort randomised to less frequent follow up by specialists. CONCLUSIONS: Reducing the frequency of routine follow up has so far proved popular among patients with breast cancer at standard risk in this cohort. A multicentre study is needed to determine the effectiveness and cost-effectiveness of routine follow up with respect to disease outcomes. PMID:9022429

  19. Long-term results of viscocanalostomy and phacoviscocanalostomy: a twelve-year follow-up study

    PubMed Central

    Gunenc, Uzeyir; Ozturk, Taylan; Arikan, Gul; Kocak, Nilufer

    2015-01-01

    AIM To evaluate the long-term efficacy and safety results of viscocanalostomy and phacoviscocanalostomy. METHODS The charts of 49 glaucoma patients who underwent viscocanalostomy or phacoviscocanalostomy surgery between February 1999 and August 2004 were reviewed retrospectively. Thirty-one eyes of 21 glaucoma patients who underwent filtering procedure with a postoperative follow-up of at least 5y were included in the study. Results of complete ophthalmologic examinations were recorded and statistically analyzed. Long-term surgical outcome was defined as an overall success when intraocular pressure (IOP) was found as ?20 mm Hg with or without antiglaucomatous medication at the last follow-up visit, while it was defined as a complete success when IOP was measured ?20 mm Hg without antiglaucomatous medication. RESULTS Mean age was 68.19.6y (range: 32-81y). Mean follow-up time was 101.527.3mo (range: 60-144mo). Viscocanalostomy was performed in 8 eyes (25.8%) and phacoviscocanalostomy was performed in 23 eyes (74.2%). The mean preoperative IOP was 23.17.6 mm Hg with 2.11.0 medications, while mean IOP was 16.83.8 mm Hg with 0.91.1 medication at the last follow-up visit. Both the IOP decrease and the reduction in the antiglaucomatous medication were statistically significant (P<0.001 and P<0.001). No case required further glaucoma surgery. Overall success and complete success were found as 87.1% and 51.6%, respectively. Complete success rate was statistically higher in phacoviscocanalostomy group compared with the viscocanalostomy group (P=0.031), however there was no significant difference in overall success rate between two groups (P=0.072). CONCLUSION Both viscocanalostomy and phacoviscocanalostomy provide good IOP reduction in the long-term period. PMID:26682166

  20. Records for the number of distinct sites visited by a random walk on the fully connected lattice

    NASA Astrophysics Data System (ADS)

    Turban, Loc

    2015-11-01

    We consider a random walk on the fully connected lattice with N sites and study the time evolution of the number of distinct sites s visited by the walker on a subset with n sites. A record value v is obtained for s at a record time t when the walker visits a site of the subset for the first time. The record time t is a partial covering time when v\\lt n and a total covering time when v = n. The probability distributions for the number of records s, the record value v and the record (covering) time t, involving r-Stirling numbers, are obtained using generating function techniques. The mean values, variances and skewnesses are deduced from the generating functions. In the scaling limit the probability distributions for s and v lead to the same Gaussian density. The fluctuations of the record time t are also Gaussian at partial covering, when n-v={{O}}(n). They are distributed according to the type-I Gumbel extreme-value distribution at total covering, when v = n. A discrete sequence of generalized Gumbel distributions, indexed by n-v, is obtained at almost total covering, when n-v={{O}}(1). These generalized Gumbel distributions are crossing over to the Gaussian distribution when n - v increases.

  1. Assessing Quality in Digital Reference Services Site Visit Reports: State Library of Florida, Bureau of Library and Network Services and Tampa-Hillsborough County Public Library System.

    ERIC Educational Resources Information Center

    Gross, Melissa; McClure, Charles R.

    The Assessing Quality on Digital Reference team conducted two site visits at Florida Libraries in August 2001. The objectives of these visits were to: document how digital reference services are currently being planned for, delivered, and evaluated in libraries; understand how "quality" in digital reference is defined in these environments;

  2. Sexually Abstinent Adolescents: An 18-Month Follow-Up

    ERIC Educational Resources Information Center

    Blinn-Pike, Lynn; Berger, Thomas J.; Hewett, John; Oleson, Jacob

    2004-01-01

    This study was a longitudinal follow-up of 697 early adolescents from 20 schools in Missouri, investigating students who, in 1997, indicated on a survey of sexual attitudes and behaviors that they had not had sexual intercourse. They completed the Reasons for Abstinence Scale (RAS) by identifying those items that were reasons why they had not had…

  3. Implementing "Starting Points": A Follow-Up Study.

    ERIC Educational Resources Information Center

    Borgen, William A.

    1999-01-01

    Describes a follow-up study of the implementation of a group-based needs assessment program for unemployed people titled "Starting Points." Study uses focus group methodology to identify and categorize participant statements into 15 themes. The themes generated suggest that the program was successful in connecting clients with needed resources.

  4. FOLLOW UP STUDY OF CHILDREN WITH DEVELOPMENTAL DISABILITIES

    EPA Science Inventory

    The Follow-Up Study involves locating and interviewing a group of young adults who, as 10-year-old children, were included in the Metropolitan Atlanta Developmental Disabilities Study, an investigation of the prevalence and risk factors for developmental disabilities that was con...

  5. Extended Follow-Up | Division of Cancer Prevention

    Cancer.gov

    NCI supports the continued follow-up of participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) to strengthen the PLCO as a valuable resource for molecular epidemiologic research as well as provide long-term data on the trial’s primary endpoints. |

  6. Follow-Up Report: 2005 Placements of 2004 NDUS Graduates

    ERIC Educational Resources Information Center

    Anderson, Debra; Dunn, Eddie; Hillman, Mike; Morth, Tom; Schepp, Julie; Padilla, Gina

    2007-01-01

    Some of the questions most frequently asked of the North Dakota University System relate to the status of graduates and program completers of state educational institutions. Follow-up Information on North Dakota Education and Training (FINDET) is a consortium of several state agencies formed to provide answers to those questions. This report,

  7. Job Training Partnership Act 8% Follow-up Summary Report.

    ERIC Educational Resources Information Center

    Peterson, Charlene M.; And Others

    From September through November 1986, the Wisconsin Department of Public Instruction (DPI) conducted a follow-up survey of Job Training Partnership Act (JTPA) 8% program participants in the 1985-86 school year. The DPI is responsible for administering half of the JTPA 8% Education Coordination and Grants for economically disadvantaged youth, ages

  8. Follow-Up of 1978 Entrants. Research Report Number 32.

    ERIC Educational Resources Information Center

    Nespoli, Lawrence A.; Radcliffe, Susan K.

    A follow-up study of students entering Howard Community College (HCC) in 1978 was conducted to obtain information on student outcomes three and one-half years after enrollment. A questionnaire developed by the Maryland Community College Research Group and the Maryland State Board for Community Colleges was sent to 592 students who entered HCC in

  9. Graduate Follow-Up Report, 1994-95.

    ERIC Educational Resources Information Center

    Wisconsin State Board of Vocational, Technical, and Adult Education, Madison.

    Each year, a follow-up study is conducted to gather data on the activities and perceptions of students approximately 6 months after their graduation from Wisconsin's Technical Colleges (WTC). Specifically, the survey seeks to identify the current activities of the WTC graduates, determine the extent to which current activities are related to the

  10. Follow-Up of the Fall 1990 FTIC Cohort.

    ERIC Educational Resources Information Center

    Windham, Patricia

    Drawing from data provided by the Florida Education and Training Placement Information Program (FETPIP), this series of reports provides follow-up information on FTIC students entering Tallahassee Community College (TCC) in fall 1990. The four reports compare students based on race, entry level test pass rates, full-/part-time status, and grade

  11. Cytokeratin-based CTC counting unrelated to clinical follow up

    PubMed Central

    de Carvalho, Fernanda Machado; Rocha, Bruna Maria Malagoli; Aguiar, Caroline Motta; Abdallah, Emne Ali; Campanha, Daniel; Mingues, Natlia Breve; de Oliveira, Thiago Bueno; Maciel, Macello Sampaio; Cervantes, Gustavo Marchioro; Dettino, Aldo L.A.; Soares, Fernando Augusto; Paterlini-Brchot, Patrizia; Fanelli, Marcello Ferretti

    2013-01-01

    Background Circulating tumor cells (CTCs) have been reported to be a relevant prognostic biomarker in metastatic patients. However, their clinical use and impact is still under debate. We have thus comparatively and kinetically assessed two CTC detection methods according to the patients clinical follow up. Methods CTC counting and characterization were repeatedly performed during follow up in a patient with metastatic undifferentiated non-small cell lung cancer by using cytokeratin (CK)-dependent immunomagnetic separation (Miltenyi) and CK-independent, size-based isolation [isolation by size of tumor cells (ISET)] (Rarecells). Results Comparison between the two methods showed a parallel increase of CTC detected by ISET and worsening of the clinical status, while CK-dependent CTC numbers were decreasing, misleadingly suggesting a response to treatment. ISET results were in agreement with the clinical follow up showing Circulating tumor microemboli (CTM) and CTC expressing a mesenchymal marker with absence of epithelial markers. Conclusions This case report study shows the interest of a comparative and kinetic analysis of different methods for CTCs detection combined with their evaluation according to the clinical follow up. Our results should open up an area for future research and validation in larger clinical cohorts. PMID:24255771

  12. Factors Associated with Adherence to Follow-up Colposcopy

    ERIC Educational Resources Information Center

    Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

    2013-01-01

    Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship

  13. Factors Associated with Adherence to Follow-up Colposcopy

    ERIC Educational Resources Information Center

    Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

    2013-01-01

    Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship…

  14. Employer Follow-Up Study: North Carolina Community College System.

    ERIC Educational Resources Information Center

    Allred, Marcus D.; Wingfield, Julian C., Jr.

    A follow-up study was conducted by the North Carolina Department of Community Colleges in summer 1981 to obtain employer evaluations of the performance of occupational curriculum students who were enrolled in college in the 1979-80 school year, but did not return in 1980-81. Drawing from employment information obtained during the first statewide

  15. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  16. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  17. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  18. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  19. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  20. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 41.315...

  1. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit findings follow-up. 3052.315 Section 3052.315 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees ...

  2. A Follow-Up Study of the Deaf.

    ERIC Educational Resources Information Center

    Reich, P. A.; Reich, C. M.

    Followed up through interviews and questionnaires were 278 former students, average age 28 years, of two residential schools and one day school for the deaf in Ontario. Data was collected on the degree of hearing loss, use of a hearing aid, educational and occupational history, social integration, methods of communication, and attitudes toward…

  3. Long-term follow-up of newborn screening patients.

    PubMed

    Berry, Susan A; Lloyd-Puryear, Michele A; Watson, Michael S

    2010-12-01

    New technology in newborn screening permits clinicians to approach strategies for defining optimal treatments for newborn-screened conditions. The Health Resources and Services Administration Maternal and Child Health Bureau, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Centers for Disease Control and Prevention have all established initiatives for long-term follow-up assessment of children identified after newborn screening. In October 2008, an inaugural meeting of the National Institute of Child Health and Human Development-sponsored National Coordinating Center Long-Term Follow-Up Data Collection Work Group brought together partners from Health Resources and Services Administration-sponsored Regional Genetics Collaboratives to review pilot projects undertaken to promote systematic long-term follow-up for children with inborn errors of metabolism identified by newborn bloodspot screening. Beginning with these projects, the goal of this meeting was to provide a foundation for national planning for a common data set to be used for long-term follow-up. This supplement summarizes these initial projects. PMID:21150374

  4. Academic Resilience in Retrospect: Following up a Decade Later

    ERIC Educational Resources Information Center

    Morales, Erik E.

    2008-01-01

    In a unique follow-up study, Hispanic (Dominican American) students identified as resilient 10 years ago were reinterviewed to assess their interim progress, and explore how their educational and professional achievements have evolved over time. By having the students reflect on their beliefs a decade ago and how those beliefs have evolved in

  5. Extended Follow-Up | Division of Cancer Prevention

    Cancer.gov

    NCI supports the continued follow-up of participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) to strengthen the PLCO as a valuable resource for molecular epidemiologic research as well as provide long-term data on the trials primary endpoints. |

  6. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 41.315...

  7. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 41.315...

  8. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees 41.315...

  9. Loss to Follow-Up: Issues and Recommendations

    ERIC Educational Resources Information Center

    Hoffman, Jeff; Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how EHDI programs address loss to follow-up, 47 coordinators responded with 277 items, and themes were identified in each

  10. A Follow-up Study: The Registered Nurses Program, 1977.

    ERIC Educational Resources Information Center

    Kondwros, Jerry M.

    Twenty-seven (77.1%) of the thirty-five 1977 graduates of the South Georgia Colleges' Division of Nursing responded to a follow-up survey, producing the following information: (1) 17 were employed full-time, two were employed part-time, and eight were unemployed; (2) 88.9% agreed they were prepared adequately for the state board examination; (3)

  11. Three Year Follow-Up of 1974 Graduates.

    ERIC Educational Resources Information Center

    Baratta, Mary Kathryne

    To evaluate the long-term benefits of attendance at Moraine Valley Community College (MVCC), a three-year follow-up study was conducted of the 620 1974 graduates (324 transfer and 296 occupational students). Each graduate was sent a questionnaire collecting information on involvement with MVCC after graduation, present educational status,…

  12. Arkansas Youth Opportunities Unlimited Follow-up. Final

    ERIC Educational Resources Information Center

    Steinmiller, Georgine; Duncan, Lisa Bergeron

    The follow-up component of the Youth Opportunities Unlimited (YOU) program tracked students who graduated from YOU programs. Each participating university--Arkansas State, Henderson State, Southern Arkansas, University of Arkansas-Monticello, University of Arkansas-Pine Bluff, and University of the Ozarks--maintained contact with its own

  13. Clouston Syndrome: 25-year follow-up of a patient*

    PubMed Central

    Trdico, Lvia Arroyo; Antonio, Joo Roberto; Pozetti, Eurides Maria de Oliveira; Rosa, Ana Maria Mendes; Antonio, Carlos Roberto

    2015-01-01

    Clouston syndrome is a rare genodermatosis that affects skin and annexes. It is a form of ectodermal dysplasia characterized by generalized hypotrichosis, palmoplantar hyperkeratosis and nail dystrophy. This paper reports a 25-year follow-up of a patient with Clouston syndrome, from childhood to adulthood, monitoring diagnosis and clinical course of the disease.

  14. How are those lost to follow-up patients really doing? A compliance comparison in arthroplasty patients

    PubMed Central

    Choi, Jung Keun; Geller, Jeffrey A; Jr, David A Patrick; Wang, Wenbao; Macaulay, William

    2015-01-01

    AIM: To determine whether there is a functional difference between patients who actively follow-up in the office (OFU) and those who are non-compliant with office follow-up visits (NFU). METHODS: We reviewed a consecutive group of 588 patients, who had undergone total joint arthroplasty (TJA), for compliance and functional outcomes at one to two years post-operatively. All patients were given verbal instructions by the primary surgeon to return at one year for routine follow-up visits. Patients that were compliant with the instructions at one year were placed in the OFU cohort, while those who were non-compliant were placed in the NFU cohort. Survey mailings and telephone interviews were utilized to obtain complete follow-up for the cohort. A ?2 test and an unpaired t test were used for comparison of baseline characteristics. Analysis of covariance was used to compare the mean clinical outcomes after controlling for confounding variables. RESULTS: Complete follow-up data was collected on 554 of the 588 total patients (93%), with 75.5% of patients assigned to the OFU cohort and 24.5% assigned to the NFU cohort. We found significant differences between the cohorts with the OFU group having a higher mean age (P = 0.026) and a greater proportion of females (P = 0.041). No significant differences were found in either the SF12 or WOMAC scores at baseline or at 12 mo postoperative. CONCLUSION: Patients who are compliant to routine follow-up visits at one to two years post-operation do not experience better patient reported outcomes than those that are non-compliant. Additionally, after TJA, older women are more likely to be compliant in following surgeon instructions with regard to follow-up office care. PMID:25621220

  15. The University of Wyoming GRB Afterglow Follow-Up Program

    NASA Astrophysics Data System (ADS)

    Savage, S. L.; Norris, J. P.; Kutyrev, A. S.; Pierce, M.; Canterna, R.

    2004-09-01

    As the Swift era approaches, the University of Wyoming in Laramie has been preparing its two observatories for a robust GRB afterglow follow-up program. The 2.3-m Wyoming Infrared Observatory (WIRO) - first of its kind in collecting power and mid-infrared optimization - is located on Jelm Mt. (2944-m elevation) in a semi-arid atmosphere, 40 km southwest of Laramie. On dry, cold winter nights, our estimates show that WIRO's sensitivity in the K-band is comparable to that of a 4-m telescope at Mauna Kea observatory in Hawaii. Three instruments are currently in use at the observatory: WIRO-Prime, WIRO-Spec, and the Goddard IR camera. WIRO-Prime is a 20482 prime-focus camera with a 20 arcmin diameter FOV (f/2.1). Its sensitivity for a 300-s exposure will reach as faint as 24th (23rd) magnitude in V (R). WIRO-Spec is an integral field, holographic spectrometer which utilizes Volume-Phase-Holographic gratings with a 20482 detector. A bundle of 293 fiber optical cables (1 fiber ~ 1 arcsec) connects the Cassegrain platform to the stationary spectrometer, optimizing the image by reduction from f/27 to f/9. At 20th magnitude, a 700-s exposure yields a S/N ratio of ~ 10 at a resolution of ~ 1 Angstrom, sufficient for resolving the MgII doublet [279.8 nm] in GRB host galaxies to determine a 0.4 < z < 2.5 for an operational wavelength range of ~ 400-1000 nm (WIRO-Prime and WIRO-Spec). The Goddard IR Camera is a 2562 InSb camera (FOV ~ 108 arcsec) mounted at Cassegrain and operated at 15K. Available filters for GRB observations include R, I, J, H, and K'. WIRO slew timescale (~ 120 s) is comparable to that of Swift. Red Buttes Observatory (RBO) is located 19 km south of Laramie in a dark site and houses a 0.6-m f/8 Cassegrain DFM reflector. RBO's Apogee AP8p 10242 camera (18 arcmin FOV, sufficiently large for BAT localizations) is available for use with filters U, B, V, R and I. We are in the final stages of implementing fully automated response to Swift BAT alerts at RBO, and expect an average acquisition timescale to random sky positions of ~ 25 s. Thus, rapid GRB detections by RBO can be forwarded to WIRO even while Swift's pointed instruments are performing first integrations.

  16. Follow-up treatment utilization by hospitalized suicidal adolescents.

    PubMed

    Yen, Shirley; Fuller, Anne K; Solomon, Joel; Spirito, Anthony

    2014-09-01

    This study examines treatment utilization in a sample of 99 adolescents who were psychiatrically hospitalized due to a risk of suicide and followed for 6 months. Descriptive information regarding participants' use of various forms of outpatient and intensive treatment, including emergency, inpatient, and residential care is presented. In addition, the relationships between utilization of mental health services and various characteristics of the adolescents and their families were assessed. Overall treatment engagement was high, with 78 participants (79%) receiving some care for the duration of the follow-up period and 91 (92%) participating in at least one session of outpatient treatment, although the extent of utilization was highly variable. In addition, 28 participants (28%) were rehospitalized during follow-up. Both family and individual characteristics were associated with differences in adolescents' participation in follow-up treatment. Specifically, adolescents with a family history of mood disorders were more likely to participate in outpatient treatment and less likely to require intensive treatments. Conversely, more impaired baseline functioning and suicide attempts during the follow-up period were associated with greater utilization of intensive treatments and less utilization of outpatient therapy. Given that 19 participants (19%) in our sample attempted suicide during the follow-up interval, the findings of this study suggest that, in spite of high rates of outpatient treatment engagement, rates of suicide attempts and use of intensive treatment services remain high. These results suggest the need for improved outpatient care, as well as possibly longer inpatient stays and more elaborate discharge and transition planning. PMID:25226196

  17. Analytical framework and tool kit for SEA follow-up

    SciTech Connect

    Nilsson, Mans Wiklund, Hans; Finnveden, Goeran; Jonsson, Daniel K.; Lundberg, Kristina; Tyskeng, Sara; Wallgren, Oskar

    2009-04-15

    Most Strategic Environmental Assessment (SEA) research and applications have so far neglected the ex post stages of the process, also called SEA follow-up. Tool kits and methodological frameworks for engaging effectively with SEA follow-up have been conspicuously missing. In particular, little has so far been learned from the much more mature evaluation literature although many aspects are similar. This paper provides an analytical framework and tool kit for SEA follow-up. It is based on insights and tools developed within programme evaluation and environmental systems analysis. It is also grounded in empirical studies into real planning and programming practices at the regional level, but should have relevance for SEA processes at all levels. The purpose of the framework is to promote a learning-oriented and integrated use of SEA follow-up in strategic decision making. It helps to identify appropriate tools and their use in the process, and to systematise the use of available data and knowledge across the planning organization and process. It distinguishes three stages in follow-up: scoping, analysis and learning, identifies the key functions and demonstrates the informational linkages to the strategic decision-making process. The associated tool kit includes specific analytical and deliberative tools. Many of these are applicable also ex ante, but are then used in a predictive mode rather than on the basis of real data. The analytical element of the framework is organized on the basis of programme theory and 'DPSIR' tools. The paper discusses three issues in the application of the framework: understanding the integration of organizations and knowledge; understanding planners' questions and analytical requirements; and understanding interests, incentives and reluctance to evaluate.

  18. Hepatocellular carcinoma after ablation: the imaging follow-up scheme.

    PubMed

    Liu, Lin-Na; Xu, Hui-Xiong; Zhang, Yi-Feng; Xu, Jun-Mei

    2013-02-14

    Percutaneous ablation using thermal or chemical methods has been widely used in the treatment of hepatocellular carcinoma (HCC). Nowadays, contrast-enhanced imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS) are widely used to evaluate local treatment response after ablation therapies. CEUS is gaining increasing attention due to its characteristics including real-time scanning, easy performance, lack of radiation, wide availability, and lack of allergy reactions. Several studies have documented that CEUS is comparable to CT or MRI in evaluating local treatment efficacy within 1 mo of treatment. However, little information is available regarding the role of CEUS in the follow-up assessment after first successful ablation treatment. Zheng et al found that in comparison with contrast-enhanced computed tomography (CECT), the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of CEUS in detecting local tumor progression (LTP) were 67.5%, 97.4%, 81.8%, 94.4% and 92.3%, respectively, and were 77.7%, 92.0%, 92.4%, 76.7% and 84.0%, respectively for the detection of new intrahepatic recurrence. They concluded that the sensitivity of CEUS in detecting LTP and new intrahepatic recurrence after ablation is relatively low in comparison with CECT, and CEUS cannot replace CECT in the follow-up assessment after percutaneous ablation for HCC. These results are meaningful and instructive, and indicated that in the follow-up period, the use of CEUS alone is not sufficient. In this commentary, we discuss the discordance between CT and CEUS, as well as the underlying mechanisms involved. We propose the combined use of CT and CEUS which will reduce false positive and negative results in both modalities. We also discuss future issues, such as an evidence-based ideal imaging follow-up scheme, and a cost-effectiveness analysis of this imaging follow-up scheme. PMID:23429970

  19. Aging and Loss to Follow-up Among Youth Living With Human Immunodeficiency Virus in the HIV Research Network

    PubMed Central

    Agwu, Allison L.; Lee, Lana; Fleishman, John A.; Voss, Cindy; Yehia, Baligh R.; Althoff, Keri N.; Rutstein, Richard; Mathews, W. Christopher; Nijhawan, Ank; Moore, Richard D.; Gaur, Aditya H.; Gebo, Kelly A.

    2015-01-01

    Purpose In the United States, 21 years is a critical age of legal and social transition, with changes in social programs such as public insurance coverage. Human immunodeficiency virus (HIV)infected youth have lower adherence to care and medications and may be at risk of loss to follow-up (LTFU) at this benchmark age. We evaluated LTFU after the 22nd birthday for HIV-infected youth engaged in care. LTFU was defined as having no primary HIV visits in the year after the 22nd birthday. Methods All HIV-infected 21-year-olds engaged in care (20022011) at the HIV Research Network clinics were included. We assessed the proportion LTFU and used multivariable logistic regression to evaluate demographic and clinical characteristics associated with LTFU after the 22nd birthday. We compared LTFU at other age transitions during the adolescent/young adult years. Results Six hundred forty-seven 21-year-olds were engaged in care; 91 (19.8%) were LTFU in the year after turning 22 years. Receiving care at an adult versus pediatric HIV clinic (adjusted odds ratio [AOR], 2.91; 95% confidence interval [CI],1.425.93), having fewer than four primary HIV visits/year (AOR, 2.72; 95% CI, 1.674.42), and antiretroviral therapy prescription (AOR, .50; 95% CI, .41.60) were independently associated with LTFU. LTFU was prevalent at each age transition, with factors associated with LTFU similar to that identified for 21-year-olds. Conclusions Although 19.8% of 21-year-olds at the HIV Research Network sites were LTFU after their 22nd birthday, significant proportions of youth of all ages were LTFU. Fewer than four primary HIV care visits/year, receiving care at adult clinics and not prescribed antiretroviral therapy, were associated with LTFU and may inform targeted interventions to reduce LTFU for these vulnerable patients. PMID:25703322

  20. Linking Outdoor School with the Home Environment. A Follow-Up Resource Guide for Teachers.

    ERIC Educational Resources Information Center

    Cole, Wallace H.; Gilfillan, Warren C.

    A source of ideas and direction for follow-up to the Multnomah County Outdoor School program, the guide identifies concepts generally common to all outdoor school sites from year to year: the water cycle; watershed; water as a habitat for plants and animals, an oxygen supplier, and a producer of usable power; sun energy; plants as producers and…

  1. Linking Outdoor School with the Home Environment. A Follow-Up Resource Guide for Teachers.

    ERIC Educational Resources Information Center

    Cole, Wallace H.; Gilfillan, Warren C.

    A source of ideas and direction for follow-up to the Multnomah County Outdoor School program, the guide identifies concepts generally common to all outdoor school sites from year to year: the water cycle; watershed; water as a habitat for plants and animals, an oxygen supplier, and a producer of usable power; sun energy; plants as producers and

  2. Natural history of herpes zoster: late follow-up of 3.9 years (n=43) and 7.7 years (n=10).

    PubMed

    Reda, Haatem; Greene, Kaitlin; Rice, Frank L; Rowbotham, Michael C; Petersen, Karin L

    2013-10-01

    Postherpetic neuralgia (PHN) is a common complication after herpes zoster (HZ). Subjects who completed a longitudinal observational 6-month study (4 visits) of the natural history of HZ were recontacted for 2 additional follow-up visits that included pain and sensory symptom assessment, quantitative sensory testing, capsaicin response test, and 3-mm punch skin biopsies in HZ-affected, mirror-image, and control skin sites. Forty-three subjects (14 with PHN at 6 months) of the original 94 subjects in the cohort were comprehensively assessed at a median 3.9 years after HZ onset (visit 5), and 10 subjects underwent a final assessment at a median 7.7 years after HZ onset (visit 6). At 3.9 years, none of the 29 subjects who had been pain free at 6 months had a recurrence of pain. Only 2 of the 14 subjects with PHN at 6 months still had pain at 3.9 years. One subject with PHN at 6 months was free of symptoms at 3.9 years but had very mild pain at 7.7 years. Sensory function continued on a path toward normalization, but was still abnormal in many subjects, especially those who met criteria for PHN at 6 months. Even at 7.7 years, reinnervation of HZ-affected skin was not apparent. PMID:23719573

  3. KLENOT Project - Near Earth Objects Follow-up Program

    NASA Astrophysics Data System (ADS)

    Tichy, Milos; Ticha, Jana; Kocer, Michal; Tichy, Milos

    2015-08-01

    Near Earth Object (NEO) research is important not only as a great challenge for science but also as an important challenge for planetary defense. Therefore NEO discoveries, astrometric follow-up, orbit computations as well as physical studies are of high interest both to science community and humankind.The KLENOT Project of the Klet Observatory, South Bohemia, Czech Republic pursued the confirmation, early follow-up, long-arc follow-up and recovery of NEOs since 2002. Tens of thousands astrometric measurements helped to make inventory of NEOs as well as to understand the NEO distribution. It ranked among the world most prolific professional NEO follow-up programmes during its first phase from 2002 to 2008.The fundamental improvement of the 1.06-m KLENOT Telescope was started in autumn 2008. The new computer controlled paralactic mount was built to substantially increase telescope-time efficiency, the number of observations, their accuracy and limiting magnitude. The testing observations of the KLENOT Telescope Next Generation were started in October 2011. The new more efficient CCD camera FLI ProLine 230 was installed in summer 2013.The original Klet Software Package has been continually upgraded over the past two decades of operation.Both the system and strategy for the NEO follow-up observation used in the framework of the KLENOT Project are described here, including methods for selecting useful and important targets for NEO follow-up astrometry.The modernized KLENOT System was put into full operation in September 2013. More than 8000 of minor planet and comet astrometric positions including NEA measurements were published from September 2013 to February 2015.The 1.06-m KLENOT telescope is still the largest telescope in continental Europe used exclusively for observations of asteroids and comets. Full observing time is dedicated to the KLENOT team. Considering our results and long-time experience obtained at the Klet Observatory, we have the large potential to contribute to recent NEO efforts.Since October 2014 the KLENOT Project has been a part of European Space Agency Space Systém Awareness Programme (ESA-SSA) - NEO Segment - Cooperating Sensors.

  4. Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial

    PubMed Central

    Moore, Sally; Corner, Jessica; Haviland, Jo; Wells, Mary; Salmon, Emma; Normand, Charles; Brada, Mike; O'Brien, Mary; Smith, Ian

    2002-01-01

    Objective To assess the effectiveness of nurse led follow up in the management of patients with lung cancer. Design Randomised controlled trial. Setting Specialist cancer hospital and three cancer units in southeastern England. Participants 203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months. Intervention Nurse led follow up of outpatients compared with conventional medical follow up. Outcome measures Quality of life, patients' satisfaction, general practitioners' satisfaction, survival, symptom-free survival, progression-free survival, use of resources, and comparison of costs. Results Patient acceptability of nurse led follow up was high: 75% (203/271) of eligible patients consented to participate. Patients who received the intervention had less severe dyspnoea at 3 months (P=0.03) and had better scores for emotional functioning (P=0.03) and less peripheral neuropathy (P=0.05) at 12 months. Intervention group patients scored significantly better in most satisfaction subscales at 3, 6, and 12 months (P<0.01 for all subscales at 3 months). No significant differences in general practitioners' overall satisfaction were seen between the two groups. No differences were seen in survival or rates of objective progression, although nurses recorded progression of symptoms sooner than doctors (P=0.01). Intervention patients were more likely to die at home rather than in a hospital or hospice (P=0.04), attended fewer consultations with a hospital doctor during the first 3 months (P=0.004), had fewer radiographs during the first 6 months (P=0.04), and had more radiotherapy within the first 3 months (P=0.01). No other differences were seen between the two groups in terms of the use of resources. Conclusion Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes. What is already known on this topicMost patients with cancer are routinely seen in outpatient clinics for many years despite lack of evidence of effectivenessDoctors and nurses often fail to detect patients' emotional distress, and patients have little time to raise concernsWhat this study addsFollow up of patients with lung cancer by clinical nurse specialists is safe, acceptable, and cost effectiveBoth patients and general practitioners were highly satisfied with the nurse led model of follow up PMID:12433764

  5. Integrated Management of Childhood Illnesses strategy: compliance with referral and follow-up recommendations in Gezira State, Sudan.

    PubMed Central

    al Fadil, Sumaia Mohammed; Alrahman, Samira Hamid Abd; Cousens, Simon; Bustreo, Flavia; Shadoul, Ahmed; Farhoud, Suzanne; el Hassan, Samia Mohamed

    2003-01-01

    OBJECTIVES: To determine the extent to which families follow referral and follow-up recommendations given in accordance with the Integrated Management of Childhood Illnesses (IMCI) strategy and the factors that influence families' responses to such recommendations. METHODS: Children aged 2 months-5 years who presented to an IMCI-trained health worker in Massalamia Health Area, Sudan, were recruited. Children with an IMCI classification that indicated the need for referral or follow-up were traced to determine whether the family complied with the referral or follow-up recommendation. Caretakers were interviewed to find out why they had or had not complied. Focus group discussions were held with health workers, caretakers, and community members. FINDINGS: Overall, 5745 children were enrolled. Of these, 162 (3%) were considered to be in need of urgent referral: 53 (33%) attended a hospital on the day of the referral, with a further 37 (23%) visiting the hospital later than the day of referral. About half of families cited cost as the reason for not visiting a hospital. A total of 1197 (21%) children were classified as needing follow-up. Compliance with a follow-up recommendation was 44% (529 children). Almost 165 (90%) of caretakers who were aware of and did not comply with follow-up, said they had not done so because the child was better. Compliance increased with the caretaker's level of education, if drugs were provided during the first visit, and if the follow-up period was short (2 or 5 days). CONCLUSION: In Massalamia--a resource-constrained environment in which IMCI implementation was well received by the community--only about half of children judged to be in need of urgent referral were taken for that care within 24 hours. Most children in need of follow-up received their first treatment dose in the health facility. This aspect of IMCI was commented upon favourably by caretakers, and it may encourage them to return for follow-up. Rates of return might also improve if return visits for children currently asked to return after 14 or 30 days were scheduled earlier. PMID:14758430

  6. Heavy vehicle industry site visits: comments from companies and conclusions from technical committee

    SciTech Connect

    McCallen, R.

    1998-02-01

    This report documents the results of several visits with industry as part of the Department of Energy (DOE), office of Transportation Technology, Office of Heavy Vehicle Technology, supported Heavy Vehicle Aerodynamics Project. The purpose of the DOE Heavy Vehicle Aerodynamics Project is to use government resources to bring the aerodynamic expertise available in government organizations and academia to bear in assisting the heavy vehicle industry to reduce aerodynamic drag on trucks. The obvious payback from this investment is the reduction in fuel usage and derivative reduction in the US's dependence on foreign oil imports. This report covers 2 projects: (1) The stated purpose of Project 1 was to provide near-term impact through emphasis on existing tools and capabilities and to focus on the trailer drag problem. (2) The stated purpose of Project 2 was to provide the tools necessary to accomplish the longer term goal of a fully-integrated, aerodynamic tractor-trailer combination.

  7. [Follow-up of newborns with hypoxic-ischaemic encephalopathy].

    PubMed

    Martnez-Biarge, M; Blanco, D; Garca-Alix, A; Salas, S

    2014-07-01

    Hypothermia treatment for newborn infants with hypoxic-ischemic encephalopathy reduces the number of neonates who die or have permanent neurological deficits. Although this therapy is now standard of care, neonatal hypoxic-ischaemic encephalopathy still has a significant impact on the child's neurodevelopment and quality of life. Infants with hypoxic-ischaemic encephalopathy should be enrolled in multidisciplinary follow-up programs in order to detect impairments, to initiate early intervention, and to provide counselling and support for families. This article describes the main neurodevelopmental outcomes after term neonatal hypoxic-ischaemic encephalopathy. We offer recommendations for follow-up based on the infant's clinical condition and other prognostic indicators, mainly neonatal neuroimaging. Other aspects, such as palliative care and medico-legal issues, are also briefly discussed. PMID:24290154

  8. Solitary intracranial plasmacytoma: two patients with extended follow-up.

    PubMed

    Krumholz, A; Weiss, H D; Jiji, V H; Bakal, D; Kirsh, M B

    1982-05-01

    Solitary neoplastic proliferation of plasma cells (plasmacytoma) rarely occurs in the central nervous system. The longest follow-Up in nine previously reported patients was 5 years. We have followed two patients with solitary intracranial plasmacytoma for 8 and 13 years, respectively. At the time of biopsy diagnosis, neither showed involvement of the adjacent calvarium or evidence of a systemic plasma cell dyscrasia. The first patient underwent partial excision of a mass in the right occipital lobe that showed no gross or microscopic involvement of the dura. The second patient had partial resection of a mass arising from dura and invading the left temporal lobe. Postoperative irradiation was given to both patients. No clinical or radiological sign of recurrent brain tumor has developed in either patient during the extended follow-up period. Neither patient has had laboratory or clinical evidence of a systemic plasma cell dyscrasia. Solitary intracranial plasmacytoma may be a "curable" brain tumor. PMID:7103430

  9. Noninvasive follow-up of complications after the Takeuchi operation.

    PubMed

    Lilje, Christian; L, Trong-Phi; Ntalakoura, Kalliopi; Weil, Jochen; Lacour-Gayet, Franois

    2007-12-01

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare lesion. Untreated, up to 90% of patients die before 1 year of age. The Takeuchi operation and direct coronary artery reimplantation have resulted in low mortality rates and excellent functional outcome. We present the case of a 6-year-old girl with impaired exercise tolerance in whom anomalous origin of the left coronary artery from the pulmonary artery was detected. A Takeuchi operation was performed. Routine follow-up was successfully done by echocardiography. The postoperative anatomy was visualized in detail, including a baffle-to-pulmonary artery fistula and a coronary artery stenosis. Potentially, given current echocardiographic technology in the hands of experienced operators, routine follow-up may be done noninvasively, leaving angiography for nonroutine indications. PMID:17628413

  10. Gastric dysplasia. A histological follow-up study.

    PubMed

    Saraga, E P; Gardiol, D; Costa, J

    1987-10-01

    To evaluate the clinical and biological significance of gastric dysplasia, we reviewed the histology of all available specimens of gastric mucosa in 85 patients in whom dysplasia had been previously diagnosed. The initial diagnosis of dysplasia was mild (Dy I) in 23 cases, moderate (Dy II) in 41 cases, and severe (Dy III) in 21 cases. The length of follow-up varied from 3 months to 11 years, with an average of 42 months. The follow-up of cases with Dy I and Dy II suggests that both lesions progress slowly and in most instances will remain stable or regress. In 18 cases, a carcinoma was found--17 in the group of Dy III and one in the group of Dy II. Of the 18 carcinomas, nine were at an early stage. Our data suggest that severe dysplasia is a reliable marker of high risk of gastric cancer and represents a strong indication for a gastrectomy. PMID:3661823

  11. Is follow-up capacity the current NHS bottleneck?

    PubMed

    Allder, Steven; Walley, Paul; Silvester, Kate

    2011-02-01

    Capacity and demand theory suggests that the presence of a queue is not necessarily an indication of a shortage of capacity in a system. It is much more likely that either there is a demand and capacity variation that creates queues or there is a delay designed into the system. A shortage of capacity is only really indicated where a backlog is not stable and continues to grow. In this article, data are taken from one NHS trust that provides evidence for a continually growing backlog for follow-up outpatient services. It is believed that these data are representative of most locations within the NHS in England and therefore suggest an immediate shortage in effective follow-up capacity. To avoid compromise to patient care, the problem will have to be addressed before the situation becomes unmanageable. The paper highlights options to reduce or deflect demand or to increase effective capacity. PMID:21404781

  12. ACR appropriateness criteria follow-up of Hodgkin lymphoma.

    PubMed

    Ha, Chul S; Hodgson, David C; Advani, Ranjana; Dabaja, Bouthaina S; Dhakal, Sughosh; Flowers, Christopher R; Hoppe, Bradford S; Mendenhall, Nancy P; Metzger, Monika L; Plastaras, John P; Roberts, Kenneth B; Shapiro, Ronald; Smith, Sonali; Terezakis, Stephanie A; Winkfield, Karen M; Younes, Anas; Constine, Louis S

    2014-11-01

    The main objectives of follow-up studies after completion of treatment for Hodgkin lymphoma are detection of recurrence for salvage therapy and monitoring for sequelae of treatment. The focus of the follow-up shifts, with time after treatment, from detection of recurrence to long-term sequelae. A majority of recurrence is detected by history and physical examination. The yield for routine imaging studies and blood tests is low. Although routine surveillance CT scan can detect recurrence not detected by history and physical examination, its benefit in ultimate survival and cost-effectiveness is not well defined. Although PET scan is a useful tool in assessing response to treatment, its routine use for follow-up is not recommended. Long-term sequelae of treatment include secondary malignancy, cardiovascular disease, pneumonitis, reproductive dysfunction, and hypothyroidism. Follow-up strategies for these sequelae need to be individualized, as their risks in general depend on the dose and volume of radiation to these organs, chemotherapy, age at treatment, and predisposing factors for each sequela. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is either lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:25278496

  13. Paediatrician office follow-up of common minor fractures

    PubMed Central

    Koelink, Eric; Boutis, Kathy

    2014-01-01

    BACKGROUND: Evidence suggests that minor paediatric fractures can be followed by primary care paediatricians (PCPs). OBJECTIVES: To determine PCP opinions, knowledge and perceived barriers to managing minor paediatric fractures in the office. METHODS: An online survey was sent between June and September 2013 to all paediatricians who subscribed to the American Academy of Pediatrics PROS-Net Listerv and to those who were registered with the Scotts Canadian Medical Directory as paediatricians who treated children in a primary care capacity. The primary outcome was the proportion of PCPs who agreed with PCP follow-up of minor paediatric fractures. Secondary outcomes included PCPs perceived barriers to office follow-up. RESULTS: A total of 1752 surveys were sent; 1235 were eligible and 459 (37.2%) responded to the survey. Overall, 296 (69.5% [95% CI 65.2% to 74.0%]) PCPs agreed that minor paediatric fractures could be followed in a PCP office. The most frequently reported barriers were lack of materials to replace immobilization (58.1%), PCP knowledge deficits (44.8%) and a perceived parental preference for an orthopedic surgeon (38.6%). Finally, 58.8% of respondents believed that further education was necessary if PCPs assumed responsibility for follow-up of midshaft clavicle fractures, while 66.5% and 77.1% (P<0.0001) believed this was necessary for distal radius buckle and fibular fractures, respectively. CONCLUSIONS: More than two-thirds of responding PCPs in Canada and the United States agreed that minor common paediatric fractures can be followed-up by paediatricians. However, PCPs reported some barriers to this management strategy, including a desire for more education on this topic. PMID:25382996

  14. Benign recurrent intrahepatic cholestasis--25 years of follow-up.

    PubMed Central

    Putterman, C.; Keidar, S.; Brook, J. G.

    1987-01-01

    Only 70 cases of recurrent intrahepatic cholestasis have been reported in the literature since the original description of this entity in 1959. The benign nature of the disease has been questioned, some authors suggesting progression to biliary cirrhosis. We report our follow-up of one such patient for over 25 years with no adverse physical consequences or histological deterioration. Sequential liver biopsies were obtained during this period. A conservative approach to diagnosis and treatment is therefore indicated. PMID:3684838

  15. [Systematic follow-up of infants born preterm].

    PubMed

    Aeby, A; Wermenbol, V; Ciardelli, R; Mûller, M-F; Wetzburger, C; Van Bogaert, P

    2015-09-01

    Advances in pediatric medicine have enabled a decrease in perinatal mortality, especially among infants born preterm (< 32 weeks gestational age) or low birth weight (< 1.500 g). However, this population is exposed to a greater risk of neurological sequelae. This is why the creation of specific follow-up program are mandatory to screen at-risk children to offer them a support able to minimize the impact of prematurity on their future neurological development. PMID:26591304

  16. Ute Unit: Study Guide and Follow Up Activities.

    ERIC Educational Resources Information Center

    North Conejos School District, Capulin, CO.

    The study guide and follow-up activities were designed primarily to give students a feeling of Ute life in the San Luis Valley in Colorado. The unit begins with six Southern Ute stories about the wolf and coyote, the race between the skunk and the coyote, the frog and the eagle, why the frog croaks, the bear (Que Ye Qat), and the two Indian…

  17. A follow-up study of attempted railway suicides.

    PubMed

    O'Donnell, I; Arthur, A J; Farmer, R D

    1994-02-01

    This paper reports the subsequent mortality of 94 persons who attempted suicide by jumping in front of London Underground trains between 1977 and 1979. The follow-up period was 10 yr. Despite the apparent seriousness of the method, completion of suicide was not found to be higher than in previous studies of attempted suicide by other methods. By the end of the follow-up period 18 persons had died, nine of natural causes. Coroners' inquests were held for the unnatural deaths. Seven verdicts of suicide and two of accidental death were recorded. Of the nine unnatural deaths four were from multiple injuries, three from drowning, one from asphyxia and one from acute narcotic poisoning. All four multiple injury deaths were women, three of these were from repeated incidents involving London Underground trains. The time interval between the index attempt and eventual death for the suicide/accident group ranged from 1 day to 43 months. For ethical reasons it was not possible to follow-up attempted suicides who were presumed to have remained alive. PMID:8153748

  18. Complications and Follow-up after Unprotected Carotid Artery Stenting

    SciTech Connect

    Hauth, Elke A.M. Drescher, Robert; Jansen, Christian; Gissler, H. Martin; Schwarz, Michael; Forsting, Michael; Jaeger, Horst J.; Mathias, Klaus D.

    2006-08-15

    Purpose. This prospective study was undertaken to determine the success rate, complications, and outcome of carotid artery stenting (CAS) without the use of cerebral protection devices. Methods. During 12 months, 94 high-grade stenoses of the carotid artery in 91 consecutive patients were treated. Sixty-six (70%) of the stenoses were symptomatic and 28 (30%) were asymptomatic. Results. In all 94 carotid stenoses CAS was successfully performed. During the procedure and within the 30 days afterwards, there were 2 deaths and 3 major strokes in the 66 symptomatic patients, resulting in a combined death and stroke rate of 5 of 66 (7%). Only one of these complications, a major stroke, occurred during the procedure. In the 6-month follow-up, one additional major stroke occurred in a originally symptomatic patient resulting in a combined death and stroke rate of 6 of 66 (10%) for symptomatic patients at 6 months. No major complications occurred in asymptomatic patients during the procedure or in the 6-month follow-up period. At 6 months angiographic follow-up the restenosis rate with a degree of >50% was 3 of 49 (6%) and the rate with a degree of {>=}70% was 1 of 49 (2%). Conclusions. Cerebral embolization during CAS is not the only cause of the stroke and death rate associated with the procedure. The use of cerebral protection devices during the procedure may therefore not prevent all major complications following CAS.

  19. Adoptions: follow-up from an orphanage in Bombay.

    PubMed

    Mehta, M N; Munshi, N N; Krishnan, P

    1983-01-01

    The practice of adoption, though long accepted as a social phenomenon, is only recently gaining popularity in India. Due to the paucity of adequate follow-ups, evaluation of these adopted children is incomplete. For the purpose of studying the well-being of these children after adoption, they were followed-up at the various places, i.e., orphanages, institutions, juvenile courts and adoption agencies, responsible for their care. One hundred sixty children, 63 boys and 97 girls, adopted from an orphanage in the vicinity of our hospital over a period of 13 years are included in this study. There were 104 local and 56 foreign adoptions. Due to sociocultural background in Indian adoptions, males were preferred; whereas the international adoptions mostly depended on human considerations without any specific preference for the sex of the child. On follow-up, all children except three were reported to be physically healthy and well-adjusted emotionally in the new family, and well accepted by the society. Although adoption is not the only solution for an abandoned child, it may open some avenues for the betterment of socially deserted and deprived children. PMID:6684979

  20. Long-term follow-up of surgically treated AIS patients.

    PubMed

    Hill, D; Raso, V J; Moreau, K; Moreau, M; Mahood, J

    2002-01-01

    The aim of this study was to determine the long-term changes in spine and trunk alignment in patients who have undergone scoliosis surgery. Twenty-three (16F; 7M; at age of surgery 15.7 +/- 4.9 years) patients with adolescent idiopathic scoliosis agreed to participate and had posterior-anterior radiographs and surface topography prior to derotation surgery, within 6 months of surgery, at 2 years post-operatively and 5-10 years (mean follow-up period 6.11 +/- 1.6 years) after surgery. Cobb angles, surface trunk rotations, and cosmetic scores were measured at each visit. A questionnaire assessed back appearance and pain at the 5-10 year follow-up. The results of the questionnaire were compared to 25 patients with idiopathic scoliosis who had recently undergone surgery. A paired two-tailed Student's t-test with p=0.05 was used to compare the deformity between visits. The Cobb angle and cosmetic score improved after surgery while the change in trunk rotation was insignificant (p=0.37). Between the two-year and 5-10 year review, the Cobb angle, cosmetic score, and surface trunk rotation significantly increased. Self-perception of appearance and pain were similar to the control group. Surgical correction of scoliosis is not completely maintained during adulthood although the radiographic and surface deterioration does not appear to be clinically significant. PMID:15457781

  1. Remote Monitoring for Follow-up of Patients with Cardiac Implantable Electronic Devices

    PubMed Central

    Morichelli, Loredana; Varma, Niraj

    2014-01-01

    Follow-up of patients with cardiac implantable electronic devices is challenging due to the increasing number and technical complexity of devices coupled to increasing clinical complexity of patients. Remote monitoring (RM) offers the opportunity to optimise clinic workflow and to improve device monitoring and patient management. Several randomised clinical trials and registries have demonstrated that RM may reduce number of hospital visits, time required for patient follow-up, physician and nurse time, hospital and social costs. Furthermore, patient retention and adherence to follow-up schedule are significantly improved by RM. Continuous wireless monitoring of data stored in the device memory with automatic alerts allows early detection of device malfunctions and of events requiring clinical reaction, such as atrial fibrillation, ventricular arrhythmias and heart failure. Early reaction may improve patient outcome. RM is easy to use and patients showed a high level of acceptance and satisfaction. Implementing RM in daily practice may require changes in clinic workflow. To this purpose, new organisational models have been introduced. In spite of a favourable cost:benefit ratio, RM reimbursement still represents an issue in several European countries. PMID:26835079

  2. Protecting the Lunar Heritage Sites from the Effects of Visiting Spacecraft

    NASA Technical Reports Server (NTRS)

    Metzger, Philip; Lane, John E.

    2012-01-01

    The Problem: Rocket exhaust blows soil and rocks over vast distances at velocities upwards of 1 to 3 km/s, and this will be highly abrasive and damaging if it impacts the valuable lunar heritage sites.

  3. Nurse-led follow-up of patients after oesophageal or gastric cardia cancer surgery: a randomised trial.

    PubMed

    Verschuur, E M L; Steyerberg, E W; Tilanus, H W; Polinder, S; Essink-Bot, M-L; Tran, K T C; van der Gaast, A; Stassen, L P S; Kuipers, E J; Siersema, P D

    2009-01-13

    Between January 2004 and February 2006, 109 patients after intentionally curative surgery for oesophageal or gastric cardia cancer were randomised to standard follow-up of surgeons at the outpatient clinic (standard follow-up; n=55) or by regular home visits of a specialist nurse (nurse-led follow-up; n=54). Longitudinal data on generic (EuroQuol-5D, European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30) and disease-specific quality of life (EORTC QLQ-OES18), patient satisfaction and costs were collected at baseline and at 6 weeks and 4, 7 and 13 months afterwards. We found largely similar quality-of-life scores in the two follow-up groups over time. At 4 and 7 months, slightly more improvement on the EQ-VAS was noted in the nurse-led compared with the standard follow-up group (P=0.13 and 0.12, respectively). Small differences were also found in patient satisfaction between the two groups (P=0.14), with spouses being more satisfied with nurse-led follow-up (P=0.03). No differences were found in most medical outcomes. However, body weight of patients of the standard follow-up group deteriorated slightly (P=0.04), whereas body weight of patients of the nurse-led follow-up group remained stable. Medical costs were lower in the nurse-led follow-up group (2600 euro vs 3800 euro), however, due to the large variation between patients, this was not statistically significant (P=0.11). A cost effectiveness acceptability curve showed that the probability of being cost effective for costs per one point gain in general quality-of-life exceeded 90 and 75% after 4 and 13 months of follow-up, respectively. Nurse-led follow-up at home does not adversely affect quality of life or satisfaction of patients compared with standard follow-up by clinicians at the outpatient clinic. This type of care is very likely to be more cost effective than physician-led follow-up. PMID:19066612

  4. Can JWST Follow Up on Gravitational-Wave Detections?

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-02-01

    Bitten by the gravitational-wave bug? While we await Thursdays press conference, heres some food for thought: if LIGO were able to detect gravitational waves from compact-object mergers, how could we follow up on the detections? A new study investigates whether the upcoming James Webb Space Telescope (JWST) will be able to observe electromagnetic signatures of some compact-object mergers.Hunting for MergersStudying compact-object mergers (mergers of black holes and neutron stars) can help us understand a wealth of subjects, like high-energy physics, how matter behaves at nuclear densities, how stars evolve, and how heavy elements in the universe were created.The Laser Interferometer Gravitational-Wave Observatory (LIGO) is searching for the signature ripples in spacetime identifying these mergers, but gravitational waves are squirrelly: LIGO will only be able to localize wave sources to tens of square degrees. If we want to find out more about any mergers LIGO discovers in gravitational waves, well need a follow-up search for electromagnetic counterparts with other observatories.The Kilonova KeyOne possible electromagnetic counterpart is kilonovae, explosions that can be produced during a merger of a binary neutron star or a neutron starblack hole system. If the neutron star is disrupted during the merger, some of the hot mass is flung outward and shines brightly by radioactive decay.Kilonovae are especially promising as electromagnetic counterparts to gravitational waves for three reasons:They emit isotropically, so the number of observable mergers isnt limited by relativistic beaming.They shine for a week, giving follow-up observatories time to search for them.The source location can beeasily recovered.The only problem? We dont currently have any sensitive survey instruments in the near-infrared band (where kilonova emission peaks) that can provide coverage over tens of square degrees. Luckily, we will soon have just the thing: JWST, launching in 2018!JWSTs SearchIntegration time needed for JWSTs NIRCam to detect a kilonova at 200 Mpc, as a function of time since the merger. Different curves correspond to different NIRCam filters. Note that the total time for follow-up is overwhelmingly dominated by things like telescope slew time, rather than by this exposure time. [Bartos et al. 2016]In a recent study, a team of authors led by Imre Bartos (Columbia University) evaluatewhether JWST will be capable of catching these kilonovae if LIGO finds gravitational wave signals.Bartos and collaborators calculate that, given the sensitivity of the different filters on JWSTs Near-Infrared Camera, the instrument should easily be able to detect a kilonova 200 Mpc away (a typical distance at which LIGO might be able to find a neutron-star binary). But theres a catch: 10 deg2 is a really big sky area, and it would take JWST an unfeasible amount of time (days!) to fully cover it.The authors suggest insteadusing a targeted search. Since most mergers are expected to be in or near galaxies, JWST could specifically focus the follow-up search on known galaxies within the searcharea. This approach would bring the total search time down to 12.6 hours, which is within the realm of feasibility. And this time could be reduced even further by concentrating on galaxies most likely to host kilonovae, like those with high star-formation rates.The conclusion: if LIGO is able to detect gravitational waves, JWST will provide an excellent means to follow up on the detection in the attempt toidentify the source.CitationI. Bartos et al 2016 ApJ 816 61. doi:10.3847/0004-637X/816/2/61

  5. Twenty-month follow-up of occlusal carious lesions deemed questionable at baseline

    PubMed Central

    Makhija, Sonia K.; Gilbert, Gregg H.; Funkhouser, Ellen; Bader, James D; Gordan, Valeria V.; Rindal, D. Brad; Qvist, Vibeke; Nørrisgaard, Pia

    2014-01-01

    Background A questionable occlusal caries (QOC) lesion can be defined as an occlusal surface with no radiographic evidence of caries, but caries is suspected because of clinical appearance. In this study, the authors report the results of a 20-month follow-up of these lesions. Methods Fifty-three clinicians from The National Dental Practice-Based Research Network participated in this study, recording lesion characteristics at baseline and lesion status at 20 months. Results At baseline, 1,341 QOC lesions were examined; the treatment that was planned for 1,033 of those at baseline was monitoring (oral hygiene instruction, applying or prescribing fluoride or varnish, or both), and the remaining 308 received a sealant (n = 192) or invasive therapy (n = 116). Of the 1,033 monitored lesions, the clinician continued at the 20-month visit to monitor 927 (90 percent). Clinicians decided to seal 61 (6 percent) of these lesions (mean follow-up, 19 months), and invasively treat 45 (4 percent) of them (mean follow-up, 15 months). Young patient age (< 18 years) (odds ratio = 3.4; 95 percent confidence interval, 1.7–6.8) and the lesion’s being on a molar (odds ratio = 1.8; 95 percent confidence interval, 1.3–2.6) were associated with the clinician’s deciding at some point after follow-up to seal the lesion or treat it invasively. Conclusions Almost all (90 percent) QOC lesions for which the treatment planned at baseline was monitoring still were planned to undergo monitoring after 20 months. This finding suggests that noninvasive management is appropriate for these lesions. Practical Implications Previous study results from baseline indicated a high prevalence for QOC lesions (34 percent). Clinicians should consider long-term monitoring when making treatment decisions about these lesions. PMID:25359642

  6. Controlled two year follow up of rehabilitation for disorders in the neck and shoulders.

    PubMed Central

    Ekberg, K; Bjrkqvist, B; Malm, P; Bjerre-Kiely, B; Axelson, O

    1994-01-01

    OBJECTIVE--To evaluate the effects of an early, active, and multidisciplinary rehabilitation programme for neck and shoulder disorders. METHODS--Primary health care and industrial health care of a nonrandomised, controlled, cohort was followed up over two years in a geographically defined area. The cohort consisted of working people who consulted a physician about disorders of the neck or shoulders from 1 August 1988 to 31 October 1989. Criteria for acceptance; not chronic symptoms, patients had sick leave of no more than four weeks. Disorders were not caused by trauma, infections, malignancy, rheumatic diseases, abuse, or pregnancy. 107 people qualified for the study, 87% were followed up for two years. They were divided into two groups. One group obtained active, multidisciplinary rehabilitation for eight weeks that comprised physical training, information, education, social interaction, and work place visits. Controls were given traditional treatment; physiotherapy, medication, rest, and sick leave. The main outcome measures were: average number of days of sick leave for the two years after rehabilitation, subjective pain on a visual analogue scale, and ratings on seven subscales of the sickness impact profile. RESULTS--At 12 and 24 months of follow up effects of the active rehabilitation programme did not differ from traditional treatment in any of the outcome measures. New work task (P < 0.05) or changed work place (P < 0.001) during the follow up period were associated with decreased sick leave, independent of treatment. CONCLUSIONS--Active, multidisciplinary rehabilitation of neck and shoulder disorders was not more effective than traditional treatment. Changed work conditions were associated with decreased sick leave, independent of type of treatment provided. PMID:7849868

  7. Profile and follow-up of patients with tuberculosis in a priority city in Brazil

    PubMed Central

    Pereira, Jisleny da Cruz; Silva, Marcio Roberto; da Costa, Ronaldo Rodrigues; Guimarães, Mark Drew Crosland; Leite, Isabel Cristina Gonçalves

    2015-01-01

    OBJECTIVE To analyze the cases of tuberculosis and the impact of direct follow-up on the assessment of treatment outcomes. METHODS This open prospective cohort study evaluated 504 cases of tuberculosis reported in the Sistema de Informação de Agravos de Notificação (SINAN – Notifiable Diseases Information System) in Juiz de Fora, MG, Southeastern Brazil, between 2008 and 2009. The incidence of treatment outcomes was compared between a group of patients diagnosed with tuberculosis and directly followed up by monthly consultations during return visits (287) and a patient group for which the information was indirectly collected (217) through the city’s surveillance system. The Chi-square test was used to compare the percentages, with a significance level of 0.05. The relative risk (RR) was used to evaluate the differences in the incidence rate of each type of treatment outcome between the two groups. RESULTS Of the outcomes directly and indirectly evaluated, 18.5% and 3.2% corresponded to treatment default and 3.8% and 0.5% corresponded to treatment failure, respectively. The incidence of treatment default and failure was higher in the group with direct follow-up (p < 0.05) (RR = 5.72, 95%CI 2.65;12.34, and RR = 8.31, 95%CI 1.08;63.92, respectively). CONCLUSIONS A higher incidence of treatment default and failure was observed in the directly followed up group, and most of these cases were neglected by the disease reporting system. Therefore, effective measures are needed to improve the control of tuberculosis and data quality. PMID:25741659

  8. Early-onset schizophrenia: a 15-year follow-up.

    PubMed

    Rpcke, Bernd; Eggers, Christian

    2005-09-01

    The study describes the psychopathological and social outcome of patients treated for schizophrenia in adolescence (mean age at onset 16.0 years/SD 1.52) after a mean follow-up period of 15.4 years (10.2-21.2 years). Out of 55 patients consecutively admitted to hospital, 47 (85 %) could be traced and 39 (71 %) could be re-examined. At follow-up, 33/39 patients (85 %) had had at least one readmission. Full remission of global psychopathological symptoms [Clinical Global Impression (CGI) follow-up. Gender, duration of first inpatient treatment and duration of untreated psychosis were of no predictive value for outcome. The nature of the diagnosis in the first episode strongly predicted the diagnosis given for the whole course after 15 years. In 26/37 cases (70 %), diagnosis at onset and overall diagnoses were the same. Our finding of an incidence of 61% insidious onset is similar to that in adult onset schizophrenia (AOS), but different to very early onset schizophrenia (VEOS), which shows a higher rate of insidious onset, cognitive impairment and poor outcome. Therefore, it seems that VEOS is a special group compared with early onset schizophrenia (EOS) and AOS. PMID:16220219

  9. Follow-up of patients undergoing percutaneous coronary intervention.

    PubMed

    Galassi, Alfredo R; Tamburino, Corrado

    2005-06-01

    Percutaneous coronary intervention (PCI) has become a mainstay in the treatment of patients with coronary artery disease in recent years. Although increasingly complex lesions and higher-risk patients are being successfully treated, restenosis, incomplete revascularization and progression of disease continue to cause a need for a clinical functional assessment, in order to reduce morbidity. Angiographic systematic follow-up, although traditionally considered the gold standard for restenosis and disease progression, should nowadays be considered a valuable approach only to monitor small groups of very high-risk patients. Recurrence of symptoms itself has low sensitivity and specificity in detecting restenosis and myocardial ischemia. Exercise testing may provide useful information on symptoms and functional capacity of the patient; however, it has a low diagnostic power for restenosis and myocardial ischemia with a low sensitivity and specificity. Conversely, the significantly increased sensitivity and specificity obtained by stress nuclear or echocardiographic imaging provide great advantage for the clinical assessment of these patients. Additional advantages of stress imaging are the ability to assess location and extent of myocardial ischemia regardless of symptoms as well as to evaluate patients who are unable to exercise or who have an uninterpretable electrocardiogram. Furthermore, the clear superiority of stress imaging with regard to specificity and predictive value for post-revascularization events makes this functional approach of paramount importance for assessing prognosis of such patients. However, as predictive values of functional stress tests are highly dependent on the pre-test probability of disease, follow-up following PCI should always take into consideration the clinical characteristics of the patient (such as diabetes and age), the angiographic characteristics (severity of disease, myocardium at risk, left ventricular function), the procedural characteristics (length of the lesion, vessel size, number of stents implanted, etc.), symptoms and physical activity of the patient. All these parameters together will assess the risk of the patient and will help to choose a functional appropriate follow-up protocol. PMID:16008159

  10. [Ataxia telangiectasia. Diagnosis and follow-up in 4 cases].

    PubMed

    Monterrubio Ledezma, César Eduardo; Corona Rivera, Alfredo; Corona Rivera, Jorge Román; Rodríguez Casillas, Lourdes Jocelyn; Hernández Rocha, Juan; Barros Nuñez, Patricio; Bobadilla Morales, Lucina

    2013-01-01

    Ataxia telangiectasia (AT) is a chromosomal instability syndrome with autosomal recessive inheritance, it is caused by more than 500 mutations of the ATM gene, which is involved in the cellular response to DNA damage. The diagnosis becomes difficult due to the evolution of the disease, their poor knowledge, and limited access to diagnostic tests. Chromosomal damage induced by ionizing radiation (IR) assay is still a sensitive method for early diagnosis, and it is essential for better management and genetic counseling. This paper shows diagnosis and follow-up in four cases with AT. PMID:23999637

  11. A follow-up neurobiological study: why volunteer?

    PubMed

    Sturges, J S; Sweeney, D R; Pickar, D

    1979-03-01

    There is usually great concern over the use of psychiatric patients for clinical research, as it raises the ethical and legal issues of human dignity and autonomy. In this paper the authors describe and evaluate a follow-up neurobiological study of patients who had been discharged from a psychiatric research ward at least ten months earlier. It is pointed out that such studies are rare and that the writers were provided with the unique opportunity to examine attitudinal and motivational dimensions involved in the patients' agreement to participate in the study. PMID:430528

  12. Root Resorption a 6-Year Follow-up Case Report

    PubMed Central

    Dias, Caroline; Closs, Luciane; Barletta, Fernando; Reston, Eduardo; Tovo, Maximiano F; Lambert, Paula

    2015-01-01

    This paper describes the clinical course of a pediatric patient developing cervical external root resorption (CERR). An 11-year old male patient had sustained dental trauma and was diagnosed with crown fracture affecting the incisal and middle thirds of the maxillary right permanent central incisor and the maxillary right permanent lateral incisor with pulp exposure and CERR after 24 months. Diagnosis and treatment of CERR are a challenge for dental practitioners. In this case, preservation of natural dentition is shown as a successful treatment in a 6-year follow-up. PMID:25870717

  13. Second primary lung cancer: importance of long term follow up.

    PubMed Central

    van Bodegom, P C; Wagenaar, S S; Corrin, B; Baak, J P; Berkel, J; Vanderschueren, R G

    1989-01-01

    Review of histopathological and clinical data showed that 153 patients at one hospital developed a second primary lung cancer during 1980-6, 10% of all those with lung carcinoma. There were 64 synchronous tumours (interval less than one year) and 89 metachronous tumours (interval over one year). The average interval between metachronous tumours was 6.1 years. The criteria for diagnosing a second primary lung cancer were any of the following: (1) different histological type; (2) different lobe; (3) interval between the two tumours of at least three years. The incidence of second primary tumours increases with survival, and close follow up is required for their early detection. PMID:2595619

  14. Geomorphic stability field reconnaissance site visit, Canonsburg, Pennsylvania, December 1992. Final report

    SciTech Connect

    1993-05-01

    To license the Canonsburg site, the US Nuclear Regulatory Commission (NRC) has required that geomorphic stability be demonstrated for the stream banks and slopes around the perimeter of the site for 200 years. Based on a study of the stream channel and slopes, it has been determined that due to recent human intervention, the required geomorphic stability cannot now be achieved without installation of erosion protection works and continued monitoring of the site. The Pittsburgh District Corps of Engineers has plans to channelize Chartiers Creek and install erosion protection rock within the next 5 or 6 years, if local government agencies raise the necessary matching funds. Much of the stream bank and slope adjacent to the ``fenced in`` western area of the site is anticipated to remain geomorphically stable for more than 20 years, but less than 200 years without human intervention. Therefore in much of this area, the Corps of Engineers will have adequate time to perform its work without jeopardizing the integrity of the controlled area. In contrast, two approximately 200-foot (ft) (60-meter [m]) long portions of the stream channel located north-northwest of the encapsulation area are subject to active stream erosion that threatens the integrity of the controlled area. These areas should be fixed by installation of erosion protection rock within the next 2 years.

  15. Language outcomes of toddlers with autism spectrum disorders: a two year follow-up.

    PubMed

    Paul, Rhea; Chawarska, Katarzyna; Cicchetti, Domenic; Volkmar, Fred

    2008-04-01

    Thirty-seven children 15-25 months of age received clinical diagnoses of autism spectrum disorder (ASD) and were re-evaluated two years later. All subjects were judged to have retained a diagnosis of ASD at the follow-up evaluation. Communication scores for the group as a whole during the first visit were significantly lower than nonverbal IQ. However, by the second visit, verbal and nonverbal scores were no longer significantly different. The group was divided into two subgroups, based on expressive language (EL) outcome at the second visit. The two groups were similar in the second year of life in terms of expressive communication skills and autistic symptoms, except for a trend toward more stereotypic and repetitive behavior in the worse outcome group. By the second visit, however, the groups differed significantly on all standard measures of expression and reception, as well as on autistic symptomotology and nonverbal IQ. When assessed during their second year, children who ended up in the better outcome group showed higher average nonverbal cognitive level, receptive language (RL) scores, number of sounds and words produced, use of symbolic play schemes, and response to joint attention bids. Regression analysis revealed that the variables for which significant differences between the two outcome groups in their second year of life were found provided significant prediction of EL outcome at age four. Stepwise regression identified RL and presence of stereotypic and repetitive at the first visit as significantly associated with EL outcome. Implications of these findings for early identification and intervention are discussed. PMID:19360656

  16. Follow-up of mild hypothyroidism in a nursing home.

    PubMed

    Drinka, P J; Nolten, W E; Voeks, S K; Langer, E H

    1991-03-01

    The course of untreated mild hypothyroidism was followed in 67 nursing home residents (mean age 78 years). The diagnosis was based on a normal free thyroxine index (FTI) and elevated thyrotropin concentration (TSH 4.6 to 15.0 microIU/mL, nl less than or equal to 4.5 microIU/mL. FTI and FSH were measured in follow-up 42-378 (mean 161) days after the diagnosis of mild hypothyroidism had been made. In 45 patients initial TSH was less than 6.8 microIU/mL; in 23 of these subjects TSH returned to normal during the observation period, whereas in 22 TSH remained elevated. In all 22 residents whose initial TSH was greater than 6.8 microIU/mL, TSH remained elevated at follow-up. In 4 subjects whose initial TSH concentrations ranged from 5.0 to 9.6 microIU/mL, FTI fell below normal 91-141 days after the diagnosis of mild hypothyroidism was made. Clinical progression of the signs or symptoms of hypothyroidism was not detected in the 4 patients who developed hypothyroxinemia. Three demonstrated positive thyroid antibody titers, and 1 had myasthenia gravis. These observations suggest a need for replacement therapy in debilitated patients with mild hypothyroidism and evidence of thyroid autoimmunity. PMID:2005340

  17. Long-term follow-up of atomic bomb survivors.

    PubMed

    Sakata, Ritsu; Grant, Eric J; Ozasa, Kotaro

    2012-06-01

    The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1 Gy), cancer incidence (47% at 1 Gy), death due to leukemia (310% at 1 Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public. PMID:22440534

  18. SZ Follow-up of New Planck-Selected Clusters

    NASA Astrophysics Data System (ADS)

    Rodriguez Gonzalvez, Carmen; Planck Collaboration; Consortium, AMI

    2013-01-01

    The Planck satellite has now surveyed the entire sky more than four times. The nominal mission of two full sky surveys is to be released to the public in early 2013. Hundreds of new cluster candidates are being identified by the Planck collaboration, which will be used to measure the cluster mass function and constrain cosmological parameters. However, achieving the mission's full potential to constrain cosmology depends on identifying spurious cluster candidates and measuring cluster masses accurately, amongst other things. Extensive follow-up of blind detections in the Planck survey and multi-wavelength studies are therefore crucial. We present our initial results on high-resolution SZ follow-up observations with AMI and the SZA instruments of a cluster sample comprising some well-known clusters as well as some new, Planck-selected massive, high-z clusters. We investigate possible biases and discrepancies in the measurements, assess the level of spurious detections and provide the first insight into the dynamical state of the new SZ-selected systems.

  19. Gastric and Duodenal Stents: Follow-Up and Complications

    SciTech Connect

    Pinto Pabon, Isabel Teresa; Paul Diaz, Laura; Ruiz de Adana, Juan Carlos; Lopez Herrero, Julio

    2001-05-15

    Purpose: To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.Methods: A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.Results: All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE {+-} 4.6).Conclusions: The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.

  20. Serial extraction: 20 years of follow-up

    PubMed Central

    de ALMEIDA, Renato Rodrigues; de ALMEIDA, Marcio Rodrigues; OLTRAMARI-NAVARRO, Paula Vanessa Pedron; CONTI, Ana Cludia de Castro Ferreira; NAVARRO, Ricardo de Lima; de SOUZA, Karen Regina Siqueira

    2012-01-01

    This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment. PMID:23032213

  1. Follow-up of prenatally diagnosed unilateral hydronephrosis.

    PubMed

    Thorup, J; Lenz, K; Rabol, A; Passalides, A; Nielsen, O H

    1996-12-01

    Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function of the affected kidney was proposed. However, the strategy of treatment after prenatally diagnosed hydronephrosis is still controversial. We studied 28 consecutive children with suspected unilateral pelviureteral junction obstruction and a normal contralateral kidney. The overall follow-up period varied between 2.5 months and 6 years (median 2 years). Eleven children had normal function of the hydronephrotic kidney and were managed nonoperatively throughout the follow-up period. None of these demonstrated any symptoms and the renal function remained normal. A further 4 children with normal function of the affected kidney were managed nonoperatively, but later had a pyeloplasty performed because of either symptoms or deterioration of renal function. Eleven children had a pyeloplasty performed after the first renography showed that the hydronephrotic kidney provided less than 40% of total renal function. The age at pyeloplasty was 3 weeks- 7 months (median 6 weeks). In all cases but 1 the function of the affected kidney improved. Two patients with impaired hydronephrotic renal function were not operated upon. Our results indicate no need to change the strategy of treatment. PMID:24057464

  2. [Follow-up of patients with inflammatory bowel disease].

    PubMed

    Garca-Lpez, Santiago

    2013-10-01

    Multiple data were presented on inflammatory bowel disease (IBD) in Digestive Disease Week (DDW). Of particular interest to gastroenterologists were those on novel treatments and information on safety. Other data, such as those relating to disease "follow-up", were possibly of lesser interest. However, the information reported this year was, in my opinion, highly important, because it could lead to significant changes in clinical practice. Thus, results presented strongly suggest that patients with asymptomatic IBD, specifically Crohn's disease (CD), often develop complications during their clinical course. Moreover, this is especially true in patients with CD and biological signs of inflammation, despite being asymptomatic. In addition, it seems clear that the absence of symptoms does not imply an absence of inflammation. These observations indicate a dual practical message: patients should be followed-up and objectively evaluated. Multiple data were presented on how to objectively evaluate disease activity in IBD. The prognostic value and objectivity of endoscopy has been reaffirmed, specifically with new data on the only validated index, the UCEIS, in ulcerative colitis. Together with endoscopy, the role of less invasive techniques such as imaging tests (magnetic resonance enterography, computed tomography enterography and even echography, with and without contrast agent) and fecal markers has been reaffirmed in several conditions and these techniques have a certain predictive value. Finally, many studies were reported that confirm the therapeutic activity of levels of anti-TNF and its antibodies in certain conditions and with some limitations. PMID:24160950

  3. The use of on-site visits to assess compliance and implementation of quality management at hospital level

    PubMed Central

    Wagner, C.; Groene, O.; Dersarkissian, M.; Thompson, C.A.; Klazinga, N.S.; Arah, O.A.; Suol, R.

    2014-01-01

    Objective Stakeholders of hospitals often lack standardized tools to assess compliance with quality management strategies and the implementation of clinical quality activities in hospitals. Such assessment tools, if easy to use, could be helpful to hospitals, health-care purchasers and health-care inspectorates. The aim of our study was to determine the psychometric properties of two newly developed tools for measuring compliance with process-oriented quality management strategies and the extent of implementation of clinical quality strategies at the hospital level. Design We developed and tested two measurement instruments that could be used during on-site visits by trained external surveyors to calculate a Quality Management Compliance Index (QMCI) and a Clinical Quality Implementation Index (CQII). We used psychometric methods and the cross-sectional data to explore the factor structure, reliability and validity of each of these instruments. Setting and Participants The sample consisted of 74 acute care hospitals selected at random from each of 7 European countries. Main Outcome Measures The psychometric properties of the two indices (QMCI and CQII). Results Overall, the indices demonstrated favourable psychometric performance based on factor analysis, item correlations, internal consistency and hypothesis testing. Cronbach's alpha was acceptable for the scales of the QMCI (?: 0.740.78) and the CQII (?: 0.820.93). Inter-scale correlations revealed that the scales were positively correlated, but distinct. All scales added sufficient new information to each main index to be retained. Conclusion This study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions. PMID:24671121

  4. Long-term Follow-up After Bariatric Surgery

    PubMed Central

    Puzziferri, Nancy; Roshek, Thomas B.; Mayo, Helen G.; Gallagher, Ryan; Belle, Steven H.; Livingston, Edward H.

    2015-01-01

    IMPORTANCE Bariatric surgery is an accepted treatment for obesity. Despite extensive literature, few studies report long-term follow-up in cohorts with adequate retention rates. OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss, type 2 diabetes, hypertension, and hyperlipidemia in severely obese adults. EVIDENCE REVIEW MEDLINE and Cochrane databases were searched from 1946 through May 15, 2014. Search terms included bariatric surgery, individual bariatric procedures, and obesity. Studies were included if they described outcomes for gastric bypass, gastric band, or sleeve gastrectomy performed on patients with a body mass index of 35 or greater, had more than 2 years of outcome information, and had follow-up measures for at least 80% of the initial cohort. Two investigators reviewed each study and a third resolved study inclusion disagreements. FINDINGS Of 7371 clinical studies reviewed, 29 studies (0.4%, 7971 patients) met inclusion criteria. All gastric bypass studies (6 prospective cohorts, 5 retrospective cohorts) and sleeve gastrectomy studies (2 retrospective cohorts) had 95% confidence intervals for the reported mean, median, or both exceeding 50% excess weight loss. This amount of excess weight loss occurred in 31% of gastric band studies (9 prospective cohorts, 5 retrospective cohorts). The mean sample-size–weighted percentage of excess weight loss for gastric bypass was 65.7% (n = 3544) vs 45.0% (n = 4109) for gastric band. Nine studies measured comorbidity improvement. For type 2 diabetes (glycated hemoglobin <6.5% without medication), sample-size–weighted remission rates were 66.7% for gastric bypass (n = 428) and 28.6% for gastric band (n = 96). For hypertension (blood pressure <140/90 mm Hg without medication), remission rates were 38.2% for gastric bypass (n = 808) and 17.4% for gastric band (n = 247). For hyperlipidemia (cholesterol <200 mg/dL, high-density lipoprotein >40 mg/dL, low-density lipoprotein <160 mg/dL, and triglycerides <200 mg/dL), remission rates were 60.4% for gastric bypass (n = 477) and 22.7% for gastric band (n = 97). CONCLUSIONS AND RELEVANCE Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results. Gastric bypass has better outcomes than gastric band procedures for long-term weight loss, type 2 diabetes control and remission, hypertension, and hyperlipidemia. Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections. PMID:25182102

  5. [Audiological assessment and follow-up after bacterial meningitis].

    PubMed

    Couto, M I; Monteiro, S R; Lichtig, I; Casella, E B; Carvallo, R M; de Navarro, J M

    1999-09-01

    Hearing loss is the more frequent sequel of bacterial meningitis in children. This study describes the audiological profile (peripheric and central) of 89 children admitted to the hospital wards with the diagnosis of bacterial meningitis. Those children attended audiological follow up, after their hospital discharge, and were submitted to audiological tests. The results showed that 85.4% among them presented normal hearing in both ears 10.1% presented bilateral neurosensorial hearing loss and 4.5% presented unilateral neurosensorial hearing loss. The results from the auditory processing skills assessment showed that 10% of those children presented auditory localization and recognition of sentences with competitive messages (Paediatric Sentences Identification-ipsilateral) disorders. PMID:10751916

  6. Injury rehabilitation: a qualitative follow-up study.

    PubMed

    Evans, Lynne; Hardy, Lew

    2002-09-01

    The current qualitative follow-up study was conducted to enhance the interpretability and meaningfulness of the findings emerging from a 5-week goal-setting intervention study with injured athletes. Semistructured interviews were conducted with a sample of 9 injured athletes, 3 from each of the three intervention study groups (goal-setting, social support control, and control), and cross-case summaries were inductively derived. The study highlighted the importance of individual difference variables, and the interaction of person and situational variables, including support from coaches and club, inability to train, weight gain, slowness of progress, physiotherapist support, and the importance of long-term outcome goals. Possible mechanisms for the observed effects of the goal-setting intervention included the effects of goal-setting on self-efficacy, attributions, perceptions of control, and attention. PMID:12230339

  7. The role of imaging in the follow up of meningiomas.

    PubMed Central

    Hodgson, T J; Kingsley, D P; Moseley, I F

    1995-01-01

    A retrospective study of 60 patients with meningiomas was conducted to evaluate the role of imaging in postoperative follow up. Using case notes and imaging studies, requests were assessed with reference to the indications for imaging radiological findings and effect on patient management. Patients were divided into three groups: 34 who had undergone a macroscopically complete resection, 18 with known residual tumour, and eight in whom surgery was not performed. These 60 patients underwent a total of 165 CT and 11 MRI studies. In the complete resection group only two patients developed a recurrence, both having highly suggestive symptoms or signs. It is concluded that routine imaging is not indicated in asymptomatic patients after complete tumour clearance. Both CT and MRI contribute to patient management in those with residual disease, MRI probably being the imaging method of choice. PMID:8530945

  8. Management and follow up of extraadrenal phaeochromocytoma

    PubMed Central

    2014-01-01

    Introduction The prevalence of phaeochromocytoma (PCC) in patients with hypertension is 0.10.6% and about 10% of PCCs are detected in extraadrenal tissue. The diagnosis and therapy of this rare disease detected as a retroperitoneal tumor mass can be difficult for clinicians. Material and methods A PubMed database was searched for the peerreviewed articles, the listed articles until Dec 2012 were included. Following key words were used: extraadrenal phaeochromocytoma, paraganglioma, diagnosis, therapy, surgery, genetic analysis, and SDH mutation. Results Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are first choice imaging tools for PCC (sensitivity 90100%). For the validation of the diagnosis or follow up, the functional imaging 123Imetaiodobenzylguanidine (MIBG) or Fluorine18Ldihydroxyphenylalanine (18FDOPA) positron emission tomography (excellent specificity and sensitivity of 90100% in detection of small tumors >12 cm) are used. Laparoscopic surgery with complete resection is a safe and a first choice approach. The conversion (about 5%) to direct open operation was needed for large lesions (>8 cm) with the suspicion of malignancy. Currently, there are no histological criteria for distinguishing benign and malignant tumors. The genetic testing (Sanger DNA sequencing) for hereditary syndromes (von HippelLindau, neurofibromatosis, etc.) is used for prediction of malignancy and recurrence. All patients should get individual and riskadapted genetic analysis and consultation, including family members. The rate of malignancy in ePCC is about 30% (PCC about 510%). In patients with proven SDHB germline mutations, higher malignancy rate, multiple PCCs and recurrences are likely. A stringent lifelong clinical followup is recommended in these cases. Patients with syndromic hereditary forms should be screened for other often associated neoplasms. Conclusions New imaging tools and genetic analysis are crucial to improve the diagnosis and prognosis of phaeochromocytoma. PMID:25140230

  9. SUBMILLIMETER FOLLOW-UP OF WISE-SELECTED HYPERLUMINOUS GALAXIES

    SciTech Connect

    Wu Jingwen; Eisenhardt, Peter R. M.; Stern, Daniel; Assef, Roberto; Tsai, Chao-Wei; Cutri, Roc; Griffith, Roger; Jarrett, Thomas; Sayers, Jack; Bridge, Carrie; Benford, Dominic; Blain, Andrew; Petty, Sara; Lake, Sean; Bussmann, Shane; Comerford, Julia M.; Evans, Neal J. II; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam; and others

    2012-09-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare ({approx}1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 {mu}m, yet are clearly detected at 12 and 22 {mu}m. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 {mu}m, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 {mu}m, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10{sup 13} L{sub Sun }. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  10. Follow-up of children born after ICSI.

    PubMed

    Van Steirteghem, A; Bonduelle, M; Devroey, P; Liebaers, I

    2002-01-01

    The comparison of outcome of assisted reproductive technology (ART) children and naturally conceived children may be hampered by the difference in characteristics of the infertile patients such as age and genetic risks. Follow-up studies are further hampered by the type of neonatal surveillance protocol, the number of individuals lost to follow-up, the size of the cohort study, and the lack of standardization, for example to define major anomalies. The limited available data on ICSI fetal karyotypes reveal that, in comparison with a general neonatal population, there is: (i) a slight but significant increase in de-novo sex chromosomal aneuploidy (0.6% instead of 0.2%) and structural autosomal abnormalities (0.4% instead of 0.07%); and (ii) an increased number of inherited (mostly from the infertile father) structural aberrations. Available data indicate that in 8319 liveborn ICSI children, the mean percentage who do not originate from singleton pregnancies was 40% (range 32.6-60.8% according to centre). Most multiples are twins, but there are also 4.4% triplets (in one survey 13.2%). This substantial increase in multiple pregnancies must be considered the most important complication of ART. The different percentages of major and minor congenital malformations cannot be compared, but overall the data in large and reliable surveys does not indicate a higher rate of malformations in ICSI children than in naturally conceived children. To date, only three studies have examined the medical and developmental outcome of ICSI children at 1 and 2 years. These do not reveal obvious problems, but in future further comparison of matched cohorts of children and case-control studies are needed before final conclusions can be drawn. PMID:12099626

  11. Submillimeter Follow-Up of WISE-Selected Hyperluminous Galaxies

    NASA Technical Reports Server (NTRS)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R.; Stern, Daniel; Petty, Sara; Assef, Roberto; Bussmann, Shane; Comerford, Julia M.; Cutri, Roc; Evans, Neal J., II; Griffith, Roger; Jarrett, Thomas; Lake, Sean; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam; Weiner, Benjamin; Wright, Edward L.; Yan, Lin

    2012-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approx.1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 microns, yet are clearly detected at 12 and 22 microns. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 microns, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 microns, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60 C120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) Stellar Luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  12. Submillimeter Follow-up of Wise-Selected Hyperluminous Galaxies

    NASA Technical Reports Server (NTRS)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R. M.; Stern, Daniel; Petty, Sara; Assef, Roberto; Bussmann, Shane; Comerford, Julia M.; Cutri, Roc; Evans, Neal J., II; Griffith, Roger; Jarrett, Thomas; Lake, Sean; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam

    2013-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approximately 1000 all-sky) population of galaxies at high redshift (peaks at zeta = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 micrometers, yet are clearly detected at 12 and 22 micrometers. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (zeta greater than 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 micrometers, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 micrometers, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) solar luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  13. Submillimeter Follow-up of WISE-selected Hyperluminous Galaxies

    NASA Astrophysics Data System (ADS)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R. M.; Stern, Daniel; Petty, Sara; Assef, Roberto; Bussmann, Shane; Comerford, Julia M.; Cutri, Roc; Evans, Neal J., II; Griffith, Roger; Jarrett, Thomas; Lake, Sean; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam; Weiner, Benjamin; Wright, Edward L.; Yan, Lin

    2012-09-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (~1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 ?m, yet are clearly detected at 12 and 22 ?m. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 ?m, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 ?m, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 1013 L ?. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  14. The LCOGT Near Earth Object (NEO) Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim; Gomez, Edward; Christensen, Eric; Larson, Steve

    2014-11-01

    Las Cumbres Observatory Global Telescope (LCOGT) network is a planned homogeneous network of over 35 telescopes at 6 locations in the northern and southern hemispheres. This network is versatile and designed to respond rapidly to target of opportunity events and also to do long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). The telescope network is now operating and observations are being executed remotely and robotically.I am using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS), NEOWISE and PanSTARRS (PS1). Over 600 NEO candidates have been targeted so far this year with 250+ objects reported to the MPC, including 70 confirmed NEOs. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects in order to improve the orbits and determine the rotation periods. This will be extended to obtain more light curves of other NEOs which could be Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) targets. Recent results have included the first period determination for the Apollo 2002 NV16 and our first NEO spectrum from the FLOYDS spectrographs on the LCOGT 2m telescopes obtained for 2012 DA14 during the February 2013 closepass.

  15. A follow-up study of agricultural chemical production workers

    SciTech Connect

    Sathiakumar, N.; Delzell, E.; Austin, H.; Cole, P. )

    1992-01-01

    This retrospective follow-up study evaluated the mortality experience of 4,323 men employed at a plant in Alabama (AL) that manufactures agricultural and other chemicals. On average, there were 18 years of follow-up per subject during the study period of 1951 to 1987. The observed numbers of deaths among cohort members were compared with the numbers expected on the basis of United States (US) and AL general population mortality rates. The all causes standardized mortality ratio (SMR), computed using US rates as the referent, was 97 (233 observed/240 expected deaths) for whites and 68 (47/69) for blacks. White subjects had more than expected deaths from buccal cavity and pharynx (BCP) cancer (SMR = 388; 95% confidence interval (CI) = 125-905) and from esophageal cancer (SMR = 417; 112-1,067). Their lung cancer mortality rate was 50% higher than the rate of US white men and 14% higher than the rate of AL white men. Each of these three cancers has strong nonoccupational determinants, the roles of which were not assessed and which may have been responsible in whole or in part for the observed increases. The excesses of lung and esophageal cancer were concentrated among short-term employees, an observation which also argues against a causal link with occupational factors. Black men experienced no increased mortality from BCP, esophageal or lung cancer, but results for blacks were imprecise. For white and black subjects combined, there were 3 observed versus 0.62 expected deaths due to soft tissue sarcoma (p = 0.05). The job histories of subjects with this type of cancer did not suggest any shared occupational exposure.

  16. Percutaneous closure of secundum type atrial septal defects: More than 5-year follow-up

    PubMed Central

    Snijder, Roel JR; Suttorp, Maarten J; Berg, Jurrin M Ten; Post, Martijn C

    2015-01-01

    AIM: To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect (ASD) closure in adults. METHODS: All patients who underwent percutaneous closure of an ASD in the St. Antonius Hospital, Nieuwegein, The Netherlands, between February 1998 and December 2006 were included. Percutaneous closure took place under general anaesthesia and transesophageal echocardiographic monitoring. Transthoracic echocardiography (TTE) was performed 24 h post-procedure to visualize the device position and to look for residual shunting using color Doppler. All complications were registered. All patients were invited for an outpatient visit and contrast TTE more than 5-years after closure. Efficacy was based on the presence of a residual right-to-left shunt (RLS), graded as minimal, moderate or severe. The presence of a residual left-to-right shunt (LRS) was diagnosed using color Doppler, and was not graded. Descriptive statistics were used for patients characteristics. Univariate analysis was used to identify predictors for residual shunting. RESULTS: In total, 104 patients (mean age 45.5 17.1 years) underwent percutaneous ASD closure using an Amplatzer device (ASO) in 76 patients and a Cardioseal/Starflex device (CS/SF) in 28 patients. The mean follow-up was 6.4 3.4 years. Device migration occurred in 4 patients of whom two cases occurred during the index hospitalization (1 ASO, 1 CS/SF). The other 2 cases of device migration occurred during the first 6 mo of follow-up (2 CS/SF). The recurrent thrombo-embolic event rate was similar in both groups: 0.4% per follow-up year. More than 12 mo post-ASD closure and latest follow-up, new-onset supraventricular tachyarrhythmias occurred in 3.9% and 0% for the ASO and CS/SF group, respectively. The RLS rate at latest follow-up was 17.4% (minimal 10.9%, moderate 2.2%, severe 4.3%) and 45.5% (minimal 27.3%, moderate 18.2%, severe 0%) for the ASO- and CS/SF groups, respectively. There was no residual LRS in both groups. CONCLUSION: Percutaneous ASD closure has good long-term safety and efficacy profiles. The residual RLS rate seems to be high more than 5 years after closure, especially in the CS/SF. Residual LRS was not observed. PMID:25810815

  17. Ten-year follow-up of endovascular aneurysm treatment with Talent stent-grafts.

    PubMed

    Pitton, Michael B; Scheschkowski, Tobias; Ring, Markus; Herber, Sascha; Oberholzer, Katja; Leicher-Dber, Annegret; Neufang, Achim; Schmiedt, Walther; Dber, Christoph

    2009-09-01

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 +/- 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 +/- 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 +/- 4.7 months. Mean survival and freedom from any event was 66.7 +/- 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks (Delta at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion, endovascular aneurysm treatment with Talent stent-grafts demonstrated encouraging long-term results with moderate secondary intervention rates. Primary occlusion of all aortic side branches reduced the incidence of large endoleaks. Large endoleaks significantly impaired aneurysm shrinkage, whereas small endoleaks did not. PMID:19636615

  18. Ten-Year Follow-Up of Endovascular Aneurysm Treatment with Talent Stent-Grafts

    SciTech Connect

    Pitton, Michael B. Scheschkowski, Tobias; Ring, Markus; Herber, Sascha; Oberholzer, Katja; Leicher-Dueber, Annegret; Neufang, Achim; Schmiedt, Walther; Dueber, Christoph

    2009-09-15

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 {+-} 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 {+-} 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 {+-} 4.7 months. Mean survival and freedom from any event was 66.7 {+-} 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks ({Delta} at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion, endovascular aneurysm treatment with Talent stent-grafts demonstrated encouraging long-term results with moderate secondary intervention rates. Primary occlusion of all aortic side branches reduced the incidence of large endoleaks. Large endoleaks significantly impaired aneurysm shrinkage, whereas small endoleaks did not.

  19. The NIH Office of Biotechnology Activities Site Visit Program: Observations About Institutional Oversight of Recombinant and Synthetic Nucleic Acid Molecule Research

    PubMed Central

    Bayha, Ryan; Harris, Kathryn L.; Shipp, Allan C.; Corrigan-Curay, Jacqueline; Wolinetz, Carrie D.

    2015-01-01

    Institutions that receive National Institutes of Health (NIH) funding for research involving recombinant or synthetic nucleic acid molecules are required, as a term and condition of their funding, to comply with the NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines) (NIH, 2013). Under the NIH Guidelines, institutions must establish and register an Institutional Biosafety Committee (IBC) with the NIH. The IBC is then responsible for reviewing and approving research projects subject to the NIH Guidelines. The IBC review of projects involving recombinant or synthetic nucleic acid molecules is critical to ensuring that such research is conducted in a safe and responsible manner. In 2006, staff from NIH began conducting educational site visits to institutions that had an IBC registered with NIH. The purpose of these site visits is to assist IBCs with their institutional programs of oversight for recombinant or synthetic nucleic molecules. Based on our findings, the site visit program has been beneficial to institutional biosafety programs. The information gathered during the site visits has allowed NIH to tailor its educational materials to help institutions address their oversight challenges. Additionally, since NIHs visits are primarily educational in nature, we have been able to foster a positive environment in which IBC members and staff feel comfortable reaching out to NIH for advice and assistance. PMID:26161045

  20. Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

    PubMed Central

    Peletz, Rachel; Simuyandi, Michelo; Simunyama, Martin; Sarenje, Kelvin; Kelly, Paul; Clasen, Thomas

    2013-01-01

    Effective household water treatment can improve drinking water quality and prevent disease if used correctly and consistently over time. One year after completion of a randomized controlled study of water filters among households in Zambia with children < 2 years old and mothers who were human immunodeficiency virus (HIV)-positive, we conducted a follow-up study to assess use and performance of new filters distributed at the conclusion of the study; 90% of participating households met the criteria for current users, and 75% of participating households had stored water with lower levels of fecal contamination than source water. Microbiologically, the filters continued to perform well, removing an average of 99.0% of fecal indicator bacteria. Although this study provides some encouraging evidence about the potential to maintain high uptake and filter performance, even in the absence of regular household visits, additional research is necessary to assess whether these results can be achieved over longer periods and with larger populations. PMID:24100635

  1. Radiographic follow-up analysis of Brnemark dental implants.

    PubMed

    Pikner, Solweig Sundn

    2008-01-01

    Radiography plays an important role in clinical routine practice and in research projects evaluating dental implants, among them Brnemark System. Presence of a peri-implant radiolucency has been used in studies as a criterion for implant failure without knowledge of its diagnostic accuracy. More precise determination, whether implants are osseointegrated or not, can be achieved if prosthetic constructions are detached to test implant stability. Such an approach is time-consuming and cumbersome. Hence, the accuracy in radiographic diagnosis of clinical instability has to be evaluated. Further, radiography is a commonly used diagnostic tool for monitoring marginal bone loss. Little is known about the observer variation. Long-term follow-up studies have shown conventional implant therapy to be a reliable procedure with few complications and minor average bone loss. Lately, studies have shown progressive bone loss in higher frequencies. When testing accuracy in diagnosis of clinical instability in intra-oral radiographs, it was found to be as good as of many other radiographic procedures, e.g. caries diagnosis. Possibility of predicting instability, however, can be low in populations with low prevalence of implants showing loss of osseointegration. Intra-observer variation was found to be the largest source of the total variation when studying inter- and intra-observer variability in radiographic bone level assessments. The number of radiographs in which individual implants were displayed had an influenced on intra-observer variation, while radiographic density and increased bone loss influenced the total inter-observer variation. Reliability can be improved by multiple readings by one observer or, even better, by letting several observers make several, independent readings, this limits the effect of a single observer who may be an outlier. Marginal bone level was assessed in 640 patients with a radiographic follow-up of > or = 5 years. The number of implants with a mean bone level of > or = 3 mm below the fixture-abutment connection increased from 2.8% at prosthesis insertion to 17.2% after 15 years. Implant-based bone loss was as a mean 0.8 mm (SD 0.8) after 5 years, followed by only minor average changes. Mean bone loss on patient level followed a similar pattern. Disregarding of follow-up time, altogether 183 implants showed a bone loss > or = 3 mm from prosthesis insertion to last examination, most of them in totally edentulous patients. Seventy of the 183 implants were found in 19 of the 107 patients. Hence, there seems to be a clustering effect. For the entire group of patients significantly larger bone loss was found the older the patient was at surgery and for lower jaw implants. Placement of the implant within the prosthetic construction, regardless of jaw-type, was found to be a predictor of a bone loss > or = 2 mm with minor bone loss around implants placed in an end position. Other predictors were age and jaw-type. The number of intra-oral radiographs per examination, and more importantly, radiographic examinations can be reduced without jeopardizing good clinical management, a statement valid also for Brnemark implants with advanced bone loss. To conclude, conventional implant treatment can still be regarded as a reliable and safe procedure. PMID:18652086

  2. Longitudinal Assessment of Blood Pressure in School-Aged Children: A 3-Year Follow-Up Study.

    PubMed

    Marcovecchio, M L; Mohn, A; Diddi, G; Polidori, N; Chiarelli, F; Fuiano, N

    2016-02-01

    The purpose of this study was to assess the prevalence of abnormal blood pressure in a population of school children during a 3-year follow-up period and its relationship with obesity. Anthropometric and blood pressure data were collected from a population of Italian school children during three consecutive years. During each year blood pressure measurements were repeated three times, at intervals of 1 week. A total of 564 school-children [311 boys; mean (SD) age 8.8 ± 1.4 years] were recruited. During each year, systolic and diastolic blood pressure decreased from visit 1 to visit 3 (p < 0.001). This was associated with a decline in the percentage of prehypertension/hypertension from visit 1 to visit 3. An abnormal blood pressure value in at least one study visit was found in 8.8-17 % of children, whereas the prevalence of hypertension at all three study visits was between 5.2 and 7.8 %, and that of prehypertension at all three visits was between 2.8 and 3.8 %. High blood pressure was more frequent in obese children. In this population of school children the percentage of prehypertension/hypertension remarkably varied when based on one versus three annual assessments, thus emphasizing the importance of repeated measurement before making a diagnosis of abnormal blood pressure. Adiposity was confirmed to be a determinant of high blood pressure. PMID:26439942

  3. Determinants of First Antenatal Care Visit by Pregnant Women at Community Based Education, Research and Service Sites in Northern Uganda

    PubMed Central

    TURYASIIMA, M.; TUGUME, R.; OPENY, A.; AHAIRWOMUGISHA, E.; OPIO, R.; NTUNGUKA, M.; MAHULO, N.; AKERA, P.; ODONGO-AGINYA, E.

    2015-01-01

    Background Antenatal care (ANC) aims mainly at prevention, early detection and management of general medical and pregnancy associated disorders. Early booking is recommended for maximum utilisation. Objective To investigate the determinants of first ANC visit and trimesters at which pregnant mothers enrol for ANC at the COBERS sites of Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Five community based education, research and service sites (COBERS) of Atiak, Madi Opei, Mungula, Namukora and Pajule health centre fours (HC IV) in the five respective districts of Amuru, Lamwo, Adjumani, Kitgum and Pader, Northern Uganda, from April to July 2013. Subjects Four hundred and seventeen (417) pregnant women attending antenatal care (ANC) in five health centers and 10 purposively selected midwives were interviewed using questionnaires. Results Of the 417 respondents, only 11.5% (n = 48) had their first ANC at the recommended period of 016 weeks. Prevalence of late entry to ANC was 88.5% (n = 369). Mean gestational age at booking was 22.65.7 weeks. Paternal level of education, outcome of previous pregnancy, previous ANC attendance, weeks of amenorrhea, convenience of opening hours at ANC facility, commuting distance from home to health facility, knowing the right time for ANC enrollment, and pregnancy planning remained significant predictors governing early booking. Conclusion Late ANC booking is still a major public health concern that demands public enlightenment, and paternal education coupled with women empowerment will reduce the magnitude of the problem. PMID:26640281

  4. The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-Year Follow-up

    PubMed Central

    Riddle, Mark A.; Yershova, Kseniya; Lazzaretto, Deborah; Paykina, Natalya; Yenokyan, Gayane; Greenhill, Laurence; Abikoff, Howard; Vitiello, Benedetto; Wigal, Tim; McCracken, James T.; Kollins, Scott H.; Murray, Desiree W.; Wigal, Sharon; Kastelic, Elizabeth; McGough, James J.; dosReis, Susan; Bauzó-Rosario, Audrey; Stehli, Annamarie; Posner, Kelly

    2013-01-01

    Objective To describe the clinical course of attention-deficit/hyperactivity disorder (ADHD) symptom severity and diagnosis from ages 3–5 to 9–12 years during a 6-year follow-up after the original Preschool ADHD Treatment Study (PATS). Method 207 participants (75% male) from the original PATS, assessed at Baseline (mean age 4.4 years, when all met criteria for ADHD) and 3-months later (prior to medication treatment), were re-evaluated in three follow-up assessment visits (Year 3, mean age 7.4 years; Year 4, 8.3 years and Year 6, 10.4 years). Parents and teachers rated symptom severity and clinicians established psychiatric diagnoses. Analyses examined longitudinal changes in symptom severity and ADHD diagnosis. Results Parent- and teacher-rated symptom severity decreased from Baseline to Year 3 but remained relatively stable and in the moderate-to-severe clinical range through Year 6. Girls showed generally steeper decreases in symptom T-scores. At Year 6, 89% (160/180) of remaining participants met ADHD symptom and impairment diagnostic criteria. Comorbidity of oppositional defiant disorder and/or conduct disorder was associated with a 30% higher risk of having an ADHD diagnosis at Year 6 in the multiple logistic model. Medication status during follow-up, on vs. off, did not predict symptom severity change from Year 3 to Year 6 after adjustment for other variables. Conclusions ADHD in preschoolers is a relatively stable diagnosis over a 6-year period. The course is generally chronic, with high symptom severity and impairment, in very young children with moderate-to-severe ADHD, despite treatment with medication. Development of more effective ADHD intervention strategies is needed for this age group. PMID:23452683

  5. Recovery process in patients followed-up due to acute kidney injury

    PubMed Central

    Magden, K; Yildirim, I; Kutu, ME; Ozdemir, MC; Peynir, S; Altas, A; Yildiz, G; Hur, E

    2013-01-01

    Introduction: Acute kidney injury (AKI) may result in complete recovery in some of the patients and partial recovery in others. AKI episodes may accelerate the progression to chronic kidney disease and end-stage renal failure, while risk for morbidity and mortality is high following AKI. Discharge of patients from the hospital, independently from dialysis is a crucial outcome. Many patients without a need for dialysis, require follow-up for various durations and different treatments. The objective of this study was to compare mean recovery time of the patients followed-up due to prerenal, renal and postrenal AKIs. Method: In this prospective observational study, a total of 159 patients hospitalized in Bulent Ecevit Hospital, clinic of nephrology or monitored in the other wards and intensive care unit due to AKI, between June 2011 and January 2012, were enrolled. The cases were divided into three groups as prerenal, renal and postrenal, and monitored with the daily visits and renal function testing. Results: Prerenal AKI was seen by 54%, while renal AKI was observed by 34% and post-renal AKI by 12%. Incidence of chronic kidney disease was 17.6%. Totally 43 patients required hemodialysis (27%). Of these patients, 23 were in the prerenal AKI (53.4%), 15 in the renal AKI (34.8%) and 5 (11.6%) in the postrenal AKI group. Blood urea nitrogen (BUN) and creatinine levels were dropped to the basal values only in the prerenal AKI group, on the seventh day of treatment. These levels remained higher in the postrenal and renal groups on the 7th day of treatment compared to the basal values. BUN levels decreased to the normal values on average 7th day in the postrenal, while remained higher in the renal group. Conclusion: Prerenal AKI patients recovered in seven days with a proper treatment, although AKI patients due to other reasons should be followed-up for a longer time. PMID:24470734

  6. Prospective follow-up study of 423 children born after intracytoplasmic sperm injection.

    PubMed

    Bonduelle, M; Legein, J; Buysse, A; Van Assche, E; Wisanto, A; Devroey, P; Van Steirteghem, A C; Liebaers, I

    1996-07-01

    In order to evaluate the safety of the intracytoplasmic sperm injection (ICSI) procedure, a prospective follow-up study of 423 children born after ICSI was carried out. The aim of this study was to compile data on karyotypes, congenital malformations, growth parameters and developmental milestones. Before starting the infertility treatment, couples were asked to participate in a follow-up study including genetic counselling and prenatal diagnosis. The follow-up study of the child was based on a visit to the paediatrician-geneticist at birth or at 2 months of age, at 1 year and at 2 years of age when a physical examination for major and minor malformations and a psychomotoric evaluation were done. Between April 1991 and September 1994, 320 pregnancies obtained after ICSI led to the birth of 423 children (222 singletons, 186 twins and 15 triplets). Prenatal diagnosis determined a total of 293 karyotypes, one of which was abnormal (0.3%), and four were benign familial structural aberrations, all inherited from the paternal side. A total of 14 (3.3%) major malformations were observed, defined as those causing functional impairment or requiring surgical correlation. Neurological or developmental problems at the age of 2 months were found in 14 children, four of whom were multiples. Compared to most registers of children born after assisted reproduction and to registers of malformations in the general population, the figure of 3.3% major malformations is within the expected range. Before drawing any firm conclusion, further careful evaluations of the available data are necessary. PMID:8671504

  7. Following up on the Discovery of Water Vapor at Europa's South Pole with HST

    NASA Astrophysics Data System (ADS)

    Roth, L.; Retherford, K. D.; Saur, J.; Strobel, D. F.; Feldman, P. D.; McGrath, M. A.; Nimmo, F.; Spencer, J. R.; Grava, C.; Bloecker, A.

    2014-12-01

    We will present new Hubble Space Telescope (HST) observations of Europa's UV aurora obtained within two campaigns in 2014 to follow up on the water vapor plume detection. HST aurora images taken in 2012 have revealed coincident signals from atomic hydrogen and oxygen pointing to the existence of transient water vapor plumes near the south pole. The water vapor was detected only during one HST visit in December 2012 when Europa was near apocenter position and was speculated to be correlated with changing tidal stresses along Europa's orbit. In a first follow-up campaign new aurora images were taken by HST early in 2014 with Europa near apocenter, but the initial detection was not confirmed. More HST aurora images will be obtained in the course of a larger Hubble observing campaign starting in November 2014. We will review all HST aurora imaging observations to date and discuss potential sources for varying plume activity and changing detectability by HST. In particular, we will examine various explanations for the non-detections in the early 2014 observations near apocenter.

  8. West Foster Creek 2007 Follow-up Habitat Evaluation Procedures (HEP) Report.

    SciTech Connect

    Ashley, Paul R.

    2008-02-01

    A follow-up habitat evaluation procedures (HEP) analysis was conducted on the West Foster Creek (Smith acquisition) wildlife mitigation site in May 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance and maintain the project site as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The West Foster Creek 2007 follow-up HEP survey generated 2,981.96 habitat units (HU) or 1.51 HUs per acre for a 34% increase (+751.34 HUs) above baseline HU credit (the 1999 baseline HEP survey generated 2,230.62 habitat units or 1.13 HUs per acre). The 2007 follow-up HEP analysis yielded 1,380.26 sharp-tailed grouse (Tympanuchus phasianellus) habitat units, 879.40 mule deer (Odocoileus hemionus) HUs, and 722.29 western meadowlark (Sturnella neglecta) habitat units. Mule deer and sharp-tailed grouse habitat units increased by 346.42 HUs and 470.62 HUs respectively over baseline (1999) survey results due largely to cessation of livestock grazing and subsequent passive restoration. In contrast, the western meadowlark generated slightly fewer habitat units in 2007 (-67.31) than in 1999, because of increased shrub cover, which lowers habitat suitability for that species.

  9. Multi-wavelength follow-up of ANTARES neutrino alerts

    NASA Astrophysics Data System (ADS)

    Mathieu, Aurore

    2015-10-01

    Transient sources are often associated with the most violent phenomena in the Universe, where the acceleration of hadrons may occur. Such sources include gamma-ray bursts (GRBs), active galactic nuclei (AGN) or core-collapse supernovae (CCSNe), and are promising candidates for the production of high energy cosmic rays and neutrinos. The ANTARES telescope, located in the Mediterranean sea, aims at detecting these high energy neutrinos, which could reveal the presence of a cosmic ray accelerator. However, to enhance the sensitivity to transient sources, a method based on multi-wavelength follow-up of neutrino alerts has been developed within the ANTARES collaboration. This program, denoted as TAToO, triggers a network of robotic optical telescopes and the Swift-XRT with a delay of only a few seconds after a neutrino detection. The telescopes start an observation program of the corresponding region of the sky in order to detect a possible electromagnetic counterpart to the neutrino event. The work presented in this thesis covers the development and implementation of an optical image analysis pipeline, as well as the analysis of optical and X-ray data to search for fast transient sources, such as GRB afterglows, and slowly varying transient sources, such as CCSNe.

  10. [Cardiological follow-up in patients with Fabry disease].

    PubMed

    Pieruzzi, Federico; Pieroni, Maurizio; Chimenti, Cristina; Frustaci, Andrea; Sarais, Cristiano; Cecchi, Franco

    2010-01-01

    Fabry disease is a rare tesaurismosis due to a deficit of the lysosomal enzyme activity of alpha-galactosidase, needed for the normal catabolism of globotriaosylceramides (GL3). Fabry cardiac involvement has several clinical manifestations: concentric left ventricular hypertrophy without left ventricular dilation and severe loss of left ventricular systolic function, mitral and aortic valvulopathy, disorders of the atrioventricular conduction or repolarization, and compromised diastolic function. Differentiating Fabry disease from similar conditions is often quite straightforward, e.g., cardiac amyloidosis is often associated with low electrocardiographic voltages, and systemic symptoms are usually associated with hemochromatosis and sarcoidosis. However, sometimes second-level (genetic analysis, alpha-galactosidase levels) or invasive investigations are required, which can include endomyocardial biopsy. Diagnostic imaging techniques have been described, but they lack specificity. Echocardiographic imaging with tissue Doppler analysis and/or strain rate analysis can allow diagnosis of Fabry disease even before left ventricular hypertrophy becomes apparent. This review illustrates the techniques for staging cardiac involvement and damage in Fabry disease and for the long-term follow-up of Fabry patients with or without cardiac involvement. Careful cardiac monitoring is especially important in elderly female carriers, who often develop renal disorders and/or left ventricular hypertrophy as the only manifestations of their late Fabry disease. In some clinical series, Fabry disease was diagnosed in 12% of women with adult-onset hypertrophic cardiomyopathy. Cardiological problems and outcomes of enzyme replacement therapy, associated with or without other cardiological treatments, are also discussed. PMID:21033333

  11. Integrated GW-EM Follow-up Analysis

    NASA Astrophysics Data System (ADS)

    Ackley, Kendall; Eikenberry, Stephen; Klimenko, Sergey; LSC Collaboration

    2015-04-01

    Advanced Gravitational-Wave (GW) detectors such as Advanced LIGO and Advanced Virgo are expected to become operational for observation runs in 2015, with an expected ultimate improvement in sensitivity over previous configurations by a factor of 10 by 2019. There are many potential electromagnetic (EM) counterparts to GWs including short and long gamma-ray bursts (GRBs) and kilonovae. While SGRBs and LGRBs predominantly emit in the X-ray, and the recently-observed kilonova primarily in the infrared, all three sources are expected to have detectable traces in the optical band, albeit requiring very sensitive optical telescopes. In order to aid in the optimization of GW trigger follow-up procedures, we perform an end-to-end analysis feasibility study using synthesized Advanced detector data simulating a GW detection with a theoretical EM counterpart injected into archival optical images. We use images from Robotic Optical Transient Search Experiment (ROTSE) and Palomar Transient Factory (PTF), and inject candidate events following observed lightcurves of SGRBs, LGRBs, and kilonovae. The use of Zernike PSF decomposition on candidate objects offers a fast way to identify point sources, speeding up the automated identification of transient sources in the images. We present our method of transient recovery and the latest results of our feasibility study of a joint GW-EM observation.

  12. [Follow-up and counselling after pelvic inflammatory disease].

    PubMed

    Derniaux, E; Lucereau-Barbier, M; Graesslin, O

    2012-12-01

    Pelvic inflammatory disease (PID) can be responsible for infertility and chronic pelvic pain. Treatment of acute PID is very important as it can reduce the risk of sequelae. However, follow-up, partner treatment and counselling are also useful to reduce the reinfection rate. Few weeks after PID, clinical evaluation as well as transvaginal and transabdominal sonography must be performed. The interest of systematic bacteriological tests is not proved. Hysterosalpingography and second-look laparoscopy should be considered only for women with infertility and severe infection. Use of condom is advisable in this population in order to prevent sexually transmitted diseases (STD) including HIV and to decrease rate of recurrence, associated to contraceptive pill, which is also a good option. In selected cases, intrauterine devices can be used in patients with history of PID if the infection is resolved and no significant risk factors for STD exist. Infertility and chronic pelvic pain are the most common sequelae in the population of young women with severe and recurrent infection. The risk of ectopic pregnancy is higher for these women and must be kept in mind. Counselling and risk-reduction interventions decreased significatively the rate of recurrence and sequelae in PID. PMID:23159202

  13. Follow-up of MARVELS Brown Dwarf Candidates using EXPERT

    NASA Astrophysics Data System (ADS)

    Ma, Bo; Ge, Jian; Li, Rui; Sithajan, Sirinrat; Thomas, Neil; Wang, Ji; De Lee, Nathan

    2013-02-01

    The SDSS-III MARVELS survey is a comprehensive radial velocity survey of 3,300 nearby F-K stars, between 7.6 < V < 12.0 in 2008-2012. All of the survey data for 2580 FGK stars from the first two and half years have been processed with the latest data pipeline. A total of 26 new brown dwarfs (BD) candidates have been identified in the processed RV data. We expect to have 8 more BD candidates from the ~800 stars currently under processing, which will make a total of 34 BD candidates. This proposal requests KPNO 2.1m telescope time with the EXPERT instrument, to follow up all of these BD candidates to confirm the detections and characterize the orbits. The results will be used to (1) reveal the overall distribution of the new BDs in the parameter space; (2) measure the occurrence rate of BD around FGK type stars; (3) measure dryness of the brown dwarf desert around stars with different mass and metallicity; (4) constrain theoretical models regarding the formation of brown dwarfs; (5) confirm the discovery of `desert in the brown dwarf desert'; (6) identify additional companions associated with the detected systems.

  14. Follow-up of MARVELS Brown Dwarf and Planet Candidates

    NASA Astrophysics Data System (ADS)

    Ge, Jian; Ma, Bo; Petersen, Eric; Li, Rui; Wang, Ji; Lee, Brian; De Lee, Nathan; Fleming, Scott

    2012-08-01

    The SDSS-III MARVELS planet search is the the largest homogeneous single radial velocity (RV) survey with moderate-high Doppler precision (10-30 m/s for V=7.6-12 FGK stars). To date, over 3000 stars have been observed at the SDSS 2.5m telescope with more than 20 times over about two year time windows. All of the survey data for 2580 FGK stars from the first two and half years have been processed with the latest data pipeline. A total of 24 new brown dwarfs (BD) and 28 new planet candidates have been identified in the processed RV data. This proposal requests KPNO 2.1m telescope time with the EXPERT instrument, to follow up all of these BD and planet candidates to confirm the detections and characterize the orbits. The results will be used to (1). reveal the overall distribution of the new BDs and giant planets in the parameter space; (2). measure occurrence rates of BDs and giants planets around stars with different mass and metallicity, especially at the low metallicity end; (3). measure dryness of the brown dwarf desert; (4). constrain theoretical models regarding the formation of substellar companions (BDs and giant planets); (5). identify additional companions associated with the detected systems.

  15. SDSS-III MARVELS Planet Candidate RV Follow-up

    NASA Astrophysics Data System (ADS)

    Ge, Jian; Thomas, Neil; Ma, Bo; Li, Rui; SIthajan, Sirinrat

    2014-02-01

    Planetary systems, discovered by the radial velocity (RV) surveys, reveal strong correlations between the planet frequency and stellar properties, such as metallicity and mass, and a greater diversity in planets than found in the solar system. However, due to the sample sizes of extant surveys (~100 to a few hundreds of stars) and their heterogeneity, many key questions remained to be addressed: Do metal poor stars obey the same trends for planet occurrence as metal rich stars? What is the distribution of giant planets around intermediate- mass stars and binaries? Is the ``planet desert'' within 0.6 AU in the planet orbital distribution of intermediate-mass stars real? The MARVELS survey has produced the largest homogeneous RV measurements of 3300 V=7.6-12 FGK stars. The latest data pipeline effort at UF has been able to remove long term systematic errors suffered in the earlier data pipeline. 18 high confident giant planet candidates have been identified among newly processed data. We propose to follow up these giant planet candidates with the KPNO EXPERT instrument to confirm the detection and also characterize their orbits. The confirmed planets will be used to measure occurrence rates, distributions and multiplicity of giants planets around F,G,K stars with a broad range of mass (~0.6-2.5 M_?) and metallicity ([Fe/H]~-1.5-0.5). The well defined MARVELS survey cadence allows robust determinations of completeness limits for rigorously testing giant planet formation theories and constraining models.

  16. Prognosis after myocardial infarction: results of 15 year follow up.

    PubMed Central

    Merrilees, M A; Scott, P J; Norris, R M

    1984-01-01

    A total of 271 out of 757 patients who had suffered a myocardial infarction during 1966-7 were still alive after six years; these patients were subsequently followed up 15 years after the infarction. Two hundred and sixty eight (99%) of the patients alive at six years and 519 (95%) of the 549 originally discharged from hospital were traced. A coronary prognostic index, which had predicted survival both to three years and from three to six years after recovery from the infarct also predicted survival from six to 15 years after recovery. The major factor affecting survival to 15 years was age at the time of the original infarct. Among patients aged under 60 at the time of infarction women fared better than men (p = 0.027). Factors in the coronary prognostic index that were associated with impairment of left ventricular function at the time of infarction and that had predicted mortality to three years and from three to six years also predicted mortality from six to 15 years. These factors were cardiac enlargement, pulmonary venous congestion, and the presence of infarction before the index infarct. The dominant cause of death remained coronary heart disease and its complications. PMID:6229313

  17. Cohort Profile: The Manitoba Follow-up Study (MFUS).

    PubMed

    Tate, Robert B; Cuddy, T Edward; Mathewson, Francis Al

    2015-10-01

    The Manitoba Follow-up Study (MFUS) is Canada's longest running study of cardiovascular disease and ageing. The MFUS cohort consists of 3983 men recruited from the Royal Canadian Air Force at the end of World War II. At entry to the study, 1 July 1948, their mean age was 31 years, with 90% between ages 20 and 39 years. All study members were free of clinical evidence of ischaemic heart disease. The protocol of MFUS was to obtain routine medical examinations from these men at regular intervals over time. The research goal of the study was to examine the role that any abnormalities detected on routine electrocardiograms from apparently healthy men might play in the prediction of subsequent diagnoses of cardiovascular disease. Over the course of 65 years, about 35% of the cohort has documented evidence of ischaemic heart disease. The research focus was expanded in 1996 to explore the roles of physical, mental and social functioning in support of healthy and successful ageing. On 1 July 2013, 429 original cohort members were alive with a mean age of 92 years. Collaborative research with others outside the in-house team is welcomed. PMID:25064641

  18. Strategies to photometric follow-up transiting exoplanets

    NASA Astrophysics Data System (ADS)

    Mancini, L.

    2014-03-01

    It is now well ascertained that those extrasolar planets that transit in front to their parent stars deserve extensive follow-up observations because they are the only ones for which we can directly measure all their physical parameters. This information currently provides the best route to constructing the mass-radius diagram of exoplanets, which channels the theoretical formation/evolution models in the right path. However, many of the discovered transiting planets do not have high-quality light curves, so their physical properties are poorly known. In this perspective, we are leading a large program to obtain ultra-high-precision photometry of transit events, which are analyzed to accurately measure the physical properties of know planetary systems. Besides measuring and refining the physical properties of the planets and their parent stars, we also try to obtain additional information from the light curves, by identifying particular features of the systems (e.g. stellar activity) and investigating the composition of the planetary atmospheres by transmission photometry. In this conference-proceedings contribution I present several observational strategies that we adopt to achieve these goals. %

  19. Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

    PubMed Central

    Şentürk, Mehmet Baki; Güraslan, Hakan; Çakmak, Yusuf; Ekin, Murat

    2015-01-01

    Objective The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Material and Methods Twenty-two patients underwent SSF between 2010 and 2012, and the results were evaluated retrospectively. The results at preoperative and postoperative 6th, 12th, and 18th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Results According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to PISQ-12 (p=0.001). Conclusion This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. PMID:26097393

  20. Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

    PubMed Central

    Zikan, Michal; Dundr, Pavel; Cibula, David

    2012-01-01

    Borderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (low-grade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type—easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. PMID:23024155

  1. Follow up study of workers manufacturing chrysotile asbestos cement products.

    PubMed Central

    Gardner, M J; Winter, P D; Pannett, B; Powell, C A

    1986-01-01

    A cohort study has been carried out of 2167 subjects employed between 1941 and 1983 at an asbestos cement factory in England. The production process incorporated the use of chrysotile asbestos fibre only, except for a small amount of amosite during four months in 1976. Measured airborne fibre concentrations available since 1970 from personal samplers showed mean levels below 1 fibre/ml, although higher levels had probably occurred previously in certain areas of the factory. No excess of lung cancer was observed in the mortality follow up by comparison with either national or local death rates, and analyses of subgroups of the workforce by job, exposure level, duration of employment, duration since entry, or calendar years of employment gave no real suggestion of an asbestos related excess for this cause of death. There was one death from pleural mesothelioma and one with asbestosis mentioned as an associated cause on the death certificate, but neither is thought to be linked to asbestos exposure at this factory. Other suggested asbestos related cancers, such as laryngeal and gastrointestinal, did not show raised risks. Although the durations of exposure were short in this study, the findings are consistent with two other studies of workers exposed to low concentrations of chrysotile fibre in the manufacture of asbestos cement products which reported no excess mortality. PMID:3024695

  2. Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial

    PubMed Central

    2014-01-01

    Background This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Methods Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education ‘booster’ sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Results Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, −0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, −1,415 to −128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. Conclusions The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Trial registration Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007). PMID:24927851

  3. Telephonic Consultation and follow-up in Diabetics: Impact on Metabolic Profile, Quality of Life, and Patient Compliance

    PubMed Central

    Kaur, Rupinderjeet; Kajal, Krishan Singh; Kaur, Amarpreet; Singh, Paramdeep

    2015-01-01

    Background: Diabetes mellitus (DM), being a long-term condition, requires consistent blood glucose monitoring and adjustment of doses of the antidiabetic drugs and insulin. Telehealth is an emerging field that can have a positive impact on the management of this disease. Aim: The aim was to study the impact of the frequency of consultation and follow-up on telephone of diagnosed follow-up patients of DM on glycemic and metabolic profiles, the patients' compliance, and their quality of life (QoL), and to compare the effectiveness of different modes of follow-up. Materials and Methods: One hundred twenty patients were enrolled from the outpatient department (OPD) including both type 1 and type 2 DM patients who had already been diagnosed and were on treatment. They were randomly assigned to one of three groups, each consisting of 40 subjects, according to the mode of follow-up: A (rare, i.e., less frequent outpatient visits), B (moderate, i.e., more frequent outpatient visits), and C (frequent, i.e., more frequent outpatient visits with weekly telephonic consultation). Metabolic profiles and the QoL were monitored. The patients' compliance with and adherence to the treatment, and dietary and exercise advice were assessed. Results: The patients' compliance with and adherence to the treatment was higher in group C, followed by groups B and A. There was a net decrease in adverse events, with an increase in the frequency of follow-up. Changes in glycated hemoglobin (HbA1c) suggested a positive impact of weekly telephonic consultation. The lipid profile was also positively affected, with maximum improvement being in high-density lipoproteins (HDLs) and triglycerides. There was an improvement in the QoL domains pertaining to physical health and endurance in patients with higher frequency of follow-ups. There was no effect on emotional or mental health. There was an overall deterioration of the financial domain, being most marked in group B. The treatment satisfaction questionnaire showed better results in the telephone intervention group. Conclusion: Telephonic consultation can be a useful measure to improve the follow-up and management of patients with DM. PMID:26110131

  4. Medulloblastoma in infants and children: computed tomographic follow-up after treatment

    SciTech Connect

    Lee, Y.Y.; Glass, J.P.; van Eys, J.; Wallace, S.

    1985-03-01

    Thirty-six proven cases of medulloblastoma were reviewed by serial CT follow-up examinations from 4 months to 10 years, 2 months after the initial diagnosis, with a mean follow-up time of 3 years, 9 months. The tumor recurred at the primary site in 20 cases (56%). Leptomeningeal metastasis was demonstrated on CT in 14 cases (39%); seven of these patients also presented with solid subarachnoid metastases. Thirteen patients (36%) showed evidence of severe brain atrophy, which was confined to the posterior fossa in seven of the 13. Calcification resulting from mineralizing microangiopathy developed in five cases (14%), including three patients who had had extensive dystrophic calcification in the corticomedullary junction and the deep-seated nuclei of the cerebrum and cerebellum. The patterns of tumor recurrence in the posterior fossa that is severely deformed by surgery and other treatment modalities and leptomeningeal spread of tumor are discussed.

  5. A Comparative Study of Nurses as Case Manager and Telephone Follow-up on Clinical Outcomes of Patients with Severe Mental Illness

    PubMed Central

    Malakouti, Seyed Kazem; Nojomi, Marzieh; Mirabzadeh, Arash; Mottaghipour, Yasaman; Zahiroddin, Alireza; Kangrani, Hamed Mohammadi

    2016-01-01

    Background: Providing community-based mental health services is crucial and is an agreed plan between the Iranian Mental Health Office and the Regional Committee for the Eastern Mediterranean (affiliated with WHO). The aim of this study was to determine the effectiveness of home-visit clinical case-management services on the hospitalization rate and other clinical outcomes in patients with severe mental illness. Methods: A total of 182 patients were randomly allocated into three groups, namely, home-visit (n=60), telephone follow-up (n=61) and as-usual care (n=61) groups. Trained nurses as clinical case-managers provided home-visit services and the telephone follow-up tasks. Hospitalization rate as a measure of recurrence, as well as burden, knowledge, general health condition of caregivers with positive/negative symptoms, satisfaction, quality of life, and social skills of the consumers were assessed as the main and secondary outcomes, respectively. Results: Most clinical variables were improved in both intervention groups compared with the control group. During the one year follow-up, the rate of rehospitalization for the telephone follow-up and as-usual groups were respectively 1.5 and 2.5 times higher than the home-visit group. Conclusion: Trained clinical case-managers are capable of providing continuous care services to patients with severe mental illness. The telephone follow-up services could also have beneficiary outcome for the consumers, their caregivers, and the health system network. PMID:26722141

  6. Stennis' granddaughter visit

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Jane Kenna of Atlanta, granddaughter of the late Sen. John C. Stennis, visits StenniSphere, the visitor center at NASA's John C. Stennis Space Center. Kenna and her husband, John, visited Stennis on April 6, her first trip to the rocket engine testing facility since the 1988 ceremony to rename the site in honor of her grandfather.

  7. [Radiological diagnostics and follow-up of rectal carcinoma].

    PubMed

    Vogl, T J; Pegios, W; Bechstein, W O; Floeter, J

    2006-10-01

    Rectal carcinoma is one of the most frequent malignant tumors in adulthood. Not only after total resection but also after partial resection of the tumor with postoperative radiochemotherapy a sufficient follow-up is necessary to diagnose recurrent rectal cancer as early as possible. Various guidelines suggest different intervals for physical examinations and diagnostic methods depending on the initial tumor stage. In addition to routine examinations, the physician can choose between CT, MRI, endosonography and functional imaging techniques such as PET and immunoscintigraphy for further evaluation if a recurrent rectal cancer is suspected. Multiple studies and meta-analyses show the differences in the specificity and sensitivity of the diagnostic methods in the detection of lymph nodes, metastases, and local tumor infiltration. Endosonography and endorectal MRI show very good results in staging local tumor infiltration. However, obstructive lesions can inhibit an adequate examination. CT provides prompt and convincing results in the evaluation of the metastases. Most of the time the tumor can be identified but the lack of detailed imaging makes it hard to perform sufficient staging. Additionally image-guided biopsy can be performed. Immunoscintigraphy and PET have a high specificity because they take advantage of the tumor's metabolism. The introduction of the PET-CT has eliminated the disadvantage of low image resolution. In addition to the detection of small nodular pulmonary metastases, MRI with its "phased-array" coils is another excellent tool for the diagnosis of recurrent rectal cancer and search for metastases. This review shows the advantages and disadvantages of each diagnostic method in the visualization of recurrent rectal cancer. PMID:17021976

  8. Latex allergy: a follow up study of 1040 healthcare workers

    PubMed Central

    Filon, F Larese; Radman, G

    2006-01-01

    Background Natural rubber latex allergy can cause skin and respiratory symptoms The aim of this study was to evaluate the prevalence and incidence of latex related symptoms and sensitisation among a large group of healthcare workers in Trieste hospitals, followed for three years before and after the introduction of powder?free gloves with low latex release. Methods In the years 199799 the authors evaluated 1040 healthcare workers exposed to latex allergen for latex related symptoms and sensitisation by means of a questionnaire, a medical examination, skin prick tests, and IgE specific antibody assay. The second evaluation was carried out in the years 200002, subsequent to the changeover to a powder?free environment. Results Glove related symptoms were seen in 21.8% of the nurses (227), mostly consisting of mild dermatitis: 38 (3.6%) complaining of contact urticaria and 24 (2.3%) of asthma and/or rhinitis. These symptoms were significantly related to skin prick tests positive to latex (OR?=?9.70; 95% CI 5.5 to 17) and to personal atopy (OR?=?2.29; 95% CI 1.6 to 3.2). Follow up was completed in 960 subjects (92.3%): 19 new subjects (2.4%) complained of itching erythema when using gloves, but none was prick positive to latex. Symptoms significantly improved and in most cases disappeared (p<0.0001). Conclusions Simple measures such as the avoidance of unnecessary glove use, the use of non?powdered latex gloves by all workers, and use of non?latex gloves by sensitised subjects can stop the progression of latex symptoms and can avoid new cases of sensitisation. PMID:16421390

  9. Follow up on the crystal growth experiments of the LDEF

    NASA Technical Reports Server (NTRS)

    Nielsen, K. F.; Lind, M. D.

    1993-01-01

    The results of the 4 solution growth experiments on the LDEF have been published elsewhere. Both the crystals of CaCO3, which were large and well shaped, and the much smaller TTF-TCNQ crystals showed unusual morphological behavior. The follow up on these experiments was begun in 1981, when ESA initiated a 'Concept Definition Study' on a large, 150 kg, Solution Growth Facility (SGF) to be included in the payload of EURECA-1, the European Retrievable Carrier. This carrier was a continuation of the European Spacelab and at that time planned for launch in 1987. The long delay of the LDEF retrieval and of subsequent missions brought about reflections both on the concept of crystal growth in space and on the choice of crystallization materials that had been made for the LDEF. Already before the LDEF retrieval, research on TTF-TCNQ had been stopped, and a planned growth experiment with TTF-TCNQ on the SGF/EURECA had been cancelled. The target of the SGF investigation is now more fundamental in nature. None of the crystals to be grown here are, like TTF-TCNQ, in particular demand by science or industry, and the crystals only serve the purpose of model crystals. The real purpose of the investigation is to study the growth behavior. One of the experiments, the Soret Coefficient Measurement experiment is not growing crystals at all, but has it as its sole purpose to obtain accurate information on thermal diffusion, a process of importance in crystal growth from solution.

  10. Asthma increase among farmers: a 12-year follow-up

    PubMed Central

    2011-01-01

    Respiratory disease is a well known health hazard for farmers, but the long-term prognosis is less well known. This is a 12-year follow-up of an investigation of Swedish farmers, most of them dairy farmers. A questionnaire was mailed to all 418 farmers who were alive of the farmers originally participating in 1982. They were invited to an interview, spirometry, and blood sampling. Ninety-one per cent (380) of the farmers, 321 men and 59 women, responded to the questionnaire. The mean age was 56 years for the men and 55 years for the women. Of the group, 10% were smokers, 25% ex-smokers, and 65% had never smoked. The population estimate for asthma in the farmers was 8.9% in 1994 compared to 2% in 1982, and to 5.4%6.6% in the general population in the region in 1982. Of the asthmatic subjects, one-third had positive RAST tests (radioallergosorbent tests). Almost 90% of the new onset asthma cases since 1982 had non-IgE-mediated asthma. Most of the IgE-mediated asthmatics had had symptoms for many years, while 70% of the non-IgE-mediated asthmatic farmers had no or only wheezing with colds 1982. Two new cases of hypersensitivity pneumonitis were identified, and 7.3% had experienced inhalation fever during the last 12 years. In general, individuals with asthma and chronic bronchitis who had left farming were in better health in 1994 as compared to 1982. In conclusion, farmers have an enhanced risk to develop asthma increasing with age. Asthma in farmers is often non-IgE-mediated. PMID:20812893

  11. Clinical follow up of uniparental disomy 16: First data

    SciTech Connect

    Dworniczak, B.; Koppers, B.; Bogdanova, N.

    1994-09-01

    Following the introduction of the concept of uniparental disomy (UPD) in 1980 by Engel this segregational anomaly is reported in an ever increasing number of patients. So far, several groups of individuals with an increased risk for UPD have been identified including abnormal carriers of familial balanced translocations or centric fusions, carriers of mosaic trisomies, and fetuses after prenatal diagnosis of confined placental mosaicism. A major pathogenetic mechanism appears to be post-meiotic chromosome loss in trisomic conceptuses. UPD was repeatedly observed in the fetus after diagnosis of mosaic or non-mosaic trisomies in the placenta which are usually considered {open_quotes}lethal{close_quotes} (i.e. trisomies 15 and 16). In an ongoing study to determine the incidence and clinical consequences of UPD we investigated the parental origin of chromosomes in the disomic cell line after prenatal diagnosis of mosaicism for various trisomies (e.g. 2, 7, 14, 15, and 16). At present, two maternal disomies 16 and one maternal disomy 15 were identified. Severe intrauterine growth retardation was a common symptome which, however, was also present in some but not all mosaics with a biparental origin of the chromosomes in question. While prognosis is clear in some instances (i.e. UPD 15) counseling can be extremely difficult in others, when imprinting effects and homozygosity for unknown recessive traits present in a parent have to be considered. To assess the clinical significance, detailed follow-up studies of proven cases of uniparental disomies are essential. First data of two cases with UPD 16 are presented.

  12. Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up

    PubMed Central

    Castells-Aulet, Laura; Hernández-Viadel, Miguel; Jiménez-Martos, Jesús; Cañete-Nicolás, Carlos; Bellido-Rodríguez, Carmen; Calabuig-Crespo, Roman; Asensio-Pascual, Pedro; Lera-Calatayud, Guillem

    2015-01-01

    Aims and method To evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared. Results No statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two. Clinical implications The findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital. PMID:26755954

  13. Crisis Nursery and Respite Care Programs: Site Visit Results of Staff and Family Interviews (Winter and Spring of 1991).

    ERIC Educational Resources Information Center

    Huntington, Gail S.; And Others

    Visits were made to selected respite care and crisis nursery programs in order to describe the programs and services they offered to families of young children with special needs and to learn more about the families who used the services and the staff who provided them. The visits to 10 crisis nurseries and 24 respite care programs resulted in

  14. THE NATIONAL ATMOSPHERIC DEPOSITION PROGRAM/NATIONAL TRENDS NETWORK (NADP/NTN) SITE VISITION PROGRAM (OCTOBER 1986 THROUGH SEPTEMBER 1987)

    EPA Science Inventory

    Survey visits to the NADP/NTN precipitation collection stations are part of the network's quality assurance program and are coordinated through the NADP/NTN Quality Assurance Director's office. Research Triangle Institute, under contract to EPA, has visited approximately two-thir...

  15. Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform.

    PubMed

    Felland, Laurie E; Grossman, Joy M; Tu, Ha T

    2011-05-01

    Lingering fallout--loss of jobs and employer coverage--from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Hospitals with significant market clout continued to command high payment rate increases from private insurers, and tighter hospital-physician alignment heightened concerns about growing provider market power. High and rising premiums led to increasing employer adoption of consumer-driven health plans and continued increases in patient cost sharing, but the broader movement to educate and engage consumers in care decisions did not keep pace. State and local budget deficits led to some funding cuts for safety net providers, but an influx of federal stimulus funds increased support to community health centers and shored up Medicaid programs, allowing many people who lost private insurance because of job losses to remain covered. Hospitals, physicians and insurers generally viewed health reform coverage expansions favorably, but all worried about protecting revenues as reform requirements phase in. PMID:21614861

  16. Supporting People in the Community: A Case Study of the Residential Support Program, Centennial Developmental Services, Weld County, Colorado. Site Visit Report.

    ERIC Educational Resources Information Center

    Walker, Pam; Salon, Rebecca

    The site visit report describes the Residential Support Program of the Centennial Developmental Services, a community-centered board providing residential services and support to persons (currently 67) with disabilities in Weld County, Colorado. Residential settings include a group home, supported apartments, foster homes, natural family homes, or

  17. Kepler Data Validation and Follow-up Programs

    NASA Technical Reports Server (NTRS)

    William, Borucki J.

    2009-01-01

    The approach that the Kepler Mission uses to remove false positive events and to validate the discoveries consists of two parts; data validation (DPI) and follow up observations program (FOP). DV consists of several methods of examining the data from the spacecraft observations. First, to rule out statistical fluctuations in the data, accept only signals that show 3 or more transits and that have a total signal-to-noise ratio that exceeds 7 sigma. Second. to identify small stellar companions to the target star, we check for secondary eclipses and determine if the transit characteristics are appropriate for a planetary companion. Third, check for background binaries that are in the target aperture. Here we measure the movement of the image centroid before, during, and after the transit. If the target is producing the signal, a dimming wi11 move the image centroid in a known direction and magnitude. If the signal comes from a nearby star, the amplitude and direction of the motion wi11 be different, This test is expected to rule out the hundreds of binary signals expected from background stars. The precision of the measurement depends on the stellar fluxes and positions but can be better than 0.01 pixel; i.e., 0.04". Those candidates that pass these tests are examined using ground-based telescopes and radial velocity spectrometers. First medium precision RV is used to rule out any remaining stellar companions. Then high spatial resolution imaging is used to check for nearby stars that are in the aperture- (The Kepler apertures depend on magnitude but are of order 36 sq are sec in area.) If no stars are present that quid generate the observed signal, then the candidate goes to a large telescope such as Keck, HET, or Wi1lilam Herschel for high precision observations to get the planet mass or an upper limit to it, if there are some stars in the aperture, then the photometric observations are employed to look for the transit by cane of the confounding stars. If none are seen, then the candidate is sent to a large telescope such as Keck

  18. Goddard Robotic Telescope - Optical Follow-up of GRBs and Coordinated Observations of AGNs

    NASA Technical Reports Server (NTRS)

    Sakamoto, T.; Wallace, C. A.; Donato, D.; Gehrels, N.; Okajima, T.; Ukwatta, T. N.

    2010-01-01

    Since it is not possible to predict when a Gamma-Ray Burst (GRB) will occur or when Active Galactic Nucleus (AGN) flaring activity starts, follow-up/monitoring ground telescopes must be located as uniformly as possible all over the world in order to collect data simultaneously with Fermi and Swift detections. However, there is a distinct gap in follow-up coverage of telescopes in the eastern U.S. region based on the operations of Swift. Motivated by this fact, we have constructed a 14" fully automated optical robotic telescope, Goddard Robotic Telescope (GRT), at the Goddard Geophysical and Astronomical Observatory. The aims of our robotic telescope are 1) to follow-up Swift/Fermi GRBs and 2) to perform the coordinated optical observations of Fermi Large Area Telescope (LAT) AGN. Our telescope system consists of off-the-shelf hardware. With the focal reducer, we are able to match the field of view of Swift narrow instruments (20' x 20'). We started scientific observations in mid-November 2008 and GRT has been fully remotely operated since August 2009. The 3(sigma) upper limit in a 30-second exposure in the R filter is approx.15.4 mag; however, we can reach to approx.18 mag in a 600-second exposures. Due to the weather condition at the telescope site. our observing efficiency is 30-40%, on average.

  19. Unusual cisternal coil migration in the follow-up period after aneurysm perforation during endovascular coiling.

    PubMed

    Meguro, Toshinari; Sasaki, Tatsuya; Haruma, Jun; Tanabe, Tomoyuki; Muraoka, Kenichiro; Terada, Kinya; Hirotsune, Nobuyuki; Nishino, Shigeki

    2011-01-01

    A 61-year-old woman suffered cisternal coil migration in the follow-up period after endovascular coil embolization for a ruptured cerebral aneurysm. She presented with sudden onset of headache. Computed tomography demonstrated diffuse subarachnoid hemorrhage, and cerebral angiography disclosed a left anterior choroidal artery aneurysm. The aneurysm was treated by endovascular embolization with Guglielmi detachable coils. During the embolization procedure, the microcatheter perforated the aneurysm. For direct closure of the perforation site with coils, the microcatheter was withdrawn and coils were deployed partially in the subarachnoid space and partially in the aneurysm sac. The coil mass was spread in the subarachnoid space around the aneurysm immediately after embolization. The patient was discharged with no neurological deficit. Three months later, follow-up radiography demonstrated obvious reduction in the size and compaction of the coil mass. Magnetic resonance angiography and digital subtraction angiography demonstrated stable occlusion of the aneurysm. The coil mass probably spread in the cistern around the aneurysm and was compacted by the shape memory of the coils and pulsation of the brain and vessels, as the subarachnoid clots around the aneurysm had disappeared. This case suggests that cisternal coil migration should be considered in the follow up of intracranial aneurysm treated with detachable coils. PMID:21613762

  20. Long-Term Follow-Up of Percutaneous Balloon Angioplasty in Adult Aortic Coarctation

    SciTech Connect

    Paddon, Alex J.; Nicholson, Anthony A.; Ettles, Duncan F.; Travis, Simon J.; Dyet, John F.

    2000-09-15

    Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly from 50.9 to 17.8 at follow-up (p = 0.001). The average number of antihypertensive drugs required per patient decreased from 0.56 to 0.31 (p = 0.234). No significant residual stenoses or restenoses were seen at MRI. Small but clinically insignificant residual pressure gradients were recorded in all patients using Doppler echocardiography. Complications included one transient ischemic attack at 5 days, one external iliac dissection requiring stent insertion, and a further patient who developed a false aneurysm close to the coarctation site at 12 months which subsequently required surgical excision.Conclusion: PTA of adult coarctation is safe and effective in the long term. Although primary stenting has recently been advocated in the treatment of this condition, our results suggest that PTA remains the treatment of choice.

  1. Lung Tumors Treated With Percutaneous Radiofrequency Ablation: Computed Tomography Imaging Follow-Up

    SciTech Connect

    Palussiere, Jean Marcet, Benjamin; Descat, Edouard; Deschamps, Frederic; Rao, Pramod; Ravaud, Alain; Brouste, Veronique; Baere, Thierry de

    2011-10-15

    Purpose: To describe the morphologic evolution of lung tumors treated with radiofrequency ablation (RFA) by way of computed tomography (CT) images and to investigate patterns of incomplete RFA at the site of ablation. Materials and Methods: One hundred eighty-nine patients with 350 lung tumors treated with RFA underwent CT imaging at 2, 4, 6, and 12 months. CT findings were interpreted separately by two reviewers with consensus. Five different radiologic patterns were predefined: fibrosis, cavitation, nodule, atelectasis, and disappearance. The appearance of the treated area was evaluated at each follow-up CT using the predefined patterns. Results: At 1 year after treatment, the most common evolutions were fibrosis (50.5%) or nodules (44.8%). Differences were noted depending on the initial size of the tumor, with fibrosis occurring more frequently for tumors <2 cm (58.6% vs. 22.9%, P = 1 Multiplication-Sign 10{sup -5}). Cavitation and atelectasis were less frequent patterns (2.4% and 1.4%, respectively, at 1 year). Tumor location (intraparenchymatous, with pleural contact <50% or >50%) was not significantly correlated with follow-up image pattern. Local tumor progressions were observed with each type of evolution. At 1 year, 12 local recurrences were noted: 2 cavitations, which represented 40% of the cavitations noted at 1 year; 2 fibroses (1.9%); 7 nodules (7.4%); and 1 atelectasis (33.3%). Conclusion: After RFA of lung tumors, follow-up CT scans show that the shape of the treatment zone can evolve in five different patterns. None of these patterns, however, can confirm the absence of further local tumor progression at subsequent follow-up.

  2. Long term follow up and retrospective study on 533 gastric cancer cases

    PubMed Central

    2014-01-01

    Background Gastric cancer (GC) is the third leading cause of cancer death in China and the outcome of GC patients is poor. The aim of the research is to study the prognostic factors of gastric cancer patients who had curative intent or palliative resection, completed clinical database and follow-up. Methods This retrospective study analyzed 533 GC patients from three tertiary referral teaching hospitals from January 2004 to December 2010 who had curative intent or palliative resection, complete clinical database and follow-up information. The GC-specific overall survival (OS) status was determined by the Kaplan-Meier method, and univariate analysis was conducted to identify possible factors for survival. Multivariate analysis using the Cox proportional hazard model and a forward regression procedure was conducted to define independent prognostic factors. Results By the last follow-up, the median follow-up time of 533 GC patients was 38.6 mo (range 6.9-100.9 mo), and the median GC-specific OS was 25.3 mo (95% CI: 23.1-27.4 mo). The estimated 1-, 2-, 3- and 5-year GC-specific OS rates were 78.4%, 61.4%, 53.3% and 48.4%, respectively. Univariate analysis identified the following prognostic factors: hospital, age, gender, cancer site, surgery type, resection type, other organ resection, HIPEC, LN status, tumor invasion, distant metastases, TNM stage, postoperative SAE, systemic chemotherapy and IP chemotherapy. In multivariate analysis, seven factors were identified as independent prognostic factors for long term survival, including resection type, HIPEC, LN status, tumor invasion, distant metastases, postoperative SAE and systemic chemotherapy. Conclusions Resection type, HIPEC, postoperative SAE and systemic chemotherapy are four independent prognostic factors that could be intervened for GC patients for improving survival. PMID:24886548

  3. Home visits

    PubMed Central

    Pereles, Laurie

    2000-01-01

    OBJECTIVE To review trends and current practices in delivery of medical care at home. QUALITY OF EVIDENCE A MEDLINE search from January 1989 to March 2000 yielded 65 articles. Most articles are descriptive; analytical studies are rare. MAIN MESSAGE The number of home visits made by physicians has consistently declined in the last 30 years. The most common reasons cited are lack of efficiency, the time required, and poor reimbursement. Home visits, reserved mainly for frail elderly people and palliative patients, are seen as valuable for preventing unnecessary visits to emergency rooms and hospitalizations. Home visits are also useful for reducing caregivers' stress, monitoring chronic illnesses, and assessing need for institutionalization. Home visiting requires special skills; these must be taught to current trainees. CONCLUSION With the shift to more community-based care, the demand for physicians to make home visits will increase. Physicians must be adequately prepared to deliver home care and be reimbursed appropriately. PMID:11072584

  4. Hamburg Center Intern Follow-Up. Second Year, 1974.

    ERIC Educational Resources Information Center

    McKee, Helen C.; And Others

    This report presents results of a questionnaire given to students involved in the competency-based teacher education program of the Hamburg central schools and SUNY at Fredonia. The program involves (a) the teaching of methods courses on-site, and (b) providing an opportunity for interns to blend theory into practice during a full-year internship.

  5. Outcomes and long term follow-up after emergent cricothyroidotomy: is routine conversion to tracheostomy necessary?

    PubMed

    Graham, David B; Eastman, Alexander L; Aldy, Kim N; Carroll, Elizabeth A; Minei, Joseph P; Brakenridge, Scott C; Phelan, Herb A

    2011-12-01

    The purpose of this study is to identify factors associated with survival after cricothyroidotomy (CRIC), and to ascertain long-term outcomes in patients simply decannulated after CRIC versus those revised to tracheostomy. All CRICs between October 1, 1995 and June 20, 2010 were reviewed. Patients were contacted by phone, visited at their last known address, or queried in the Center for Disease Control's National Death Index. DECAN were those CRICs decannulated without revision. TRACH were those revised to a tracheostomy at any point. Ninety-five CRIC patients were identified. In 94 per cent of survivors of initial admission, a Glasgow Coma Score (GCS) of 15 was noted at disposition. Cardiopulmonary resuscitation before or during CRIC performance was strongly associated with all-cause death during index admission, and increasing head Abbreviated Injury Score was associated with lower odds of a neurologically intact survival. Of survivors, 82 per cent of DECAN and 57 per cent of TRACH patients were followed-up with at medians of 48 (interquartile range 19-57) and 53 (20-119) months, respectively. DECAN occurred at a median of 4 days (2-7) whereas TRACH revision occurred at a median of 2 days (1-7). Endoscopy was performed on 36 per cent of DECAN patients and 22 per cent of TRACH patients. Two DECAN patients with acute subglottic edema/stenosis decannulated successfully on days 9 and 15 postinjury and had no problems at 54 and 91 months postinjury. At follow-up, no patient in either group had suffered a clinically evident airway complication. The need for cardiopulmonary resuscitation before or during CRIC portends poorly for neurologically intact survival. Simple decannulation is appropriate for CRIC patients when their need for airway protection has resolved. PMID:22273235

  6. Robot-assisted laparoscopic pyeloplasty: minimum 1-year follow-up

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    Objectives: To evaluate the feasibility and efficacy of robotic-assisted laparoscopic pyeloplasty. Laparoscopic pyeloplasty has been shown to have a success rate comparable to that of the open surgical approach. However, the steep learning curve has hindered its acceptance into mainstream urologic practice. The introduction of robotic assistance provides advantages that have the potential to facilitate precise dissection and intracorporeal suturing. Methods: A total of 50 patients underwent robotic-assisted laparoscopic dismembered pyeloplasty. A four-trocar technique was used. Most patients were discharged home on day 1, with stent removal at 3 weeks. Patency of the ureteropelvic junction was assessed in all patients with mercaptotriglycylglycine Lasix renograms at 1, 3, 6, 9, and 12 months, then every 6 months for 1 year, and then yearly. Results: Each patient underwent a successful procedure without open conversion or transfusion. The average estimated blood loss was 40 ml. The operative time averaged 122 minutes (range 60 to 330) overall. Crossing vessels were present in 30% of the patients and were preserved in all cases. The time for the anastomosis averaged 20 minutes (range 10 to 100). Intraoperatively, no complications occurred. Postoperatively, the average hospital stay was 1.1 days. The stents were removed at an average of 20 days (range 14 to 28) postoperatively. The average follow-up was 11.7 months; at the last follow-up visit, each patient was doing well. Of the 50 patients, 48 underwent one or more renograms, demonstrating stable renal function, improved drainage, and no evidence of recurrent obstruction. Conclusions: Robotic-assisted laparoscopic pyeloplasty is a feasible technique for ureteropelvic junction reconstruction. The procedure provides a minimally invasive alternative with good short-term results.

  7. Follow up investigation of workers in synthetic fibre plants with humidifier disease and work related asthma

    PubMed Central

    Pal, T. M.; de Monchy, J. G.; Groothoff, J. W.; Post, D.

    1999-01-01

    OBJECTIVE: To investigate the clinical and sociomedical outcome in patients with various clinical manifestations of humidifier disease and work related asthma after removal from further exposure. METHODS: Follow up investigation (range 1-13 years) of respiratory symptoms, spirometry, airway responsiveness, sickness absence, and working situation in patients with (I) humidifier fever (n = 12), (II) obstructive type of humidifier lung (n = 8), (III) restrictive type of humidifier lung (n = 4), and (IV) work related asthma (n = 22). All patients were working at departments in synthetic fibre plants with microbiological exposure from contaminated humidification systems or exposure to small particles (< 1 micron) of oil mist. RESULTS: At follow up patients with work related asthma were less often symptom free (37%, 7/19) than patients with humidifier disease (I, II, III) (67%, 16/24). Mean forced expiratory volume in one second (FEV1) of patients with obstructive impairment had been increased significantly at follow up but still remained below the predicted value. Mean forced vital capacity (FVC) of patients with initially restrictive impairment had returned to normal values at follow up. Airway hyperresponsiveness at diagnosis persisted in patients with obstructive impairment (II + IV 14/17, but disappeared in patients with humidifier fever (3/3) and restrictive type of humidifier lung (2/2). In patients with obstructive impairment (II + IV), FVC and FEV1 at diagnosis were negatively associated with the duration between onset of symptoms and diagnosis and the number of years of exposure. Those with positive pre-employment history of respiratory disease had a lower FEV1 at diagnosis. Sickness absence due to respiratory symptoms decreased in all groups of patients after removal from further exposure, but this was most impressive in patients with the humidifier lung (II, III) and patients with work related asthma (IV). At follow up 83% of the patients were still at work at the same production site, whereas 11% received a disability pension because of respiratory disease. CONCLUSION: In patients with work related respiratory disease caused by exposure from contaminated humidification systems or oil mist, removal from further exposure resulted in clinical improvement, although, especially in those with obstructive impairment, signs persisted. Because of the possibility of transferring patients to exposure-free departments most patients could be kept at work. PMID:10474537

  8. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women.

    PubMed

    Kramer, F M; Jeffery, R W; Forster, J L; Snell, M K

    1989-01-01

    Maintenance of weight loss continues to be a critical concern in behavioral treatment programs. Problems with the acquisition and/or application of behavioral skills are a likely contributor to relapse. However, biological models, especially the hypothesis of a body weight setpoint, are being offered increasingly as alternative explanations for maintenance failure. Within the context of these sometimes opposing viewpoints the present study describes long-term weight outcomes for 114 men and 38 women assessed annually for 4 or 5 years following completion of a 15 week behavioral weight loss program. Although significant mean weight loss was evident at long-term follow-up, a negatively accelerating pattern of weight regain was the predominant outcome. Less than 3 percent of the subjects were at or below their posttreatment weight on all follow-up visits. Consistent sex differences were found, with women having better weight loss maintenance than men. Implications and potential future directions are discussed. PMID:2663745

  9. Neuroendocrine Predictors of Emotional and Behavioral Adjustment in Boys: Longitudinal Follow-Up of a Community Sample

    PubMed Central

    Tyrka, Audrey R.; Lee, Janet K; Graber, Julia A.; Clement, Ashley M.; Kelly, Megan M.; DeRose, Laura; Warren, Michelle P.; Brooks-Gunn, Jeanne

    2012-01-01

    Background Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been observed in adults and children with mood and anxiety disorders and is thought to be involved in the pathogenesis of these disorders. We recently studied a diverse community sample of boys and found associations of behavioral problems, including symptoms of depression and anxiety, with basal and stress-induced cortisol concentrations. Here we examine cortisol-emotional/behavioral associations at a two-year follow-up and test whether initial cortisol is predictive of worsening of emotional/behavioral problems two years later. Method Seventy-eight 1014 year-old boys and their mothers completed a battery of psychosocial assessments, provided morning and afternoon saliva samples, and participated in a home visit involving mildly stressful tasks and saliva collection for cortisol assay during a two-year follow-up assessment. Results Consistent with the findings from our time 1 assessment, greater declines in cortisol across the home-visit challenge task were significantly associated with internalizing and externalizing behaviors as well as attention problems and social problems at the two-year follow-up. In addition, morning and afternoon cortisol concentrations at the initial assessment were significant positive predictors of the later development of child depressive symptoms at follow-up after controlling for initial depressive symptoms. Conclusion These findings demonstrate that children in the community with internalizing and externalizing behavior problems have altered patterns of HPA axis stress reactivity. In addition, our prospective findings suggest that elevated cortisol concentrations may influence the later development of emotional/behavioral problems in boys. PMID:22575356

  10. Thallium-201 imaging in the follow-up of differentiated thyroid carcinoma

    SciTech Connect

    Brendel, A.J.; Guyot, M.; Jeandot, R.; Lefort, G.; Manciet, G.

    1988-09-01

    Since thallium-201 imaging has been reported as a potential means of follow-up of patients with differentiated thyroid carcinoma (DTC) during ongoing thyroid suppression therapy, the authors evaluated the diagnostic sensitivity of this procedure in 31 patients known to have metastases or local recurrence. Among 51 tumor sites /sup 201/TI imaging had a detection rate of 45% whereas 84% was noted for imaging with /sup 131/I administered in therapeutic doses. Thus, even though the effectiveness of the two radionuclides is not strictly comparable due to the difference in the administered doses, Thallium imaging cannot be recommended as the only modality for the follow-up of patients with DTC. Six of the eight tumor sites negative with /sup 131/I were positive with /sup 201/TI (especially metastatic cervico-mediastinal lymph nodes). So /sup 201/TI imaging may particularly be helpful in localizing metastases or recurrences in patients with a negative /sup 131/I scan and abnormal levels of serum thyroglobulin.

  11. Parent-child development center follow-up project: child behavior problem results.

    PubMed

    Johnson, Dale L

    2006-07-01

    The long-term effectiveness of the Parent-Child Development Centers (PCDCs) as programs to prevent behavior problems in children was examined with follow-up data collected 6-13 years after program completion. Data were collected for 581 children who had been in the programs with their mothers (Ns: Birmingham, 151; New Orleans, 186; Houston, 244). Mothers and teachers were interviewed. There were few significant differences between program and control groups. Only the early cohorts of the Houston program showed significant differences between groups on the Child Behavior Checklist (CBCL). EDITORS' STRATEGIC IMPLICATIONS: This is a rare example of long-term longitudinal evaluation of a cross-site prevention program with a large sample size. Practitioners and program designers will be interested in the author's descriptions of cohort and site implementation differences. The absence of major effects at follow-up (despite significant short-term effects) in this well-designed study must caution us against thinking of early prevention programs as inoculations. PMID:16802073

  12. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

    PubMed Central

    Jaquet, Antoine; Garanet, Franck; Balestre, Eric; Ekouevi, Didier K.; Azani, Jean Claude; Bognounou, Ren; Dah, Elias; Kondombo, Jean Charlemagne; Dabis, Franois; Drabo, Joseph

    2013-01-01

    Introduction The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 3044] and their median CD4 count was 181 cells/mm3 (IQR 97269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p<10?4) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (p<10?2). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10?4) and 45.3 (p<10?3), respectively. Discussion The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the follow-up of HAART-treated patients is a key component to restore HRQOL. PMID:24369739

  13. Loss to follow-up and bias assessment among a cohort of Thai men who have sex with men in Bangkok, Thailand.

    PubMed

    Pattanasin, Sarika; Wimonsate, Wipas; Chonwattana, Wannee; Tongtoyai, Jaray; Chaikummao, Supaporn; Sriporn, Anuwat; Sukwicha, Wichuda; Mock, Philip A; Holtz, Timothy H

    2016-03-01

    Minimising loss to follow-up is essential to obtain unbiased results. This study aimed to assess factors associated with loss to follow-up and effects on biasing exposure-outcome associations in a cohort of men who have sex with men in Bangkok. We enrolled sexually-active Thai men who have sex with men, at least 18 years old, in a study with four-monthly follow-up visits. At each visit, men answered HIV risk behaviour questions using audio computer-assisted self-interview. Logistic regression was used to evaluate factors associated with loss to follow-up and bias between exposures and prevalent HIV infection were estimated using adjusted relative odds ratios. From 2006 to 2010, we enrolled 1744 men who have sex with men; as of April, 2014, 1256 (72%) had completed at least the month-36 visit; loss to follow-up was 9.6%. Factors independently associated with loss to follow-up were age (18-21 years), education (primary level or less, secondary or vocational education), living outside Bangkok and vicinity, sexual orientation (bisexual, heterosexual), previous HIV testing, HIV infection, and behaviour in the past 4 months (recreational drug use, reporting group sex). An effect of loss to follow-up on factors of prevalent HIV infection was found by sexual orientation (transgender) and unprotected anal intercourse (receptive/insertive). These findings highlight the need to strengthen post-HIV test counselling. Directed counselling for HIV care should be given to young men who have sex with men and recreational drug users. PMID:25792548

  14. Using social networking sites (namely Facebook) in health visiting practice--an account of five years experience.

    PubMed

    Dion, Xena

    2015-02-01

    With new developments in electronic and social networking communication methods the way health visitors communicate with clients is rapidly changing. With good governance these technologies can be utilised to enhance the health visiting service and can be an effective way of accessing hard-to-reach families, saving time and resources. This paper presents five years' experience in the use of Facebook between the health visiting team and clients and explains the benefits and potential it offers to health visitors and other community practitioners. PMID:25720211

  15. Effects of telephone follow-up on blood glucose levels and postpartum screening in mothers with Gestational Diabetes Mellitus

    PubMed Central

    Khorshidi Roozbahani, Rezvan; Geranmayeh, Mehrnaz; Hantoushzadeh, Sedigheh; Mehran, Abbas

    2015-01-01

    Background: Gestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy. GDM, defined as glucose intolerance, first diagnosed or initiated during pregnancy affects 1-14% of pregnancies based on various studies. Screening and early diagnosis and appropriate glycemic control can improve prenatal outcomes. Telephone follow-up seems to be a reasonable way for pregnant women follow-up. The present study evaluated the effects of telephone follow-up on blood glucose level during pregnancy and postpartum screening. Methods: Eighty mothers with GDM were enrolled in this clinical trial and randomly divided into intervention and control groups. All mothers were asked to check their blood sugar levels fivetimes daily. In intervention group, telephone intervention was performed for 10 weeks. In each follow-up, individuals were followed for insulin injections, diet, clinical tests and reminding the next visit. In control group, three times of telephone call was established to record blood sugar levels. Another telephone call was established at 6 weeks of postpartum in both study groups to evaluate the performance of the screening test for blood sugar. Results: The mean age of mothers was 30.95 years in the control and 30.75.1 years in the intervention groups In intervention group, mean level of blood glucose, 2 hours after lunch at 28 weeks of pregnancy was significantly lower than the control group (P<0.05). Mean differences in levels of fasting blood glucose between 28 weeks and 32 and between 28 and 36 weeks of pregnancy were significantly higher in the intervention than the control group (P<0.05). Rate of postpartum glucose screening test was significantly higher in the intervention group (P<0.001). Conclusion: The findings of this study demonstrated that telephone follow-up could significantly reduce fasting blood glucose levels in mothers with gestational diabetes and also increased the rate of postpartum screening test. PMID:26793640

  16. General practice vs surgical-based follow-up for patients with colon cancer: randomised controlled trial

    PubMed Central

    Wattchow, D A; Weller, D P; Esterman, A; Pilotto, L S; McGorm, K; Hammett, Z; Platell, C; Silagy, C

    2006-01-01

    This trial examined the optimal setting for follow-up of patients after treatment for colon cancer by either general practitioners or surgeons. In all, 203 consenting patients who had undergone potentially curative treatment for colon cancer were randomised to follow-up by general practitioners or surgeons. Follow-up guidance recommended three monthly clinical review and annual faecal occult blood tests (FOBT) and were identical in both study arms. Primary outcome measures (measured at baseline, 12 and 24 months were (1) quality of life, SF-12; physical and mental component scores, (2) anxiety and depression: Hospital Anxiety and Depression Scale and (3) patient satisfaction: Patient Visit-Specific Questionnaire. Secondary outcomes (at 24 months) were: investigations, number and timing of recurrences and deaths. In all, 170 patients were available for follow-up at 12 months and 157 at 24 months. At 12 and 24 months there were no differences in scores for quality of life (physical component score, P=0.88 at 12 months; P=0.28 at 24 months: mental component score, P=0.51, P=0.47; adjusted), anxiety (P=0.72; P=0.11) depression (P=0.28; P=0.80) or patient satisfaction (P=0.06, 24 months). General practitioners ordered more FOBTs than surgeons (rate ratio 2.4, 95% CI 1.44.4), whereas more colonoscopies (rate ratio 0.7, 95% CI 0.51.0), and ultrasounds (rate ratio 0.5, 95% CI 0.31.0) were undertaken in the surgeon-led group. Results suggest similar recurrence, time to detection and death rates in each group. Colon cancer patients with follow-up led by surgeons or general practitioners experience similar outcomes, although patterns of investigation vary. PMID:16622437

  17. The 49th hour: analysis of a follow-up medication and vaccine dispensing field test.

    PubMed

    Puerini, Raymond; Caum, Jessica; Francis, Natalie; Alles, Steven

    2015-01-01

    Anthrax response plans, exercises, and assessments over the past decade have focused almost exclusively on the first 48 hours of the public health response following a jurisdiction-wide exposure and provision of an initial 10-day supply of antibiotics from the Strategic National Stockpile (SNS). But mass dispensing of the subsequent 50-day course of antibiotics and administration of the 3-dose vaccine series have received considerably less attention, although these follow-up activities may prove even more complex. In 2014, the Philadelphia Department of Public Health (PDPH) made its first foray into this next frontier of mass prophylaxis planning by: (1) researching patient safety and adherence considerations relevant to the antibiotics in the SNS; (2) designing a model for a second-visit antibiotic and vaccine point of dispensing (POD), including development of an enhanced screening protocol that assumes a higher level of medical responsibility; and (3) field testing this model during a real seasonal influenza vaccination clinic to assess throughput and accuracy and to evaluate the resources needed to operationalize this model. While the observations and data presented here provide some framework for local long-term mass prophylaxis planning efforts, many areas remain undefined, including the distribution of responsibilities among the public health and healthcare communities to ensure patient safety. In addition to presenting findings, the larger intent of this article is to initiate a dialogue with other stakeholders at the local, state, and federal levels to advance long-term mass prophylaxis planning. PMID:25812429

  18. Follow-up of patients with systemic lupus erythematosus: what is not found in the guidelines.

    PubMed

    Jimnez-Alonso, J; Vargas-Hitos, J A; Navarrete-Navarrete, N; Zamora-Pasadas, M; Aguilar-Huergo, S; Jimez, L; Sabio, J M

    2013-12-01

    A series of measures in the management of patients with systemic lupus erythematosus (SLE) which usually are not found in the lupus guidelines are discussed. In the lupus patient who has been well-controlled in the long term, the dose of hydroxychloroquine should be progressively reduced, without decreasing more than approximately 600 mg per week. We recommend taking this drug in the morning in patients with insomnia, at night in those with dyspepsia and to separate the intake of the drug from the shower (and the water should be as cool as possible) in those patients with aquagenic pruritus. We do not use prednisone on alternate days and exceptionally divide the dose into before breakfast and before dinner. Twenty to 30 min should be used per patient in every scheduled visit to assure a good clinical and human practice. We analyzed the follow-up of 112 consecutive patients from our systemic disease unit and found that 71.4% of them had symptoms that were unexplained by lupus and we only referred 8.9% of them to other specialists, probably because of our general training as internal medicine doctors. We suggest that knowing the views of SLE specialists might be of interest since, well-designed studies that would allow to progress in the understanding of this disease could be performed based on their experience. PMID:23790517

  19. Psychological adjustment in children after traumatic disfiguring injuries: a 12-month follow-up.

    PubMed

    Rusch, M D; Grunert, B K; Sanger, J R; Dzwierzynski, W W; Matloub, H S

    2000-12-01

    The psychological adjustment of 57 children (age range, 3 to 12 years) who sustained mutilating traumatic injuries to the face or upper or lower extremities was assessed over a 12-month interval. The injuries had occurred as a result of boating, lawn mower, or home accidents or dog bites. Within 5 days of the traumatic event, 98 percent of the children were symptomatic for posttraumatic stress disorder, depression, or anxiety. One month after the injury, 82 percent were symptomatic. Symptom frequency had declined by the time of the 3-month and 6-month evaluations, but 44 percent of the children continued to report symptoms at 12-month follow-up visits, and 21 percent met the diagnostic criteria for posttraumatic stress disorder. Typical symptoms included flashbacks, fear of re-injury, mood disorders, body-image changes secondary to disfigurement, sleep disturbances, and anxiety. These findings support the importance of psychological evaluation and treatment of children who suffer mutilating injuries that require the attention of plastic surgeons. PMID:11129171

  20. Lymphoma Survivors May Not Get All Recommended Follow-Up Care

    MedlinePLUS

    ... fullstory_156730.html Lymphoma Survivors May Not Get All Recommended Follow-Up Care California study finds gaps ... adult survivors of Hodgkin lymphoma do not receive all the recommended follow-up care, a new study ...

  1. RUPP AUTISM NETWORK RANDOMIZED CLINICAL TRIAL OF PARENT TRAINING AND MEDICATION: ONE-YEAR FOLLOW-UP

    PubMed Central

    Arnold, L. Eugene; Aman, Michael G.; Li, Xiaobai; Butter, Eric; Humphries, Kristina; Scahill, Laurence; Lecavalier, Luc; McDougle, Christopher J.; Swiezy, Naomi B.; Handen, Benjamin; Wilson, Krystina; Stigler, Kimberly A.

    2013-01-01

    Objective To follow up on a 3-site 24-week randomized clinical trial (N=124) comparing antipsychotic medication alone (MED) to antipsychotic plus parent training (PT) in behavior management (COMB) for autism spectrum disorders with severe behavior problems. COMB had shown a significant advantage for child behavioral noncompliance (p=.006, d=.34), irritability (p=.01, d=.48), and hyperactivity/noncompliance (p=.04, d=.55), with a lower medication dose. Method: A year after each participant’s termination we priority-mailed an assessment packet with a return-addressed envelope; a phone call alerted the family. Failure to return packets within a month elicited recontact and offers to resend. Results Eighty-seven of 124 families (70.2%) participated in follow-up. The improvement difference between treatments attenuated from post-treatment to follow-up for noncompliance (d=0.32 to d=0.12) and irritability (d=0.46 to d=0.03). Follow-up differences were nonsignificant. (The noncompliance difference was nonsignificant also at post-treatment for these 87.) 67% of COMB and 53% of MED were still taking risperidone, the original study medication. Most had needed dose adjustments or additional medication, and COMB no longer had a significantly lower dose. All COMB families but only 39% of MED reported seeking PT post-treatment. Daily living skills improvement during treatment predicted noncompliance improvement at follow-up for COMB, but noncompliance deterioration, and especially hyperactivity/noncompliance deterioration for MED-only children. Conclusions Study treatment experience/familiarity greatly influenced follow-up treatment: those who had received PT reported seeking it while those who had not experienced it tended not to seek it. The superiority of COMB over MED at post-treatment attenuated by over half at follow-up. PMID:23101743

  2. Teacher Education Follow-up Surveys: Variables Related to Response Rate.

    ERIC Educational Resources Information Center

    Boser, Judith A.

    This study of teacher education graduate follow-up surveys examined the relationship between response rate and number of graduates, questionnaire length, and follow-up contacts. Also, the study investigated survey practices differentiating between surveys which had high and low return rates in such areas as number of follow-up contacts,

  3. Practices and Opinions Related to Follow-up Studies by Public Junior Colleges: An Empirical Study.

    ERIC Educational Resources Information Center

    Deem, Thomas E., Jr.

    This study proposed to identify and report current programs of student follow-up at 16 Illinois and 24 non-Illinois public junior colleges. Plans and recommendations are given for improving follow-up programs in Illinois. The author concluded that (1) the purpose of follow-up is to evaluate and improve the institution's performance; (2)…

  4. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--FOLLOW-UP QUESTIONNAIRE DATA

    EPA Science Inventory

    The Follow-up Questionnaire data set provides information concerning the activities within the household during the sampling week. The information is from 201 Follow-up Questionnaires for 91 households. Medication and supplemental dietary information is provided. The Follow-up...

  5. Follow-up of K2 planet candiates with the LCOGT network

    NASA Astrophysics Data System (ADS)

    Dragomir, Diana; Bayliss, Daniel; Colón, Knicole; Cochran, William; Zhou, George; Brown, Timothy; Shporer, Avi; Espinoza, Nestor; Fulton, Benjamin

    2015-12-01

    K2 has proven to be an outstanding successor to the Kepler mission. It has already revealed dozens of new planet candidates, and unlike those found by the primary mission, many of these systems’ host stars are sufficiently bright to allow extensive follow-up observations. This is especially important since each of the K2 observing campaigns are only ~80 days long, leaving the community with the discovery of exciting new systems but often not enough time coverage to enable a thorough characterization of these systems.We are leading a large effort to observe K2 transiting planet candidates with the LCOGT telescope network. LCOGT’s longitudinal coverage, multiple identical telescopes per site and automated queue observing make it an ideal facility for fast, high-precision and multi-color follow-up. Our program focuses on specific aspects of K2 follow-up for which the network is especially powerful: period determination for candidates with fewer than three K2 transits; transit timing variation monitoring to measure planetary masses, orbital parameters and to search for additional planets in multiple systems; and multi-color photometry to vet planet candidates and carry-out preliminary atmospheric spectroscopy.We will present new results for a selection of systems observed so far through this program. These include K2-19, a multi-planet system extremely close to 3:2 resonance and experiencing transit timing variations with amplitudes as large as one hour; EPIC201702477, a long-period planet with only two K2 transits; WASP-47, a system hosting a hot Jupiter and two K2-discovered small planets; and EPIC201637175b, a disintegrating rocky planet.Our program demonstrates that LCOGT is uniquely positioned to be the primary ground-based photometric follow-up resource for K2 exoplanet discoveries, but also for the numerous bright systems that will result from the TESS mission. LCOGT photometry complements ongoing radial velocity and atmospheric spectroscopy efforts to reveal a more complete picture of the bright, nearby exoplanet systems discovered by these missions.

  6. Equalizing rural health professionals' information access: lessons from a follow-up outreach project.

    PubMed Central

    Dorsch, J L

    1997-01-01

    A follow-up outreach project was undertaken to extend and reinforce the work of a National Library of Medicine-funded outreach project conducted in west central Illinois in 1991. The participants included five of the eight original sites as well as additional populations. An evolving partnership with the state's Center for Rural Health expanded the project's geographic area statewide. Evaluation showed benefits of varied training formats, reexposure to end-user searching, and the importance of "readiness." Follow-up training and longer trials for practice searching resulted in greater volume of search and document delivery activity. Varied training formats proved successful in reaching specific groups. Loansome Doc activity throughout the eighteen-month project suggested sustained use of Grateful Med beyond the two-month trial periods. The introduction of Grateful Med/Loansome Doc to unaffiliated health professionals is an important component in equalizing information access. Future information service initiatives are suggested to meet the challenge of building a rural information infrastructure and support system for health professionals. PMID:9028570

  7. Micro-Bypass Implantation for Primary Open-Angle Glaucoma Combined with Phacoemulsification: 4-Year Follow-Up

    PubMed Central

    Fea, Antonio Maria; Consolandi, Giulia; Zola, Marta; Pignata, Giulia; Cannizzo, Paola; Lavia, Carlo; Rolle, Teresa; Grignolo, Federico Maria

    2015-01-01

    Purpose. To report the long-term follow-up results in patients with cataract and primary open-angle glaucoma (POAG) randomly assigned to cataract surgery combined with micro-bypass stent implantation or phacoemulsification alone. Methods. 36 subjects with cataract and POAG were randomized in a 1?:?2 ratio to either iStent implantation and cataract surgery (combined group) or cataract surgery alone (control group). 24 subjects agreed to be evaluated again 48 months after surgery. Patients returned one month later for unmedicated washout assessment. Results. At the long-term follow-up visit we reported a mean IOP of 15,9 2,3?mmHg in the iStent group and 17 2,5?mmHg in the control group (p = NS). After washout, a 14,2% between group difference in favour of the combined group was statistically significant (p = 0,02) for mean IOP reduction. A significant reduction in the mean number of medications was observed in both groups compared to baseline values (p = 0,005 in the combined group and p = 0,01 in the control group). Conclusion. Patients in the combined group maintained low IOP levels after long-term follow-up. Cataract surgery alone showed a loss of efficacy in controlling IOP over time. Both treatments reduced the number of ocular hypotensive medications prescribed. This trial is registered with: NCT00847158. PMID:26587282

  8. Full mouth rehabilitation with zygomatic implants in patients with generalized aggressive periodontitis: 2 year follow-up of two cases.

    PubMed

    Rajan, Gunaseelan; Natarajarathinam, Gowri; Kumar, Saravana; Parthasarathy, Harinath

    2014-01-01

    Rehabilitation of severely atrophied maxillae is often a challenge and patients with generalized aggressive periodontitis (GAP) make it even more complicated. This clinical report describes rehabilitation of GAP patients with zygomatic implants and followed-up for 2 years. Two patients of age 33 and 44 reported to a private dental practice and were diagnosed with GAP. Various treatment options were considered after which it was decided to do a full mouth implant supported fixed rehabilitation, with a combination of conventional and zygomatic implants. Two zygomatic and four conventional implants were placed and immediately loaded with a provisional prosthesis. After 6 months, definitive prosthesis was delivered. Implants and prostheses were followed-up for 2 years. No implant failures occurred, but a few biological complications were observed. The most common clinical observation in these patients during recall visits was peri-implant soft-tissue inflammation, which is a biological complication. This was with no trouble, controlled by using proper oral hygiene aids and maintenance. Within the limitations of this study, we can state that it can definitely be considered as a viable treatment option treating patients with GAP. However, studies with more follow-up time and controlled clinical trials should be performed in order to document the longevity of this treatment modality. PMID:24744558

  9. Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

    PubMed Central

    Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

    1997-01-01

    Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

  10. Cohort Profile Update: 2004 Pelotas (Brazil) Birth Cohort Study. Body composition, mental health and genetic assessment at the 6 years follow-up

    PubMed Central

    Santos, Iná S; Barros, Aluísio JD; Matijasevich, Alicia; Zanini, Roberta; Chrestani Cesar, Maria Aurora; Camargo-Figuera, Fabio Alberto; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G

    2014-01-01

    This is an update of the 2004 Pelotas Birth Cohort profile, originally published in 2011. In view of the high prevalence of overweight and mental health problems among Brazilian children, together with the availability of state-of-the-art equipment to assess body composition and diagnostic tests for mental health in childhood, the main outcomes measured in the fifth follow-up (mean age 6.8 years) included child body composition, mental health and cognitive ability. A total of 3722 (90.2%) of the original mothers/carers were interviewed and their children examined in a clinic where they underwent whole-body dual X-ray absorptiometry (DXA), air displacement plethysmography and a 3D photonic scan. Saliva samples for DNA were obtained. Clinical psychologists applied the Development and Well-Being Assessment questionnaire and the Wechsler Intelligence Scale for Children to all children. Results are being compared with those of the two earlier cohorts to assess the health effects of economic growth and full implementation of public policies aimed at reducing social inequalities in the past 30 years. For further information visit the programme website at [http://www.epidemio-ufpel.org.br/site/content/coorte_2004/questionarios.php]. Applications to use the data should be made by contacting 2004 cohort researchers and filling in the application form available at [http://www.epidemio-ufpel.org.br/site/content/estudos/formularios.php]. PMID:25063002

  11. Follow up of patients who start treatment with antidepressants: treatment satisfaction, treatment compliance, efficacy and safety

    PubMed Central

    2013-01-01

    Background Measuring satisfaction with treatment has proved useful to ascertain the treatment features that are most important to the patients, and to explain increased treatment compliance. However, there are few studies that relate satisfaction to other clinical or self-perceived health status indicators. Recent studies have shown the close relationship between satisfaction with treatment, treatment compliance, and effectiveness. This study attempts to design and validate a scale to evaluate satisfaction with antidepressant drug therapy, assess treatment compliance (self-reported, validated questionnaire, drug accountability and electronic monitorization system), assess efficacy in reducing depressive symptoms and safety in patients who initiate antidepressant drug therapy, as well as to establish predictors of satisfaction, compliance and effectiveness with these drugs. Methods/design This is an observational longitudinal study with a cohort of adults initiating treatment with antidepressant drugs. A multi-centre study will be performed in which 20 Primary Care practices from Castilla-La Mancha are expected to participate. An initial interview and follow-up visits at 15 days, 1, 3, 6, 9 and 12 months will be conducted with all study participants. 706 subjects will be studied (95% confidence interval, precision 3%, expected rate of non-compliance 50%, expected non-responders and lost to follow up rate 15%). The following measurements will be performed: development and validation of a scale of satisfaction with antidepressant therapy, participant and antidepressant characteristics, treatment compliance evaluation (Haynes-Sackett Test, Morisky-Green Test, drug accountability and Medication Event Monitoring System), depression symptom reduction (Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale), observation of adverse effects, and beliefs about treatment (The Beliefs about Medicines Questionnaire). Discussion Antidepressant drugs are an extraordinarily important therapeutic group in the pharmacy composition; economic repercussions and social impact associated to their use is clear. Despite their well-established efficacy in clinical trials, treatment non-compliance is a major obstacle to their effectiveness in clinical practice. The proposed study brings about useful conclusions to improve the results of these drugs. Additionally, devising a scale specifically designed to evaluate satisfaction with antidepressant treatment could be of interest in healthcare outcomes research. PMID:23425500

  12. Follow-up of cancer in primary care versus secondary care: systematic review

    PubMed Central

    Lewis, Ruth A; Neal, Richard D; Williams, Nefyn H; France, Barbara; Hendry, Maggie; Russell, Daphne; Hughes, Dyfrig A; Russell, Ian; Stuart, Nicholas SA; Weller, David; Wilkinson, Clare

    2009-01-01

    Background Cancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care. Aim To compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. Design of study Systematic review. Setting Primary and secondary care settings. Method A search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care. Results There was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrence-related serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancer-related referrals. Conclusion Weak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached. PMID:19566990

  13. Spectroscopic Follow-Up Observations of Transiting Planet Candidates Identified by the Kepler Mission

    NASA Astrophysics Data System (ADS)

    Latham, David; Sasselov, D. D.; Szentgyorgyi, A. H.

    2006-12-01

    NASA's Kepler Mission is expected to identify many hundreds of transiting planet candidates in four years of continuous photometric monitoring of 100 square degrees in Cygnus and Lyra. To sort out true planets from eclipsing stellar systems that are masquerading as transiting planets, a variety of follow-up observations are planned. High resolution ground-based spectroscopy at modest signal-to-noise ratio will be used to detect orbital motion induced by stellar companions, for example by small M dwarf secondaries eclipsing solar-type primaries. The most challenging stellar imposters are blends of eclipsing binaries with nearby bright stars; even high-quality spectra may have difficulty resolving such systems. A workhorse for this initial phase of spectroscopic follow up will be TRES, a new fiber-fed echelle spectrograph on the 1.5-m Tillinghast Reflector at the Whipple Observatory. Ultimate confirmation of a transiting planet comes with the solution for a spectroscopic orbit and the derivation of an actual mass of the planet compared to the parent star. A primary goal of the Kepler Mission is to find earth-sized planets in or near the habitable zones of their host stars. The radial-velocity precision needed to derive spectroscopic orbits for the most interesting cases will require considerable improvement beyond 1 m/s. The Geneva Observatory and Harvard University have joined in a collaboration to develop such a capability at a northern site with access to the Kepler field of view. A version of the HARPS spectrograph, now in highly successful operation on the 3.6-m telescope at ESO on La Silla, is being built. Negotiations are underway to site HARPS North at the William Herschel Telescope operated by the Isaac Newton Group of Telescopes on La Palma. The goal is to achieve velocity performance at the level of 20 cm/s and to push the determination of planetary masses into the terrestrial planet regime.

  14. Evaluation of a residential nutrition rehabilitation center in rural Bolivia: Short-term effectiveness and follow-up results

    PubMed Central

    Rebolledo, Paulina A.; Huamani, Katherine Foy; Mues, Katherine E.; Ramakrishnan, Usha; Leon, Juan S.

    2015-01-01

    Background Nutrition rehabilitation centers (NRCs) have shown mixed results in reducing morbidity and mortality among undernourished children in the developing world. Follow-up on children after leaving these programs remains undocumented. Objective To assess the nutritional improvement of children attending the Centro de Rehabilitación Infantil Nutricional (CRIN), a residential NRC in rural Bolivia, from entrance to exit and to a household follow-up visit 1 month to 6 years later, and to identify factors associated with nutritional improvement. Methods A retrospective analysis was conducted of clinical records collected by CRIN staff from 135 children under 3 years of age attending CRIN in rural Cochabamba, Bolivia, from 2003 to 2009, and of clinical records of household follow-up measurements on a subset of 26 children that were taken between 1 month and 6 years postexit. Nutritional status was evaluated by calculating z-scores for weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ). Children with z-scores < − 2 were considered to be wasted, underweight, or stunted, respectively. Results The prevalence of wasting decreased significantly, while the prevalence of stunting did not change significantly between entrance and exit from the program. From entrance to exit, the mean changes in WHZ (0.79) and WAZ (1.08) were statistically significant, while the mean change in HAZ (− 0.02) was not significant. Linear regression analysis suggested that nutritional status and diarrhea at entrance had the greatest effect on WHZ and HAZ changes between entrance and exit. Children maintained their nutritional gains from the program between exit and follow-up and showed statistically significant improvement in WAZ (but not HAZ). Conclusions CRIN is effective at rehabilitating nutritional deficits associated with wasting, but not those associated with stunting. PMID:25076769

  15. Semen quality improves marginally during young adulthood: a longitudinal follow-up study

    PubMed Central

    Perheentupa, Antti; Sadov, Sergey; Rönkä, Riitta; Virtanen, Helena E.; Rodprasert, Wiwat; Vierula, Matti; Jørgensen, Niels; Skakkebæk, Niels E.; Toppari, Jorma

    2016-01-01

    STUDY QUESTION Does semen quality improve during early adulthood? SUMMARY ANSWER Semen variables change little during the third decade of life, however some improvement in sperm morphology and motility may occur. WHAT IS KNOWN ALREADY A suspicion of deteriorating semen quality has been raised in several studies. The longitudinal development of semen quality in early adulthood is insufficiently understood. STUDY DESIGN, SIZE, DURATION A longitudinal follow-up of two cohorts of volunteer young adult Finnish men representing the general population was carried out. Cohorts A (discovery cohort, born 1979–1981, n = 336) and B (validation cohort, born 1983, n = 197) were followed up from the age of 19 years onward for 10 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria included that both the men and their mothers were born in Finland. Semen analysis was performed in cohorts A and B at 2–4 year intervals over a period of 10 years. Semen volume, sperm concentration, total sperm count, motility, total motile count and morphology were the variables assessed in the analysis. A physical examination was carried out at each visit to detect any significant andrological abnormalities. The overall participation rate was 13.4%. MAIN RESULTS AND THE ROLE OF CHANCE During the follow-up, the percentage of sperm with normal morphology and the percentage of motile sperm increased significantly both in the discovery (A) (P < 0.001 at 19 versus 29 years for both) and validation (B) (P < 0.001 and P = 0.03 at 19 versus 29 years, respectively) cohort. Sperm concentration and total sperm count showed a significant increase with age only in cohort B (P = 0.03 at 21 versus 29 years, P = 0.009 at 19 versus 29 years, respectively). LIMITATIONS, REASONS FOR CAUTION A limited number of men participated both in the first round and in the final fourth round (cohort A, n = 111 and cohort B, n = 90 men) and in all four rounds (cohort A, n = 61 and cohort B, n = 52). WIDER IMPLICATIONS OF THE FINDINGS Almost full spermatogenic capacity is reached by the age of 19 years. However, the improvement in sperm motility and morphology during early adulthood may slightly improve male fecundity. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the European Commission (QLK4-CT-1999-01422, QLK4-CT-2001-00269, QLK4-2002-0063, FP7/2008-2012: DEER 212844), The Danish Medical Research Council (9700833, 9700909), Danish Agency for Science (Technology and Innovation 09-067180), the Svend Andersen's Foundation, Velux Foundation, and Novo Nordisk Foundation, the Turku University Hospital, Sigrid Jusélius Foundation and the Academy of Finland. There are no conflicts of interest. PMID:26740579

  16. Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality.

    PubMed

    Rahu, Kaja; Auvinen, Anssi; Hakulinen, Timo; Tekkel, Mare; Inskip, Peter D; Bromet, Evelyn J; Boice, John D; Rahu, Mati

    2013-06-01

    This study examined cancer incidence (1986-2008) and mortality (1986-2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardised incidence ratio (SIR) and standardised mortality ratio (SMR), respectively. Poisson regression was used to analyse the effects of year of arrival, duration of stay and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93-1.20 (232 cases). Elevated risks were found for cancers of the pharynx, the oesophagus and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96-1.08 (1018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted. PMID:23532116

  17. Results from the LCOGT Near-Earth Object Follow-up Network

    NASA Astrophysics Data System (ADS)

    Greenstreet, Sarah; Lister, Tim; Gomez, Edward; Christensen, Eric; Larson, Steve

    2015-11-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter and two 2-meter telescopes to five locations in the northern and southern hemispheres, with plans to extend to twelve 1-meter telescopes at 6 locations. The versitility and design of this network allows for rapid response to target of opportunity events as well as the long-term monitoring of slowly changing astronomical phenomena. The network's global coverage and the apertures of telescopes available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of the nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). This is complimented by the two 2-meter telescopes at Haleakala (Hawaii) and Siding Spring Observatory. The telescope network has been fully operational since May 2014, and observations are being executed remotely and robotically. Future expansion to sites in the Canary Islands and Tibet are planned for 2016.The LCOGT near-Earth object group is using the network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS), PanSTARRS (PS1) and NEOWISE, with several hundred targets being followed per year. Follow-up astrometry and photometry of radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists are improving orbits, producing light curves and rotation periods, and better characterizing these NEOs. Recent results include the first period determinations for several of the Goldstone-targeted NEOs. In addition, we are in the process of building a NEO portal that will allow professionals, amateurs, and Citizen Scientists to plan, schedule, and analyze NEO imaging and spectroscopy observations and data using the LCOGT Network and to act as a coordination hub for the NEO follow-up efforts.

  18. SRC liquid spill episode, SRC Pilot Plant, Ft. Lewis, Washington. Intermediate report: site visit observations and findings, January 29-February 20, 1980. [2300 gallon spill

    SciTech Connect

    Meyer, A.F. Jr.

    1980-02-27

    This report is intended to provide responsible DOE authorities with the professional observations and recommendations resulting from this firm's technical assistance in evaluating an accidental release of solvent refined coal (SRC) processed liquids at the SRC Pilot Plant, Ft. Lewis, Washington. The spill occurred during the night of December 19-20, 1979 at the facility operated for DOE by the Pittsburgh and Midway Coal Mining Company. The site visit on January 29, 1980 was made by DOE's staff member, Mr. John Abrahams, and this firm's representative, Mr. ALvin F. Meyer, Jr., P.E., President. In brief, the spill of approximately 2300 gallons of SRC processed liquids was caused by human failure. Compounding the circumstances was the presence of a bleeder valve which was inexplicably left open. Additional factors contributing to the episode were the fact that the operation was conducted at night, and the presence of steam and noise which obscured, at least partially, the possibility of detecting the spill occurrence. After operating personnel discovered the spill, the plant management of Pittsburg and Midway Coal Mining Company were informed. It was decided that environmental surveys and measurements would be undertaken to detect any possible contamination. Subsequent to the site visit, additional information was provided by Pittsburg and Midway Coal Mining Company, and by Hqs. ASFE Program officials. Analysis of the available data to date (February 22, 1980) indicates that no off site (SRC Plant boundaries) environmental contamination has occurred. A need exists for close further study and evaluation.

  19. Effect of telephone follow-up on retention and balance in an alcohol intervention trial

    PubMed Central

    Johnson, Natalie A.; Kypri, Kypros; Latter, Joanna; McElduff, Patrick; Attia, John; Saitz, Richard; Saunders, John B.; Wolfenden, Luke; Dunlop, Adrian; Doran, Christopher; McCambridge, Jim

    2015-01-01

    Objectives Telephone follow-up is not currently recommended as a strategy to improve retention in randomized trials. The aims of this study were to estimate the effect of telephone follow-up on retention, identify participant characteristics predictive of questionnaire completion during or after telephone follow-up, and estimate the effect of including participants who provided follow-up data during or after telephone follow-up on balance between randomly allocated groups in a trial estimating the effect of electronic alcohol screening and brief intervention on alcohol consumption in hospital outpatients with hazardous or harmful drinking. Method Trial participants were followed up 6 months after randomization (June–December 2013) using e-mails containing a hyperlink to a web-based questionnaire when possible and by post otherwise. Telephone follow-up was attempted after two written reminders and participants were invited to complete the questionnaire by telephone when contact was made. Results Retention before telephone follow-up was 62.1% (520/837) and 82.8% (693/837) afterward: an increase of 20.7% (173/837). Therefore, 55% (95% CI 49%–60%) of the 317 participants who had not responded after two written reminders responded during or after the follow-up telephone call. Age < 55 years, a higher AUDIT-C score and provision of a mobile/cell phone number were predictive of questionnaire completion during or after telephone follow-up. Balance between randomly allocated groups was present before and after inclusion of participants who completed the questionnaire during or after telephone follow-up. Conclusion Telephone follow-up improved retention in this randomized trial without affecting balance between the randomly allocated groups. PMID:26844146

  20. Ground-based follow-up of Solar System objects detected by Gaia

    NASA Astrophysics Data System (ADS)

    Thuillot, W.; Carry, B.; Berthier, J.; David, P.; Devillepoix, H.; Hestroffer, D.

    2014-07-01

    In the frame of the DPAC consortium preparing the Gaia mission, a specific follow-up activity has been set up in order to ensure best scientific return related to solar-system-object (SSO) science. This activity encompasses a system of alerts for newly detected objects provided by CNES, the French data center in charge of the Solar System data processing, and IMCCE, to organize and publish the alerts, and to retrieve the objects astrometry and feed the Minor Planet Center database. We are expecting in particular the detection of new near-Earth objects (NEO) at low solar elongation, or even inner-Earth objects. Owing to its observing mode, the satellite will not be able to monitor these objects after discovery and they could be lost. It is thus important to consolidate and improve their orbital parameters. This is the objective of the SSO ground-based follow-up. Once the objective is reached, it is possible to update the auxiliary database of orbital elements used within the Gaia data reduction pipeline for identifying the known SSOs and to allow Gaia to subsequently identify these objects properly during its mission. In order to reach these goals we have carried out two main activities: -- We have developed a pipeline for processing the Gaia raw data that will be received, and for disseminating only the topocentric data useful for observers in an automatized way -- We have set up a worldwide network of observing stations, the Gaia-FUN-SSO network (shortly described at https://www.imcce.fr/gaia-fun-sso/). At this date, 55 observing sites have registered and many participants have already contributed to several training campaigns for NEO observations. We will describe both activities and we will give preliminary results regarding the Gaia Solar System alerts, depending on the status of the triggering system during this early stage of the mission.

  1. HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

    PubMed Central

    2013-01-01

    Background HPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women. Methods We conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 20072010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits. Results Seventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0??3.8months) to clear HPV, compared to those not infected by HIV (5.9??3.0months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%). Conclusions Both HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women. PMID:24289532

  2. Assessing hypertension control in the community: the need for follow-up measurements to ensure clinical relevance.

    PubMed Central

    Birkett, N J; Donner, A P; Maynard, M D

    1987-01-01

    In community surveys of hypertension control the diagnosis is often based on blood pressure measurements taken on only one visit. The clinical diagnosis of hypertension requires demonstration of sustained blood pressure elevation. We conducted a survey that contrasted the results of these two approaches to determining the prevalence of hypertension and the extent to which hypertension is detected and treated. A multistage random sample of 2737 people was selected, examined and interviewed on up to three occasions. Rates of hypertension prevalence and control were computed from data from one, two and three visits. The prevalence of hypertension was overestimated by 30% when the diagnosis was based on data from one rather than three visits, the rates being 149 and 115/1000. The prevalence of undetected hypertension was overestimated by 350%, the rates being 27 and 6/1000. The proportion of subjects with controlled hypertension was underestimated by 23%, at 56%, compared with 73%. These results confirm the need for follow-up measurements to provide a valid assessment of hypertension control in the community. PMID:3815229

  3. Congressman Clyburn Visit

    ScienceCinema

    Cody, Tom

    2012-06-14

    Congressman James Clyburn visits the new employees of the Savannah River Site. These new jobs the graduates have received are a result of the Recovery Act at work. Lisa Jackson of the Environmental Protection Agency speaks about how the ARRA is in line with President Obama's vision of a better economy and cleaner environment.

  4. Congressman Clyburn Visit

    SciTech Connect

    Cody, Tom

    2010-01-01

    Congressman James Clyburn visits the new employees of the Savannah River Site. These new jobs the graduates have received are a result of the Recovery Act at work. Lisa Jackson of the Environmental Protection Agency speaks about how the ARRA is in line with President Obama's vision of a better economy and cleaner environment.

  5. [Bone scintiscanning in the diagnosis and follow-up of breast carcinoma].

    PubMed

    Arzano, S; Curzi, N M; Fatati, G; Grimani, A; Buzzi, A; Giordano, G P; Grignani, F

    1980-12-01

    Bone scans with Tc + 99m phosphate were performed in 87 patients with histological diagnosis of breast cancer, in order to evaluate whether this technique was suitable in detecting small metastasis both at first staging and in follow-up. The scans were considered as: a) "malignant", when an isotope uptake in usually inactive sites and/or an increased uptake in normally active areas were demonstrated; b) "equivocal", when the uptake in normally inactive and/or in normally active sites was only moderately increased; c) "benign", when only slight uptake increase in normally active structures was detectable. The scans have been carried out before or soon after mastectomy (early scans), and repeated at 6 month intervals (N+ patients and/or malignant or equivocal scans) or at 12 month intervals. A significantly greater incidence of malignant scans was observed in stages 2 and 3 as compared to stage 1, and in stage 4 as compared to all the other stages, as well as in premenopause versus postmenopause patients. PMID:7244115

  6. X-ray follow-up observations of unidentified VHE {gamma}-ray sources

    SciTech Connect

    Puehlhofer, Gerd

    2008-12-24

    A large fraction of the recently discovered Galactic Very High Energy (VHE) source population remains unidentified to date. VHE {gamma}-ray emission traces high energy particles in these sources, but for example in case of hadronic processes also the gas density at the emission site. Moreover, the particles have sufficiently long lifetimes to be able to escape from their acceleration sites. Therefore, the {gamma}-ray sources or at least the areas of maximum surface brightness are in many cases spatially offset from the actual accelerators. A promising way to identify the objects in which the particles are accelerated seems to be to search for emission signatures of the acceleration process (like emission from shock-heated plasma). Also the particles themselves (through primary or secondary synchrotron emission) can be traced in lower wavebands. Those signatures are best visible in the X-ray band, and current X-ray observatories are well suited to conduct such follow-up observations. Some aspects of the current status of these investigations are reviewed.

  7. A Two Year Follow Up of Infants in Community Based Infant Day Care.

    ERIC Educational Resources Information Center

    Rubenstein, Judith L.; And Others

    To determine whether the daily mother-infant separation involved in day care adversely affects children's emotional development, follow-up data on emotional development were compared for preschool children in day care and their home-reared counterparts. Follow-up assessments were done in the home at approximately age 3-1/2 for ten white middle

  8. The RETHINK Parenting and Anger Management Program: A Follow-Up Validation Study

    ERIC Educational Resources Information Center

    Fetsch, Robert J.; Yang, Raymond K.; Pettit, Matthew J.

    2008-01-01

    This study is the first follow-up assessment of the RETHINK Parenting and Anger Management Program. Parent participants (N = 168) reduced their anger, violence, and family conflict levels from posttest to follow-up, on average, at 2.5 months on 13 of 15 dependent variables. Current findings are consistent with a small, albeit growing body of

  9. Utility of Follow-Up Skeletal Surveys in Suspected Child Physical Abuse Evaluations

    ERIC Educational Resources Information Center

    Zimmerman, Stephanie; Makoroff, Kathi; Care, Marguerite; Thomas, Amy; Shapiro, Robert

    2005-01-01

    Objective: To evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations. Methods: In this prospective study, follow-up skeletal surveys were recommended for 74 children who, after an initial skeletal survey and evaluation by the Child Abuse Team, were suspected victims of physical abuse. The number and

  10. Documentation for the 2008-09 Teacher Follow-up Survey. NCES 2011-304

    ERIC Educational Resources Information Center

    Graham, Shawna; Parmer, Randall; Chambers, Lisa; Tourkin, Steven; Lyter, Deanna M.

    2011-01-01

    The Teacher Follow-up Survey (TFS) is sponsored by the National Center for Education Statistics (NCES) on behalf of the U.S. Department of Education and is conducted by the U.S. Census Bureau. TFS is a follow-up survey of selected elementary and secondary school teachers who participated in the Schools and Staffing Survey (SASS). SASS is the

  11. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    ERIC Educational Resources Information Center

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories

  12. How Do Mode and Timing of Follow-up Surveys Affect Evaluation Success?

    ERIC Educational Resources Information Center

    Koundinya, Vikram; Klink, Jenna; Deming, Philip; Meyers, Andrew; Erb, Kevin

    2016-01-01

    This article presents the analysis of evaluation methods used in a well-designed and comprehensive evaluation effort of a significant Extension program. The evaluation data collection methods were analyzed by questionnaire mode and timing of follow-up surveys. Response rates from the short- and long-term follow-ups and different questionnaire…

  13. NHEXAS PHASE I ARIZONA STUDY--FOOD FOLLOW-UP QUESTIONNAIRE DATA

    EPA Science Inventory

    The Food Follow-up Questionnaire data set provides information on the eating patterns and the food identification and preparation methods that occurred during the period the food sample was taken. The information is for 179 Food Follow-up Questionnaires for 179 households. In t...

  14. Follow-Up Survey, Graduates of 1993-1994, Macomb Community College. Project #94-069.

    ERIC Educational Resources Information Center

    Adams, Judith

    As part of a program of graduate follow-up studies, Macomb Community College (MCC), in Michigan, regularly conducts surveys of graduates or certificate earners 1, 3, and 5 years after their departure from the college. For the 1-year follow-up of the class of 1993-94, surveys were sent to all 2,808 alumni requesting information on characteristics,

  15. A Research on Students' Needs for Follow-Up Curriculum of College English

    ERIC Educational Resources Information Center

    Jin, Jie; Liu, Hengying; Zhang, Yan

    2015-01-01

    Increased universities and colleges offer the undergraduates with more follow-up courses with the further reform in college English education in China. An investigation on self-evaluation, difficulty, and willingness of undergraduates in learning English further was made in order to design more appropriate and adaptable follow-up courses. This…

  16. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Follow-up by Government. 2027.305-3 Section 2027.305-3 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION... 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  17. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Follow-up by Government. 2027.305-3 Section 2027.305-3 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION... 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  18. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Follow-up by Government. 2027.305-3 Section 2027.305-3 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION... 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  19. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Follow-up by Government. 2027.305-3 Section 2027.305-3 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION... 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  20. Client Follow-Up Studies: A Handbook on Program Evaluation for Chemical Dependency Programs.

    ERIC Educational Resources Information Center

    Mayer, Steven E.; And Others

    This handbook outlines procedures for planning and conducting follow-up studies of clients involved in chemical dependency programs. It is organized into eight chapters. Chapter I discusses purposes and applications of client follow-up studies. Studies may be used in program evaluation, program design, and staff development. Also, the study itself

  1. Career Program Completers. 1989-90 Long-Term Follow-Up Study.

    ERIC Educational Resources Information Center

    Johnson County Community Coll., Overland Park, KS. Office of Institutional Research.

    In summer 1994, a long-term follow-up study was conducted of 1989-90 graduates of career programs at Johnson County Community College (JCCC) in Kansas. A survey was mailed to 536 graduates, certificate holders, and students who left JCCC with marketable skills to assess their satisfaction with JCCC and their jobs. With telephone follow-up, a

  2. A Two Year Follow Up of Infants in Community Based Infant Day Care.

    ERIC Educational Resources Information Center

    Rubenstein, Judith L.; And Others

    To determine whether the daily mother-infant separation involved in day care adversely affects children's emotional development, follow-up data on emotional development were compared for preschool children in day care and their home-reared counterparts. Follow-up assessments were done in the home at approximately age 3-1/2 for ten white middle…

  3. Utility of Follow-Up Skeletal Surveys in Suspected Child Physical Abuse Evaluations

    ERIC Educational Resources Information Center

    Zimmerman, Stephanie; Makoroff, Kathi; Care, Marguerite; Thomas, Amy; Shapiro, Robert

    2005-01-01

    Objective: To evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations. Methods: In this prospective study, follow-up skeletal surveys were recommended for 74 children who, after an initial skeletal survey and evaluation by the Child Abuse Team, were suspected victims of physical abuse. The number and…

  4. Men with Intellectual Disabilities Who Have Attended Sex Offender Treatment Groups: A Follow-up

    ERIC Educational Resources Information Center

    Heaton, Kathryn M.; Murphy, Glynis H.

    2013-01-01

    Background: There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. Method Thirty-four men (from seven

  5. NHEXAS PHASE I REGION 5 STUDY--FOLLOW-UP QUESTIONNAIRE DATA (ALL MONITORING PERIODS)

    EPA Science Inventory

    This data set includes responses for 249 participants with a total of 444 follow-up questionnaires. Some participants were studied for more than one monitoring period. The Follow-up Questionnaire was used to provide information on relatively infrequent (e.g., less than daily) ac...

  6. NHEXAS PHASE I REGION 5 STUDY--FOLLOW-UP QUESTIONNAIRE DATA (MONITORING PERIOD 1)

    EPA Science Inventory

    This data set includes responses for 249 follow-up questionnaires collected during the first week-long monitoring period. The Follow-up Questionnaire was used to provide information on relatively infrequent (e.g., less than daily) activities during the sampling period to explain ...

  7. What Happens Next? Follow-Up from the Children's Toddler School Program

    ERIC Educational Resources Information Center

    Akshoomoff, Natacha; Stahmer, Aubyn C.; Corsello, Christina; Mahrer, Nicole E.

    2010-01-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class,

  8. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    ERIC Educational Resources Information Center

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

  9. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--FOOD FOLLOW-UP QUESTIONNAIRE DATA

    EPA Science Inventory

    The Food Follow-up Questionnaire data set provides information on the eating patterns and the food identification and preparation methods that occurred during the period the food sample was taken. The information is for 86 Food Follow-up Questionnaires for 86 households. In the...

  10. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores

  11. Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

    ERIC Educational Resources Information Center

    Dale, Jack

    Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

  12. NHEXAS PHASE I REGION 5 STUDY--FOOD FOLLOW-UP QUESTIONNAIRE DATA

    EPA Science Inventory

    This data set includes responses for 163 food follow-up questionnaires. The food diary follow-up questionnaire was used to identify how the dietary patterns observed for study participants who had submitted duplicate diet samples and completed the associated food diary related to...

  13. Follow-Up 89. Minnesota High School Follow-Up. Class of 1988: One Year Later. Trend Data: 1978-1988.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1988. Data regarding 15,232 students (14,151 graduates, 503 dropouts, and 578 students school leavers not classified as dropouts) were collected from 87 high schools participating in the Minnesota Secondary School Follow-up System and from 966

  14. Follow-Up 92. Minnesota High School Follow-Up. Class of 1991--One Year Later. Trend Data: 1978-1991.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1991. Data regarding 12,270 students (11,674 graduates, 218 dropouts, and 378 students school leavers not classified as dropouts) were collected from 107 high schools participating in the Minnesota Secondary School Follow-up System and from

  15. Follow-Up 90. Minnesota High School Follow-Up. Class of 1989: One Year Later. Trend Data: 1978-1989.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1989. Data regarding 14,636 students (14,024 graduates, 324 dropouts, and 288 students school leavers not classified as dropouts) were collected from 97 high schools participating in the Minnesota Secondary School Follow-up System and from 853

  16. Follow-Up 91. Minnesota High School Follow-Up. Class of 1990--One Year Later. Trend Data: 1978-1990.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1990. Data regarding 12,458 students (11,814 graduates, 356 dropouts, and 288 students school leavers not classified as dropouts) were collected from 90 high schools participating in the Minnesota Secondary School Follow-up System and from 926

  17. EA follow-up in the Ghanaian mining sector: Challenges and opportunities

    SciTech Connect

    Appiah-Opoku, Seth; Bryan, Hobson C.

    2013-07-15

    Environmental assessment (EA) follow-up provides a means for monitoring and evaluating the implementation of environmental impact studies. It is integral to the success or failure of a project or program. In spite of its importance, very little attention is given to the need for follow-up programs in most jurisdictions in Africa. Using a case study in the Ghanaian mining sector, this paper explores the challenges and opportunities within the country's EA process for an effective follow-up program. The paper is based on informal interviews, content analysis of relevant publications, official EA documents, and internet searches. The authors suggest a standard EA follow-up program to be formalized as an integral part of Ghana's environmental assessment policy. They also propose a follow-up process that harnesses existing opportunities within the country's EA system. This approach can be replicated in other African countries.

  18. Reducing noncompliance to follow-up appointment keeping at a family practice center.

    PubMed Central

    Rice, J M; Lutzker, J R

    1984-01-01

    In this study, we evaluated follow-up appointment keeping at a family practice center. To determine if noncompliance could be reduced, four treatments were implemented: no-treatment control, modified appointment card, free follow-up, and a reduced rate follow-up. Thereafter, the reduced rate follow-up was implemented again to determine the extent noncompliance could be reduced for all eligible patients. Incentives significantly increased follow-up appointment keeping, whereas the modified appointment card was ineffective. A cost analysis suggested that the no-treatment control and modified appointment card conditions were the least expensive, but also the least effective. The incentive conditions were more expensive, but the reduced rate condition generated the most net revenue. Questionnaire data suggested that the incentive conditions had an effect on noncompliance and may be considered for use in other medical settings. PMID:6439713

  19. Quality of cancer follow-up care: a focus on Latina breast cancer survivors

    PubMed Central

    Ashing, Kimlin; Napoles, Anna

    2014-01-01

    Introduction Receiving quality cancer follow-up care influences survivorship outcomes. Among Latinas, breast cancer is the number one cause of cancer death; yet Latinas do not receive adequate follow-up care. This study examined quality of cancer follow-up care among Latina breast cancer survivors (BCS) and whether it differs by participant language and healthcare system variables (provider specialty, and medical setting). Methods Two hundred thirty-two (95 English-speaking Latina and 137 Spanish-speaking) Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. Results English-speaking Latina BCS were more likely to report receiving cancer follow-up care at a doctor’s office (p<0.001). BCS without a regular place for cancer follow-up care were more likely to report not seeing a primary care provider (p<0.05) or cancer specialist (p<0.001) in the past 12 months. English-speaking Latina BCS (p<0.001), BCS who saw a cancer specialist in the past 12 months (p<0.001), and received follow-up care at a doctor’s office (p<0.05) reported higher quality of care. Speaking English, having seen a cancer specialist, and receiving follow-up care at a doctor’s office were independently associated with higher quality of care, explaining 44 % of the variance. Conclusions Our study findings suggest that examining the influence of ethnic and linguistic factors on quality of cancer follow-up care is necessary to address health disparities. Improved access to cancer follow-up care for Spanish-speaking Latina BCS is of particular concern. Implication of Cancer Survivors Identifying follow-up care needs of Latina BCS may contribute to providing high-quality care and improved survivorship outcomes. PMID:24563169

  20. General practitioners attitudes toward follow-up after cancer treatment: A cross-sectional questionnaire study

    PubMed Central

    Brekke, Mette; Vistad, Ingvild

    2015-01-01

    Objective An increasing number of cancer patients place a significant workload on hospital outpatient clinics, and health authorities are considering alternative follow-up regimens. It has been suggested that follow-up of cancer patients could be provided by GPs. This study aimed to explore GPs experiences with the provision of follow-up care for cancer patients, and their views on assuming greater responsibility in the future. Design Electronic questionnaire study. Subjects GPs in seven regions in Norway. Results A total of 317 GPs responded. Many GPs reported experience in providing follow-up care to cancer patients, during the years following initial diagnosis primarily in collaboration with hospital specialists. More than half of the GPs were satisfied with their collaboration. Most GPs preferred to be involved at an early stage in follow-up care and, generally, GPs felt confident in their skills to provide this type of service. Fewer than 10% were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason. Conclusions GPs acknowledged the importance of providing follow-up care to cancer patients, and the majority felt confident in their own ability to provide such care. However, they were hesitant to assume greater responsibility primarily due to fears of increased workload.Key PointsIt has been suggested that follow-up of cancer patients can be provided by general practitioners (GPs). The viewpoints and attitudes of GPs regarding such follow-up were investigated.GPs reported broad experience in providing follow-up care to patients after active cancer treatment.GPs acknowledged the importance of follow-up care, and they felt confident in their own ability to provide such care.Fewer than 10% of GPs were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason. PMID:26649452

  1. General practitioners' attitudes toward follow-up after cancer treatment: A cross-sectional questionnaire study.

    PubMed

    Fidjeland, Heidi Lidal; Brekke, Mette; Vistad, Ingvild

    2015-12-01

    Objective An increasing number of cancer patients place a significant workload on hospital outpatient clinics, and health authorities are considering alternative follow-up regimens. It has been suggested that follow-up of cancer patients could be provided by GPs. This study aimed to explore GPs' experiences with the provision of follow-up care for cancer patients, and their views on assuming greater responsibility in the future. Design Electronic questionnaire study. Subjects GPs in seven regions in Norway. Results A total of 317 GPs responded. Many GPs reported experience in providing follow-up care to cancer patients, during the years following initial diagnosis primarily in collaboration with hospital specialists. More than half of the GPs were satisfied with their collaboration. Most GPs preferred to be involved at an early stage in follow-up care and, generally, GPs felt confident in their skills to provide this type of service. Fewer than 10% were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason. Conclusions GPs acknowledged the importance of providing follow-up care to cancer patients, and the majority felt confident in their own ability to provide such care. However, they were hesitant to assume greater responsibility primarily due to fears of increased workload. Key Points It has been suggested that follow-up of cancer patients can be provided by general practitioners (GPs). The viewpoints and attitudes of GPs regarding such follow-up were investigated. GPs reported broad experience in providing follow-up care to patients after active cancer treatment. GPs acknowledged the importance of follow-up care, and they felt confident in their own ability to provide such care. Fewer than 10% of GPs were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason. PMID:26649452

  2. Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

    PubMed Central

    Zheng, Ying-Fang; Saito, Tami; Takahashi, Miyako; Ishibashi, Teruo; Kai, Ichiro

    2006-01-01

    Background To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC) screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. Methods During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT) result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. Results Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. Conclusion The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is also important. PMID:17083746

  3. Case Study of Home-School Visits

    ERIC Educational Resources Information Center

    Aguerrebere, Yolanda

    2009-01-01

    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten

  4. Long-term follow-up of study participants from prophylactic HIV vaccine clinical trials in Africa.

    PubMed

    Schmidt, Claudia; Jaoko, Walter; Omosa-Manyonyi, Gloria; Kaleebu, Pontiano; Mpendo, Juliet; Nanvubya, Annet; Karita, Etienne; Bayingana, Roger; Bekker, Linda-Gail; Chomba, Elwyn; Kilembe, William; Nchabeleng, Maphoshane; Nyombayire, Julien; Stevens, Gwynn; Chetty, Paramesh; Lehrman, Jennifer; Cox, Josephine; Allen, Susan; Dally, Len; Smith, Carol; Fast, Patricia E

    2014-01-01

    Long-term safety is critical for the development and later use of a vaccine to prevent HIV/AIDS. Likewise, the persistence of vaccine-induced antibodies and their impact on HIV testing must be established. IAVI has sponsored several Phase I and IIA HIV vaccine trials enrolling healthy, HIV-seronegative African volunteers. Plasmid DNA and viral vector based vaccines were tested. No vaccine-related serious adverse events were reported. After completion of vaccine trials conducted between 2001-2007, both vaccine and placebo recipients were offered enrolment into an observational long-term follow-up study (LTFU) to monitor potential late health effects and persistence of immune responses. At scheduled 6-monthly clinic visits, a health questionnaire was administered; clinical events were recorded and graded for severity. Blood was drawn for HIV testing and cellular immune assays. 287 volunteers were enrolled; total follow-up after last vaccination was 1463 person years (median: 5.2 years). Ninety-three (93)% of volunteers reported good health at their last LTFU visit. Infectious diseases and injuries accounted for almost 50% of the 175 reported clinical events, of which over 95% were mild or moderate in severity. There were 30 six pregnancies, six incident HIV infections and 14 volunteers reported cases of social harm. Persistence of immune responses was rare. No safety signal was identified. No potentially vaccine-related medical condition, no immune mediated disease, or malignancy was reported. HIV vaccines studied in these trials had a low potential of induction of persisting HIV antibodies. PMID:24374365

  5. Long-term follow-up of study participants from prophylactic HIV vaccine clinical trials in Africa

    PubMed Central

    Schmidt, Claudia; Jaoko, Walter; Omosa-Manyonyi, Gloria; Kaleebu, Pontiano; Mpendo, Juliet; Nanvubya, Annet; Karita, Etienne; Bayingana, Roger; Bekker, Linda-Gail; Chomba, Elwyn; Kilembe, William; Nchabeleng, Maphoshane; Nyombayire, Julien; Stevens, Gwynn; Chetty, Paramesh; Lehrman, Jennifer; Cox, Josephine; Allen, Susan; Dally, Len; Smith, Carol; Fast, Patricia E

    2014-01-01

    Long-term safety is critical for the development and later use of a vaccine to prevent HIV/AIDS. Likewise, the persistence of vaccine-induced antibodies and their impact on HIV testing must be established. IAVI has sponsored several Phase I and IIA HIV vaccine trials enrolling healthy, HIV-seronegative African volunteers. Plasmid DNA and viral vector based vaccines were tested. No vaccine-related serious adverse events were reported. After completion of vaccine trials conducted between 2001–2007, both vaccine and placebo recipients were offered enrolment into an observational long-term follow-up study (LTFU) to monitor potential late health effects and persistence of immune responses. At scheduled 6-monthly clinic visits, a health questionnaire was administered; clinical events were recorded and graded for severity. Blood was drawn for HIV testing and cellular immune assays. 287 volunteers were enrolled; total follow-up after last vaccination was 1463 person years (median: 5.2 years). Ninety-three (93)% of volunteers reported good health at their last LTFU visit. Infectious diseases and injuries accounted for almost 50% of the 175 reported clinical events, of which over 95% were mild or moderate in severity. There were 30 six pregnancies, six incident HIV infections and 14 volunteers reported cases of social harm. Persistence of immune responses was rare. No safety signal was identified. No potentially vaccine-related medical condition, no immune mediated disease, or malignancy was reported. HIV vaccines studied in these trials had a low potential of induction of persisting HIV antibodies. PMID:24374365

  6. Outcome of Preterm Infants With Postnatal Cytomegalovirus Infection via Breast Milk: A Two-Year Prospective Follow-Up Study.

    PubMed

    Jim, Wai-Tim; Chiu, Nan-Chang; Ho, Che-Sheng; Shu, Chyong-Hsin; Chang, Jui-Hsing; Hung, Han-Yang; Kao, Hsin-An; Chang, Hung-Yang; Peng, Chun-Chih; Yui, Bey-Hwa; Chuu, Chih-Pin

    2015-10-01

    Approximately 15% of preterm infants may develop postnatal cytomegalovirus (CMV) infection from seropositive mothers via breast milk and are at risk for neurological sequelae in childhood. The aims of this study were to assess the effects and outcomes on growth, neurodevelopmental status, and hearing in very low birth weight (VLBW) premature infants with postnatal CMV infection via breast milk at the corrected age of 12 and 24 months.The prospective follow-up study population comprised all living preterm children (n = 55) with a birth weight ≤1500 g and gestational age of ≤35 weeks, who had been participated in our "postnatal CMV infection via breast milk" studies in 2000 and 2009, respectively. The cohort of children was assessed at 12 and 24 months. Clinical outcomes were documented during hospitalization and after discharge. Long-term outcomes included anthropometry, audiologic tests, gross motor quotient, Infant International Battery, and neurodevelopmental outcomes; all were assessed at postcorrected age in 12 and 24 months during follow-up visits.Of the 55 infants enrolled in the study (4 noninfected infants were excluded because their parents did not join this follow-up program later), 14 infants postnatally acquired CMV infection through breast-feeding (infected group) and were compared with 41 infants without CMV infection (control group). No significant differences were observed between the groups with regard to baseline characteristics, clinical outcomes, anthropometry, or psychomotor and mental development on the Bayley scale of infant development. None of the infants had CMV-related death or permanent sensorineural hearing loss.Transmission of CMV from seropositive mother via breast milk to preterm infants does not appear at this time to have major adverse effects on clinical outcomes, growth, neurodevelopmental status, and hearing function at 12 and 24 months corrected age. PMID:26512588

  7. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies.

    PubMed

    Ziegler, O; Sirveaux, M A; Brunaud, L; Reibel, N; Quilliot, D

    2009-12-01

    This review is an update of the long-term follow-up of nutritional and metabolic issues following bariatric surgery, and also discusses the most recent guidelines for the three most common procedures: adjustable gastric bands (AGB); sleeve gastrectomy (SG); and roux-en-Y gastric bypass (GBP). The risk of nutritional deficiencies depends on the percentage of weight loss and the type of surgical procedure performed. Purely restrictive procedures (AGB, SG), for example, can induce digestive symptoms, food intolerance or maladaptative eating behaviours due to pre- or postsurgical eating disorders. GBP also has a minor malabsorptive component. Iron deficiency is common with the three types of bariatric surgery, especially in menstruating women, and GBP is also associated with an increased risk of calcium, vitamin D and vitamin B12 deficiencies. Rare deficiencies can lead to serious complications such as encephalopathy or protein-energy malnutrition. Long-term problems such as changes in bone metabolism or neurological complications need to be carefully monitored. In addition, routine nutritional screening, recommendations for appropriate supplements and monitoring compliance are imperative, whatever the bariatric procedure. Key points are: (1) virtually routine mineral and multivitamin supplementation; (2) prevention of gallstone formation with the use of ursodeoxycholic acid during the first 6 months; and (3) regular, life-long, follow-up of all patients. Pre- and postoperative therapeutic patient education (TPE) programmes, involving a new multidisciplinary approach based on patient-centred education, may be useful for increasing patients'long-term compliance, which is often poor. The role of the general practitioner has also to be emphasized: clinical visits and follow-ups should be monitored and coordinated with the bariatric team, including the surgeon, the obesity specialist, the dietitian and mental health professionals. PMID:20152742

  8. Retrospective hospital-based analysis of age-related macular degeneration patterns in India: 5-year follow-up

    PubMed Central

    Sudhalkar, Aditya; Sethi, Vaibhav; Gogte, Priyanka; Bondalapati, Sailaja; Khodani, Mitali; Chhablani, Jay Kumar

    2015-01-01

    Purpose: To provide a detailed analysis of age-related macular degeneration (AMD) with a 5-year follow-up at a Tertiary Eye Care Center in India. Methods: In this retrospective institutional study, 408 eyes of 204 subjects (100 males) with a diagnosis of AMD with minimum 5-year follow-up were included. Data collected included demographics, details of the ocular exam, special investigations performed, treatment offered, complications, and systemic diseases, if any. Results: The median age was 74.24 ± 8.23 years. Median follow-up was 5.77 years. The visual acuity (VA) at baseline and last visit was 0.74 ± 0.12 (Snellen's equivalent 20/100) and 0.54 ± 0.12 logarithm of the minimum angle of resolution (Snellen's equivalent 20/50; P = 0.032) in patients with choroidal neovascular membrane (CNVM). The most common complaint was decreased vision (94.5%). AMD (any stage) was found to be bilateral in 93% of patients at baseline and 197 patients (96.56%) at 5 years. Seventeen eyes had active CNVM (12 of these were occult) at presentation. At baseline, 43 eyes had a disciform scar. Three hundred twenty-one eyes had dry AMD at baseline (geographic atrophy - 12 [3.7%] eyes). Five-year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%. Median number of anti-vascular endothelial growth factor injections administered per patient was 2.8 ± 1.2. CNVM bilaterality was low (7.5%). Conclusion: Patients with AMD in India presented later in the course of the disease. Bilateral advanced AMD and geographic atrophy were uncommon. Five-year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%. PMID:26862094

  9. Quality of life in the follow-up of uveal melanoma patients after CyberKnife treatment.

    PubMed

    Klingenstein, Annemarie; Fürweger, Christoph; Nentwich, Martin M; Schaller, Ulrich C; Foerster, Paul I; Wowra, Berndt; Muacevic, Alexander; Eibl, Kirsten H

    2013-12-01

    To assess quality of life in uveal melanoma patients within the first and second year after CyberKnife radiosurgery. Overall, 91 uveal melanoma patients were evaluated for quality of life through the Short-form (SF-12) Health Survey at baseline and at every follow-up visit over 2 years after CyberKnife radiosurgery. Statistical analysis was carried out using SF Health Outcomes Scoring Software and included subgroup analysis of patients developing secondary glaucoma and of patients maintaining a best corrected visual acuity (BCVA) of the treated eye of 0.5 log(MAR) or better. Analysis of variance, Greenhouse-Geisser correction, Student's t-test, and Fisher's exact test were used to determine statistical significance. Physical Functioning (PF) and Role Physical (RP) showed a significant decrease after CyberKnife radiosurgery, whereas Mental Health (MH) improved (P=0.007, P<0.0001 and P=0.023). MH and Social Functioning (SF) increased significantly (P=0.0003 and 0.026) in the no glaucoma group, MH being higher compared with glaucoma patients (P=0.02). PF and RP were significantly higher in patients with higher BCVA at the second follow-up (P=0.02). RP decreased in patients with BCVA<0.5 log(MAR) (P=0.013). Vitality (VT) increased significantly in patients whose BCVA could be preserved (P=0.031). Neither tumor localization nor size influenced the development of secondary glaucoma or change in BCVA. Although PF and RP decreased over time, MH improved continuously. Prevention of secondary glaucoma has a significant influence on both SF and MH, whereas preservation of BCVA affects VT. Emotional stability throughout follow-up contributes positively toward overall quality of life. CyberKnife radiosurgery may contribute to attenuation of emotional distress in uveal melanoma patients. PMID:24048223

  10. Follow-up care for breast cancer survivors: improving patient outcomes

    PubMed Central

    Chopra, Ishveen; Chopra, Avijeet

    2014-01-01

    Background Appropriate follow-up care is important for improving health outcomes in breast cancer survivors (BCSs) and requires determination of the optimum intensity of clinical examination and surveillance, assessment of models of follow-up care such as primary care-based follow-up, an understanding of the goals of follow-up care, and unique psychosocial aspects of care for these patients. The objective of this systematic review was to identify studies focusing on follow-up care in BCSs from the patient’s and physician’s perspective or from patterns of care and to integrate primary empirical evidence on the different aspects of follow-up care from these studies. Methods A comprehensive literature review and evaluation was conducted for all relevant publications in English from January 1, 1990 to December 31, 2013 using electronic databases. Studies were included in the final review if they focused on BCS’s preferences and perceptions, physician’s perceptions, patterns of care, and effectiveness of follow-up care. Results A total of 47 studies assessing the different aspects of follow-up care were included in the review, with a majority of studies (n=13) evaluating the pattern of follow-up care in BCSs, followed by studies focusing on BCS’s perceptions (n=9) and preferences (n=9). Most of the studies reported variations in recommended frequency, duration, and intensity of follow-up care as well as frequency of mammogram screening. In addition, variations were noted in patient preferences for type of health care provider (specialist versus non-specialist). Further, BCSs perceived a lack of psychosocial support and information for management of side effects. Conclusion The studies reviewed, conducted in a range of settings, reflect variations in different aspects of follow-up care. Further, this review also provides useful insight into the unique concerns and needs of BCSs for follow-up care. Thus, clinicians and decision-makers need to understand BCS’s preferences in providing appropriate follow-up care tailored specifically for each patient. PMID:25210481

  11. Soft Tissue Response and Survival of Extraoral Implants: A Long-Term Follow-up.

    PubMed

    Balik, Ali; Ozdemir-Karatas, Meltem; Peker, Kadriye; Cifter, Ebru Demet; Sancakli, Erkan; Gkcen-Rhlig, Bilge

    2016-02-01

    Maxillofacial defects may be reconstructed by plastic surgery or treated by prosthetic mean rehabilitation. In case of large defects, prosthetic rehabilitation rather than surgical reconstruction is preferred due to the insufficient esthetic results of surgical interventions. However, retention of the craniofacial prosthesis is a great problem despite the satisfactory esthetic results. With the presentation of extraoral implants, the retention of maxillofacial prostheses was improved, and osseointegrated craniofacial implants have become indispensable for retention and stability. However, there are conflicting results regarding the success rates of osseointegrated implants used at the craniofacial region. A total of 24 patients with 64 implants (30 in auricular region of 13 patients, 24 in nasal region of 8 patients, and 10 in orbital region of 3 patients) ranging in age from 16 to 83 years (mean age = 45.45 years) were evaluated. One patient among 13 patients (1/13) has lost his implants in the auricular area, 1 patient among 8 patients (1/8) lost his implants, and 1 patient among 3 patients (1/3) has lost all of her implants. Peri-implant soft tissue response was evaluated for a 60-month period and a total of 654 visits/sites recorded. Grade 0 (no irritation) was present in 72.8% (476/654) of the visits/sites. Grade 1 (slight redness) was observed for 18.8% (123/654). Grade 2 (red and slightly moist tissue) was scored in 6.9% (45/654). Grade 3 (red and slightly moist tissue with granulation) was noted in 1.5% (10/654) and grade 4 (infection) could not be found. Ossseointegrated implants provide reasonable support and show successful results when used with maxillofacial prostheses. PMID:25295726

  12. Race-Neutral Campuses in Urban Areas: A Follow-Up Report on Merger and Joint Planning.

    ERIC Educational Resources Information Center

    Godard, James M.

    Developments during the 1980-81 academic year concerning mergers/joint planning projects designed to eliminate unnecessary duplication of programs between historically black and white colleges in Nashville, Tennessee; Savannah, Georgia; and Norfolk, Virginia are examined. Site visits were made during the second year of operation of the programs at

  13. Urolastic for the treatment of women with stress urinary incontinence: 24-month follow-up

    PubMed Central

    Zajda, Janusz; Farag, Fawzy

    2015-01-01

    Introduction To evaluate the efficacy and durability of Urolastic, a new urethral bulking agent in women with stress urinary incontinence (SUI), after a follow-up of 24-months. Material and methods A follow-up study of women with SUI who received a Urolastic injection and successfully passed the 12-month follow-up. Assessment included the Stamey Grade, 1-h Pad weight test, and the International quality of life (I-QoL) score. Results Nineteen women who completed the 12-month follow-up were invited for the 24-month follow-up study. One patient did not respond to the correspondence. Four of the 18 patients who responded to the correspondence reported removal of the Urolastic implant at another facility, based on their desire. The explanation for this removal was painful intercourse (n = 1) or less than optimal dryness (n = 3). The overall objective improvement in continence status at 24-months was 66% compared to the 89% at the 12-month follow-up, while in addition the 1-h pad weight test showed >50% reduction in pad weight in 66% of patients compared to 84% at the 12-month follow-up. Adverse events reported were urinary tract infection (n = 1), local genital infection with erosion into the vagina (n = 1), painful intercourse (n = 2), and urgency (n = 4). Conclusions Urolastic is comparable to other bulking agents in terms of durability, efficacy, and complications. PMID:26568877

  14. Abnormal mammogram follow-up: do community lay health advocates make a difference?

    PubMed

    Crump, Sherry R; Shipp, Michle P-L; McCray, Gail G; Morris, Selma J; Okoli, Joel A; Caplan, Lee S; Thorne, Stacy L; Blumenthal, Daniel S

    2008-04-01

    This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality. PMID:18340089

  15. A NEPA follow-up study of DOE loan guarantee fuel ethanol plants

    SciTech Connect

    Hunsaker, D.B. Jr.; Eddlemon, G.K.; Miller, R.L.; Webb, J.W.

    1989-04-01

    This study was implemented to examine and characterize the actual environmental impacts of three fuel ethanol plants constructed under the US Department of Energy, Office of Alcohol Fuels Loan Guarantee Program, and to compare actual impacts with those predicted about six years ago in environmental assessments (EAs) prepared for these facilities. The objective of the program, established under the Energy Security Act of 1980, was to conserve petroleum resources by promoting the use of fuel ethanol in motor vehicles. The plants were designed to produce fuel-grade ethanol for blending with gasoline and reflect differentfeedstocks, processes, fuel sources, and site locations. Although two of the facilities as constructed differed substantially from those assessed previously, actual environmental impacts generally occurred in the areas predicted by the EAs. Major impacts not anticipated include odor from air emissions, effects of wastewater discharge on operation of a municipal sewage treatment plant, possible classification of treated wastewater from a molasses-based process as a nuisance, and habitat losses from both vegetation removal and unforeseen construction of barge terminals. In all cases, impacts were judged to be not significantn the final outcome, either because plant management (or other involved parties) took corrective action or because the resources affected in these particular cases were not important. Mitigation measures reliedon in the EAs to limit adverse impacts to insignificant levels were implemented and were required by permit condition, law, or regulation. Future follow-up studies would benefit from the availability of ambientmonitoring data to more thoroughly characterize actual impacts.

  16. Interventional Radiology in the Diagnosis, Management, and Follow-Up of Pseudoaneurysms

    SciTech Connect

    Keeling, A. N.; McGrath, F. P.; Lee, M. J.

    2009-01-15

    Arterial wall disruption, as a consequence of inflammation/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.

  17. Two year follow up of pulmonary function values among welders in New Zealand

    PubMed Central

    Erkinjuntti-Pekka..., R.; Slater, T.; Cheng, S.; Fishwick, D.; Bradshaw, L.; Kimbell-, D; Dronfield, L.; Pearce, N.

    1999-01-01

    OBJECTIVES: To examine whether welding is a risk factor for an accelerated decline in pulmonary function. METHODS: 2 Year follow up of pulmonary function and respiratory symptoms among 54 welders and 38 non- welders in eight New Zealand welding sites. RESULTS: There were no significant differences in age, height, smoking habits, ethnicity, or total time in industrial work between welders and non-welders. No overall differences were noted in the changes of pulmonary function variables between the two study groups. However, when the comparison was restricted to smokers, welders had a significantly greater (p = 0.02) annual decline (88.8 ml) in FEV1 than non-welders, who had a slight non-significant annual increase (34.2 ml). Also, welders without respiratory protection or local exhaust ventilation while welding had a greater annual decline both in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) than welders with protection (p = 0.001 and 0.04, respectively). Among welders a significant association was found between the acute across shift change and the annual decline in FEV1. Chronic bronchitis was more common among welders (24%) than non-welders (5%). Only one welder (2%) but eight non- welders (21%) reported having asthma. CONCLUSIONS: Welders who smoked and welders working without local exhaust ventilation or respiratory protection have an increased risk of accelerated decline in FEV1. PMID:10472307

  18. REMIR: The REM infrared camera to follow up the early phases of GRBs afterglows

    NASA Astrophysics Data System (ADS)

    Calzoletti, L.; Melandri, A.; Testa, V.; Antonelli, L. A.; Vitali, F.; D'Alessio, F.; di Paola, A.; Zerbi, F. M.; Chincarini, G.; Cunniffe, R.; Jordan, B.; Rodonò, M.; Conconi, P.; Covino, S.; Cutispoto, G.; Molinari, E.; Tosti, G.; Ross/Rem Team

    2005-07-01

    REMIR is a near-infrared camera, covering the 0.95-2.3 μm range with 5 filters (z,J,H,Ks and H2), mounted at one of the Nasmyth foci of the REM (Rapid Eye Mount) telescope. REM is a fully robotic fast-slewing 60 cm telescope, primarily designed to follow-up the early phases of the afterglow of GRBs detected by dedicated instruments onboard satellites (like SWIFT, a satellite entirely dedicated to GRBs science launched the 12 November 2004). Moreover REM hosts a slitless spectrograph covering the range 0.45-0.95 μm, with 30 sample points and with the possibility to perform broad-band V,R,I photometry (ROSS, REM Optical Slitless Spectrograph). The main task of REMIR is to perform realtime NIR observations of GRBs detected by gamma-ray monitors onboard satellites, looking for any possible infrared transient source. As soon as a transient source is detected in the IR images, larger telescopes are promptly alerted to perform early spectroscopy of the afterglow. All the above operations are performed in a fully automatic way and without any human supervision. We present the results of on-site tests that have been done to characterize the REMIR camera and the performances of the dedicated reduction pipeline AQuA (Automatic Quick Analysis), suited for fast transients detection.

  19. Twenty-four Years of Follow-Up for a Hanford Plutonium Wound Case

    SciTech Connect

    Carbaugh, Eugene H.; Lynch, Timothy P.; Antonio, Cheryl L.; Medina-Del Valle, Fernando

    2010-10-01

    A 1985 plutonium puncture wound resulted in the initial deposition of 48 kBq of transuranic alpha activity, primarily 239Pu and 241Am, in a worker’s right index finger. Surgical excisions in the week following reduced the long-term residual wound activity to 5.4 kBq, and 164 DTPA chelation therapy administrations over a 17-month period resulted in urinary excretion of about 7 kBq. The case was published in 1988, but now 20 additional years of follow-up data are available. Annual bioassay measurements have included wound counts, skeleton counts, liver counts, lung counts, axillary lymph node counts, and urinalyses for plutonium and 241Am. These measurements have shown relatively stable levels of 241Am at the wound site, with gradually increasing amounts of 241Am detected in the skeleton. Liver counts has shown erratic detection of 241Am, and lung counts indicate 241Am as shine from the axillary lymph nodes and skeleton. Urine excretion of 239Pu since termination of chelation therapy has typically ranged from 10 to 20 mBq d-1, with 241Am excretion being about 10% of that for 239Pu. In addition, the worker has undergone annual routine medical exams, which have not identified any adverse health effects associated with the intake.

  20. Success and pitfalls in myringoplasty: follow-up study of 404 cases.

    PubMed

    Vartiainen, E; Nuutinen, J

    1993-05-01

    Results of 404 primary myringoplasty operations were critically analyzed. Patients who underwent tympanic membrane repair as the only procedure were included. In all cases, temporal muscle fascia was used as graft material. Mean follow-up period was 5.5 years. Overall success rate was found to be 88 percent. Welding injuries did not heal as well as other traumatic perforations or perforations caused by otitis media. Age of the patient, size or site of perforation, or surgical technique (underlay or overlay) did not affect success rate. Twenty-five percent of the failures were considered to be attributable to eustachian tube insufficiency. One percent (5 cases) failed as a result of chronic mastoiditis overlooked by the surgeon. Postoperative cholesteatoma developed in three ears (0.7%). Postoperative air-bone gap within 10 dB was achieved in 61 percent and within 20 dB in 87 percent of patients. In 11 of the audiologic failures, the cause of persistent conductive hearing loss was found to be fixation or erosion of the ossicles overlooked by the surgeon. The most decisive factor influencing results appeared to be the surgeon's experience. PMID:8372930

  1. Perineal pain after rectal amputation: a 5-year follow-up.

    PubMed

    Boas, R A; Schug, S A; Acland, R H

    1993-01-01

    A long-term study was undertaken on 286 patients who underwent perineal resection for rectal cancer to ascertain the incidence of chronic post-surgical pain in this group and to determine the likely cause for these pains. In 33 patients (11.5%) experiencing persistent perineal pain over the 5-year follow-up, most (70%) developed pain within weeks after surgery. The remaining 30% presented with pain several months later. This group with late onset pain died from known recurrence of adenocarcinoma in 80% of cases, giving this symptom the highest early confirmatory sign for tumour over other clinical tests. Those with early onset pain had a 26% tumour recurrence rate and clinical features of pain indicative of phantom anorectal pains in most cases. While the pain-onset time from surgery was the most sensitive predictor of cause and outcome, other distinguishing features in respect of site and quality of pain as well as differing responsiveness to drug therapy allowed for further separation of deafferentation from nociceptive pain for these two clinical groups. PMID:8446438

  2. Covered Stents in the Treatment of Peripheral Arterial Aneurysms: Procedural Results and Midterm Follow-Up

    SciTech Connect

    Beregi, Jean-Paul; Prat, Alain; Willoteaux, Serge; Vasseur, Marc-Antoine; Boularand, Valerie; Desmoucelle, Frederic

    1999-01-15

    Purpose: To evaluate initial and midterm results of percutaneous treatment of peripheral aneurysms using covered stents. Methods: Between June 1994 and December 1997 we used covered stents (EndoPro System or Passager) on 19 patients with peripheral aneurysms (7 iliac, 5 subclavian, 3 femoral, 3 popliteal, 1 carotid). Results: Successful aneurysm exclusion was achieved in 18 of 19 patients (95%). In the short term (<30 days), one patient died of puncture site hemorrhage complicated by myocardial infarction; two femoral stents were surgically removed because of leakage. At subsequent follow-up (mean 20 months) two further unrelated deaths occurred. At 1 year (intention-to-treat) the stent was patent in 13 of 19 patients (68%) and the aneurysm was excluded in 17 of 19 (89%). Conclusion: Treatment of peripheral aneurysms with covered stents has a high rate of immediate procedural success. Continued exclusion of the aneurysms is achieved in a large proportion of patients but there is a relatively high rate of stent thrombosis.

  3. Emergency department follow?up of bereaved relatives: an audit of one particular service

    PubMed Central

    Parris, R J; Schlosenberg, J; Stanley, C; Maurice, S; Clarke, S F J

    2007-01-01

    Background Although much has been written about the treatment of bereaved relatives in emergency departments, very little has been published about their follow?up after they have left the department. Methods One model of follow?up is described, in which relatives are invited to a meeting in the department 46?weeks after their loss. In this model, it is emphasised that the follow?up is not a counselling session but an opportunity to ask questions, and an audit of the service is presented. Results and conclusion It is suggested that the provision of information is theoretically beneficial to the bereavement process. PMID:17452701

  4. A Risk-adapted Approach to Follow-up in Differentiated Thyroid Cancer

    PubMed Central

    Tarasova, Valentina D.; Tuttle, R. Michael

    2016-01-01

    The last 10 years have seen a renewed interest in a risk-adapted approach to the management of differentiated thyroid cancer. This review outlines a state-of-the-art approach to individualized management in which the original follow-up plan that was developed based on initial risk stratification is modified over time as new data become available. This risk-adapted follow-up approach allows clinicians to determine the intensity of follow-up and management recommendations in response to real-time dynamic risk assessments which may change over time. PMID:26886955

  5. Improved newborn hearing screening follow-up results in more infants identified.

    PubMed

    Alam, Suhana; Gaffney, Marcus; Eichwald, John

    2014-01-01

    Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed. PMID:23803975

  6. Ginkgo Biloba Extract and Long-Term Cognitive Decline: A 20-Year Follow-Up Population-Based Study

    PubMed Central

    Amieva, Hélène; Meillon, Céline; Helmer, Catherine; Barberger-Gateau, Pascale; Dartigues, Jean François

    2013-01-01

    Background Numerous studies have looked at the potential benefits of various nootropic drugs such as Ginkgo biloba extract (EGb761®; Tanakan®) and piracetam (Nootropyl®) on age-related cognitive decline often leading to inconclusive results due to small sample sizes or insufficient follow-up duration. The present study assesses the association between intake of EGb761® and cognitive function of elderly adults over a 20-year period. Methods and Findings The data were gathered from the prospective community-based cohort study ‘Paquid’. Within the study sample of 3612 non-demented participants aged 65 and over at baseline, three groups were compared: 589 subjects reporting use of EGb761® at at least one of the ten assessment visits, 149 subjects reporting use of piracetam at one of the assessment visits and 2874 subjects not reporting use of either EGb761® or piracetam. Decline on MMSE, verbal fluency and visual memory over the 20-year follow-up was analysed with a multivariate mixed linear effects model. A significant difference in MMSE decline over the 20-year follow-up was observed in the EGb761® and piracetam treatment groups compared to the ‘neither treatment’ group. These effects were in opposite directions: the EGb761® group declined less rapidly than the ‘neither treatment’ group, whereas the piracetam group declined more rapidly (β = −0.6). Regarding verbal fluency and visual memory, no difference was observed between the EGb761® group and the ‘neither treatment’ group (respectively, β = 0.21 and β = −0.03), whereas the piracetam group declined more rapidly (respectively, β = −1.40 and β = −0.44). When comparing the EGb761® and piracetam groups directly, a different decline was observed for the three tests (respectively β = −1.07, β = −1.61 and β = −0.41). Conclusion Cognitive decline in a non-demented elderly population was lower in subjects who reported using EGb761® than in those who did not. This effect may be a specific medication effect of EGb761®, since it was not observed for another nootropic medication, piracetam. PMID:23326356

  7. Observational follow-up study following two cohorts of children with severe pneumonia after discharge from day care clinic/hospital in Dhaka, Bangladesh

    PubMed Central

    Alam, Nur H; Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ahmed, Tahmeed; Gyr, Niklaus

    2012-01-01

    Objectives To compare the features of relapse, morbidity, mortality and re-hospitalisation following successful discharge after severe pneumonia in children between a day care group and a hospital group and to explore the predictors of failures during 3?months of follow-up. Design An observational study following two cohorts of children with severe pneumonia for 3?months after discharge from hospital/clinic. Setting Day care was provided at the Radda Clinic and hospital care at a hospital in Dhaka, Bangladesh. Participants Children aged 259?months with severe pneumonia attending the clinic/hospital who survived to discharge. Intervention No intervention was done except providing some medications for minor illnesses, if indicated. Primary outcome measures The primary outcome measures were the proportion of successes and failures of day care at follow-up visits as determined by estimating the OR with 95% CI in comparison to hospital care. Results The authors enrolled 360 children with a mean (SD) age of 8 (7)?months, 81% were infants and 61% were men. The follow-up compliance dropped from 95% at first to 85% at sixth visit. The common morbidities during the follow-up period included cough (28%), fever (17%), diarrhoea (9%) and rapid breathing (7%). During the follow-up period, significantly more day care children (n=22 (OR 12.2 (95% CI 8.217.8))) required re-hospitalisation after completion of initial day care compared with initial hospital care group (n=11 (OR 6.1 (95% CI 3.410.6))). The predictors for failure were associated with tachycardia, tachypnoea and hypoxaemia on admission and prolonged duration of stay. Conclusions There are considerable morbidities in children discharged following treatment of severe pneumonia like cough, fever, rapid breathing and diarrhoea during 3-month period. The findings indicate the importance of follow-up for early detection of medical problems and their management to reduce the risk of death. Establishment of an effective community follow-up would be ideal to address the problem of non-compliance with follow-up. Trial registration The original randomised control trial comparing day care with hospital care was registered at http://www.clinicaltrials.gov (identifier NCT00455468). PMID:22842561

  8. A minimally invasive technique for the management of severely fluorosed teeth: A two-year follow-up

    PubMed Central

    Yildiz, Gul; Celik, Esra Uzer

    2013-01-01

    Objective: Severely fluorosed and heavily discolored teeth that have large enamel defects give rise to esthetic concerns and require permanent treatment. In such cases, restorative techniques such as porcelain or composite laminate veneers or crowns are generally preferred, in which tooth preparation is inevitably required. Materials and Methods: This clinical report describes a patient with severely fluorosed teeth who was successfully treated with a minimally invasive technique including enamel microabrasion (6.6% hydrochloric acid slurry with silicon carbide micro-particles, Opalustre, Ultradent Products, Inc., South Jordan, UT, USA) followed by in-office bleaching (38% hydrogen peroxide, Opalescence Boost, Ultradent). Enamel microabrasion was conducted in two visits while three visits were required for in-office bleaching. Patient was followed-up after 2 years. Result: A slight staining had occurred during this period, but it was acceptable for patient. No adverse effects were observed. Conclusions: The minimally invasive technique including enamel microabrasion and in-office bleaching was efficient and may represent a good alternative to traditional restorative techniques for the management of severely fluorosed teeth. PMID:24932129

  9. Time to Follow-Up After a Positive Colon Cancer Test Varies by Hospital

    MedlinePLUS

    ... html Time to Follow-Up After a Positive Colon Cancer Test Varies by Hospital Patients at one health ... 3, 2016 (HealthDay News) -- If your stool-based colon cancer test should come back positive, just how long ...

  10. Breast Cancer and the Environment on Long Island Follow-up Study

    Cancer.gov

    A follow-up study on women with breast cancer who participated in the parent population-based case-control study of Long Island women to determine whether environmental and other lifestyle factors influence breast cancer survival.

  11. Many Depressed Teens Don't Get Follow-Up Care

    MedlinePLUS

    ... raise concerns about the quality of care for adolescent depression," concluded a team led by Briannon O'Connor, ... study that the guidelines for follow-up of adolescent depression fall significantly below the mark," Swedler said, "and ...

  12. 49 CFR 655.47 - Follow-up testing after returning to duty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... follow-up testing of each employee who returns to duty, as specified in 49 CFR Part 40, subpart O. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN...

  13. 49 CFR 655.47 - Follow-up testing after returning to duty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... follow-up testing of each employee who returns to duty, as specified in 49 CFR Part 40, subpart O. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN...

  14. 49 CFR 655.47 - Follow-up testing after returning to duty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... follow-up testing of each employee who returns to duty, as specified in 49 CFR Part 40, subpart O. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN...

  15. 49 CFR 655.47 - Follow-up testing after returning to duty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... follow-up testing of each employee who returns to duty, as specified in 49 CFR Part 40, subpart O. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN...

  16. 49 CFR 655.47 - Follow-up testing after returning to duty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... follow-up testing of each employee who returns to duty, as specified in 49 CFR Part 40, subpart O. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN...

  17. Benefits of and barriers to SEA follow-up - Theory and practice

    SciTech Connect

    Gachechiladze-Bozhesku, M.; Fischer, T.B.

    2012-04-15

    If SEA is to facilitate 'strategic' changes, it needs to focus on shaping the ways in which strategic initiatives are implemented, not just formulated. This is why follow-up which refers to postdecisional activities of SEA and strategic initiatives is increasingly seen as crucial. However, to date follow-up has only received limited attention in the SEA literature, as well as in practical guidance. The key reasons for why post decision activities are often overlooked are the lack of understanding of its actual benefits and purportedly multiple problems with its accomplishment. This paper reports on the results of a comprehensive literature review and an international e-survey on the topic, as well as an in-depth analysis of six SEA follow-up cases from England and Canada. Practically encountered and perceived benefits of, and obstacles to SEA follow-up are identified and discussed.

  18. Using Structured Telephone Follow-up Assessments to Improve Suicide-related Adverse Event Detection

    PubMed Central

    Arias, Sarah A.; Zhang, Zi; Hillerns, Carla; Sullivan, Ashley F.; Boudreaux, Edwin D.; Miller, Ivan; Camargo, Carlos A.

    2014-01-01

    Adverse event (AE) detection and reporting practices were compared during the first phase of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE), a suicide intervention study. Data were collected using a combination of chart reviews and structured telephone follow-up assessments post-enrollment. Beyond chart reviews, structured telephone follow-up assessments identified 45% of the total AEs in our study. Notably, detection of suicide attempts significantly varied by approach with 53 (18%) detected by chart review, 173 (59%) by structured telephone follow-up assessments, and 69 (23%) marked as duplicates. Findings provide support for utilizing multiple methods for more robust AE detection in suicide research. PMID:24588679

  19. Personal Care Plans Tied to Better Follow-Up in Breast Cancer Survivors

    MedlinePLUS

    ... Care Plans Tied to Better Follow-Up in Breast Cancer Survivors Study found improvement in number of low- ... Jan. 15, 2016 (HealthDay News) -- For low-income breast cancer survivors, personalized care plans may lead to better ...

  20. Many Stroke Patients Prefer Video Follow-Up Versus Phone Call

    MedlinePLUS

    ... news/fullstory_157346.html Many Stroke Patients Prefer Video Follow-Up Versus Phone Call People may benefit ... A majority of stroke patients would prefer a video call, instead of a phone call, when their ...

  1. Community-based infant hearing screening in a developing country: parental uptake of follow-up services

    PubMed Central

    Olusanya, Bolajoko O; Akinyemi, Oladele O

    2009-01-01

    Background Universal newborn hearing screening is now considered an essential public health care for the early detection of disabling life-long childhood hearing impairment globally. However, like any health interventions in early childhood, parental support and participation is essential for achieving satisfactory uptake of services. This study set out to determine maternal/infant socio-demographic factors associated with follow-up compliance in community-based infant hearing screening programmes in a developing country. Methods After health educational/counselling sessions, infants attending routine childhood immunisation clinics at four primary care centres were enrolled into a two-stage infant hearing screening programme consisting of a first-stage screening with transient-evoked otoacoustic emissions and second-stage screening with automated auditory brainstem response. Infants referred after the second-stage screening were scheduled for diagnostic evaluation within three months. Maternal and infant factors associated with completion of the hearing screening protocol were determined with multivariable logistic regression analysis. Results No mother declined participation during the study period. A total of 285 out of 2,003 eligible infants were referred after the first-stage screening out of which 148 (51.9%) did not return for the second-stage, while 32 (39.0%) of the 82 infants scheduled for diagnostic evaluation defaulted. Mothers who delivered outside hospitals were significantly more likely to return for follow-up screening than those who delivered in hospitals (Odds ratio: 1.62; 95% confidence intervals: 0.98 – 2.70; p = 0.062). No other factors correlated with follow-up compliance for screening and diagnostic services. Conclusion Place of delivery was the only factor that correlated albeit marginally with infant hearing screening compliance in this population. The likely influence of issues such as the number of return visits for follow-up services, ineffective tracking system and the prevailing unfavourable cultural perception towards childhood deafness on non-compliance independently or through these factors warrant further investigation. PMID:19236718

  2. After the diabetes care trial ends, now what? A 1-year follow-up of the RxING study

    PubMed Central

    Al Hamarneh, Yazid N; Sauriol, Luc; Tsuyuki, Ross T

    2015-01-01

    Introduction There is strong evidence that pharmacist care improves patients glycaemic control. However, the sustainability and durability of such interventions beyond the research period is not known. RxING was the first trial of pharmacist prescribing in diabetes and it showed an improvement in glycated haemoglobin (HbA1c) of 1.8% over 6?months. Objective 1 objective: To evaluate glycaemic control in the RxING study patients 12?months after the end of the formal study follow-up. 2 objective: To assess the patients risk of cardiovascular events in the next 10?years. Methods We contacted the participating pharmacists to check if the patients who participated in the RxING study are still taking insulin, the dose of insulin they are taking, and their HbA1c. There were no mandated follow-up visits with the pharmacist after the study completion. Results A total of 100 patients with poorly controlled type 2 diabetes were enrolled in the original RxING study; 93 of them completed the study, while 83 participated in the 12-month follow-up. Seventy-five patients were still taking insulin, with the average dose increasing from 31.1 units (SD 18.4) at study completion to 37.4 units (SD 30.8) (95% CI ?13.3 to 0.88, p=0.085). HbA1c was reduced from 9.1% (SD 1) at baseline to 7.3% (SD 0.9) at study completion (95% CI 1.4 to 2, p <0.001), and increased to 8.1% (SD 1.3) 12?months later (95% CI ?1.1 to ?0.5, p <0.001 vs study completion). Conclusions Twelve months after completing the intervention, approximately half of the glycaemic control gains were lost. This highlights the importance of structured follow-up with the pharmacist in this patient population. Trial registration number clinicaltrials.gov; Identifier: NCT01335763. PMID:26270946

  3. Primary-care-based episodes of care and their costs in a three-month follow-up in Finland

    PubMed Central

    Heinonen, J.; Koskela, T.H.; Soini, E.; Ryynänen, O.P.

    2015-01-01

    Objective To explore patient characteristics, resource use, and costs related to different episodes of care (EOC) in Finnish health care. Design Data were collected during a three-month prospective, non-randomized follow-up study (Effective Health Centre) using questionnaires and an electronic health record. Setting Three primary health care practices in Pirkanmaa, Finland. Subjects Altogether 622 patients were recruited during a one-week period. Inclusion criteria: the patient had a doctor’s or nurse’s appointment on the recruiting day and agreed to participate. Exclusion criteria: patients visiting a specialized health guidance clinic for pregnant women, children, and mothers. Main outcome measures Patient characteristics, resource use, and costs based on the ICPC-2 EOC classification. Results On average, the patients had 1.22 EOCs during the three months. Patient characteristics and resource use differed between the EOC chapters. Chapter L, “Musculoskeletal”, had the most episodes (17%). The most common (8%) single EOC was “upper respiratory infection”. The mean cost of an episode (COE) was €389.56 (standard error 61.11) and the median COE was €165.00 (interquartile range €118.46–288.56) during the three-month follow-up. The most expensive chapter was K, “Circulatory”, with a mean COE of €909.85. The most expensive single COE was in chapter K, €32 545.56. The most expensive 1% of the COEs summed up covered 36% of the total COEs. Conclusion Patient characteristics, resource use, and costs differed between the ICPC-2 chapters, which could be taken into account in service planning and pricing. Future studies should incorporate more specific diagnoses, larger data sets, and longer follow-up times.Key pointsThe most common episodes were under the ICPC-2 “Musculoskeletal” chapter, but the highest mean and single-episode costs were related to the “Circulatory” chapter.The mean (median) cost of episodes that started in primary care was €390 (€165) during the three-month follow-up.Patient characteristics, resource use, and costs differed significantly between the ICPC-2 chapters. The most expensive 1% of the episodes covered 36% of the total costs of all the episodes. PMID:26683288

  4. Type IV congenital laryngeal web: Case report and 15 year follow up.

    PubMed

    Sorichetti, Brendan; Moxham, John P; Kozak, Frederick K

    2016-01-01

    A five day old patient with mild VACTERL syndrome had repair of a type IV congenital laryngeal web with successful decannulation 76days later. Voice and respiratory outcome is good with follow up 15years later. This case presents a rare clinical finding of a type IV laryngeal web successfully repaired with a keel and subsequent long term follow up during an era when it was suggested that repair be delayed until 18months of age at the earliest. PMID:26954872

  5. Living with faecal incontinence: a 10-year follow-up study.

    PubMed

    Wilson, Mary

    Faecal incontinence (FI) is a taboo subject, and people living with it can feel stigmatised. This article reports on a 10-year qualitative follow-up to an initial constructivist-grounded theory project, investigating living with FI. This article will also look back at the initial study and the 5-year follow-up study undertaken. The research examines the challenges associated with living with FI and different ways of managing the condition, including the importance of social support. PMID:25757581

  6. Phylloides tumours of the breast: best practice for follow-up.

    PubMed

    Mylvaganam, Senthurun; Toro, Clare; Frank, Lucinda; Vestey, Sarah; Thrush, Steven

    2015-03-01

    Phylloides tumours are rare fibroepithelial breast tumours accounting for 1% of breast cancers. No UK guidance exists on the assessment, treatment and follow-up of these patients. To assess the diagnostic accuracy of the clinical core biopsy compared to the gold standard excision biopsy and determine the current follow-up practice and recurrence rate of phylloides tumours across two UK hospital trusts. Multicentre retrospective analysis of all cases of phylloides tumours over 6 years at Worcestershire Acute NHS Trust (WANHST) and Gloucestershire Hospitals NHS Trust (GHNHST). 94 Patients included. Mean age 48 years. Mean clinical and radiological size of lesions 31.7 and 35.4 mm, respectively, preoperative core biopsy sensitivity was 87% for WANHST and 74% for GHNHST with a positive predictive value of 90 and 100%, respectively. 29 Different follow-up regimes were observed from the practice of the 10 surgeons observed following diagnosis and resection of tumours. The follow-up length ranged from discharge following one post-operative clinic attendance to 5-year clinical and/or radiological follow-up. 4 Benign and 2 malignant recurrent phylloides tumours were seen. All benign recurrences were local and found independently of follow-up. The earliest benign phylloides recurrence was at 6 years and the latest at 10 years. There is no standard follow-up of benign or malignant phylloides tumours. This study suggests that in the benign group, the risk of recurrence is small. We advocate no routine follow-up of benign phylloides tumours. PMID:25575495

  7. Late clinical and echocardiographic follow up after percutaneous balloon dilatation of the mitral valve.

    PubMed Central

    Ruiz, C. E.; Zhang, H. P.; Gamra, H.; Allen, J. W.; Lau, F. Y.

    1994-01-01

    OBJECTIVE--To assess the outcome after attempted percutaneous balloon dilatation of the mitral valve in patients with severe mitral stenosis between February 1986 and June 1992. DESIGN--Clinical state, mitral valve area, and restenosis at follow up were analysed. Mitral valve area as determined by the Gorlin formula, planimetry, and Doppler methods was compared before and after dilatation and at follow up. SETTING--University hospital. PATIENTS--176 patients had serial clinical and Doppler echocardiographic follow up and 44 of them also underwent recatheterisation. RESULT--At follow up 93% of patients were in New York Heart Association functional class I or class II. Mitral valve area (planimetry) increased from 0.97(0.24) cm2 before to 1.86(0.39) cm2 after dilatation (p = 0.0001) and then decreased to 1.72(0.39) cm2 at follow up (p < 0.001); mitral valve area (Doppler) increased from 1.01 (0.24) to 1.89 (0.42) cm2 (p = 0.0001) and then decreased to 1.78(0.40) cm2 (p < 0.05). The overall restenosis rate was 15% and over 90% of the patients were free from cardiovascular events. Age, valvar calcification, echocardiographic score, and mitral valve area after dilatation were found to be determinant predictors of restenosis. In patients who underwent recatheterisation, mitral valve area by the Gorlin method at follow up was comparable with that by planimetry and Doppler methods whereas a significant discrepancy between the three methods was noted immediately after dilatation. CONCLUSION--Balloon dilatation of the mitral valve provided sustained anatomical and functional improvement in over 80% of patients at late follow up. Older age, heavy calcification, high echocardiographic score, and suboptimal immediate results are significant predictors of restenosis. Doppler echocardiographic examination is the procedure of choice for follow up evaluation. PMID:8011410

  8. Cohort profile of the Japan Collaborative Cohort Study at final follow-up.

    PubMed

    Tamakoshi, Akiko; Ozasa, Kotaro; Fujino, Yoshihisa; Suzuki, Koji; Sakata, Kiyomi; Mori, Mitsuru; Kikuchi, Shogo; Iso, Hiroyasu; Sakauchi, Fumio; Motohashi, Yutaka; Tsuji, Ichiro; Nakamura, Yosikazu; Mikami, Haruo; Kurosawa, Michiko; Hoshiyama, Yoshiharu; Tanabe, Naohito; Tamakoshi, Koji; Wakai, Kenji; Tokudome, Shinkan; Hashimoto, Shuji; Wada, Yasuhiko; Kawamura, Takashi; Watanabe, Yoshiyuki; Miki, Tsuneharu; Date, Chigusa; Kurozawa, Yoichi; Yoshimura, Takesumi; Shibata, Akira; Okamoto, Naoyuki; Shio, Hideo

    2013-01-01

    The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s to evaluate the risk impact of lifestyle factors and levels of serum components on human health. During the 20-year follow-up period, the results of the study have been published in almost 200 original articles in peer-reviewed English-language journals. However, continued follow-up of the study subjects became difficult because of the retirements of principal researchers, city mergers throughout Japan in the year 2000, and reduced funding. Thus, we decided to terminate the JACC Study follow-up at the end of 2009. As a final point of interest, we reviewed the population registry information of survivors. A total of 207 (0.19%) subjects were ineligible, leaving 110 585 eligible participants (46 395 men and 64 190 women). Moreover, errors in coding date of birth and sex were found in 356 (0.32%) and 59 (0.05%) cases, respectively, during routine follow-up and final review. Although such errors were unexpected, their impact is believed to be negligible because of the small numbers relative to the large total study population. Here, we describe the final cohort profile at the end of the JACC Study along with selected characteristics of the participants and their status at the final follow-up. Although follow-up of the JACC Study participants is finished, we will continue to analyze and publish study results. PMID:23583921

  9. Comfort monitoring? Environmental assessment follow-up under community-industry negotiated environmental agreements

    SciTech Connect

    Noble, Bram; Birk, Jasmine

    2011-01-15

    Negotiated environmental agreements are becoming common practice in the mining industry. In principle, negotiated environmental agreements are said to respond to many of the shortcomings of environmental impact assessment by providing for improved follow-up of project impacts through, among other things, data provision, engaging stakeholders in the monitoring and management of project impacts, and building capacity at the local level to deal with project-induced environmental change. In practice, however, little is known about the efficacy of follow-up under negotiated environmental agreements between proponents and communities and the demonstrated value added to project impact management. This paper examines follow-up practice under negotiated environmental agreements with a view to understanding whether and how community-based monitoring under privatized agreements actually contributes to improved follow-up and impact management. Based on lessons emerging from recent experiences with environmental agreements in Canada's uranium industry, we show that follow-up under negotiated agreements may be described as 'comfort monitoring'. While such monitoring does improve community-industry relations and enhance corporate image, it does little to support effects-based management. If follow-up under negotiated agreements is to be credible over the long term, there is a need to ensure that monitoring results are useful for, and integrated with, regulatory-based monitoring and project impact management practices.

  10. Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

    PubMed Central

    Kim, Soo Dong; Yoon, Seong Guk

    2012-01-01

    Objective To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). Materials and Methods Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy. Results Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases. Conclusion RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control. PMID:22977331

  11. Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times

    SciTech Connect

    Lee, L.; Taylor, J.; Munneke, G.; Morgan, R.; Belli, A.-M.

    2012-04-15

    Purpose: Successful IVC filter retrieval rates fall with time. Serious complications have been reported following attempts to remove filters after 3-18 months. Failed retrieval may be associated with adverse clinical sequelae. This study explored whether retrieval rates are improved if interventional radiologists organize patient follow-up, rather than relying on the referring clinicians. Methods: Proactive follow-up of patients who undergo filter placement was implemented in May 2008. At the time of filter placement, a report was issued to the referring consultant notifying them of the advised timeframe for filter retrieval. Clinicians were contacted to arrange retrieval within 30 days. We compared this with our practice for the preceding year. Results: The numbers of filters inserted during the two time periods was similar, as were the numbers of retrieval attempts and the time scale at which they occurred. The rate of successful retrievals increased but not significantly. The major changes were better documentation of filter types and better clinical follow-up. After the change in practice, only one patient was lost to follow-up compared with six the preceding year. Conclusions: Although there was no significant improvement in retrieval rates, the proactive, radiology-led approach improved follow-up and documentation, ensuring that a clinical decision was made about how long the filter was required and whether retrieval should be attempted and ensuring that patients were not lost to follow-up.

  12. Cost of patient follow-up after potentially curative lung cancer treatment.

    PubMed

    Virgo, K S; Naunheim, K S; McKirgan, L W; Kissling, M E; Lin, J C; Johnson, F E

    1996-08-01

    The two objectives of this study were to determine the range of recommended follow-up strategies for patients with lung cancer treated with curative intent and to estimate the cost of such follow-up. Ten articles delineating eight specific follow-up strategies were identified from a Medline search of the literature for 1980 through 1995. An economic analysis was done of the costs associated with the identified strategies. Charge data obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file were used as a proxy for cost. Follow-up intensity varied widely across strategies for 5 years of posttreatment follow-up. Medicare-allowed charges for 5-year follow-up ranged from a low of $946 to a high of $5645. When Medicare-allowed charges were converted to a proxy for actual charges by a conversion ratio of 1.62, the range was $1533 to $9145, a fivefold difference in charges. There was no indication that more intensive, higher-cost strategies increased survival or quality of life. The published literature, including textbooks, holds few answers in this area. PMID:8751503

  13. Using a site visit to a contaminated location as a focus for environmental health education for academic and public health nurses.

    PubMed

    Backus, Ann S N; Hewitt, Jeanne Beauchamp; Chalupka, Stephanie M

    2006-01-01

    We describe a conference initiative that is distinguished by the use of a "community case study" to increase the knowledge and skills of nursing faculty and public health nurses in environmental health and to provide networking support to facilitate infusion of environmental health into nursing curricula and public health nursing practice. The Institute of Medicine's (1995) general environmental health competencies for nurses provided the conference framework. Woburn, Massachusetts, a Superfund site, served as the community case study to illustrate a complex environmental health problem. Over an extended period of time, Woburn was contaminated with multiple chemicals that eventually contaminated the drinking water supply; a cluster of childhood leukemia cases was linked subsequently to the Superfund site contaminants. A 6-hr interpreted walking and bus tour of the Superfund site enabled us to visit the premises of responsible parties, the vapor extraction fields, the capped Well H in the wooded wetlands, and to tour the affected neighborhood. This intensive, hands-on approach to learning environmental health content and skills that incorporated multiple learning strategies serves as a model for developing future conferences for public health nurses and nursing faculty. PMID:16961561

  14. Does routine follow up after head injury help? A randomised controlled trial.

    PubMed Central

    Wade, D T; Crawford, S; Wenden, F J; King, N S; Moss, N E

    1997-01-01

    OBJECTIVE: To evaluate the Medical Disability Society's 1988 recommendation that "every patient attending hospital after a head injury should be registered and offered an outpatient follow up appointment" by determining whether offering a routine follow up service to patients presenting to hospital with a head injury of any severity affects outcome six months later. DESIGN: A randomised controlled trial design with masked assessment of outcome. SETTING: A mixed rural and urban health district with a population of about 560000. PATIENTS: 1156 consecutive patients resident in Oxfordshire aged between 16 and 65 years presenting over 13 months to accident and emergency departments or admitted to hospital and diagnosed as having a head injury of any severity, including those with other injuries. INTERVENTIONS: Patients were registered and randomised to one of two groups. Both groups continued to receive the standard service offered by the hospitals. The early follow up group were approached at 7-10 days after injury and offered additional information, advice, support, and further intervention as needed. All randomised patients were approached for follow up assessment six months after injury by independent clinicians blind to their group. MAIN OUTCOME MEASURES: Validated questionnaires were used to elicit ratings of post-concussion symptoms (the Rivermead postconcussion symptoms questionnaire), and changes in work, relationships, leisure, social, and domestic activities (the Rivermead head injury follow up questionnaire). RESULTS: The two groups were comparable at randomisation. Data was obtained at six months on 226 of 577 "control" patients and 252 of 579 "trial" patients (59% were lost to follow up). There were no significant differences overall between the trial and control groups at follow up, but subgroup analysis of the patients with moderate or severe head injuries (posttraumatic amnesia > or = one hour, or admitted to hospital), showed that those in the early intervention group had significantly fewer difficulties with everyday activities (P = 0.03). CONCLUSIONS: The results from the 41% of patients followed up do not support the recommendation of offering a routine follow up to all patients with head injury, but they do suggest that routine follow up is most likely to be beneficial to patients with moderate or severe head injuries. Some of those with less severe injuries do continue to experience difficulties and need access to services. A further trial is under way to test these conclusions. PMID:9153604

  15. Incident atrial fibrillation in the emergency department in Ontario: a population-based retrospective cohort study of follow-up care

    PubMed Central

    Yu, Bing; Ivers, Noah; Rochon, Paula; Lee, Douglas S.; Schull, Michael J.; Austin, Peter C.

    2015-01-01

    Background Continuity of care has been shown to be poor following in-hospital discharge, and there are substantially fewer resources to facilitate follow-up care arrangements after discharge from an emergency department. Our objective was to assess the frequency, timeliness and predictors for obtaining follow-up care following discharge from an emergency department in Ontario with a new diagnosis of atrial fibrillation. Methods We conducted a retrospective cohort study involving all patients discharged from the 157 nonpediatric emergency departments in Ontario, who received a new diagnosis of atrial fibrillation between 2007 and 2012. We determined the frequency of follow-up care with a family physician, cardiologist or internist within 7 (timely) and 30 days of the emergency department visit, and assessed the association of emergency and family physician characteristics, including primary care model type, with obtaining timely follow-up care. Results Among 14 907 patients discharged from Ontario emergency departments with a new, primary diagnosis of atrial fibrillation, half (n = 7473) had timely follow-up care. At 30 days, 2678 patients (18.0%) still had not obtained follow-up care. Among emergency and family physician factors, lack of a family physician had the largest independent association with acquiring timely follow-up care (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.500.69). Using patients with a family physician belonging to a primarily fee-for-service remuneration model as the comparison group, patients with a family physician belonging to a capitation-based Family Health Network, as part of a Family Health Team, were less likely to receive timely follow-up care (OR 0.73, 95% CI 0.620.86), as were those whose family physician belonged to the same model type that was not part of a Family Health Team (OR 0.77, 95% CI 0.600.97). Interpretation Only half of the patients who were discharged from an emergency department in Ontario with a new diagnosis of atrial fibrillation were seen within 7 days of discharge. The most influential factor was having a family physician; patients with a family physician being remunerated via primarily fee-for-service methods were more likely to be seen within 7 days than those who were reimbursed through a primarily capitation model. Systems-wide solutions are needed to ensure timely follow-up care is available for all patients with chronic diseases. PMID:26389096

  16. Serum ghrelin and prediction of metabolic parameters in over 20-year follow-up.

    PubMed

    Leinonen, Tuija; Antero Kesniemi, Y; Hedberg, Pirjo; Ukkola, Olavi

    2016-02-01

    Ghrelin is a peptide hormone from the stomach, with an ability to release growth-hormone from the pituitary. Numerous cross-sectional studies indicate that ghrelin also has a role in metabolic abnormalities, such as metabolic syndrome and type 2 diabetes, but evidence for long-term effect is scarce. We investigated, whether ghrelin concentration measured in middle age would predict the development or absence of metabolic disturbances subsequently. Study population consisted of 600 middle-aged persons, and the follow-up time was approximately 21 years. Plasma total ghrelin concentration was measured at the baseline, and divided to tertiles. Numerous anthropometric and other clinical measurements (including blood pressure), and laboratory test were made both at the baseline and at the follow-up. After the follow-up the prevalence of high systolic blood pressure according to MetS IDF-criteria was the lowest in the highest ghrelin tertile, and the highest in the first (p<0.03). When only subjects free of hypertension medication at baseline were considered, subjects belonging to the highest ghrelin tertile developed less new hypertension and high blood pressure according to IDF-criteria as well as medication for it during the follow-up (p<0.05). Although serum insulin levels were negatively correlated to ghrelin levels at both points in time (p<0.001 at baseline and p=0.003 at follow-up), plasma ghrelin concentration did not predict the development of abnormalities in glucose tolerance. The association with ghrelin and metabolic syndrome was lost during the follow-up. In conclusion, our results suggest high ghrelin to be protective against the development of hypertension in the long-term follow-up. PMID:26721207

  17. Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial.

    PubMed

    Gevensleben, Holger; Holl, Birgit; Albrecht, Bjrn; Schlamp, Dieter; Kratz, Oliver; Studer, Petra; Rothenberger, Aribert; Moll, Gunther H; Heinrich, Hartmut

    2010-09-01

    Neurofeedback (NF) could help to improve attentional and self-management capabilities in children with attention-deficit/hyperactivity disorder (ADHD). In a randomised controlled trial, NF training was found to be superior to a computerised attention skills training (AST) (Gevensleben et al. in J Child Psychol Psychiatry 50(7):780-789, 2009). In the present paper, treatment effects at 6-month follow-up were studied. 94 children with ADHD, aged 8-12 years, completed either 36 sessions of NF training (n = 59) or a computerised AST (n = 35). Pre-training, post-training and follow-up assessment encompassed several behaviour rating scales (e.g., the German ADHD rating scale, FBB-HKS) completed by parents. Follow-up information was analysed in 61 children (ca. 65%) on a per-protocol basis. 17 children (of 33 dropouts) had started a medication after the end of the training or early in the follow-up period. Improvements in the NF group (n = 38) at follow-up were superior to those of the control group (n = 23) and comparable to the effects at the end of the training. For the FBB-HKS total score (primary outcome measure), a medium effect size of 0.71 was obtained at follow-up. A reduction of at least 25% in the primary outcome measure (responder criterion) was observed in 50% of the children in the NF group. In conclusion, behavioural improvements induced by NF training in children with ADHD were maintained at a 6-month follow-up. Though treatment effects appear to be limited, the results confirm the notion that NF is a clinically efficacious module in the treatment of children with ADHD. PMID:20499120

  18. Patients' and healthcare professionals' views of cancer follow-up: systematic review

    PubMed Central

    Lewis, Ruth A; Neal, Richard D; Hendry, Maggie; France, Barbara; Williams, Nefyn H; Russell, Daphne; Hughes, Dyfrig A; Russell, Ian; Stuart, Nicholas SA; Weller, David; Wilkinson, Clare

    2009-01-01

    Background Cancer follow-up places a significant burden on hospital outpatient clinics. There are increasing calls to develop alternative models of provision. Aim To undertake a systematic review of qualitative studies examining patients' and healthcare professionals' views about cancer follow-up. Design of study Systematic review. Setting Primary and secondary care. Method Comprehensive literature searches included: 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. Eligible studies included qualitative studies examining patients' and healthcare professionals' views of cancer follow-up. Studies of patients with any type of cancer, considered free of active disease, or no longer receiving active treatment were included. Findings were synthesised using thematic analysis. Results Nineteen studies were included; seven were linked to randomised controlled trials. Eight studies examined the views of healthcare professionals (four of which included GPs) and 16 examined the views of patients. Twelve descriptive themes were identified, from which 12 perceived implications for practice were derived. Most themes related to conventional follow-up in secondary care. Some views concerning other models of care were based on participants' ideas, rather than experiences. Conclusion Patients' main concern is recurrent disease, and they find regular follow-up, expertise of specialists, and quick access to tests reassuring. Information regarding the effectiveness of follow-up is not given to patients who also have unmet information needs, which would help them to cope and be more involved. Continuity of care, unhurried consultations, and psychosocial support are important, but sometimes lacking in secondary care. GPs are thought to be unwilling and to have insufficient time and expertise to conduct follow-up. PMID:19566991

  19. Evaluation of Small Adrenal Incidental Nodules: Is Imaging Follow-Up Necessary?

    PubMed Central

    Young, Kara M; Wong, Michael K; Mitsunaga, Myles M; Yoon, Hyo-Chun

    2016-01-01

    Introduction: Low incidence of adrenal cortical carcinoma in the general adult population has prompted a reevaluation of current protocol for the assessment of adrenal incidentalomas. Objective: To determine whether follow-up imaging for small (? 4 cm) incidental adrenal nodules is necessary for patients without known cancer. Methods: We performed a retrospective analysis of all patients found to have an incidental adrenal nodule on abdominal computed tomography (CT) scan during a 27-month period. The electronic medical record was reviewed to determine clinical outcomes in all patients with a minimum of 3 years of follow-up (mean follow-up = 6.7 years). Patients with a known primary cancer were excluded from the analysis unless they had a prior CT scan that documented an incidental adrenal nodule. Unenhanced CT attenuation was measured for all nodules, if available. Results: A total of 392 patients with an incidental adrenal nodule had a mean (standard deviation [SD]) clinical follow-up of 6.7 (2.7) years. There were 200 men and 192 women with a mean (SD) age of 66.0 (13.2) years. None of these patients developed primary adrenocortical carcinoma during the follow-up period. Two hundred forty of these patients also had a minimum 3 years of imaging follow-up (mean [SD], 6.4 [2.4] years; range, 3.113.6 years). There were 173 left-sided and 91 right-sided nodules on index CT scan. There was no significant difference in the mean (SD) rate of growth between left- and right-sided nodules (0.1 [0.8] mm/year vs 0.1 [0.8] mm/year, p = 0.58). Mean unenhanced CT attenuation of adrenal nodules did not affect the likelihood of adrenal malignancy during follow-up. Conclusion: Patients with small incidental adrenal nodules do not require additional imaging to exclude the possibility of adrenocortical carcinoma. PMID:26694019

  20. Implant success rates in full-arch rehabilitations supported by upright and tilted implants: a retrospective investigation with up to five years of follow-up

    PubMed Central

    2015-01-01

    Purpose The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate. PMID:26734491

  1. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results.

  2. Recurrent Metacarpal Enchondroma Treated With Strut Allograft: 14-year Follow-up.

    PubMed

    Yalcinkaya, Merter; Akman, Yunus Emre; Bagatur, A Erdem

    2015-07-01

    Enchondroma of the hand is a common lesion with a recurrence rate of up to 13.3% after curettage and bone grafting. Pathologic fractures often occur. Although allograft bone chips are widely used in the surgical treatment of enchondroma, the use of structural allograft bone has not been reported before. This case report presents a recurrent enchondroma of the fifth metacarpal with pathologic fracture in a 13-year-old girl who had 2 previous interventions and 2 more interventions for other enchondromas in the same hand. These interventions consisted of curettage and autogenous iliac crest bone grafting. The metacarpal diaphysis was resected and reconstructed with an intercalary freeze-dried strut allograft fibular bone segment to avoid further donor graft site morbidity. At 14 years of follow-up, the patient had full range of motion of the hand, with no symptoms, and the allograft bone had been incorporated completely, with no recurrence of the tumor. With strut allograft bone, healing occurs by creeping substitution at its ends that is limited to a few millimeters. Limited vascularization also occurs on the allograft surface, leaving most of the allograft segment devoid of vascularity and leading to the complications seen in massive bone allografts. However, because of their thin cortices and decreased total volume, smaller bone allografts show higher rates of osteointegration and revascularization. In selected cases, a strut allograft bone may be considered a suitable material for long-term reconstruction of the hand after enchondroma excision, especially in young patients, who have increased healing potential compared with older patients. PMID:26186330

  3. Five-year clinical and angiographic follow-up after intracoronary iridium-192 radiation therapy

    SciTech Connect

    Condado, Jose A.; Waksman, Ron; Saucedo, Jorge F.; Bhargava, Balram; Lansky, Alexandra J.; Calderas, Carlos; Gurdiel, Orlando; Gonzalez, Juan; Fadoul, Merche; Parra, Bogart; Iturria, Isabel; Amezaga, Bingen

    2002-06-01

    Background: Ionizing gamma radiation has been shown to reduce neointimal formation and the incidence of restenosis after balloon angioplasty and stenting in clinical trials. However, the long-term effects of this therapy are unknown. The first cohort of patients to receive intracoronary gamma radiation after balloon angioplasty for the prevention of restenosis have completed a 5-year angiographic and clinical follow-up. The outcome of these patients is presented and discussed. Methods: Twenty-one patients with unstable angina (22 arteries) underwent standard balloon angioplasty. Intracoronary radiation therapy was performed immediately after the intervention using an Iridium-192 source wire hand-delivered to the angioplasty site. All patients were followed clinically and Quantitative Coronary Analysis (QCA) was performed at 6, 24, 36 and 60 months. Results: Target lesion revascularization occurred in six lesions, three of which were total occlusions (two early within 30 days and one occurred at 2 years), and one patient had a myocardial infarction attributable to a nontarget vessel. Serial QCA detected a binary restenosis rate of 28.6% (n=6) at 6 months. The late loss (0.29 mm) and loss index (0.25) remained low at 2, 3 and 5 years. Angiographic complications included four aneurysms (two procedure related and two occurring within 3 months). At 2 years, only one aneurysm increased in size (46 vs. 27 mm{sup 2}); and at 3 and 5 years, all aneurysms remained unchanged. No other angiographic complications were observed. Conclusion: The early clinical and angiographic effects of intracoronary gamma radiation were maintained at 5 years without further increase in the aneurysm formation or apparent new adverse effects related to the radiation therapy between 2 and 5 years.

  4. Genotype and phenotype characterization in a large dystrophinopathic cohort with extended follow-up.

    PubMed

    Magri, Francesca; Govoni, Alessandra; D'Angelo, Maria Grazia; Del Bo, Roberto; Ghezzi, Serena; Sandra, Gandossini; Turconi, Anna Carla; Sciacco, Monica; Ciscato, Patrizia; Bordoni, Andreina; Tedeschi, Silvana; Fortunato, Francesco; Lucchini, Valeria; Bonato, Sara; Lamperti, Costanza; Coviello, Domenico; Torrente, Yvan; Corti, Stefania; Moggio, Maurizio; Bresolin, Nereo; Comi, Giacomo Pietro

    2011-09-01

    Duchenne and Becker muscular dystrophy (DMD and BMD, respectively) are allelic disorders with different clinical presentations and severity determined by mutations in the gene DMD, which encodes the sarcolemmal protein dystrophin. Diagnosis is based on clinical aspects and muscle protein analysis, followed by molecular confirmation. We revised the main aspects of the natural history of dystrophinopathies to define genotype-phenotype correlations in large patient cohorts with extended follow-up. We also specifically explored subjects carrying nucleotide substitutions in the DMD gene, a comparatively less investigated DMD/BMD subgroup. We studied 320 dystrophinopathic patients (205 DMD and 115 BMD), defining muscular, cardiac, respiratory, and cognitive involvement. We also subdivided patients according to the kind of molecular defect (deletions, duplications, nucleotide substitutions or other microrearrangements) and the mutation sites (proximal/distal to exon 45), studying phenotype-genotype correlations for each group. In DMD, mutation type did not influence clinical evolution; mutations located in distal regions (irrespective of their nature) are more likely to be associated with lower IQ levels (p = 0.005). BMD carrying proximal deletions showed a higher degree of cardiac impairment than BMD with distal deletions (p = 0.0046). In the BMD population, there was a strong correlation between the entity of muscle dystrophin deficiency and clinical course (p = 0.002). An accurate knowledge of natural history may help in the clinical management of patients. Furthermore, several clinical trials are ongoing or are currently planned, some of which aim to target specific DMD mutations: a robust natural history is therefore essential to correctly design these experimental trials. PMID:21399986

  5. The Irish DAFNE Study Protocol: A cluster randomised trial of group versus individual follow-up after structured education for Type 1 diabetes

    PubMed Central

    Dinneen, Sen F; O' Hara, Mary Clare; Byrne, Molly; Newell, John; Daly, Lisa; O' Shea, Donal; Smith, Diarmuid

    2009-01-01

    Background Structured education programmes for individuals with Type 1 diabetes have become a recognised means of delivering the knowledge and skills necessary for optimal self-management of the condition. The Dose Adjustment for Normal Eating (DAFNE) programme has been shown to improve biomedical (HbA1c and rates of severe hypoglycaemia) and psychosocial outcomes for up to 12 months following course delivery. The optimal way to support DAFNE graduates and maintain the benefits of the programme has not been established. We aimed to compare 2 different methods of follow-up of DAFNE graduates in a pragmatic clinical trial delivered in busy diabetes clinics on the island of Ireland. Methods Six participating centres were cluster randomised to deliver either group follow-up or a return to traditional one-to-one clinic visits. In the intervention arm group follow-up was delivered at 6 and 12 months post DAFNE training according to a curriculum developed for the study. In the control arm patients were seen individually in diabetes clinics as part of routine care. Study outcomes included HbA1c levels, self-reported rates of severe hypoglycaemia, body weight and measures of diabetes wellbeing and quality of life. These were measured at 6, 12 and 18 months after recruitment. Generalisability (external validity) was maximised by recruiting study participants from existing DAFNE waiting lists in each centre, by using broad inclusion criteria (including HbA1c values less than 13 percent with no lower limit) and by using existing clinic staff to deliver the training and follow-up. Internal validity and treatment fidelity were maximised by quality assuring the training of all DAFNE educators, by external peer review of the group follow-up sessions and by striving for full attendance at follow-up visits. Assays of HbA1c were undertaken in a central laboratory. Discussion This pragmatic clinical trial evaluating group follow-up after a structured education programme has been designed to have broad generalisability. The results should inform how best to manage the well educated patient with Type 1 diabetes in the real world of clinical practice Trial registration Current Controlled Trials ISRCTN79759174 PMID:19775465

  6. Performance of HPV DNA testing in the follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ (AIS) and microinvasive carcinoma

    PubMed Central

    Costa, Silvano; Venturoli, Simona; Origoni, Massimo; Preti, Mario; Mariani, Luciano; Cristoforoni, Paolo; Sandri, Maria Teresa

    2015-01-01

    Background Over the last two decades it has become clear that distinct types of human papillomavirus (HPV), the so-called high-risk types (hrHPV), are the major cause of cervical cancer. The hrHPV-DNA testing has shown excellent performance in several clinical applications from screening to the follow-up of conservatively treated patients. Methods We conducted a systematic review of the recent literature on the performance of HPV DNA testing in follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ, and microinvasive carcinoma compared to Pap smear cytology. Results Observational studies have demonstrated that the high risk hrHPV-DNA test is significantly more sensitive (95%) compared to follow-up cytology(70%) in detecting post-treatment squamous intraepithelial high-grade lesions. Moreover, in patients treated conservatively for cervical adenocarcinoma in situ, the hrHPV-DNA test is the most significant independent predictor of recurrent disease or progression to invasive cancer, and the combination of viral DNA testing and cytology reaches 90% sensitivity in detecting persistent lesions at the first follow-up visit and 100% at the second follow-up visit. The cause of microinvasive squamous cervical carcinoma is increasingly treated with conservative therapies in order to preserve fertility, and an effective strategy allowing early detection of residual or progressive disease has become more and more important in post-treatment follow-up. Primary results seem to indicate that the median time for viral clearance is relatively longer compared with patients treated for CIN and suggest a prolonged surveillance for these patients. However, the potential clinical value of HPV-DNA testing in this clinical setting needs to be confirmed by further observations. Conclusions The excellent sensitivity, negative predictive value, and optimal reproducibility of the hrHPV DNA testing, currently is considered a powerful tool in the clinicians hands to better manage post-treatment follow-up either in cervical squamous lesion or in situ adenocarcinoma. PMID:25987897

  7. Unexpected Return for Follow-up During the First Year of Multidisciplinary Care May Be Predictive of Rapid Deterioration of Renal Function

    PubMed Central

    Tsai, Ming-Hsien; Fang, Yu-Weil; Wang, Li Hui; You, Xiang Gin; Leu, Jyh-Gang

    2015-01-01

    Abstract Multidisciplinary predialysis education and team care (MDC) may slow the decline in renal function in patients with chronic kidney disease (CKD). However, associations between unexpected return during MDC and progression of renal dysfunction have not been characterized in patients with CKD. Our study aimed to determine the association between exacerbation of renal dysfunction and the frequency of unexpected return during follow-up. A total of 437 patients with CKD receiving multidisciplinary care between January 2009 and June 2013 at the Shin-Kong Wu Ho-Su Memorial Hospital were included in this retrospective observational cohort study, and multiple imputations were performed for missing data. The predictor was the frequency of unexpected return for follow-up during the first year after entering MDC. Main outcome was monthly declines in estimated glomerular filtration rates (eGFR). Moreover, the demographic data, comorbidities, history of medication, and routine laboratory data for patients with CKD were collected. Among all patients, 59.7% were male, the mean age at initiation of MDC was 69.4??13.2 years, and the duration of follow-up was 21.4??3.3 months. The subjects were divided into 2 groups according to frequencies of follow-up (?4 and >?4 visits) during the 1st year of MDC. The patients with CKD were regularly followed up every 3 months as a part of MDC in our hospital, and patients who returned for more than 4 follow-up visits were included in the unexpected return group. In crude regression analyses, unexpected return was significantly associated with higher monthly declines of eGFR (??=?0.092, 95% confidence interval, 0.0140.170). This association remained after adjustments for multiple variables, and subgroup analyses of unexpected return showed that male gender, older age, CKD stage 1 to 3, hypertension, history of coronary artery disease, and use of reninangiotensin system blockade were significantly associated with declines in renal function. In conclusion, unexpected return for follow-up during the 1st year of MDC was significantly associated with the deterioration of renal function. PMID:26469913

  8. [Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

    PubMed

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

    Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment. PMID:25536896

  9. Applicable Railroad Commission rules regarding notification, cleanup, and follow up reporting of inland crude spills

    SciTech Connect

    Grossman, G.M.

    1996-08-01

    There are a myriad of regulations, both federal, state, and local dealing with spill notification cleanup, and follow up reporting. This paper describes the applicable Railroad Commission (RRC) Oil and Gas Division Rules and Regulations requiring notification, cleanup, and follow up reporting of inland crude oil spills in the state of Texas. Statewide Rule (SWR) titled {open_quotes}water protection{close_quotes} requires that {open_quotes}no person conducting activities subject to the regulation of RRC may cause or allow pollution of the surface or subsurface water in the state{close_quotes}. SWR 20 titled {open_quotes}notification of fire, breaks, leaks, or blowouts{close_quotes}, requires immediate notice of a fire, leak, spill, or break from production facilities to the appropriate district office and follow up written reporting. SWR 71 titled {open_quotes}Pipeline Tariffs{close_quotes} requires pipeline companies to give immediate notice of spills and fires to the appropriate district office along with follow up reports. SWR 91 titled {open_quotes}Cleanup of soil contaminated by a crude oil spill{close_quotes} requires notification, cleanup, and follow up reporting requirements for crude oil spills.

  10. A follow-up study of neurobehavioral functions in welders exposed to manganese.

    PubMed

    Ellingsen, Dag G; Chashchin, Maxim; Bast-Pettersen, Rita; Zibarev, Evgenij; Thomassen, Yngvar; Chashchin, Valery

    2015-03-01

    Welders may be exposed to high amounts of manganese (Mn). In this study 63 welders and 65 referents were followed up with neurobehavioral tests approximately 6 years after the initial examination at baseline. The welders were exposed to the geometric mean (GM) Mn concentration of 116μg/m(3) at baseline and 148μg/m(3) at follow-up. Their mean duration of employments as welders was 19.5 years at follow-up. Being exposed as a welder was associated with a decline between baseline and follow-up in the performance on the Static Steadiness Test, Finger Tapping Test and Grooved Pegboard Test. However, the decline was also associated with having high concentrations of carbohydrate deficient transferrin in serum (sCDT), indicating high alcohol consumption. When subjects with sCDT above the upper reference limit of the laboratory (≥1.7%) were excluded from the analyses, no difference in the decline in performance was observed between welders and referents for any of the applied neurobehavioral tests. Three welders had developed bradykinesia at follow-up, as assessed by a substantial decline in their Finger Tapping Test performance. They had also experienced a severe decline in Foot Tapping, Grooved Pegboard and Postural Sway Test scores (while blindfolded), while postural tremor as assessed with the CATSYS Tremor 7.0 was normal. Their neurobehavioral test performance at baseline 6 years previously had been normal. PMID:25579701

  11. Combination of Paris and Vienna Classifications may Optimize Follow-Up of Gastric Epithelial Neoplasia Patients

    PubMed Central

    Hu, Wen; Ai, Xin-Bo; Zhu, Yi-Miao; Han, Tie-Mei; Shen, Bo; Pan, Wen-Sheng

    2015-01-01

    Background The aim of this study was to evaluate the efficiency of the combination of Paris and Vienna classifications in a follow-up study of gastric epithelial neoplasia (GEN) patients. Material/Methods This study was conducted between January 2003 and September 2010, during which 170 biopsy-proven GEN patients were followed up by gastroenterologists and pathologists according to our follow-up regimen (modified Vienna classification). Results In total, 161 patients with low-grade neoplasia (LGN) and 9 patients with high-grade neoplasia (HGN) were randomly enrolled in our study. Eighteen patients with depressed appearance were observed, of which 9 patients had HGN and 9 patients had low-grade dysplasia (LGD). Three patients with type 0-IIa were observed with low-grade adenoma (LGA), and type 0I was observed in 2 patients with LGN. Endoscopic or surgical treatments were performed to avoid potential malignancy or bleeding. Two patients with ulcer lesions, 2 patients with non-depressed type 0 appearance, and 3 patients without visible lesions were shown to have higher-grade lesions during follow-up. The misdiagnosis rate of forceps biopsy 62.07% was determined by comparing pre- and post-resection diagnoses of 29 patients. Conclusions The combination of the Paris and Vienna classifications for GEN may optimize the follow-up routines for patients with suspicious precancerous lesions and may significantly improve the detection of early gastric cancer (EGC) while helping gastroenterologists select the best therapy option. PMID:25841675

  12. Follow up of women with borderline cervical smears as defined by national guidelines.

    PubMed Central

    Heatley, M K

    1999-01-01

    AIM: To determine the proportion of women with abnormalities in cervical smears corresponding to borderline nuclear change, as defined by national guidelines, which return to normal or persist as cytological or histological abnormalities. METHODS: 313 women with borderline nuclear change diagnosed by a single pathologist using the national criteria were followed up for up to two years. RESULTS: On initial follow up, 45% of women had a negative smear or biopsy, 46.5% had a low grade cytological or histological abnormality, and 8.5% had a high grade abnormality. Of 81 patients in whom a second follow up smear or biopsy was available, 47% had no detectable abnormality, 38.5% had low grade lesion, and 14.5% had a high grade lesion. In total, 32 patients (10.2%) had a high grade lesion (defined as moderate or severe dyskaryosis on smear or CINII or CINIII on biopsy) on at least one follow up sample. CONCLUSIONS: The results support the use of the national criteria defining borderline nuclear change in identifying women at increased risk of developing a high grade cervical intraepithelial neoplasia, as identified histologically or cytologically, and highlight the importance of follow up in these patients. PMID:10674043

  13. Follow-up evaluation of cognitive function in the randomized Alzheimer's Disease Anti-inflammatory Prevention Trial (ADAPT) and its Follow-up Study (ADAPT-FS)

    PubMed Central

    2014-01-01

    Objective The Alzheimer's Disease Anti-Inflammatory Prevention Trial (ADAPT) and follow-up study (ADAPT-FS) examined effects of naproxen and celecoxib on cognition in the elderly. We report here results describing trajectories of cognitive evaluation test scores. Methods 2356 participants completed baseline and at least one follow-up cognitive evaluation between 2001-2004. Study treatments were discontinued in 2004, but participants were followed until 2007. 1537 participants were re-evaluated in 2010-2011. Outcomes include seven cognitive evaluations administered yearly in-person in ADAPT and three of these evaluations that were administered by telephone near the end of ADAPT and again in ADAPT-FS. Results There were no important differences over time by treatment group on any ADAPT cognitive measure, a global composite, or the three cognitive measures re-assessed in ADAPT-FS by telephone. Conclusions Treatment for 1 – 3 years with naproxen or celecoxib did not protect against cognitive decline in older adults with a family history of AD. PMID:25022541

  14. Guidelines for a Middle Level School Visit

    ERIC Educational Resources Information Center

    Arth, Alfred A.; Wheeler, Kathleen B.

    2005-01-01

    The school visit is an effective tool for stimulating the continued professional growth of middle level educators. In the past, however, a major problem with school visits was that they were conducted with positive expectations, but very little preplanning activities, little or no on-site structure, little or no debriefing for either the visiting

  15. Clinical experience of levetiracetam monotherapy for adults with epilepsy: 1-year follow-up study.

    PubMed

    Alsaadi, Taoufik M; Shatzel, Alan; Marquez, Anna Vinter; Jorgensen, Julie; Farias, Sarah

    2005-03-01

    We identified 46 patients with a history of partial seizures, with and without secondarily generalization, who received levetiracetam (LEV) (Keppra) monotherapy. Patients began LEV either as first line therapy (n=11) or were converted to LEV monotherapy (n=35) after failing prior antiepileptic medications (AEDs). Patients were followed up to 12 months after LEV started. The majority of these patients were able to continue on LEV and a small number of patients discontinued LEV secondary to lack of efficacy. One third of the non-seizure free group at 6 months of follow-up had worse seizure control at 12 months and two thirds had the same or better seizure control. Our 1-year follow-up data of LEV as monotherapy suggests that LEV can be effective and well tolerated in adults with either new or difficult to control epilepsy. A prospective, large, long-term double-blind study is needed to confirm this finding. PMID:15694569

  16. [Neuroimaging follow-up of cerebral aneurysms treated with endovascular techniques].

    PubMed

    Delgado, F; Saiz, A; Hilario, A; Murias, E; San Romn Manzanera, L; Lagares Gomez-Abascal, A; Gabarrs, A; Gonzlez Garca, A

    2014-01-01

    There are no specific recommendations in clinical guidelines about the best time, imaging tests, or intervals for following up patients with intracranial aneurysms treated with endovascular techniques. We reviewed the literature, using the following keywords to search in the main medical databases: cerebral aneurysm, coils, endovascular procedure, and follow-up. Within the Cerebrovascular Disease Group of the Spanish Society of Neuroradiology, we aimed to propose recommendations and an orientative protocol based on the scientific evidence for using neuroimaging to monitor intracranial aneurysms that have been treated with endovascular techniques. We aimed to specify the most appropriate neuroimaging techniques, the interval, the time of follow-up, and the best approach to defining the imaging findings, with the ultimate goal of improving clinical outcomes while optimizing and rationalizing the use of available resources. PMID:24144295

  17. Sierra Leone's Former Child Soldiers: A Follow-up Study of Psychosocial Adjustment and Community Reintegration

    PubMed Central

    Betancourt, Theresa Stichick; Borisova, Ivelina Ivanova; Williams, Timothy Philip; Brennan, Robert T.; Whitfield, T. Hatch; de la Soudiere, Marie; Williamson, John; Gilman, Stephen E.

    2009-01-01

    This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (n=156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the two-year period of follow up, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape had higher levels of anxiety and hostility, but also demonstrated greater confidence and prosocial attitudes at follow up. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at follow up and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes. PMID:20636683

  18. Improving the follow-up of microbiology results: the origins of the Pink Book

    PubMed Central

    Boyle, Henry; Hunt, Charlie; McIlroy, Catherine; Qureshi, Imran

    2014-01-01

    Failure to check microbiology results put patients at risk of prolonged infections, resulting in increased morbidity and mortality from sepsis. There are some electronic systems designed to address this risk although they are rarely used in the hospital setting. In many hospitals the follow-up of microbiology results for discharged patients is reliant upon individual doctor's vigilance or ad hoc lists. Our intervention, the Pink Book, provides a simple, cost effective system to follow-up microbiology results for discharged patients. This simple paper based system enables prompt, effective, efficient follow-up of microbiology results, saving our paediatric department an estimated 1.5 hours per week, 17,440 per year and helping to prevent one case of inadequately treated infection per month. This project highlights how small scale, simple interventions at the local level, born out of the frustration at existing inefficient systems, can make great improvements to patient safety and the efficiency of healthcare.

  19. Pi of the Sky preparations for LSC-Virgo's electromagnetic follow-up project

    NASA Astrophysics Data System (ADS)

    ZadroŻny, Adam; Sokołowski, Marcin; Majcher, Ariel; Opiela, Rafał; Obara, Łukasz

    2015-09-01

    The presentation focuses on plans of the Pi of the Sky collaboration to participate in the future LSC-Virgo's Electromagnetic (EM) Follow-up campaigns. Pi of the Sky telescope participated in the first "EM Follow-up project", called Looc-Up1-3 2009-2010 organized by LSC-Virgo collaboration. Pi of the Sky brought to the project an instrument with the biggest field of view and with a very high time resolution. Recently Pi of the Sky has signed an Memorandum of Understanding (MOU) with LSC-Virgo for EM Follow-up observations in the Advanced Detector Era (ADE). Plans of the Pi of the Sky telescope for joint observations with advanced LIGO and Virgo detectors will be also outlined.

  20. Inpatient psychiatric adolescents function better than expected after discharge. A follow-up study.

    PubMed

    Pelkonen, M

    1990-04-01

    In order to evaluate and develop an inpatient program for adolescents, a follow-up study was carried out based on interviews with 58 adolescents discharged from the inpatient unit on average 7 years before. The mental status of these patients had been poor on admission. At the time of follow-up interviews, approximately 30% of patients appeared to have normal, socially varied lives. The results were better for patients whose treatment at the unit had lasted for more than 3 months and had included psychotherapy. Roughly 10% of the patients at the time of follow-up interviews had severe problems. The prognosis was worst for the patients who needed to be transferred from the adolescent unit to adult psychiatric treatment units because of suicidal and violent behavior. Young patients with severe disturbances need an individualized, multidisciplinary treatment approach, including individual psychotherapy and vocational training. The treatment should continue uninterrupted on an outpatient basis. PMID:2343757

  1. Statistical controversies in clinical research: long-term follow-up of clinical trials in cancer

    PubMed Central

    Cuzick, J.

    2015-01-01

    Long-term follow-up is an important unmet need for the full analysis of new treatments for cancer. Earlier detection of cancer and more effective treatment have led to many more patients surviving for more than 5 and even 10 years, so that evaluating late recurrences and side-effects is an increasingly important issue. This is particularly relevant for oestrogen receptor-positive breast cancer, where the existence of late recurrences is well documented. However, survival for other cancers, notably prostate, colorectal and cervix cancer, has dramatically increased in recent years due to screening and better treatment of early lesions. Trials of preventive therapies have an even greater need for long follow-up. Here, we review these issues and suggest ways in which provision for long-term follow-up can be improved. PMID:26433395

  2. Long-Term Follow-Up of a Revascularized Immature Necrotic Tooth Evaluated by CBCT

    PubMed Central

    She, C. M. L.; Cheung, G. S. P.; Zhang, C. F.

    2016-01-01

    This case study reports the successful treatment of an immature upper premolar with periapical pathosis and sinus tract using revascularization technique. Clinical and radiographic examination demonstrated the recovery of vitality, continued root development, and periapical healing at the 7-month follow-up. In addition, severe calcification of the canal was noted at the 36-month follow-up. At the 66-month follow-up, cone-beam computed tomography (CBCT) revealed complete periapical healing, apical closure, increase in root length and thickness of dentin, and severe calcification of the root canal. Even though the nature of tissue within the root canal is unknown, revascularization appears to give good clinical and radiographic success. This case report highlights that severe calcification of the canal is one of the long-term outcomes of revascularized root canals. PMID:26949550

  3. Statistical controversies in clinical research: long-term follow-up of clinical trials in cancer.

    PubMed

    Cuzick, J

    2015-12-01

    Long-term follow-up is an important unmet need for the full analysis of new treatments for cancer. Earlier detection of cancer and more effective treatment have led to many more patients surviving for more than 5 and even 10 years, so that evaluating late recurrences and side-effects is an increasingly important issue. This is particularly relevant for oestrogen receptor-positive breast cancer, where the existence of late recurrences is well documented. However, survival for other cancers, notably prostate, colorectal and cervix cancer, has dramatically increased in recent years due to screening and better treatment of early lesions. Trials of preventive therapies have an even greater need for long follow-up. Here, we review these issues and suggest ways in which provision for long-term follow-up can be improved. PMID:26433395

  4. [Clinical and paraclinical follow-up after radiotherapy for head and neck cancer].

    PubMed

    Clment-Colmou, K; Troussier, I; Bardet, ; Lapeyre, M

    2015-10-01

    Head and neck cancer management often involves heavy multimodal treatments including radiotherapy. Despite the improvement of intensity-modulated radiation therapy, acute and late toxicities remain important. After such treatment, patients have to face different potential problems, depending on the post-therapeutic delay. In this way, short-term follow-up permits to appreciate the healing of acute toxicities and response to treatment. Long-term follow-up aims to recognize second primitive tumours and distant failure, and to detect and manage late toxicities. Medical and psychosocial supportive cares are essential, even after several years of complete remission. The objective of this article is to review the modalities of short-term and long-term follow-up of patients who receive a radiotherapy for head and neck cancer. PMID:26278985

  5. Follow up of infants born to women with hepatitis B in the National Maternity Hospital.

    PubMed

    Travers, C P; Connell, J; Thornton, L; Keane, E; Knowles, S; Murphy, J F A

    2015-05-01

    Infants born to women with hepatitis B virus (HBV) are at risk of vertical transmission. This risk is significantly reduced with correct post-natal treatment After initial perinatal management and neonatal treatment, these infants receive subsequent follow up HBV immunisations at two, four and six months. These infants then require post vaccination serological testing. This review was conducted to determine the number of infants born to mothers with HBV in the National Maternity Hospital who had appropriate post vaccination serological testing. There were seventy-eight HBV infections identified antenatally in the years 2010 and 2011 resulting in seventy live born infants at our institution. Thirteen (18.6%) infants had evidence of post vaccination serological testing. This is below international rates of follow up. There is an urgent need for a centralised national programme to ensure adequate follow up and management of all infants born to women with HBV in Ireland. PMID:26062242

  6. What Happens Next? Follow-Up From the Children's Toddler School Program

    PubMed Central

    Akshoomoff, Natacha; Stahmer, Aubyn C.; Corsello, Christina; Mahrer, Nicole E.

    2010-01-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class, but among the children who were in elementary school at the time of follow-up, 63% were in general education classroom placement. Diagnoses of autism spectrum disorders remained stable, socialization skills remained a weakness, and child-related parental stress remained high despite average cognitive and language skills in the majority of children. Social skill development and support remained a service need. PMID:21113315

  7. Impact of visit-to-visit variability and systolic blood pressure control on subsequent outcomes in hypertensive patients with coronary artery disease (from the HIJ-CREATE substudy).

    PubMed

    Arashi, Hiroyuki; Ogawa, Hiroshi; Yamaguchi, Jun-Ichi; Kawada-Watanabe, Erisa; Hagiwara, Nobuhisa

    2015-07-15

    Although visit-to-visit variability in systolic blood pressure (BP) is a strong predictor of stroke, the impact on subsequent major adverse cardiac events (MACEs) in patients with coronary artery disease (CAD) in terms of secondary prevention remains unclear. The aim of this study was to clarify the prognostic significance of visit-to-visit variability in systolic BP on subsequent MACE in hypertensive patients with CAD. In the Heart Institute of Japan Candesartan Randomised Trial for Evaluation in Coronary Artery Disease, a total of 2,049 hypertensive patients with CAD were enrolled. Incidence of MACEs in addition to biochemistry tests and office BP were determined during follow-up. Achieved BP was defined as the mean value of systolic BP in patients who did not experience MACE and the mean value of systolic BP before MACE in those who experienced MACE during follow-up. In the present study, 1,734 patients had multiple follow-up visits (?3 times) until their final follow-up. During a median follow-up of 4.2 years, the primary outcome occurred in 317 patients (18.3%). Visit-to-visit variability of systolic BP was defined as the SD. Participants were divided into equal quartiles based on the mean systolic BP during follow-up and visit-to-visit variability of systolic BP, respectively. Although there was no relation between visit-to-visit variability of systolic BP and the incidence of MACE, the highest quartile based on mean systolic BP showed a significant relation with subsequent MACE. In conclusion, in hypertensive patients with CAD, inadequate BP control is a strong predictor of subsequent MACE, whereas visit-to-visit variability of systolic BP is not. PMID:25966826

  8. Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia.

    PubMed

    Krebs, D W; Chi, B H; Mulenga, Y; Morris, M; Cantrell, R A; Mulenga, L; Levy, J; Sinkala, M; Stringer, J S A

    2008-03-01

    Timely adherence to clinical and pharmacy appointments is well correlated with favourable patient outcomes among HIV-infected individuals on antiretroviral therapy. To date, however, there is little work exploring reasons behind missed visits or evaluating programmatic strategies to recall patients. For this study we implemented community-based follow-up of late patients as part of a large-scale programme for HIV care and treatment in Lusaka, Zambia. Through a network of local home-based care organizations, we attempted home visits to recall patients using locator information provided at time of enrolment. Between May and September 2005, home-based caregivers were dispatched to trace 1,343 patients with missed appointments. Of these, 554 (41%) were untraceable because the provided address was invalid, the patient had moved or no one was at the home. Of the remaining 789, 359 (46%) were reported to have died. Only 430 (54% of those traced, 32% overall) were contacted directly and encouraged to return for care. The likelihood of patient return was higher among traced patients in crude analysis (relative risk [RR] = 2.5; 95%CI = 1.9-3.2) and in multivariable analysis controlling for baseline body mass index, sex and CD4 + count < or = 50/microL (adjusted RR = 2.3; 95%CI = 1.7-3.2). However, the process was inefficient: one late patient returned for every 18 home visits that were made. Reasons for missed visits were provided in 271 of 430 (63%) of the patients who were successfully traced. Common reasons included feeling too sick to come to the clinic, travelling away from home and being too busy. Despite the availability of free ART in Lusaka, patients face significant barriers to attending scheduled clinical visits. Cost-effective and feasible strategies are urgently needed to improve timely patient follow-up. PMID:18351478

  9. Home versus hospital deliveries: follow up study of matched pairs for procedures and outcome. Zurich Study Team.

    PubMed Central

    Ackermann-Liebrich, U.; Voegeli, T.; Günter-Witt, K.; Kunz, I.; Züllig, M.; Schindler, C.; Maurer, M.

    1996-01-01

    OBJECTIVE: To assess procedures and outcomes in deliveries planned at home versus those planned in hospital among women choosing the place of delivery. DESIGN: Follow up study of matched pairs. SETTING: Antenatal clinics and reference hospitals in Zurich between 1989 and 1992. SUBJECTS: 489 women opting for home delivery and 385 opting for hospital delivery; the women comprised all those attending members of the study team for antenatal care and those attending the reference hospital for antenatal care who could be matched with the women planning home confinement. MAIN OUTCOME MEASURES: Need for medication and incidence of interventions during delivery (caesarean section, forceps, vacuum extraction, episiotomy), duration of labour, occurrence of severe perineal lesions, maternal blood loss, and perinatal morbidity and death. RESULTS: All women were followed up from their first antenatal visit till three months after delivery. Referrals during pregnancy (n = 37) and labour (70), changes of mind (15 home to hospital, eight hospital to home), and 17 miscarriages resulted in 369 births occurring at home and 486 in hospital. During delivery the home birth group needed significantly less medication and fewer interventions whereas no differences were found in durations of labour, occurrence of severe perineal lesions, and maternal blood loss. Perinatal death was recorded in one planned hospital delivery and one planned home delivery (overall perinatal mortality 2.3/1000). There was no difference between home and hospital delivered babies in birth weight, gestational age, or clinical condition. Apgar scores were slightly higher and umbilical cord pH lower in home births, but these differences may have been due to differences in clamping and the time of transportation. CONCLUSION: Healthy low risk women who wish to deliver at home have no increased risk either to themselves or to their babies. PMID:8942694

  10. The Safe Passage Study: Design, Methods, Recruitment, and Follow-Up Approach

    PubMed Central

    Dukes, Kimberly A.; Burd, Larry; Elliott, Amy J.; Fifer, William P.; Folkerth, Rebecca D.; Hankins, Gary D.V.; Hereld, Dale; Hoffman, Howard J.; Myers, Michael M.; Odendaal, Hein J.; Signore, Caroline; Sullivan, Lisa M.; Willinger, Marian; Wright, Colleen; Kinney, Hannah C.

    2014-01-01

    Background The Safe Passage Study is a large, prospective, multidisciplinary study designed to (1) investigate the association between prenatal alcohol exposure, sudden infant death syndrome (SIDS), and stillbirth, and (2) determine the biological basis of the spectrum of phenotypic outcomes from exposure, as modified by environmental and genetic factors that increase the risk of stillbirth, SIDS, and in surviving children, fetal alcohol spectrum disorders. Methods The results provided are based on an interim assessment of 6004 women enrolled, out of the 12 000 projected, from the Northern Plains, US, and Cape Town, South Africa, areas known to be of high risk for maternal drinking during pregnancy. Research objectives, study design, and descriptive statistics, including consent, recruitment, and retention information, are provided. Results Overall visit compliance is 87%, and includes prenatal, delivery/newborn, and postnatal contacts through 1 year post-delivery. Pregnancy outcome ascertainment is 98% prior to medical chart review; less than 2% of women withdraw. Consent for the use of DNA and placental tissue exceed 94%, and consent to participate in the autopsy portion of the study is 71%. Conclusions The Safe Passage Study is the first multi-site study of SIDS and stillbirth to integrate prospectively collected exposure information with multidisciplinary biological information in the same maternal and fetal/ infant dyad using a common protocol. Essential components of the study design and its success are close ties to the community and rigorous systems and processes to ensure compliance with the study protocol and procedures. PMID:25131605

  11. Dietary changes in Vietnamese marriage immigrant women: The KoGES follow-up study

    PubMed Central

    Hwang, Ji-Yun; Lee, Hakim; Ko, Ahra; Han, Chan-Jung; Chung, Hye Won

    2014-01-01

    BACKGROUND/OBJECTIVES The immigrant population has grown considerably in South Korea since the early 1990s due to international marriages. Dietary changes in immigrants are an important issue, because they are related to health and disease patterns. This study was conducted to compare changes in dietary intake between baseline and follow-up periods. SUBJECTS/METHODS Two hundreds thirty three Vietnamese female married immigrants. Baseline data were collected during 2006-2009, and the follow-up data were collected during 2008 and 2010. Food consumption was assessed using a 1-day 24-hour recall. RESULTS The amount of the total food consumed (P < 0.001) including that of cereals (P = 0.004), vegetables (P = 0.003), and fruits (P = 0.002) decreased at follow-up compared to that at baseline, whereas consumption of milk and dairy products increased (P = 0.004). Accordingly, the overall energy and nutrient intake decreased at follow-up, including carbohydrates (P = 0.012), protein (P = 0.021), fiber (P = 0.008), iron (P = 0.009), zinc (P = 0.006), and folate (P = 0.002). Among various anthropometric and biochemical variables, mean skeletal muscle mass decreased (P = 0.012), plasma high density lipoprotein-cholesterol increased, (P = 0.020) and high sensitivity C-reactive protein decreased at follow-up (P < 0.001). CONCLUSIONS A long-term follow-up study is needed to investigate the association between changes in food and nutrient intake and anthropometric and biochemical variables in these Vietnamese female marriage immigrants. PMID:24944778

  12. Outcome of knee injuries in general practice: 1-year follow-up

    PubMed Central

    Wagemakers, Harry PA; Luijsterburg, Pim AJ; Heintjes, Edith M; Berger, Marjolein Y; Verhaar, Jan; Koes, Bart W; Bierma-Zeinstra, Sita MA

    2010-01-01

    Background Knee injuries may lead to pain and to functional limitations in the activities of daily living. Patients with knee injuries are frequently seen in general practice; however, the outcome and management in these patients is not known. Aim To assess the outcome and management of knee injuries at 12 months' follow-up in general practice. Design of study A prospective observational cohort study with a 1-year follow-up. Setting Primary health care. Method Adult patients consulting their GP after knee injury (n = 134) participated in the cohort. A magnetic resonance imaging scan was carried out and patients were diagnosed as either no lesion or an isolated meniscal tear, an isolated collateral or cruciate ligament lesion, or a combination. Follow-up questionnaires were filled in up to 12 months' follow-up. Results At 12 months' follow-up, 34 patients reported full recovery and 67 patients reported major improvement. At baseline, 37 patients (28%) were referred to physical therapy and 17 patients (13%) were referred to secondary care. During 1 year of follow-up, another 21 referrals to physical therapy and 11 referrals to secondary care took place. The pain severity decreased the most, and the Lysholm knee score increased in the majority of patients during the first 3 months after injury. In total, 18 arthroscopies were performed in 15 patients. One patient underwent an anterior cruciate ligament reconstruction. Conclusion The vast majority of patients report clinically relevant recovery. There is no clear difference in outcomes between patients with meniscal tears or ligament lesions and patients without these diagnoses. PMID:20132694

  13. Follow-up Actions on Electronic Referral Communicationin a Multispecialty Outpatient Setting

    PubMed Central

    Esquivel, Adol; Sittig, Dean F.; Murphy, Daniel; Kadiyala, Himabindu; Schiesser, Rachel; Espadas, Donna; Petersen, Laura A.

    2010-01-01

    ABSTRACT OBJECTIVES Electronic health records (EHR) enable transmission and tracking of referrals between primary-care practitioners (PCPs) and subspecialists. We used an EHR to examine follow-up actions on electronic referral communication in a large multispecialty VA facility. METHODS We retrieved outpatient referrals to five subspecialties between October 2006 and December 2007, and queried the EHR to determine their status: completed, discontinued (returned to PCP), or unresolved (no action taken by subspecialist). All unresolved referrals, and random samples of discontinued and completed referrals were reviewed to determine whether subspecialists took follow-up actions (i.e., schedule appointments anytime in the future) within 30 days of referral-receipt. For referrals without timely follow-up, we determined whether inaction was supported by any predetermined justifiable reasons or associated with certain referral characteristics. We also reviewed if PCPs took the required action on returned information. RESULTS Of 61,931 referrals, 22,535 were discontinued (36.4%), and 474 were unresolved (0.8%). We selected 412 discontinued referrals randomly for review. Of these, 52% lacked follow-up actions within 30 days. Appropriate justifications for inaction were documented in 69.8% (150/215) of those without action and included lack of prerequisite testing by the PCP and subspecialist opinion that no intervention was required despite referral. We estimated that at 30 days, 6.3% of all referrals were associated with an unexplained lack of follow-up actions by subspecialists. Conversely, 7.4% of discontinued referrals returned to PCPs were associated with an unexplained lack of follow-up. CONCLUSIONS Although the EHR facilitates transmission of valuable information at the PCP-subspecialist interface, unexplained communication breakdowns in the referral process persist in a subset of cases. PMID:20848235

  14. Clinical Effects and Radiological Results of Vertebroplasty: Over a 2-year Follow-Up Period

    PubMed Central

    Nam, Han Ga Wi; Shin, Il Young; Moon, Seung-Myung; Hwang, Hyung Sik

    2012-01-01

    Objective We investigated the association between clinical and radiological results and assessed the radiological changes according to the distribution pattern and amount of injected cement after vertebroplasty. Methods Two hundred and one patients underwent vertebroplasty; of these, 15 were follow up for more than 2 years. For radiological analysis, we grouped the patients according to cement distribution as follows: group 1, unilateral, unilateral distribution of cement; group 2, bilateral-uneven, bilateral distribution of cement but separated mass; and group 3, bilateral-even, bilateral single mass of cement. To compare radiologic with clinical results, we assessed the visual analogue scale (VAS) score, amount of injected cement, bone mineral density (BMD), postoperative and follow-up vertebral body compression ratios, and postoperative and follow-up kyphotic angles. Results There were 4 (26.7%) patients in group 1, 6 (40.0%) in group 2, and 5 (33.3%) in group 3. The mean VAS score was 5.2 preoperatively, 1.8 postoperatively, and 3.2 at 2-year follow-up. The 2-year follow-up compression ratio was better in patients with even distribution of injected cement (group 2 and 3) than group 1. However, it was not statistically insignificant (p>0.05). The follow-up kyphotic angle was more aggravated in the group 1 than in the other groups (p<0.05). Conclusion Our study showed that vertebroplasty had a beneficial effect on pain relief, particularly in the immediate postoperative stage. The augmented spine tended to be more stable in the cases with increased amount and more even distribution of injected cement. PMID:25983842

  15. International survey of Cronobacter sakazakii and other Cronobacter spp. in follow up formulas and infant foods.

    PubMed

    Chap, J; Jackson, P; Siqueira, R; Gaspar, N; Quintas, C; Park, J; Osaili, T; Shaker, R; Jaradat, Z; Hartantyo, S H P; Abdullah Sani, N; Estuningsih, S; Forsythe, S J

    2009-12-31

    A coordinated survey for Cronobacter and related organisms in powdered infant formula, follow up formula and infant foods was undertaken by 8 laboratories in 7 countries in recognition of and in response to the data needs identified in an FAO/WHO call for data in order to develop global risk management guidance for these products. The products (domestic and imported) were purchased from the local market and were categorised according to their principle ingredients. A total of 290 products were analysed using a standardised procedure of pre-enrichment in 225 ml Buffered Peptone Water (BPW), followed by enrichment in Enterobacteriaceae Enrichment (EE) broth, plating on the chromogenic Cronobacter Druggan-Forsythe-Iversen (DFI) agar and presumptive identification with ID 32 E. Presumptive Cronobacter isolates were identified using 16S rRNA gene sequence analysis. Aerobic plate counts (APC) of the products were also determined on nutrient agar. Fourteen samples had APC>10(5) cfu/g, 3 of which contained probiotic cultures. C. sakazakii was isolated from 27 products; 3/91 (3%) follow up formulas (as defined by Codex Alimentarius Commission), and 24/199 (12%) infant foods and drinks. Hence C. sakazakii was less prevalent in follow up formula than other foods given to infants over the same age range. A range of other bacteria were also isolated from follow up formulas, including Acinetobacter baumannii, Enterobacter cloacae, Klebsiella pneumoniae, Citrobacter freundii, and Serratia ficaria. There was significant variation in the reconstitution instructions for follow up formulas. These included using water at temperatures which would enable bacterial growth. Additionally, the definition of follow up formula varied between countries. PMID:19729216

  16. Cervical Cancer Screening and Follow-Up in 4 Geographically Diverse US Health Care Systems, 1998 Through 2007

    PubMed Central

    Weinmann, Sheila; Williams, Andrew E.; Kamineni, Aruna; Buist, Diana S.M.; Masterson, Erin E.; Stout, Natasha K.; Stark, Azadeh; Ross, Tyler R.; Owens, Christopher L.; Field, Terry S.; Doubeni, Chyke A.

    2015-01-01

    Background Cervical cancer screening and follow-up guidelines have changed considerably in recent years, but to the authors' knowledge few published reports exist to estimate the impact of these changes in community-based settings. The authors examined the patterns and results of cervical cancer testing and follow-up over a decade in 4 geographically diverse US health care systems to inform future evaluation of changes resulting from increased uptake of the human papillomavirus (HPV) vaccination. Methods The authors studied women aged 21 to 65 years who were members of one of these health systems at any time between1998 and 2007. Data were collected and standardized across sites, based on receipt of Papanicolaou (Pap) and HPV tests, HPV vaccination, cervical biopsies, and treatment of cervical dysplasia. Annual rates (per 1000 person-years) of Pap testing, HPV testing, and cervical biopsy and treatment procedures were calculated. Screening intervals and trends in the results of screening Pap tests and cervical biopsies also were examined. Results Pap testing rates decreased (from 483 per 1000 person-years in 2000 to 412 per 1000 person-years in 2007) and HPV testing rates increased over the study period. Screening frequency varied across health care systems, and many women continued to receive annual testing. All 4 sites moved to less frequent screening over the study period without marked changes in the overall use of cervical biopsy or treatment. Conclusions Despite differences over time and across health plans in rates of cervical cancer testing and follow-up cervical procedures, the authors found no notable differences in Pap test results, diagnostic or treatment procedure rates, or pathological outcomes. This finding suggests that the longer screening intervals did not lead to more procedures or more cancer diagnoses. PMID:25989253

  17. [Lung ventilation parameters in various pneumoconiosis forms during follow-up in miners of Kouzbass].

    PubMed

    2011-01-01

    Studies of spirometric parameters in 120 miners who live in Kemerovo region and suffer from diagnosed pneumoconiosis demonstrated disordered pulmonary ventilation in 53.3% of the examinees. The highest velocity parameters in spirometry are seen in nodular form, the lowest ones--in mixed form of pneumoconiosis. During 2 years of follow-up forced expiratory volume over the first second decreased. Velocity and volume spirometric parameters in pneumoconiosis among coal miners of Kemerovo region under 2 years of follow-up demonstrate invert correlation with initial age of the patients when pneumoconiosis was diagnosed. PMID:22413425

  18. Optimal delivery of male breast cancer follow-up care: improving outcomes

    PubMed Central

    Ferzoco, Raina M; Ruddy, Kathryn J

    2015-01-01

    Male breast cancer is a rare disease. There are limited data to inform optimal treatment and follow-up strategies in this population. Currently, most follow-up guidelines are drawn from the vast literature on female breast cancer, despite the fact that male breast cancer has unique biological characteristics. In this review, we discuss clinical characteristics of male breast cancer as well as current best practices for long-term care with a focus on surveillance, screening, and treatment-related symptom management in male breast cancer survivors. PMID:26648754

  19. MRI of cerebral rheumatoid pachymeningitis: report of two cases with follow-up.

    PubMed

    Cellerini, M; Gabbrielli, S; Maddali Bongi, S; Cammelli, D

    2001-02-01

    We report the clinical and neuroradiological features of cerebral rheumatoid pachymeningitis with 1 year follow-up in two patients. MRI of the head enabled noninvasive diagnosis of both the meningeal abnormality and its complications, consisting of hypertensive hydrocephalus and superior sagittal sinus thrombosis, respectively. Dural sinus thrombosis, very uncommon in rheumatoid arthritis, was confirmed by phase-contrast MRA. Worsening of the pachymeningitis at follow-up was observed in both patients despite regression or stability of the clinical picture and long-term therapy. PMID:11326561

  20. Pediatric vocal fold immobility: natural history and the need for long-term follow-up.

    PubMed

    Jabbour, Jad; Martin, Timothy; Beste, David; Robey, Thomas

    2014-05-01

    IMPORTANCE The clinical course and outcomes of pediatric vocal fold immobility (VFI) vary widely in the literature, and follow-up in these patients varies accordingly. A better understanding of the natural history of pediatric VFI is crucial to improved management. OBJECTIVE To characterize the natural history of pediatric VFI, including symptoms and rates of resolution and surgical intervention. DESIGN, SETTING, AND PARTICIPANTS Retrospective review at an academically affiliated private pediatric otolaryngology practice in a metropolitan area of all patients seen between July 15, 2001, and September 1, 2012, with a diagnosis of complete or partial VFI. After elimination of 92 incomplete or duplicate files, 404 patient records were reviewed for demographic characteristics, etiologies, symptoms, follow-up, resolution, and interventions. Follow-up records were available for 362 patients (89.6%). MAIN OUTCOMES AND MEASURES Resolution of VFI confirmed by repeated laryngoscopy, length of follow-up, and surgical intervention rates. RESULTS Among the 404 patients, left VFI was present in 66.8%, right VFI in 7.9%, and bilateral VFI in 25.3%. Median (range) age at presentation was 2.9 (0-528.1) months. Major etiological categories included cardiac surgery in 68.8%, idiopathic immobility in 21.0%, and neurologic disease in 7.4%. At presentation, 61.4%experienced dysphonia, 54.0%respiratory symptoms, and 49.5%dysphagia. Tracheotomy was performed in 25.7%and gastrostomy in 40.8%. Median (range) duration of follow-up among the 89.6%of patients with follow-up was 17.2 (0.2-173.5) months. Resolution evidenced by laryngoscopy was found in 28.0%, with a median (range) time to resolution of 4.3 (0.4-38.7) months. In patients without laryngoscopic resolution, median follow-up was 26.0 months, and 28.9% reported symptomatic resolution. CONCLUSIONS AND RELEVANCE The natural history of pediatric VFI involves substantial morbidity, with lasting symptoms and considerable rates of surgical intervention. In this large database, the majority of patients did not experience resolution. This suggests a need for more regimented follow-up in these patients, a recommendation for which is proposed here. PMID:24626342

  1. Follow-up study using iodine-131 metaiodobenzylguanidine imaging in a patient with neuroblastoma

    SciTech Connect

    Ikekubo, K.; Habuchi, Y.; Jeong, S.; Yamaguchi, H.; Saiki, Y.; Ito, H.; Hino, M.; Higa, T.

    1986-11-01

    A new radiopharmaceutical, I-131 metaiodobenzylguanidine (I-131 MIBG) was used to determine the location and to follow-up tumors in a 13-month-old girl with neuroblastoma. I-131 MIBG imaging revealed both a primary abdominal tumor and a distant metastatic orbital tumor. Follow-up study with I-131 MIBG imaging demonstrated significant resolution of tumors after external radiotherapy and chemotherapy. I-131 MIBG imaging is a simple, safe, and specific method of determining the location of tumors and also is clinically useful in the evaluation and management of patients with neuroblastoma.

  2. Long-term follow up of renal anastomosing hemangioma mimicking renal angiosarcoma.

    PubMed

    Heidegger, Isabel; Pichler, Renate; Schäfer, Georg; Zelger, Bernhard; Zelger, Bettina; Aigner, Friedrich; Bektic, Jasmin; Horninger, Wolfgang

    2014-08-01

    Anastomosing hemangioma of the kidney is a very rare neoplasm, currently 19 cases have been reported in the literature. First described in 2009, histopathologically anastomosing hemangioma is similar to aggressive angiosarcoma. No long-term follow-up data of anastomosing hemangioma have been described yet. Here, we present the case of a healthy 56-year-old man diagnosed in 2002 with a 7 × 5-cm anastomosing hemangioma mimicking an aggressive renal angiosarcoma. The patient underwent nephrectomy and has been followed up disease free for 13 years. PMID:24650180

  3. Maturogenesis of Two Maxillary Central Incisors: A Case Report with 10 Years of Follow Up

    PubMed Central

    Ghorbanzadeh, Abdollah

    2015-01-01

    This case report describes the treatment of two immature maxillary central incisors in a 7-year-old female patient. She suffered complicated crown fracture because of trauma, and the root formation was incomplete. White mineral trioxide aggregate (MTA) was selected as the pulp-capping material after cervical pulpotomy to preserve the pulp tissue vitality and achieve maturogenesis. Follow-up evaluations showed successful treatment in terms of preservation of pulp vitality and demonstrated marked continuous physiological root development. During 10 years of follow-up, both teeth were clinically asymptomatic, and radiographic evaluations showed apparent root regeneration with apical root-end closure without pulp or periapical pathosis. PMID:26622286

  4. [BTA tests in the diagnosis and follow-up of superficial bladder cancer].

    PubMed

    Bassi, Pier Francesco; Mostaccio, Giuseppe; Pappagallo, Gian Luigi; Longo, Fabrizio; Bertoloni, Rossella; Ingrassia, Antonio; Gottardo, Fedra; Iafrate, Massimo; Tavolini, Ivan Matteo

    2003-06-01

    We reviewed the literature on Bladder Tumor Antigen (BTA Trak and STat) tests to evaluate the usefulness of such tests in the diagnosis and follow-up of bladder cancer and to compare these tests to routine diagnostic tools. We also report our experience on BTA tests in monitoring tumor recurrence of superficial bladder cancer in 194 patients: a correlation between an augmented risk of tumor recurrence and serial measurements of BTA Trak and positive BTA Stat have been identified. According to the available data, BTA tests can be useful in the diagnosis and follow-up of superficial bladder cancer. PMID:12868149

  5. Management of vascular prosthetic infections: results of long-term follow-up.

    PubMed

    Zeltsman, D; Tzarnas, C D; Kerstein, M D

    1999-04-01

    An infected vascular prosthesis is a risk to life and limb, with many of the infections insidious in nature. A retrospective analysis with a minimum 49-month follow-up identified 18 patients (mean age, 61.3 years) with culture-positive infections and exposed prosthetic grafts in the infrainguinal region. All patients were managed with muscle flaps. Mean follow-up was 59 months, with a long-term salvage of infected prosthetic grafts in 16 of 18 patients; there was no loss of life or limb. Early, aggressive reconstruction of infected prosthetic grafts using a muscle flap technique saves graft, leg, and patient. PMID:10190357

  6. A follow-up study of patients with Dhat syndrome: Treatment pattern, outcome, and reasons for dropout from treatment

    PubMed Central

    Grover, Sandeep; Gupta, Sunil; Avasthi, Ajit

    2016-01-01

    Aim: The aim of this study was to evaluate the treatment pattern and satisfaction with treatment provided to patients with Dhat syndrome. It was also aimed to study the follow-up rates and reasons for dropping out of treatment in patients with Dhat syndrome. Materials and Methods: Sixty-four subjects diagnosed with Dhat syndrome were prospectively contacted to evaluate treatment satisfaction and reason for dropout after 6 months of baseline evaluation. Sociodemographic, clinical details were recorded at initial intake and Sex Knowledge and Attitude Questionnaire was applied. After 6 months, information on treatment received, number of follow-up visits to the clinic and the outcome were extracted from the treatment records. Treatment satisfaction using Patient Satisfaction Questionnaire and reasons for dropping out from treatment were assessed by a telephonic interview. Results: Twenty-three patients were categorized as treatment completers, 14 as early drop-outs and 27 as late drop-out. The mean (standard deviation) number of visits over the period of 6 months was 3.81 (3.06). The outcome at 6 months was no change in 45.3%, improved in 32.8% and recovered in 21.9%. Higher proportion of treatment completers (52.2%) sought psychiatric help on their own compared to those who dropped out early from the treatment (7.1%). Treatment completers had better knowledge, and more positive attitude toward sex compared to late drop-out group. 34.4%of the subjects were fully satisfied with the various components of treatment. Level of satisfaction was highest for treatment completers. The most common reasons given by those who dropped out early were “not able to spare time for consultation” (21.4%) and “not prescribed medications” (21.4%). The most common reason given by those belonging to “late drop-out” group was ‘no improvement with treatment in symptoms of Dhat syndrome (40.7%). Conclusions: Patients with Dhat syndrome frequently drop-out of the treatment network. There is a need to reorganize the services for these patients and understand their expectations from the treatment so as to provide better care. PMID:26985105

  7. Health in overweight children: 2-year follow-up of Finnmark Activity School—a randomised trial

    PubMed Central

    Kokkvoll, Ane; Grimsgaard, Sameline; Steinsbekk, Silje; Flægstad, Trond; Njølstad, Inger

    2015-01-01

    Objective To compare a comprehensive lifestyle intervention for overweight children performed in groups of families with a conventional single-family treatment. Two-year follow-up data on anthropometric and psychological outcome are presented. Design Overweight and obese children aged 6–12 years with body mass index (BMI) corresponding to ≥27.5 kg/m2 in adults were randomised to multiple-family (n=48) or single-family intervention (n=49) in a parallel design. Multiple-family intervention comprised an inpatient programme with other families and a multidisciplinary team, follow-up visits in their hometown, weekly physical activity and a family camp. Single-family intervention included counselling by paediatric nurse, paediatric consultant and nutritionist at the hospital and follow-up by a community public health nurse. Primary outcome measures were change in BMI kg/m2 and BMI SD score after 2 years. Results BMI increased by 1.29 kg/m2 in the multiple-family intervention compared with 2.02 kg/m2 in the single-family intervention (p=0.075). BMI SD score decreased by 0.20 units in the multiple-family group and 0.08 units in the single-family intervention group (p=0.046). A between-group difference of 2.4 cm in waist circumference (p=0.038) was detected. Pooled data from both treatment groups showed a significant decrease in BMI SD score of 0.14 units and a significant decrease in parent-reported and self-reported Strength and Difficulty Questionnaire total score of 1.9 units. Conclusions Two-year outcome showed no between-group difference in BMI. A small between-group effect in BMI SD score and waist circumference favouring multiple-family intervention was detected. Pooled data showed an overall improvement in psychological outcome measures and BMI SD score. Trial registration number NCT00872807, http://www.clinicaltrials.gov. PMID:25414250

  8. Factors Associated with Loss-to-Follow-Up during Behavioral Interventions and HIV Testing Cohort among Men Who Have Sex with Men in Nanjing, China

    PubMed Central

    Tang, Weiming; Huan, Xiping; Zhang, Ye; Mahapatra, Tanmay; Li, Jianjun; Liu, Xiaoyan; Mahapatra, Sanchita; Yan, Hongjing; Fu, Gengfeng; Zhao, Jinkou; Gu, Chenghua; Detels, Roger

    2015-01-01

    Background Behavioral interventions (BIs) remained the cornerstone of HIV prevention in resource-limited settings. One of the major concerns for such efforts is the loss-to-follow-up (LTFU) that threatens almost every HIV control program involving high-risk population groups. Methods To evaluate the factors associated with LTFU during BIs and HIV testing among men who have sex with men (MSM), 410 HIV sero-negatives MSM were recruited using respondent driven sampling (RDS) in Nanjing, China during 2008, they were further followed for 18 months. At baseline and each follow-up visits, each participant was counseled about various HIV risk-reductions BIs at a designated sexually transmitted infection (STI) clinic. Results Among 410 participants recruited at baseline, altogether 221 (53.9%) were LTFU at the 18-month follow-up visit. Overall, 46 participants were found to be positive for syphilis infection at baseline while 13 participants were HIV sero-converted during the follow-up period. Increasing age was less (Adjusted Odds Ratio(aOR) of 0.90, 95% confidence Interval (CI) 0.86–0.94) and official residency of provinces other than Nanjing (AOR of 2.49, 95%CI 1.32–4.71), lower level of education (AOR of 2.01, 95%CI 1.10–3.66) and small social network size (AOR of 1.75, 95%CI 1.09–2.80) were more likely to be associated with higher odds of LTFU. Conclusion To improve retention in the programs for HIV control, counseling and testing among MSM in Nanjing, focused intensified intervention targeting those who were more likely to be LTFU, especially the young, less educated, unofficial residents of Nanjing who had smaller social network size, might be helpful. PMID:25559678

  9. Associations of Demographic and Socioeconomic Factors with Complete Treatment and Follow-up of Colon Cancer

    PubMed Central

    Davoudi-Monfared, Esmat; Heidarnia, Mohammad Ali; Akbari, Mohammad Esmail; Yavari, Parvin; Abadi, Alireza

    2012-01-01

    Background Cancer is the second cause of death in the world, and colon cancer is the third cause of death and is one of the most common cancers which will cure with early diagnosis, treatment and sufficient follow up. Assessing factors which affect this cancer is important for prolonging patient survival. Socioeconomic factors are among effective factors of cancer morbidity and mortality. Because mortality rates for colon cancers vary by socioeconomic characteristics, this study has been performed to recognize the relationship between socioeconomic factors with treatment and follow up of colon cancer. Methods This was a cross-sectional, descriptive study for patients with colon cancer registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from April 2005 to November 2006. Patients were selected randomly, and the study was conducted using questionnaires filled by interviewing the patients via phone (if a patient was dead, the questions were asked from their family members). Data analysis was done using SPSS (version 19) software. Results The study was performed on 520 colon cancer patients with age range of 23-88 years. The mean age of the patients was 63 (S.D.=11.8) and the median age was 64. Two hundred thirty seven (45.4%) patients were female and 283 (54.4%) were male. Using Chi-square test, age<60 (p=0.002) and female gender (p=0.034) had a significant correlation with complete treatment and there was a significant relationship between complete follow up and age<60 (p=0.037), academic education (p=0.02) and having insurance (p=0.021). Multiple logistic regression tests were used to evaluate concurrent effects of variables on treatment and follow up. Correlated variables to complete treatment include: age<60 (p=0.001), and female gender The Odds Ratio (OR) of completing treatment for patients under 60 years of age versus patients above 60 years was 3.13 (95% C.I. 1.55 to 6.34), and the OR of completing treatment for women versus men was 1.91(95% C.I. 1.33 to 2.74). Correlated variables to follow up were academic education ( ) and having insurance . The OR of cancer follow up in illiterate patients versus college-educated patients was 0.45 (95% C.I. 0.24 to 0.82), and the OR of cancer follow up in patients without insurance versus patients with health was 0.46 (95% C.I. 0.21 to 0.98). Conclusion Age is a correlated factor on completing colon cancer treatment. Women have more complete colon cancer treatment than men. Academic education and having insurance were the most important factors among socioeconomic factors observed in a five-year follow up after treatment. As the population of the old is increasing, executing effective interventions to improve treatment and follow up procedures for old patients is of prime importance. It seems that increasing the insurance contribution in follow up measures may lead to increase in the regular follow up and may affect patients' survival. PMID:25352971

  10. Development and Validation of Electronic Health Record-based Triggers to Detect Delays in Follow-up of Abnormal Lung Imaging Findings.

    PubMed

    Murphy, Daniel R; Thomas, Eric J; Meyer, Ashley N D; Singh, Hardeep

    2015-10-01

    Purpose To develop an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up of patients with imaging results that are suggestive of lung cancer and to validate this trigger on retrospective data. Materials and Methods The local institutional review board approved the study. A "trigger" algorithm was developed to automate the detection of delays in diagnostic evaluation of chest computed tomographic (CT) images and conventional radiographs that were electronically flagged by reviewing radiologists as being "suspicious for malignancy." The trigger algorithm was developed through literature review and expert input. It included patients who were alive and 40-70 years old, and it excluded instances in which appropriate timely follow-up (defined as occurring within 30 days) was detected (eg, pulmonary visit) or when follow-up was unnecessary (eg, in patients with a terminal illness). The algorithm was iteratively applied to a retrospective test cohort in an EHR data warehouse at a large Veterans Affairs facility, and manual record reviews were used to validate each individual criterion. The final algorithm aimed at detecting an absence of timely follow-up was retrospectively applied to an independent validation cohort to determine the positive predictive value (PPV). Trigger performance, time to follow-up, reasons for lack of follow-up, and cancer outcomes were analyzed and reported by using descriptive statistics. Results The trigger algorithm was retrospectively applied to the records of 89 168 patients seen between January 1, 2009, and December 31, 2009. Of 538 records with an imaging report that was flagged as suspicious for malignancy, 131 were identified by the trigger as being high risk for delayed diagnostic evaluation. Manual chart reviews confirmed a true absence of follow-up in 75 cases (trigger PPV of 57.3% for detecting evaluation delays), of which four received a diagnosis of primary lung cancer within the subsequent 2 years. Conclusion EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed. () RSNA, 2015. PMID:25961634

  11. Predictors of timely follow-up after abnormal cancer screening among women seeking care at urban community health centers

    PubMed Central

    Battaglia, Tracy A.; Santana, M. Christina; Bak, Sharon; Gokhale, Manjusha; Lash, Timothy L.; Ash, Arlene S.; Kalish, Richard; Tringale, Stephen; Taylor, James O.; Freund, Karen M.

    2009-01-01

    Background We sought to measure time and identify predictors of timely follow-up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities. Methods Eligible women had an abnormality detected on a mammogram or Pap test between January 2004 and December 2005 in one of six community health centers in Boston, MA. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality). Results Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 versus 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow up for both mammogram and Pap test abnormalities. Conclusions Site specific community based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations. PMID:20052731

  12. Treatment of Chronic PTSD by Cognitive Therapy and Exposure: 5-Year Follow-up

    ERIC Educational Resources Information Center

    Tarrier, Nicholas; Sommerfield, Claire

    2004-01-01

    Patients who had taken part in a randomized clinical trial of the treatment of chronic PTSD by either cognitive therapy or imaginal exposure were reassessed after 5 years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure emerged, although there had been no difference between the two treatment groups up to 12

  13. Fifteen-Year Follow-Up of Thyroid Status in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Prasher, V.; Ninan, S.; Haque, S.

    2011-01-01

    Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…

  14. Follow-Up of a Pre-College Program for Minority and Disadvantaged Students.

    ERIC Educational Resources Information Center

    Kammer, Phyllis Post; And Others

    1988-01-01

    The Pre-College Program (PCP) promotes high school completion and college graduation of disadvantaged students who show potential in mathematics and natural science. Follow-up study of 157 PCP participants revealed that PCP participants completed high schools, tended to enter post-secondary training, and tended to enter into mathematics or science…

  15. Automated Student Follow-up: A University Perspective. AIR 1995 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Brandt, Dennis M.

    An automated student follow-up system developed by a Texas state agency was pilot tested at East Texas State University (ETSU) for the public university system. Students enrolled at ETSU during summer 1991, fall 1991, and spring 1992 who were not enrolled at ETSU during fall 1992 were tracked. The data files were used to determine the present…

  16. Personality Disorders in People with Learning Disabilities: Follow-Up of a Community Survey

    ERIC Educational Resources Information Center

    Lidher, J.; Martin, D. M.; Jayaprakash, M. S.; Roy, A.

    2005-01-01

    Background: A sample of community-based service users with intellectual disability (ID) was re-examined after 5 years to determine the impact of a diagnosis of personality disorder (PD). Methods: Seventy-five of the original 101 participants were followed up. Of these, 21 people had a PD identified during the original study. Results: Compared with

  17. Schizo-Affective Psychoses in Childhood: A Follow-Up Study.

    ERIC Educational Resources Information Center

    Eggers, Christian

    1989-01-01

    The follow-up study examined 16 schizo-affective children after a mean of 16 years. In comparison to purely schizophrenic controls, subjects showed an increased incidence of affective psychoses, suicide in the ancestry, and more pre-morbidly well-adjusted personalities. The schizo-affective psychoses had mainly an acute-recurrent character.

  18. Emotionally Focused Interventions for Couples with Chronically Ill Children: A 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Cloutier, Paula F.; Manion, Ian G.; Walker, Jan Gordon; Johnson, Susan M.

    2002-01-01

    Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with

  19. Adolescents' Declining Motivation to Learn Science: A Follow-Up Study

    ERIC Educational Resources Information Center

    Vedder-Weiss, Dana; Fortus, David

    2012-01-01

    This is a mix methods follow-up study in which we reconfirm the findings from an earlier study [Vedder-Weiss & Fortus [2011] "Journal of Research in Science Teaching, 48(2)", 199-216]. The findings indicate that adolescents' declining motivation to learn science, which was found in many previous studies [Galton [2009] "Moving to secondary school:…

  20. Self-Assessment Processes: The Importance of Follow-up for Success

    ERIC Educational Resources Information Center

    Tari, Juan Jose

    2010-01-01

    Purpose: The purpose of this paper is to review the literature on self-assessment processes and to identify the difficulties, benefits and success factors of the European Foundation for Quality Management self-assessment model, analysing the importance of follow-up. Design/methodology/approach: First, the paper carries out a literature review on…