Using 'nudge' principles for order set design: a before and after evaluation of an electronic prescribing template in critical care.

PubMed

Bourdeaux, Christopher P; Davies, Keith J; Thomas, Matthew J C; Bewley, Jeremy S; Gould, Timothy H

2014-05-01

Computerised order sets have the potential to reduce clinical variation and improve patient safety but the effect is variable. We sought to evaluate the impact of changes to the design of an order set on the delivery of chlorhexidine mouthwash and hydroxyethyl starch (HES) to patients in the intensive care unit. The study was conducted at University Hospitals Bristol NHS Foundation Trust, UK. Our intensive care unit uses a clinical information system (CIS). All drugs and fluids are prescribed with the CIS and drug and fluid charts are stored within a database. Chlorhexidine mouthwash was added as a default prescription to the prescribing template in January 2010. HES was removed from the prescribing template in April 2009. Both interventions were available to prescribe manually throughout the study period. We conducted a database review of all patients eligible for each intervention before and after changes to the configuration of choices within the prescribing system. 2231 ventilated patients were identified as appropriate for treatment with chlorhexidine, 591 before the intervention and 1640 after. 55.3% were prescribed chlorhexidine before the change and 90.4% after (p<0.001). 6199 patients were considered in the HES intervention, 2177 before the intervention and 4022 after. The mean volume of HES infused per patient fell from 630 mL to 20 mL after the change (p<0.001) and the percentage of patients receiving HES fell from 54.1% to 3.1% (p<0.001). These results were well sustained with time. The presentation of choices within an electronic prescribing system influenced the delivery of evidence-based interventions in a predictable way and the effect was well sustained. This approach has the potential to enhance the effectiveness of computerised order sets.

Poverty and Economic Decision-Making: Evidence from Changes in Financial Resources at Payday

PubMed Central

Carvalho, Leandro S.; Meier, Stephan; Wang, Stephanie W.

2016-01-01

We study the effect of financial resources on decision-making. Low-income U.S. households are randomly assigned to receive an online survey before or after payday. The survey collects measures of cognitive function and administers risk and intertemporal choice tasks. The study design generates variation in cash, checking and savings balances, and expenditures. Before-payday participants behave as if they are more present-biased when making intertemporal choices about monetary rewards but not when making intertemporal choices about non-monetary real-effort tasks. Nor do we find before-after differences in risk-taking, the quality of decision-making, the performance in cognitive function tasks, or in heuristic judgments. PMID:28003681

Selective Attentional Effects of Adjunct Study Questions on Achievement in Nigerian Secondary School Science

ERIC Educational Resources Information Center

Okoye, Nnamdi S.

2008-01-01

The study investigated the selective attentional effects of adjunct study questions inserted before or after the presentation of science flow diagrams. The basic design for the study was a post-test only control group design involving a total of 252 students randomly selected from six secondary schools in Ile-Ife, Oshun State Nigeria. These were…

Bituminous concrete overlay studies.

DOT National Transportation Integrated Search

1971-01-01

Deflection tests conducted on eight sections of primary highway, both before and after asphaltic concrete resurfacings, were analyzed as a study of the utility of such tests in the design of overlays. The application of tentative traffic and allowabl...

PRELIMINARY HEALTH BURDEN ANALYSIS FOR EPIDEMIOLOGIC RECREATIONAL WATER STUDY

EPA Science Inventory

Introduction: The National Epidemiological and Environmental Assessment of Recreational Water Study (NEEAR) offers a rare opportunity for researchers. The study's design involves the collection of health data before and after visiting the beach in conjunction with water quality...

Indexing of Diagnostic Accuracy Studies in MEDLINE and EMBASE

PubMed Central

Wilczynski, Nancy L.; Haynes, R. Brian

2007-01-01

Background: STAndards for Reporting of Diagnostic Accuracy (STARD) were published in 2003 and endorsed by some journals but not others. Objective: To determine whether the quality of indexing of diagnostic accuracy studies in MEDLINE and EMBASE has improved since the STARD statement was published. Design: Evaluate the change in the mean number of “accurate index terms” assigned to diagnostic accuracy studies, comparing STARD (endorsing) and non-STARD (non-endorsing) journals, for 2 years before and after STARD publication. Results: In MEDLINE, no differences in indexing quality were found for STARD and non-STARD journals before or after the STARD statement was published in 2003. In EMBASE, indexing in STARD journals improved compared with non-STARD journals (p = 0.02). However, articles in STARD journals had half the number of accurate indexing terms as articles in non-STARD journals, both before and after STARD statement publication (p < 0.001). PMID:18693947

Ultrafiltration for the Determination of Cu Complexed with Dissolved Organic Matters of Different Molecular Weight from a Eutrophic River, China.

PubMed

Li, Anding; Zhang, Yan; Zhou, Beihai; Xin, Kailing; Gu, Yingnan; Xu, Weijie; Tian, Jie

2018-05-21

The molecular weight of dissolved organic matter (DOM) is one of the essential factors controlling the properties of metal complexes. A continuous ultrafiltration experiment was designed to study the properties of Cu complexes with different molecular weights in a river before and after eutrophication. The results showed that the concentration of DOM increased from 26.47 to 38.20 mg/L during the eutrophication process, however, DOM was still dominated by the small molecular weight fraction before and after eutrophication. The amount of Cu-DOM complexes increased with the increasing of molecular weight, however, the amounts of DOM-Cu complexes before eutrophication were higher than those after eutrophication. This is because DOM contained more -COOH and -OH before eutrophication and these functional groups are the active sites complexed with Cu.

Africa: A Social Studies and Science Curriculum.

ERIC Educational Resources Information Center

Holboke, Kathy; And Others

This packet was designed to help teachers maximize a visit to a zoo's Africa exhibit. The packet provides two levels of activities, grades 3-5, and grades 6-8, for use before, during and after the visit. Activities are designed to enhance skills taught in science, social studies, language arts, reading, art, and math. A multi-grade background…

Heterogeneity in application, design, and analysis characteristics was found for controlled before-after and interrupted time series studies included in Cochrane reviews.

PubMed

Polus, Stephanie; Pieper, Dawid; Burns, Jacob; Fretheim, Atle; Ramsay, Craig; Higgins, Julian P T; Mathes, Tim; Pfadenhauer, Lisa M; Rehfuess, Eva A

2017-11-01

The aim of the study was to examine the application, design, and analysis characteristics of controlled before-after (CBA) and interrupted time series (ITS) studies and their use in Cochrane reviews. We searched the Cochrane library for reviews including these study designs from May 2012 to March 2015 and purposively selected, where available, two reviews each across 10 prespecified intervention types. We randomly selected two CBA and two ITS studies from each review. Two researchers independently extracted information from the studies and the respective reviews. Sixty-nine reviews considered CBA and ITS studies for inclusion. We analyzed 21 CBA and 16 ITS studies from 11 to 8 reviews, respectively. Cochrane reviews inconsistently defined and labeled CBA and ITS studies. Many studies did not meet the Cochrane definition or the minimum criteria provided by Cochrane Effective Practice and Organisation of Care. The studies present a heterogeneous set of study features and applied a large variety of analyses. While CBA and ITS studies represent important study designs to evaluate the effects of interventions, especially on a population or organizational level, unclear study design features challenge unequivocal classification and appropriate use. We discuss options for more specific definitions and explicit criteria for CBA and ITS studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Which echocardiographic parameter is a better marker of volume status in hemodialysis patients?

PubMed

Sabaghian, Tahereh; Hajibaratali, Bahareh; Samavat, Shiva

2016-11-01

Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA. In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis. All the cases of dialysis were performed in the middle of the week. This study also assessed the correlation between echocardiographic parameters and BIA parameters. There were significant differences between ECW, TBW, and TBW% (TBW/W) before and after HD. Significant differences were observed between echocardiographic parameters of IVCD, IVCDi min , IVCDi max before and after the HD. LVEDD, LVESD, LA area, mitral valve inflow, E/E', and IVRT, were improved after dialysis, too. There was a significant correlation between IVCDi min as an index of volume status, ECW% and TBW% before HD and IVCDi min change after dialysis had a significant correlation with %ECW change after dialysis. Comparison between hypertensive and non-hypertensive groups indicated IVCDi min was significantly lower in non-hypertensive group after dialysis. Our results showed a correlation between IVCDi min and BIA parameters before HD. So, it seems that IVCDi min can be a good parameter for determining the volume status of HD patients. However, further studies, with larger sample size and with a prospective study design, are required to confirm these results.

Minnesota Heart Safe Communities: Are community-based initiatives increasing pre-ambulance CPR and AED use?

PubMed

Boland, Lori L; Formanek, Michelle B; Harkins, Kim K; Frazee, Carol L; Kamrud, Jonathan W; Stevens, Andrew C; Lick, Charles J; Yannopoulos, Demetris

2017-10-01

Implementation research that describes how successfully resuscitation guidelines are translated into practice are lacking. We examined whether recent community-based initiatives being conducted as part of the Minnesota Heart Safe (HS) Communities program increase the delivery of CPR and use of automated external defibrillators (AED) by bystanders and first responders prior to ambulance arrival. Non-EMS witnessed out-of-hospital cardiac arrests (OHCA) with presumed cardiac etiology treated by a single ambulance service in 2013-2015 were studied. Data were obtained from the Minnesota HS program and the Cardiac Arrest Registry to Enhance Survival (CARES) Surveillance Registry. Pre-ambulance CPR and AED use within HS communities before and after completion of the program were compared. As of July 2016, 17 Minnesota communities within the ambulance service area had achieved HS designation and 294 OHCAs that occurred in these communities met inclusion criteria for analysis (120 before HS designation, 174 after). CPR was initiated by bystanders or first responders prior to ambulance arrival in 83% of OHCA events that occurred before HS designation and in 95% of events that occurred after designation (OR=4.23 [1.80-9.98]). Pre-ambulance AED use increased from 63% to 77% after the community intervention (OR=1.94 [1.16-3.24]). Overall unadjusted survival to hospital discharge increased slightly after HS designation, but this difference was not statistically significant (17% vs 20%, p=0.32). Implementation of the Heart Safe program in communities within our ambulance service area in Minnesota has increased use of CPR and AEDs by bystanders and first responders prior to ambulance arrival. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessing effects of BL67 points stimulation on fetal heart rate parameters and fetal movements during nonstress test.

PubMed

Pirhadi, Masume; Valiani, Mahboube

2017-01-01

One of the main goals of antenatal testing is to identify fetuses at the risk of neurologic injury or death so that these adverse outcomes can be prevented. We want to assess the effects of BL67 points' stimulation on fetal heart rate parameters and fetal movements during nonstress test (NST). We did a quasi-experimental design in Shahid Beheshti Hospital in Isfahan in 2011. This study aims to assessment of the effects of BL67 points' stimulation on fetal heart rate parameters and fetal movements. We did a randomized controlled clinical trial in Shahid Beheshti Hospital in Isfahan in 2011. This study is a quasi-experimental design that was conducted in one group and the two steps (before-after study). Participants were pregnant women (primigravida) who were 35-18 years that refer to Shahid Beheshti Hospital in Isfahan in 2011 to receive routine prenatal care. The 32 pregnant women were selected for acupressure during the second NST. The statistical processing was performed by descriptive, paired t -test through SPSS version 20. There was no significant difference in mean number of accelerations in fetal heart rate and mean number of fetal movement before and after intervention; however, there was a significant difference in mean time to the second acceleration before and after the intervention ( P = 0.04). No difference between parameters of the fetal heart rate before and after stimulation and lack of uterine response by this method is a significant advantage and is probably why stimulating this point could not create a risk to the fetuses.

Loss of local capture of the pulmonary vein myocardium after antral isolation: prevalence and clinical significance.

PubMed

Squara, Fabien; Liuba, Ioan; Chik, William; Santangeli, Pasquale; Zado, Erica S; Callans, David J; Marchlinski, Francis E

2015-03-01

Capture of the myocardial sleeves of the pulmonary veins (PV) during PV pacing is mandatory for assessing exit block after PV isolation (PVI). However, previous studies reported that a significant proportion of PVs failed to demonstrate local capture after PVI. We designed this study to evaluate the prevalence and the clinical significance of loss of PV capture after PVI. Thirty patients (14 redo) undergoing antral PVI were included. Before and after PVI, local PV capture was assessed during circumferential pacing (10 mA/2 milliseconds) with a circular multipolar catheter (CMC), using EGM analysis from each dipole of the CMC and from the ablation catheter placed in ipsilateral PV. Pacing output was varied to optimize identification of sleeve capture. All PVs demonstrated sleeve capture before PVI, but only 81% and 40% after first time and redo PVI, respectively (P < 0.001 vs. before PVI). In multivariate analysis, absence of spontaneous PV depolarizations after PVI and previous PVI procedures were associated with less PV sleeve capture after PVI (40% sleeve capture, P < 0.001 for both). Loss of PV local capture by design was coincident with the development of PV entrance block and importantly predicted absence of acute reconnection during adenosine challenge with 96% positive predictive value (23% negative predictive value). Loss of PV local capture is common after antral PVI resulting in entrance block, and may be used as a specific alternate endpoint for PV electrical isolation. Additionally, loss of PV local capture may identify PVs at very low risk of acute reconnection during adenosine challenge. © 2014 Wiley Periodicals, Inc.

Investigation of the effects of planned mouth care education on the degree of oral mucositis in pediatric oncology patients.

PubMed

Yavuz, Betül; Bal Yılmaz, Hatice

2015-01-01

This study was designed as a longitudinal study with the purpose of investigating the effects of providing mouth care education to pediatric oncology patients on the degree of oral mucositis. The study sample included 16 children aged 8 to 18 years who were hospitalized in the pediatric oncology and hematology clinics at a university hospital. The results revealed a statistically significant difference between the degree of mucositis before and after the education given to children undergoing chemotherapy (P < .05). The median pain values were significantly different before and after the education (P < .05) as well. It was also found that there was a strong positive statistically significant correlation between the degree of mucositis and mean pain score both before and after the education (P < .001). Consequently, it is reported that both the degree of mucositis and pain levels decreased when children were given planned mouth care education before chemotherapy and when they regularly performed mouth care. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Simulation-based power calculation for designing interrupted time series analyses of health policy interventions.

PubMed

Zhang, Fang; Wagner, Anita K; Ross-Degnan, Dennis

2011-11-01

Interrupted time series is a strong quasi-experimental research design to evaluate the impacts of health policy interventions. Using simulation methods, we estimated the power requirements for interrupted time series studies under various scenarios. Simulations were conducted to estimate the power of segmented autoregressive (AR) error models when autocorrelation ranged from -0.9 to 0.9 and effect size was 0.5, 1.0, and 2.0, investigating balanced and unbalanced numbers of time periods before and after an intervention. Simple scenarios of autoregressive conditional heteroskedasticity (ARCH) models were also explored. For AR models, power increased when sample size or effect size increased, and tended to decrease when autocorrelation increased. Compared with a balanced number of study periods before and after an intervention, designs with unbalanced numbers of periods had less power, although that was not the case for ARCH models. The power to detect effect size 1.0 appeared to be reasonable for many practical applications with a moderate or large number of time points in the study equally divided around the intervention. Investigators should be cautious when the expected effect size is small or the number of time points is small. We recommend conducting various simulations before investigation. Copyright © 2011 Elsevier Inc. All rights reserved.

Efficacy of communication skills training for giving bad news and discussing transitions to palliative care.

PubMed

Back, Anthony L; Arnold, Robert M; Baile, Walter F; Fryer-Edwards, Kelly A; Alexander, Stewart C; Barley, Gwyn E; Gooley, Ted A; Tulsky, James A

2007-03-12

Few studies have assessed the efficacy of communication skills training for postgraduate physician trainees at the level of behaviors. We designed a residential communication skills workshop (Oncotalk) for medical oncology fellows. The intervention design built on existing successful models by teaching specific communication tasks linked to the patient's trajectory of illness. This study evaluated the efficacy of Oncotalk in changing observable communication behaviors. Oncotalk was a 4-day residential workshop emphasizing skills practice in small groups. This preintervention and postintervention cohort study involved 115 medical oncology fellows from 62 different institutions during a 3-year study. The primary outcomes were observable participant communication skills measured during standardized patient encounters before and after the workshop in giving bad news and discussing transitions to palliative care. The standardized patient encounters were audiorecorded and assessed by blinded coders using a validated coding system. Before-after comparisons were made using each participant as his or her own control. Compared with preworkshop standardized patient encounters, postworkshop encounters showed that participants acquired a mean of 5.4 bad news skills (P<.001) and a mean of 4.4 transitions skills (P<.001). Most changes in individual skills were substantial; for example, in the bad news encounter, 16% of participants used the word "cancer" when giving bad news before the workshop, and 54% used it after the workshop (P<.001). Also in the bad news encounter, blinded coders were able to identify whether a standardized patient encounter occurred before or after the workshop in 91% of the audiorecordings. Oncotalk represents a successful teaching model for improving communication skills for postgraduate medical trainees.

Four Case Studies, Six Years Later: Developing System Thinking Skills in Junior High School and Sustaining Them over Time

ERIC Educational Resources Information Center

Ben-Zvi-Assaraf, Orit; Orion, Nir

2010-01-01

This study examines the process by which system thinking perceptions develop within the context of a water cycle curriculum. Four junior high school students undergoing an especially designed inquiry-based intervention were closely observed before, during, immediately after, and 6 years after completing a year long systems-based learning program.…

The Paired Availability Design and Related Instrumental Variable Meta-analyses | Division of Cancer Prevention

Cancer.gov

Stuart G. Baker, 2017 Introduction This software computes meta-analysis and extrapolation estimates for an instrumental variable meta-analysis of randomized trial or before-and-after studies (the latter also known as the paired availability design). The software also checks on the assumptions if sufficient data are available. |

Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis.

PubMed

Shaw, Gregory; Lee-Barthel, Ann; Ross, Megan Lr; Wang, Bing; Baar, Keith

2017-01-01

Musculoskeletal injuries are the most common complaint in active populations. More than 50% of all injuries in sports can be classified as sprains, strains, ruptures, or breaks of musculoskeletal tissues. Nutritional and/or exercise interventions that increase collagen synthesis and strengthen these tissues could have an important effect on injury rates. This study was designed to determine whether gelatin supplementation could increase collagen synthesis. Eight healthy male subjects completed a randomized, double-blinded, crossover-design study in which they consumed either 5 or 15 g of vitamin C-enriched gelatin or a placebo control. After the initial drink, blood was taken every 30 min to determine amino acid content in the blood. A larger blood sample was taken before and 1 h after consumption of gelatin for treatment of engineered ligaments. One hour after the initial supplement, the subjects completed 6 min of rope-skipping to stimulate collagen synthesis. This pattern of supplementation was repeated 3 times/d with ≥6 h between exercise bouts for 3 d. Blood was drawn before and 4, 24, 48, and 72 h after the first exercise bout for determination of amino-terminal propeptide of collagen I content. Supplementation with increasing amounts of gelatin increased circulating glycine, proline, hydroxyproline, and hydroxylysine, peaking 1 h after the supplement was given. Engineered ligaments treated for 6 d with serum from samples collected before or 1 h after subjects consumed a placebo or 5 or 15 g gelatin showed increased collagen content and improved mechanics. Subjects who took 15 g gelatin 1 h before exercise showed double the amino-terminal propeptide of collagen I in their blood, indicating increased collagen synthesis. These data suggest that adding gelatin to an intermittent exercise program improves collagen synthesis and could play a beneficial role in injury prevention and tissue repair. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12616001092482. © 2017 American Society for Nutrition.

Twenty years of stream restoration in Finland: little response by benthic macroinvertebrate communities.

PubMed

Louhi, Pauliina; Mykrä, Heikki; Paavola, Riku; Huusko, Ari; Vehanen, Teppo; Mäki-Petäys, Aki; Muotka, Timo

2011-09-01

The primary focus of many in-stream restoration projects is to enhance habitat diversity for salmonid fishes, yet the lack of properly designed monitoring studies, particularly ones with pre-restoration data, limits any attempts to assess whether restoration has succeeded in improving salmonid habitat. Even less is known about the impacts of fisheries-related restoration on other, non-target biota. We examined how restoration aiming at the enhancement of juvenile brown trout (Salmo trutta L.) affects benthic macroinvertebrates, using two separate data sets: (1) a before-after-control-impact (BACI) design with three years before and three after restoration in differently restored and control reaches of six streams; and (2) a space-time substitution design including channelized, restored, and near-natural streams with an almost 20-year perspective on the recovery of invertebrate communities. In the BACI design, total macroinvertebrate density differed significantly from before to after restoration. Following restoration, densities decreased in all treatments, but less so in the controls than in restored sections. Taxonomic richness also decreased from before to after restoration, but this happened similarly in all treatments. In the long-term comparative study, macroinvertebrate species richness showed no difference between the channel types. Community composition differed significantly between the restored and natural streams, but not between restored and channelized streams. Overall, the in-stream restoration measures used increased stream habitat diversity but did not enhance benthic biodiversity. While many macroinvertebrates may be dispersal limited, our study sites should not have been too distant to reach within almost two decades. A key explanation for the weak responses by macroinvertebrate communities may have been historical. When Fennoscandian streams were channelized for log floating, the loss of habitat heterogeneity was only partial. Therefore, habitat may not have been limiting the macroinvertebrate communities to begin with. Stream restoration to support trout fisheries has strong public acceptance in Finland and will likely continue to increase in the near future. Therefore, more effort should be placed on assessing restoration success from a biodiversity perspective using multiple organism groups in both stream and riparian ecosystems.

Building nursing intellectual capital for safe use of information technology: a before-after study to test an evidence-based peer coach intervention.

PubMed

Poe, Stephanie S; Abbott, Patricia; Pronovost, Peter

2011-01-01

Use of peer coaches may be effective in building and maintaining competencies bedside nurses need to safely use electronic health records (EHRs). A nonexperimental design with before-after measures was used to evaluate the effectiveness of peer coaches in increasing learner satisfaction and confidence in EHR use on 9 units at an academic medical center. Survey findings suggested that nurses experienced higher than expected satisfaction with training and increased self-confidence in the EHR use following program implementation.

Symbolic Drawings Reveal Changes in Preservice Teacher Mathematics Attitudes after a Mathematics Methods Course

ERIC Educational Resources Information Center

Rule, Audrey C.; Harrell, Mary H.

2006-01-01

A new method of analyzing mathematics attitudes through symbolic drawings, situated within the field of Jungian-oriented analytical psychology, was applied to 52 preservice elementary teachers before and after a mathematics methods course. In this triangulation mixed methods design study, pretest images related to past mathematics experiences…

Dallas area rapid transit LRT starter line assessment study design. Final research report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shunk, G.A.; Turnbull, K.F.; Lindquist, N.F.

1995-03-01

Light rail transit (LRT) systems have recently been implemented in a number of urban areas throughout the United States and additional projects are in various stages of planning and development. Questions have been raised concerning the impact of these systems on ridership levels, transit operating costs, regional mobility, land use, economic development, energy, air quality, congestion levels, and other factors. The implementation of the Dallas Area Rapid Transit (DART) LRT starter line provides the opportunity to assess the impact of an LRT system in a Southwestern city in the United States. This research project was undertaken to assist with themore » development of a comprehensive study design for assessing the effects of the DART LRT starter line. To accomplish this objective, a review was conducted of before-and-after studies of recent LRT, heavy rail, and high-occupancy vehicle (HOV) projects. The goals and objectives of the DART system were also reviewed and existing transportation-related data collection activities in the Dallas area were examined. This information was used to develop a preliminary study design for assessing the effects of the DART LRT starter line. This report documents the review of recent before-and-after studies and presents the preliminary study design for assessing the effects of the DART LRT starter line.« less

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

PubMed

Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it.

PubMed

Simon, S; Higginson, I J

2009-01-01

Hospital palliative care teams (HPCTs) are well established as multi-professional services to provide palliative care in an acute hospital setting and are increasing in number. However, there is still limited evaluation of them, in terms of efficacy and effectiveness. The gold standard method of evaluation is a randomised control trial, but because of methodological (e.g., randomisation), ethical and practical difficulties such trials are often not possible. HPCT is a complex intervention, and the specific situation in palliative care makes it challenging to evaluate (e.g., distress and cognitive impairment of patients). The quasi-experimental before-after study design has the advantage of enabling an experimental character without randomisation. But this has other weaknesses and is prone to bias, for example, temporal trends and selection bias. As for every study design, avoidance and minimisation of bias is important to improve validity. Therefore, strategies of selecting an appropriate control group or time series and applying valid outcomes and measurement tools help reducing bias and strengthen the methods. Special attention is needed to plan and define the design and applied method.

A before-and-after study of traffic conflicts at the U.S. Route One entrance to Camden Hills State Park : an evaluation of a portion of a context sensitive design project.

DOT National Transportation Integrated Search

2007-09-01

Route 1 has been reconstructed as a Context Sensitive Design Project in the Camden, : Maine area. The purpose of this study is to evaluate the safety effect of the reconstruction of the highway at the entrances to the Camden Hills State Park. The two...

Students' memorization of anatomy, influence of drawing.

PubMed

Alsaid, B; Bertrand, M

2016-03-01

Anatomy is the cornerstone of medical education. Different teaching methods can be combined. This study was designed to evaluate the influence of students' drawing of the anatomical region before and after the dissection session on their memorization of the studied anatomical region. Four hundred and sixteen second-year medical students in the faculty of medicine of Damascus were included in this study during the 2013-2014 academic year. Students were randomly divided into three blinded groups. Two groups had to draw the anatomical region respectively before and after the dissection session, while the third group did not have to draw. The memorization of the region was evaluated twice, one and seven weeks after the course. Means were compared using a t-test. Scores were significantly higher at 1 and 7 weeks tests in groups who were asked to draw either before or after the dissection compared to those who were not asked to draw. No statistical difference was found between the two groups who drew. The authors recommend the use of drawing in teaching anatomy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Senior medical students' attitudes toward psychiatry as a career choice before and after an undergraduate psychiatry internship in Iran.

PubMed

Amini, Homayoun; Moghaddam, Yasaman; Nejatisafa, Ali-Akbar; Esmaeili, Sara; Kaviani, Hosein; Shoar, Saeed; Shabani, Amir; Samimi-Ardestani, Mehdi; Akhlaghi, Amir Abbas Keshavarz; Noroozi, Alireza; Mafi, Mostafa

2013-05-01

The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to the medical school psychiatry rotation in the United States, but mandatory in Iran) in three major medical schools in Tehran, the capital of Iran. Sixth- and seventh-year medical students (locally called interns, N=347) at Tehran, Shahid Beheshti, and Iran Universities of Medical Sciences were consecutively invited to complete anonymous self-report questionnaires designed to assess their perceptions of careers in psychiatry before and after internship in psychiatry wards. Also, students evaluated psychiatry in terms of the factors that reflected the degree of attractiveness of this specialty. Positive responses toward choosing psychiatry as a career were seen in 18.8% before and 20.0% after psychiatry rotation. No significant differences were observed in the positive responses before and after psychiatry internship. The students' opinions changed to a more attractive degree in terms of only 3 out of the 13 defined aspects. There was also no significant difference in the total score on attractiveness of psychiatry before and after the psychiatry internship. The study indicated that undergraduate psychiatry internship might not induce more students to consider psychiatry as a possible career. The present pattern of psychiatry education in Iran seems not to positively affect most aspects of medical students' attitudes toward psychiatry.

Effects of the Professional Development Program on Turkish Teachers: Technology Integration along with Attitude towards ICT in Education

ERIC Educational Resources Information Center

Uslu, Oner; Bumen, Nilay T.

2012-01-01

The purpose of this study is to analyze the impact of the professional development (PD) program on technology integration (TI) besides attitudes towards ICT in education of Turkish teachers. This study demonstrates the outcomes of one group pre-test and post-test design based on data, collected before, just after and six weeks after the PD…

Teaching engineering ethics using BLOCKS game.

PubMed

Lau, Shiew Wei; Tan, Terence Peng Lian; Goh, Suk Meng

2013-09-01

The aim of this study was to investigate the use of a newly developed design game called BLOCKS to stimulate awareness of ethical responsibilities amongst engineering students. The design game was played by seventeen teams of chemical engineering students, with each team having to arrange pieces of colored paper to produce two letters each. Before the end of the game, additional constraints were introduced to the teams such that they faced similar ambiguity in the technical facts that the engineers involved in the Challenger disaster had faced prior to the space shuttle launch. At this stage, the teams had to decide whether to continue with their original design or to develop alternative solutions. After the teams had made their decisions, a video of the Challenger explosion was shown followed by a post-game discussion. The students' opinion on five Statements on ethics was tracked via a Five-Item Likert survey which was administered three times, before and after the ethical scenario was introduced, and after the video and post-game discussion. The results from this study indicated that the combination of the game and the real-life incident from the video had generally strengthened the students' opinions of the Statements.

Does An Education Seminar Intervention Improve the Parents’ Knowledge on Vaccination? Evidence from Yiwu, East China

PubMed Central

Hu, Yu

2015-01-01

Background: caregivers’ knowledge on vaccination is an important impact factor for their children’s vaccination status. The aims of this study were to evaluate the caregivers’ knowledge of vaccination, and to assess effectiveness of a health education seminar for improving caregivers’ knowledge on immunization. Methods: pre- and post-assessment design was adopted for a single group to evaluate the effectiveness of the health education seminar on vaccination. The seminar consisted of a lecture using simple understandable language. Improvements in total knowledge score before and after the seminar were assessed using a validated questionnaire that included ten questions. Description analysis and non-parametric tests were applied to evaluate and compare the vaccination knowledge level before and after the seminar. Results: 378 caregivers participated in this study. The majority were mothers. Of the ten questions, the correct response rates had significantly increased for nine questions after the education seminar. The mean total score of the assessment before the seminar was 5.2 ± 1.2 while that was 8.4 ± 0.9 for the assessment after the seminar, with a significant increase of 3.18 points. Conclusion: a short education seminar designed for caregivers had a remarkable effect on their vaccination knowledge. Health education on vaccination targeting migrant caregivers, caregivers with lower education level or household income, and employed caregivers are needed in future. PMID:25811770

A Comparative study on sexual dysfunctions before and after menopause

PubMed Central

Beigi, Marjan; Fahami, Fariba

2012-01-01

Background: Sexual instinct which is the cause of numerous changes in an individual’s life could be influenced by different factors such as menopause and ageing. This study was designed to compare sexual dysfunction before and after menopause. Materials and Methods: This was a cross-sectional study. Participants were 174 menopausal women who referred to medical health centers of Isfahan, Iran. Data were collected through self constructed sexual dysfunctions questionnaire in relation to their sexual activities before and after menopause. The reliability and validity of this questionnaire was determined by content validity and Cronbach’s alpha coefficient. Findings: Findings showed that the relative frequency of sexual dysfunctions was 38% in the productive period and 72.4% in the menopause period. There was a significant association between sexual dysfunctions before and after the menopause period (p < 0.001). Sexual dysfunctions in these women in the productive and menopause period were 49.2% and 62.6% in desire disorder, 34.3% and 34.9% in dyspareunia, 26.8% and 75.3% in arousal disorder, 23.5% and 56.3% in orgasmic disorder and 16.4% and 15.6% in vaginismus, respectively. Conclusions: A considerable percentage of women experienced sexual dysfunctions in productive and menopause periods, and menopause could be a factor to maintain or intensify sexual dysfunctions. PMID:23833604

Undertriage in older emergency department patients--tilting against windmills?

PubMed

Grossmann, Florian F; Zumbrunn, Thomas; Ciprian, Sandro; Stephan, Frank-Peter; Woy, Natascha; Bingisser, Roland; Nickel, Christian H

2014-01-01

The aim of this study was to investigate the long-term effect of a teaching intervention designed to reduce undertriage rates in older ED patients. Further, to test the hypothesis that non-adherence to the Emergency Severity Index (ESI) triage algorithm is associated with undertriage. Additionally, to detect patient related risk factors for undertriage. Pre-post-test design. The study sample consisted of all patients aged 65 years or older presenting to the ED of an urban tertiary and primary care center in the study periods. A teaching intervention designed to increase adherence to the triage algorithm. To assess, if the intervention resulted in an increase of factual knowledge, nurses took a test before and immediately after the teaching intervention. Undertriage rates were assessed one year after the intervention and compared to the pre-test period. In the pre-test group 519 patients were included, and 394 in the post-test-group. Factual knowledge among triage nurses was high already before the teaching intervention. Prevalence of undertriaged patients before (22.5%) and one year after the intervention (24.2%) was not significantly different (χ2 = 0.248, df = 1, p = 0.619). Sex, age, mode of arrival, and type of complaint were not identified as independent risk factors for undertriage. However, undertriage rates increased with advancing age. Adherence to the ESI algorithm is associated with correct triage decisions. Undertriage of older ED patients remained unchanged over time. Reasons for undertriage seem to be more complex than anticipated. Therefore, additional contributing factors should be addressed.

Diabetes and cardiovascular disease interventions by community pharmacists: a systematic review.

PubMed

Evans, Charity D; Watson, Erin; Eurich, Dean T; Taylor, Jeff G; Yakiwchuk, Erin M; Shevchuk, Yvonne M; Remillard, Alfred; Blackburn, David

2011-05-01

To systematically review and assess the quality of studies evaluating community pharmacist interventions for preventing or managing diabetes or cardiovascular disease (CVD) and/or their major risk factors. A comprehensive literature search was performed using MEDLINE (1950-February 2011), EMBASE (1980-February 2011), International Pharmaceutical Abstracts (1970-February 2011), Cumulative Index to Nursing and Allied Health Literature (1982-June 2007), and Cochrane Central Register of Controlled Trials (1898-February 2011). Search terms included: community pharmacy(ies), community pharmacist(s), cardiovascular, diabetes, and intervention. The grey literature was searched using the ProQuest Dissertations and Theses, Theses Canada, and OAlster databases. Articles published in English or French with all study designs were considered for the review. Studies were included if they contained interventions designed to reduce the incidence, risk, or mortality of CVD or diabetes; affect clinical indicators of CVD or diabetes mellitus (including hypertension, dyslipidemia, or hemoglobin A(1c)); and/or improve adherence to treatment strategies. Only studies involving interventions carried out primarily by pharmacists in community pharmacy settings were included. Study quality was assessed using a checklist validated for both randomized and nonrandomized studies. A total of 4142 studies were initially identified, with 40 meeting our inclusion criteria. Eleven studies were randomized controlled trials, 4 were cluster randomized trials, and 2 studies had randomized before-after designs. The remaining studies were controlled before-after (n = 2), cohort (n = 4), and uncontrolled before-after (n = 17) designs. Interventions focused on diabetes (n = 12), hypertension (n = 9), medication adherence (n = 9), lipids (n = 5), evidence-based medication initiation or optimization (n = 3), risk factor prediction scores (n = 1), and body mass index (n = 1). All studies contained interventions focused at the patient level and the majority of studies (34/40) involved interventions directed at both the physician and patient. No specific intervention emerged as superior, and study quality was generally poor, making it difficult to determine the true effect of the interventions. Poor study quality, time-intensive interventions, and unproven clinical significance warrant the need for further high-quality studies of community pharmacist interventions for preventing or managing diabetes or CVD and/or their major risk factors.

29 CFR 4022.94 - What are the PBGC's rules on designating a person to get benefits the PBGC may owe me at the time...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... At any time on or after the date we take over your plan, you may designate with us who will get any...) you designate with us, you must submit another designation to us. (c) If your designee dies before you—(1) In general. If the person(s) you designate with us dies before you or at the same time as you, we...

Improving Student Teachers' Perceptions on Technology Integration Using a Blended Learning Programme

ERIC Educational Resources Information Center

Edannur, Sreekala; Marie, S. Maria Josephine Arokia

2017-01-01

This study examined student teachers' perceptions about Technology Integration (Blended Learning in this study) before and after their exposure to a Blended Learning Experimental Programme designed for the study for eight weeks. EDMODO (an open access Learning Management System) was used as the teaching learning platform for the implementation of…

Antidepressant Use Before and After the Diagnosis of Type 2 Diabetes

PubMed Central

Kivimäki, Mika; Tabák, Adam G.; Lawlor, Debbie A.; Batty, G. David; Singh-Manoux, Archana; Jokela, Markus; Virtanen, Marianna; Salo, Paula; Oksanen, Tuula; Pentti, Jaana; Witte, Daniel R.; Vahtera, Jussi

2010-01-01

OBJECTIVE To examine antidepressant use before and after the diagnosis of diabetes. RESEARCH DESIGN AND METHODS This study was a longitudinal analysis of diabetic and nondiabetic groups selected from a prospective cohort study of 151,618 men and women in Finland (the Finnish Public Sector Study, 1995–2005). We analyzed the use of antidepressants in those 493 individuals who developed type 2 diabetes and their 2,450 matched nondiabetic control subjects for each year during a period covering 4 years before and 4 years after the diagnosis. For comparison, we undertook a corresponding analysis on 748 individuals who developed cancer and their 3,730 matched control subjects. RESULTS In multilevel longitudinal models, the odds ratio for antidepressant use in those who developed diabetes was 2.00 (95% CI 1.57–2.55) times greater than that in nondiabetic subjects. The relative difference in antidepressant use between these groups was similar before and after the diabetes diagnosis except for a temporary peak in antidepressant use at the year of the diagnosis (OR 2.66 [95% CI 1.94–3.65]). In incident cancer case subjects, antidepressant use substantially increased after the cancer diagnosis, demonstrating that our analysis was sensitive for detecting long-term changes in antidepressant trajectories when they existed. CONCLUSIONS Awareness of the diagnosis of type 2 diabetes may temporarily increase the risk of depressive symptoms. Further research is needed to determine whether more prevalent use of antidepressants noted before the diagnosis of diabetes relates to effects of depression, side effects of antidepressant use, or a common causal pathway for depression and diabetes. PMID:20368411

In-flight sleep, pilot fatigue and Psychomotor Vigilance Task performance on ultra-long range versus long range flights.

PubMed

Gander, Philippa H; Signal, T Leigh; van den Berg, Margo J; Mulrine, Hannah M; Jay, Sarah M; Jim Mangie, Captain

2013-12-01

This study evaluated whether pilot fatigue was greater on ultra-long range (ULR) trips (flights >16 h on 10% of trips in a 90-day period) than on long range (LR) trips. The within-subjects design controlled for crew complement, pattern of in-flight breaks, flight direction and departure time. Thirty male Captains (mean age = 54.5 years) and 40 male First officers (mean age = 48.0 years) were monitored on commercial passenger flights (Boeing 777 aircraft). Sleep was monitored (actigraphy, duty/sleep diaries) from 3 days before the first study trip to 3 days after the second study trip. Karolinska Sleepiness Scale, Samn-Perelli fatigue ratings and a 5-min Psychomotor Vigilance Task were completed before, during and after every flight. Total sleep in the 24 h before outbound flights and before inbound flights after 2-day layovers was comparable for ULR and LR flights. All pilots slept on all flights. For each additional hour of flight time, they obtained an estimated additional 12.3 min of sleep. Estimated mean total sleep was longer on ULR flights (3 h 53 min) than LR flights (3 h 15 min; P(F) = 0.0004). Sleepiness ratings were lower and mean reaction speed was faster at the end of ULR flights. Findings suggest that additional in-flight sleep mitigated fatigue effectively on longer flights. Further research is needed to clarify the contributions to fatigue of in-flight sleep versus time awake at top of descent. The study design was limited to eastward outbound flights with two Captains and two First Officers. Caution must be exercised when extrapolating to different operations. © 2013 European Sleep Research Society.

Effects of a portion design plate on food group guideline adherence among hospital staff.

PubMed

de Korne, Dirk F; Malhotra, Rahul; Lim, Wai Yee; Ong, Christine; Sharma, Ashu; Tan, Tai Kiat; Tan, Thiam Chye; Ng, Kee Chong; Østbye, Truls

2017-01-01

Food group guideline adherence is vital to prevent obesity and diabetes. Various studies have demonstrated that environmental variables influence food intake behaviour. In the present study we examined the effect of a portion design plate with food group portion guidelines demarcated by coloured lines (ETE Plate™). A two-group quasi-experimental design was used to measure proportions of carbohydrate, vegetable and protein portions and user experience in a hospital staff lounge setting in Singapore. Lunch was served on the portion design plate before 12.15 hours. For comparison, a normal plate (without markings) was used after 12.15 hours. Changes in proportions of food groups from 2 months before the introduction of the design plate were analysed in a stratified sample at baseline (859 subjects, all on normal plates) to 1, 3 and 6 months after (in all 1016 subjects on the design plate, 968 subjects on the control plate). A total of 151 participants were asked about their experiences and opinions. Between-group comparisons were performed using t tests. Among those served on the portion design plate at 6 months after its introduction, the proportion of vegetables was 4·71 % ( P  < 0·001) higher and that of carbohydrates 2·83 % ( P  < 0·001) lower relative to the baseline. No significant change was found for proteins (-1·85 %). Over 6 months, we observed different change patterns between the different food group proportions. While participants were positive about the portion design plate, they did not think it would influence their personal behaviour. A portion design plate might stimulate food group guideline adherence among hospital staff and beyond.

An Empirical Bayes before-after evaluation of road safety effects of a new motorway in Norway.

PubMed

Elvik, Rune; Ulstein, Heidi; Wifstad, Kristina; Syrstad, Ragnhild S; Seeberg, Aase R; Gulbrandsen, Magnus U; Welde, Morten

2017-11-01

This paper presents an Empirical Bayes before-after evaluation of the road safety effects of a new motorway (freeway) in Østfold county, Norway. The before-period was 1996-2002. The after-period was 2009-2015. The road was rebuilt from an undivided two-lane road into a divided four-lane road. The number of killed or seriously injured road users was reduced by 75 percent, controlling for (downward) long-term trends and regression-to-the-mean (statistically significant at the 5 percent level; recorded numbers 71 before, 11 after). There were small changes in the number of injury accidents (185 before, 123 after; net effect -3%) and the number of slightly injured road users (403 before 279 after; net effect +5%). Motorways appear to mainly reduce injury severity, not the number of accidents. The paper discusses challenges in implementing the Empirical Bayes design when less than ideal data are available. Copyright © 2017 Elsevier Ltd. All rights reserved.

Headwater stream temperature: interpreting response after logging, with and without riparian buffers, Washington, USA

Treesearch

Jack E. Janisch; Steven M. Wondzell; William J. Ehinger

2012-01-01

We examined stream temperature response to forest harvest in small forested headwater catchments in western Washington, USA over a seven year period (2002-2008). These streams have very low discharge in late summer and many become spatially intermittent. We used a before-after, control-impact (BACl) study design to contrast the effect of clearcut logging with two...

A ‘one-stop shop’ approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?

PubMed Central

Zachariah, R.; Bissell, K.; Ndebele, W.; Moyo, J.; Mutasa-Apollo, T.

2013-01-01

Setting: Prevention of mother-to-child transmission (PMTCT) programme, Mpilo Hospital antenatal clinic, Zimbabwe. Objective: Before and after the introduction of a one-stop shop approach and task-shifting of antiretroviral treatment (ART) to midwives in the PMTCT programme, 1) to compare ART uptake and 2) to determine socio-demographic and other characteristics associated with non-initiation of ART post integration. Design: Before and after cohort study. Results: A total of 285 women were eligible for ART before the introduction of the one-stop approach and 280 after. Of the 285, 163 (57%) initiated ART before integration; this increased to 244/280 (87%) after integration (RR 1.5, 95% CI 1.4–1.7, P < 0.001). A total of 36 (13%) women did not initiate ART after integration; this was significantly associated with cotrimoxazole uptake (P = 0.03). Conclusion: Integrating ART into antenatal care along with task-shifting to midwives considerably increased the uptake of ART. This provides further evidence for scaling up integration rapidly to other facilities in Zimbabwe, and is in line with the vision of a world where no child will be born with the human immunodeficiency virus by 2015. PMID:26393047

Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study.

PubMed

Collin, Simon M; Bakken, Inger J; Nazareth, Irwin; Crawley, Esther; White, Peter D

2017-05-05

Our aim was to investigate patterns of health care resource use by patients before and after a diagnosis of CFS/ME, as recorded by Clinical Practice Research Datalink (CPRD) GP practices in the UK. We used a case-control study design in which patients who had a first recorded diagnosis of CFS/ME during the period 01/01/2001 to 31/12/2013 were matched 1:1 with controls by age, sex, and GP practice. We compared rates of GP consultations, diagnostic tests, prescriptions, referrals, and symptoms between the two groups from 15 years (in adults) or 10 years (in children) before diagnosis to 10 years after diagnosis. Data were available for 6710 adult and 916 child (age <18 years) matched case-control pairs. Rates of GP consultations, diagnostic tests, prescriptions, referrals, and symptoms spiked dramatically in the year when a CFS/ME diagnosis was recorded. GP consultation rates were 50% higher in adult cases compared to controls 11-15 years before diagnosis (rate ratio (RR) 1.49 (95% CI 1.46, 1.52)) and 56% higher 6-10 years after diagnosis (RR 1.56 (1.54, 1.57)). In children, consultation rates in cases were 45% higher 6-10 years before diagnosis (RR 1.45 (1.40, 1.51)) and 62% higher 6-10 years after diagnosis (RR 1.62 (1.54, 1.70)). For adults and children, rates of tests, prescriptions, referrals, and symptoms were higher in cases compared to controls for up to 10 years before and after diagnosis. Adults and children with CFS/ME have greater health care needs than the rest of the population for at least ten years before their diagnosis, and these higher levels of health care resource use continue for at least ten years after diagnosis.

Does increasing active warm-up duration affect afternoon short-term maximal performance during Ramadan?

PubMed

Baklouti, Hana; Aloui, Asma; Chtourou, Hamdi; Briki, Walid; Chaouachi, Anis; Souissi, Nizar

2015-01-01

The purpose of this study was to examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the afternoon. Twelve healthy active men took part in the study. The experimental design consisted of four test sessions conducted at 5 p.m., before and during Ramadan, either with a 5-minute or a 15-minute warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. During each session, the subjects performed two vertical jump tests (squat jump and counter movement jump) for measurement of vertical jump height followed by a 30-second Wingate test for measurement of peak and mean power. Oral temperature was recorded at rest and after warming-up. Moreover, ratings of perceived exertion were obtained immediately after the Wingate test. Oral temperature was higher before Ramadan than during Ramadan at rest, and was higher after the 15-minute warm-up than the 5-minute warm-up both before and during Ramadan. In addition, vertical jump heights were not significantly different between the two warm-up conditions before and during Ramadan, and were lower during Ramadan than before Ramadan after both warm-up conditions. Peak and mean power were not significantly different between the two warm-up durations before Ramadan, but were significantly higher after the 5-minute warm-up than the 15-minute warm-up during Ramadan. Moreover, peak and mean power were lower during Ramadan than before Ramadan after both warm-up conditions. Furthermore, ratings of perceived exertion were higher after the 15-minute warm-up than the 5-minute warm-up only during Ramadan. The prolonged active warm-up has no effect on vertical jump height but impairs anaerobic power assessed during Ramadan in the afternoon.

Does Increasing Active Warm-Up Duration Affect Afternoon Short-Term Maximal Performance during Ramadan?

PubMed Central

Baklouti, Hana; Aloui, Asma; Chtourou, Hamdi; Briki, Walid; Chaouachi, Anis; Souissi, Nizar

2015-01-01

Aim The purpose of this study was to examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the afternoon. Methods Twelve healthy active men took part in the study. The experimental design consisted of four test sessions conducted at 5 p.m., before and during Ramadan, either with a 5-minute or a 15-minute warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. During each session, the subjects performed two vertical jump tests (squat jump and counter movement jump) for measurement of vertical jump height followed by a 30-second Wingate test for measurement of peak and mean power. Oral temperature was recorded at rest and after warming-up. Moreover, ratings of perceived exertion were obtained immediately after the Wingate test. Results Oral temperature was higher before Ramadan than during Ramadan at rest, and was higher after the 15-minute warm-up than the 5-minute warm-up both before and during Ramadan. In addition, vertical jump heights were not significantly different between the two warm-up conditions before and during Ramadan, and were lower during Ramadan than before Ramadan after both warm-up conditions. Peak and mean power were not significantly different between the two warm-up durations before Ramadan, but were significantly higher after the 5-minute warm-up than the 15-minute warm-up during Ramadan. Moreover, peak and mean power were lower during Ramadan than before Ramadan after both warm-up conditions. Furthermore, ratings of perceived exertion were higher after the 15-minute warm-up than the 5-minute warm-up only during Ramadan. Conclusion The prolonged active warm-up has no effect on vertical jump height but impairs anaerobic power assessed during Ramadan in the afternoon. PMID:25646955

Educational intervention for collecting sputum for tuberculosis: a quasi-experimental study 1

PubMed Central

Sicsú, Amélia Nunes; Salem, Julia Ignez; Fujimoto, Luciana Botinelly Mendonça; Gonzales, Roxana Isabel Cardozo; Cardoso, Maria do Socorro de Lucena; Palha, Pedro Fredemir

2016-01-01

Abstract Objective: to evaluate the quality of the sputum sample before and after the Nursing guidance to patients. Methods: this is a quasi-experimental research design, single group type, before and after, non-randomized study. The study enrolled patients with suspected pulmonary tuberculosis, respiratory symptomatic patients for over three weeks, aged over 18 years, of both genders and without tuberculosis history in the last two years. The educational intervention consisted of individualized guidance on the collection of sputum sample, which was based on the guidelines of the Ministry of Health of Brazil and on the explanatory folder delivery. Results: in this study participated 138 patients with suspected pulmonary tuberculosis. The results showed significant increase of the samples with purulent particles, volume greater than 5 mL and increased rate of patients diagnosed with tuberculosis, after the educational intervention. Conclusion: it was shown that after the educational intervention, it was observed sputum samples with better quality, with satisfactory aspect and volume for the effectiveness of the bacilloscopic examination. PMID:27276015

Reduction of Inpatient Hospital Length of Stay in Lumbar Fusion Patients With Implementation of an Evidence-Based Clinical Care Pathway.

PubMed

Bradywood, Alison; Farrokhi, Farrokh; Williams, Barbara; Kowalczyk, Mark; Blackmore, C Craig

2017-02-01

Quality improvement with before and after evaluation of the intervention. To improve lumbar spine postoperative care and quality outcomes through a series of Lean quality improvement events designed to address root causes of error and variation. Lumbar spine fusion procedures are common, but highly variable in process of care, outcomes, and cost. We implemented a standardized lumbar spine fusion clinical care pathway through a series of Lean quality improvement events. The pathway included an evidence-based electronic order set; a patient visual tool; and multidisciplinary communication, and was designed to delineate expectations for patients, staff, and providers. To evaluate the effectiveness of the intervention, we performed a quality improvement study with before and after evaluation of consecutive patients from January 2012 to September 2014. Outcomes were hospital length of stay and quality measures before and after the April 1, 2013 intervention. Data were analyzed with chi-square and t tests for before and after comparisons, and were explored graphically for temporal trends with statistical process control charts. Our study population was 458 patients (mean 65 years, 65% women). Length of stay decreased from 3.9 to 3.4 days, a difference of 0.5 days (CI 0.3, 0.8, P < 0.001). Discharge disposition also improved with 75% (183/244) being discharged to home postintervention versus 64% (136/214) preintervention (P = 0.002). Urinary catheter removal also improved (P = 0.003). Patient satisfaction scores were not significantly changed. Applying Lean methods to produce standardized clinical pathways is an effective way of improving quality and reducing waste for lumbar spine fusion patients. We believe that quality improvements of this type are valuable for all spine patients, to provide best care outcomes at lowest cost. 4.

Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico.

PubMed

Sánchez Cuén, Jaime Alberto; Irineo Cabrales, Ana Bertha; Bernal Magaña, Gregorio; Peraza Garay, Felipe

2016-12-01

Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia. While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject. The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori. A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria. An upper endoscopy was performed in which four gastric biopsy samples were taken (two from the antrum and two from the body) before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher's exact test and the McNemar's test. Forty-six patients were studied, of whom 20 (43.5%) were men and 26 (56.5%) were women, with an average age of 58.9 (DE 11.2). Intestinal metaplasia was found in 46 (100%) patients before treatment and in 21 (45.7%) patients post-eradication. Complete intestinal metaplasia (type I) was found in 35 patients (76.1%) before treatment and in 11 (23.9%) patients post-eradication (p = 0.000), while incomplete intestinal metaplasia (type II) was found in 10 (21.7%) patients before treatment and in 10 (21.7%) patients post-eradication. Non-atrophic chronic gastritis was found in 35 (76.1%) patients before treatment and in 32 (69.6%) patients post-eradication. In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of 54.3% one year after the eradication of this microorganism. This treatment could modify the natural history of the development of gastric cancer.

Analysis of corridor delay under SCATS control : FAST-TRAC Phase III deliverable

DOT National Transportation Integrated Search

1998-04-01

The study was designed to determine the change in travel time following the implementation of the Sydney Coordinated Adaptive Traffic System (SCATS) in Oakland County, Michigan. A before/after comparison was used to examine the change in travel time ...

Exploring the feasibility and use of acceleromters before, during, and after a camp-based CIMT program for children with cerebral palsy.

PubMed

Coker-Bolt, Patty; Downey, Ryan J; Connolly, Jacqueline; Hoover, Reagin; Shelton, Daniel; Seo, Na Jin

2017-01-01

The aim of this pilot study was to determine the feasibility and use accelerometers before, during, and after a camp-based constraint-induced movement therapy (CIMT) program for children with hemiplegic cerebral palsy. A pre-test post-test design was used for 12 children with CP (mean = 4.9 yrs) who completed a 30-hour camp-based CIMT program. The accelerometer data were collected using ActiGraph GT9X Link. Children wore accelerometers on both wrists one day before and after the camp and on the affected limb during each camp day. Three developmental assessments were administered pre-post CIMT program. Accelerometers were successfully worn before, during, and directly after the CIMT program to collect upper limb data. Affected upper limb accelerometer activity significantly increased during the CIMT camp compared to baseline (p< 0.05). Significant improvements were seen in all twelve children on all assessments of affected upper limb function (p< 0.05) measuring capacity and quality of affected upper limb functioning. Accelerometers can be worn during high intensity pediatric CIMT programs to collect data about affected upper limb function. Further study is required to determine the relationship between accelerometer data, measure of motor capacity, and real-world performance post-CIMT.

Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death.

PubMed

Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids; Giraldi, Annamaria

2016-03-01

Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Somatic morbidity and cause of death. Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality. Copyright © 2016. Published by Elsevier Inc.

Tanning salons in Santiago, Chile: the knowledge of the staff in charge and the quality of information provided to potential clients before and after a new regulatory law.

PubMed

Salomone, Claudia; Majerson, Daniela; Molgó, Montserrat; de Santa María, Mariá Luisa Sáenz; Romero, William

2009-04-01

In recent years, the use of artificial tanning devices has become very popular in Chile. In April, 2007, a new law was established to regulate the non-medical use of tanning beds and tanning booths. The aim of this study was to evaluate the level and quality of information provided by tanning salon staff to clients before deciding on using the services. This information was collected before and 6 months after the law was enacted by researchers visiting tanning salons posing as potential clients. Using a previously designed questionnaire, 24 tanning salons in Santiago, Chile, were evaluated by researchers acting as potential customers without experience with artificial tanning devices. Employees were questioned using a hidden questionnaire before and 6 months after enactment of the law. Before the law, 25% of the establishments gave spontaneous information about the risks of using tanning beds, which increased to 45.8% after enactment of the law. Clients never received written information, either before or after enactment of the law. On both evaluations, more than 1/3 of the employees affirmed that there were no risks in using tanning beds. Before enactment of the law, only 12.5% of the tanning salons required the use of goggles, while after the law, this increased to 25% (P=NS). Only two establishments required that clients sign an informed consent form after enactment of the law. The level of knowledge among employees in tanning salons was very low and the quality of the information they provided to the clients was very poor. It was important to legislate on ultraviolet tanning services, but at present, the impact of the law has been very limited.

Effects of anesthesia and surgery on serial blood gas values and lactate concentrations in yellow perch (Perca flavescens), walleye pike (Sander vitreus), and koi (Cyprinus carpio).

PubMed

Hanley, Christopher S; Clyde, Victoria L; Wallace, Roberta S; Paul-Murphy, Joanne; Patterson, Tamatha A; Keuler, Nicholas S; Sladky, Kurt K

2010-05-15

OBJECTIVE-To evaluate serial blood gas values and lactate concentrations in 3 fish species undergoing surgery and to compare blood lactate concentrations between fish that survived and those that died during the short-term postoperative period. DESIGN-Prospective cohort study. Animals-10 yellow perch, 5 walleye pike, and 8 koi. PROCEDURES-Blood samples were collected from each fish at 3 time points: before anesthesia, during anesthesia, and immediately after surgery. Blood gas values and blood lactate concentrations were measured. Fish were monitored for 2 weeks postoperatively. RESULTS-All walleye and koi survived, but 2 perch died. Blood pH significantly decreased in perch from before to during anesthesia, but increased back to preanesthesia baseline values after surgery. Blood Pco(2) decreased significantly in perch from before anesthesia to immediately after surgery, and also from during anesthesia to immediately after surgery, whereas blood Pco(2) decreased significantly in koi from before to during anesthesia. Blood Po(2) increased significantly in both perch and koi from before to during anesthesia, and also in koi from before anesthesia to immediately after surgery. For all 3 species, blood lactate concentrations increased significantly from before anesthesia to immediately after surgery. Blood lactate concentration (mean +/- SD) immediately after surgery for the 8 surviving perch was 6.06 +/- 1.47 mmol/L, which was significantly lower than blood lactate concentrations in the 2 nonsurviving perch (10.58 and 10.72 mmol/L). CONCLUSIONS AND CLINICAL RELEVANCE-High blood lactate concentrations following surgery in fish may be predictive of a poor short-term postoperative survival rate.

The effect of expiratory rib cage compression before endotracheal suctioning on the vital signs in patients under mechanical ventilation.

PubMed

Bousarri, Mitra Payami; Shirvani, Yadolah; Agha-Hassan-Kashani, Saeed; Nasab, Nouredin Mousavi

2014-05-01

In patients undergoing mechanical ventilation, mucus production and secretion is high as a result of the endotracheal tube. Because endotracheal suction in these patients is essential, chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretion and improving alveolar ventilation. As one of the complications of mechanical ventilation and endotracheal suctioning is decrease of cardiac output, this study was carried out to determine the effect of expiratory rib cage compression before endotracheal suctioning on the vital signs in patients under mechanical ventilation. This study was a randomized clinical trial with a crossover design. The study subjects included 50 mechanically ventilated patients, hospitalized in intensive care wards of Valiasr and Mousavi hospitals in Zanjan, Iran. Subjects were selected by consecutive sampling and randomly allocated to groups 1 and 2. The patients received endotracheal suctioning with or without rib cage compression, with a minimum of 3 h interval between the two interventions. Expiratory rib cage compression was performed for 5 min before endotracheal suctioning. Vital signs were measured 5 min before and 15 and 25 min after endotracheal suctioning. Data were recorded on a data recording sheet. Data were analyzed using paired t-tests. There were statistically significant differences in the means of vital signs measured 5 min before with 15 and 25 min after endotracheal suctioning with rib cage compression (P < 0. 01). There was no significant difference in the means of diastolic pressure measured 25 min after with baseline in this stage). But on the reverse mode, there was a significant difference between the means of pulse and respiratory rate 15 min after endotracheal suctioning and the baseline values (P < 0.002). This effect continued up to 25 min after endotracheal suctioning just for respiratory rate (P = 0.016). Moreover, there were statistically significant differences in the means of vital signs measured 5 min before and 15 min after endotracheal suctioning between the two methods (P ≤ 0001). Findings showed that expiratory rib cage compression before endotracheal suctioning improves the vital signs to normal range in patients under mechanical ventilation. More studies are suggested on performing expiratory rib cage compression before endotracheal suctioning in patients undergoing mechanical ventilation.

The Impact of Surgical Patent Ductus Arteriosus Closure on Autonomic Function in Premature Infants.

PubMed

Andescavage, Nickie N; Metzler, Marina; Govindan, Vedavalli; Al-Shargabi, Tareq; Nath, Dilip S; Krishnan, Anita; Massaro, An; Wang, Yunfei; duPlessis, Adre J; Govindan, R B

2017-07-01

Background  Patent ductus arteriosus (PDA) is a common complication of prematurity and a risk factor for poor outcome. Infants undergoing surgical PDA ligation are at highest risk for neurodevelopmental injury. Autonomic dysfunction has been described in premature infants with PDA. Aim  To interrogate the autonomic nervous system by analysis of advanced heart rate variability (HRV) metrics before and after surgical closure of the PDA. Study Design  Prospective, observational study. Subjects  Twenty-seven infants born before 28 weeks' gestation were included in this study. Methods  Continuous electrocardiogram data were sampled at a rate of 125 Hz for a total of 6 hours before and 6 hours after 30 hours of surgical closure. HRV was determined by detrended fluctuation analysis to calculate the short and long root mean square (RMS L and RMS S ) and α components at two time scales (long and short). Results  Gestational age (GA) was positively associated with RMS L , RMS S , and α S and was negatively associated with α L . There was no difference between RMS s , RMS L , α S , or α L before and after surgery; however, median heart rate was lower after surgery ( p  < 0.01). Conclusion  Advancing GA is highly associated with increasing HRV; however, surgical ligation does not affect HRV in the postoperative period. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A preliminary report of an educational intervention in practice management

PubMed Central

Crites, Gerald E; Schuster, Richard J

2004-01-01

Background Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. Methods After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. Results The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. Conclusions This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education. PMID:15380023

The Effectiveness of Worked Examples Associated with Presentation Format and Prior Knowledge: A Web-Based Experiment

ERIC Educational Resources Information Center

Hsiao, E-Ling

2010-01-01

The aim of this study is to explore whether presentation format and prior knowledge affect the effectiveness of worked examples. The experiment was conducted through a specially designed online instrument. A 2X2X3 factorial before-and-after design was conducted. Three-way ANOVA was employed for data analysis. The result showed first, that prior…

The Effects of an Ethics Training Program on Attitude, Knowledge, and Transfer of Training of Office Professionals: A Treatment- and Control-Group Design

ERIC Educational Resources Information Center

Frisque, Deloise A.; Kolb, Judith A.

2008-01-01

This study examines the effects of ethics training on the attitudes, knowledge-based scores, and analysis of ethical dilemmas among office professionals. A treatment- and control-group design was used with variables of interest measured before, immediately after, and ninety days following completion of a six-hour ethics training workshop. A…

Change in Teacher Candidates' Metaphorical Images about Classroom Management in a Social Constructivist Learning Environment

ERIC Educational Resources Information Center

Akar, Hanife; Yildirim, Ali

2009-01-01

The purpose of this study was to understand the conceptual change teacher candidates went through in a constructivist learning environment in a classroom management course. Within a qualitative case study design, teacher candidates' metaphorical images about classroom management were obtained through document analysis before and after they were…

Elementary School Consolidation and Reconfiguration: An Autoethnographic Case Study

ERIC Educational Resources Information Center

Winer, Ellen J.

2010-01-01

This qualitative study was designed to examine the processes and practices that occurred before, during and after consolidation of the four elementary schools in the Great Local School district with the goal of developing a conceptual framework to be utilized by school districts that plan on implementing a school consolidation or reconfiguration.…

A COMPARISON OF TEACHING METHODS BUILDING CULTURAL COMPETENCY INFORMED BY CONTACT THEORY.

PubMed

Stough-Hunter, Anjel; Guinan, Jill; Hart, Julie P

2016-01-01

This study examines students' levels of cultural competency before and after taking three different semester-long courses dealing with diversity and cultural competence with each course representing a different teaching methodology. A new 20-item survey, designed for students across disciplines, was used to measure cultural competency among 226 students from the fall of2012 to the spring of2 015. Differences were examined between scores before and after taking each class, as well as differences between classes. There were significant improvements in all three groups, and a significant difference between two of the three classes in the improvement of scores.

Encouraging post-stroke patients to be active seems possible: results of an intervention study with knowledge brokers.

PubMed

Willems, Mia; Schröder, Carin; van der Weijden, Trudy; Post, Marcel W; Visser-Meily, Anne M

2016-08-01

Although physical activity and exercise for stroke patients is highly recommended for fast recovery, patients in hospitals and rehabilitation centres are insufficiently encouraged to be physically active. In this study, we investigated the impact of knowledge brokers (KBs), enterprising nurses and therapists, on health professionals' (HP) performance to encourage stroke inpatients to be physically active. This multicenter intervention study used a pre-post test design. Two or three KBs were trained in each stroke unit of 12 hospitals and 10 rehabilitation centres in The Netherlands. Questionnaires were completed by patients and HPs before and after the KB-intervention. The primary outcome was encouragement given by HPs to their patients to be physically active, as reported by patients and HPs. After the KB-intervention, many more patients (48%; N=217) reported at least some encouragement by HPs to be physically active than before (26%; N=243, p<0.000). HPs (N=288) on an average reported encouraging patients more often after the intervention, but this difference was significant only for occupational therapists and KBs. Based on patient's reports of HP behaviour, the KB-intervention appears effective since more patients felt encouraged to be physically active after the intervention compared to before. Replication of this study in an experimental design is needed to allow causal inferences. Implications for rehabilitation We advise rehabilitation teams to make use of knowledge brokers (KBs), since the KB-intervention was shown to increase the encouragement felt by stroke patients to be physically active. It seems worthwhile to involve physicians, nurses and patients' families more frequently in efforts to encourage stroke patients to be physically active.

Long-Duration Space Flight and Bed Rest Effects on Testosterone and Other Steroids

PubMed Central

Heer, Martina; Wang, Zuwei; Huntoon, Carolyn L.; Zwart, Sara R.

2012-01-01

Context: Limited data suggest that testosterone is decreased during space flight, which could contribute to bone and muscle loss. Objective: The main objective was to assess testosterone and hormone status in long- and short-duration space flight and bed rest environments and to determine relationships with other physiological systems, including bone and muscle. Design: Blood and urine samples were collected before, during, and after long-duration space flight. Samples were also collected before and after 12- to 14-d missions and from participants in 30- to 90-d bed rest studies. Setting: Space flight studies were conducted on the International Space Station and before and after Space Shuttle missions. Bed rest studies were conducted in a clinical research center setting. Data from Skylab missions are also presented. Participants: All of the participants were male, and they included 15 long-duration and nine short-duration mission crew members and 30 bed rest subjects. Main Outcome Measures: Serum total, free, and bioavailable testosterone were measured along with serum and urinary cortisol, serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, and SHBG. Results: Total, free, and bioavailable testosterone was not changed during long-duration space flight but were decreased (P < 0.01) on landing day after these flights and after short-duration space flight. There were no changes in other hormones measured. Testosterone concentrations dropped before and soon after bed rest, but bed rest itself had no effect on testosterone. Conclusions: There was no evidence for decrements in testosterone during long-duration space flight or bed rest. PMID:22049169

Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

PubMed

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

2017-03-01

In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

Influence on ocular surface after cataract surgery and effect of topical diquafosol on postoperative dry eye: a multicenter prospective randomized study

PubMed Central

Miyake, Kensaku; Yokoi, Norihiko

2017-01-01

Purpose To investigate influences of 3% diquafosol sodium ophthalmic solution (DQS) on ocular surface after cataract surgery and effects on postoperative dry eye. Design This study had two consecutive prospective study phases. The former was an observational study from before cataract surgery to 4 weeks after surgery and the latter was a randomized open-label study from 4 to 8 weeks after surgery. Methods Subjects were 433 eyes of 433 patients undergoing cataract surgery with intraocular lens implantation. Dry eye examination of tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, total subjective symptom score (12 symptoms), and Schirmer I test were conducted before surgery and 4 weeks after surgery. Patient demographics and these examination results were used to analyze risk factors to predict postoperative dry eye. In a randomized study, 154 eyes diagnosed with dry eye postoperatively were applied either DQS or artificial tears (AT) six times daily for 4 weeks. The data of the examinations were compared. Results At 4 weeks after surgery, BUT was shortened significantly (P=0.036), fluorescein staining score increased significantly (P=0.012), but total subjective symptom score was significantly improved (P<0.001). The majority of postoperative dry eye was shortened BUT type (53.1%). The dry eye prevalence after surgery decreased (55.7%) compared with before surgery (69.7%). Females and the patient with dry eye symptoms before surgery had significant risk factors for postoperative dry eye. In a randomized study, BUT was significantly prolonged in the DQS group (P=0.015), but not in the AT group. Fluorescein staining score was significantly improved in both groups (P<0.001). Total subjective symptom score was significantly decreased in the AT group (P<0.001), but not in the DQS group. Conclusion Our study suggests that cataract surgery has harmful effects on tear film stability and ocular surface, and DQS has a capability to improve them. PMID:28360509

Development of a new technique (ATP) for training visually impaired children in oral hygiene maintenance.

PubMed

Hebbal, M; Ankola, A V

2012-10-01

To develop a special oral health education technique and compare plaque scores before and after health education. Non-randomised before and after comparison trial without controls. The final study population comprised of 96 visually impaired children aged 6-18 years old. Silness and Loe plaque index scores were recorded at baseline. 'Audio tactile performance technique' (ATP Technique) a specially designed health education method was used to educate these children regarding oral hygiene maintenance. Periodic reinforcement of health education was performed at an interval of 9 months. Re-examination was carried out after 18 months of health education to assess plaque scores. Wilcoxon's sign rank test and paired t test was used to assess the difference between the scores before and after health education. There was increase in frequency of tooth brushing after health education. The mean plaque scores pre- and post-health education were 1.41 (+/-0.58) and 0.63 (+/-0.39) respectively. The difference was statistically significant (p<0.001). Visually impaired children could maintain an acceptable level of oral hygiene when taught using special customised methods.

Dose accuracy of a durable insulin pen with memory function, before and after simulated lifetime use and under stress conditions.

PubMed

Xue, Ligang; Mikkelsen, Kristian Handberg

2013-03-01

The objective of this study was to assess the dose accuracy of NovoPen® 5 in delivering low, medium and high doses of insulin before and after simulated lifetime use. A secondary objective was to evaluate the durability of the pen and its memory function under various stress conditions designed to simulate conditions that may be encountered in everyday use of an insulin pen. All testing was conducted according to International Organization for Standardization guideline 11608-1, 2000 for pen injectors. Dose accuracy was measured for the delivery of 1 unit (U) (10 mg), 30 U (300 mg) and 60 U (600 mg) test medium in standard, cool and hot conditions and before and after simulated lifetime use. Dose accuracy was also tested after preconditioning in dry heat storage; cold storage; damp cyclical heat; shock, bump and vibration; free fall and after electrostatic charge and radiated field test. Memory function was tested under all temperature and physical conditions. NovoPen 5 maintained dosing accuracy and memory function at minimum, medium and maximum doses in standard, cool and hot conditions, stress tests and simulated lifetime use. The pens remained intact and retained dosing accuracy and a working memory function at all doses after exposure to variations in temperature and after physical challenge. NovoPen 5 was accurate at all doses tested and under various functionality tests. Its durable design ensured that the dose accuracy and memory function were retained under conditions of stress likely to be encountered in everyday use.

Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey.

PubMed Central

Klassen, A.; Fitzpatrick, R.; Jenkinson, C.; Goodacre, T.

1996-01-01

OBJECTIVES: To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population. DESIGN: Postal questionnaire survey sent to patients before and six months after surgery. SETTING: The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993. SUBJECTS: 166 women (over the age of 16 years) referred for breast reduction; scores from the "short form 36" (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey. MAIN OUTCOME MEASURES: Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients. RESULTS: Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively. CONCLUSION: The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts. PMID:8776311

Using a Before-During-After (BDA) Model to Plan Effective Secondary Mathematics Lessons

ERIC Educational Resources Information Center

Wilburne, Jane Murphy; Peterson, Winnie

2007-01-01

Creating effective mathematics lessons can be a challenge for any teacher. One approach to design an effective lesson is using a before-during-after (BDA) format. This article describes what a BDA format is and provides two examples of how it is implemented in high school mathematics classes. (Contains 2 tables and 5 figures.)

Utilization patterns in an asthma intervention.

PubMed

Portnoy, Jay M; Jennings, Donna

2006-07-01

The National Cooperative Inner-City Asthma Study (NCICAS) tested a model of asthma management in which a master's degree-prepared social worker functioned as an asthma counselor. The NCICAS resulted in decreased symptom days and a trend toward fewer emergency department (ED) visits and hospital admissions in the intervention group compared with the control group. To determine whether a real-world implementation would give similar results to the NCICAS. Children with moderate or severe persistent asthma were enrolled in a 1-year program, the Inner-City Asthma Intervention (ICAI) program, modeled on the NCICAS. Since the program initially was not designed to be research, data were collected retrospectively. ED and hospital visits were compared 1 year before and after the intervention at 2 of the intervention sites, Children's Mercy Hospital (CMH) and Baystate Medical Center, to determine whether there was a significant change. Data for 93 children from CMH and 77 from Baystate were evaluated. At CMH annual ED visits were 0.38 before, 0.42 during, and 0.41 after the intervention, whereas at Baystate ED visits were 0.09 before, 0.17 during, and 0.15 after the intervention. Mean hospitalizations at CMH increased from 0.06 before to 0.22 during and then decreased to 0.12 after (P > .05), whereas admissions at Baystate increased from 0.03 before to 0.05 during and 0.04 after the intervention. Asthma self-management interventions can lead to decreases in asthma utilization under controlled circumstances. Further prospective studies are needed to determinewhether the ICAI intervention is effective under real-world conditions.

The effects of setarud on the immunological status of HIV-positive patients: Efficacy of a novel multi-herbal drug.

PubMed

Gholamzadeh Baeis, Mehdi; Amiri, Ghasem; Miladinia, Mojtaba

2017-01-01

This study examines the effect of the addition of IMOD, a novel multi-herbal drug to the highly active anti-retroviral therapy (HAART) regimen, on the immunological status of HIV-positive patients. A randomized two-parallel-group (HAART group versus HAART+IMOD group), pretest-posttest design was used.Sixty patients with indications for treatment with the HAART regimen participated. One week before and 2 days after the treatments, immunological parameters including total lymphocyte count (TLC) and CD4 cell count were assessed.The intervention group received the HAART regimen plus IMOD every day for 3 months. The control group received only the HAART regimen every day for 3 months. In the intervention group, a significant difference was observed in CD4between before and after drug therapy (CD4 was increased). However, in the control group, the difference in CD4 was not significant before and after drug therapy. The difference in TLC was not significantly different between the two groups before and after therapy. Nevertheless, TLC was higher in the intervention group. IMOD (as a herbal drug) has been successfully added to the HAART regimen to improve the immunological status of HIV-positive patients.

Attitudes of physical therapist students toward physical therapist assistants before and after full-time clinical internships.

PubMed

Cavallo, Cheryl L; Richter, Randy R

2004-01-01

Development of attitudes of physical therapists (PTs) toward physical therapist assistants (PTAs) begins during their professional education, and attitudes are influenced further by clinical experiences. The purpose of this study was to understand attitudes of student PTs toward PTAs. We surveyed 66 clinical intern students enrolled in an entry-level master of physical therapy program. PT students received the same survey before and after their full-time clinical internship. Eleven Likert scale items were used to assess students' attitudes toward PTAs in the areas of competence, financial remuneration, and job security. One item was designed to determine whether PT students' level of contact with PTAs influenced attitudes. A random sample of 13 (20.9%) students who returned surveys were asked to participate in a telephone interview designed to enrich the quantitative data. After item analysis, five of the scale items were eliminated from the analyses due to poor internal consistency. Cronbach's alpha of the remaining six scale items was 0.75. Survey results reveal that PT students maintain an overall positive attitude toward PTAs before and after full-time clinical internship. Qualitative interview data support this finding. Students' attitudes in specific areas of PTA competence were negative and positive, however. The negative attitude may have been based on the students' beliefs that PTAs are not competent to perform physical therapy in situations that are changing or unpredictable. Positive attitudes may have been reflective of the students' beliefs that PTAs are competent to implement established plans of care. Student ranking of four professional issues showed a significant difference before and after full-time clinical internships.

Student understanding development in chemistry concepts through constructivist-informed laboratory and science camp process in secondary school

NASA Astrophysics Data System (ADS)

Pathommapas, Nookorn

2018-01-01

Science Camp for Chemistry Concepts was the project which designed to provide local students with opportunities to apply chemistry concepts and thereby developing their 21st century skills. The three study purposes were 1) to construct and develop chemistry stations for encouraging students' understandings in chemistry concepts based on constructivist-informed laboratory, 2) to compare students' understandings in chemistry concepts before and after using chemistry learning stations, and 3) to study students' satisfactions of using their 21st century skills in science camp activities. The research samples were 67 students who attended the 1-day science camp. They were levels 10 to 11 students in SumsaoPittayakarn School, UdonThani Province, Thailand. Four constructivist-informed laboratory stations of chemistry concepts were designed for each group. Each station consisted of a chemistry scenario, a question, answers in tier 1 and supporting reasons in tier 2, and 4 sets of experimental instruments. Four to five-member subgroups of four student groups parallel participated in laboratory station for an hour in each station. Student activities in each station concluded of individual pretest, group prediction, experimental design, testing out and collection data, interpreting the results, group conclusion, and individual post-test. Data collection was done by station mentors using two-tier multiple choice questions, students' written work and interviews. Data triangulation was used for interpreting and confirming students' understandings of chemistry concepts which divided into five levels, Sound Understanding (SU), Partial Understanding (PU), Specific Misconception (SM), No Understanding (NU) and No Response (NR), before and after collaborating at each station. The study results found the following: 1) four constructivist-laboratory stations were successfully designed and used to investigate student' understandings in chemistry concepts via collaborative workshop of chemistry teachers and researcher, 2) the percentage of students having understandings of chemistry concepts before and after learning at the four stations ranged from 15.92-54.23% and 83.89-97.02%, respectively, and 3)students' opinions of using their 21st century skills in the science camp after finishing the camp activities were at a high level of satisfactions, ranged from 4.09-4.47 of 5 rating scores.

Prospective Teacher Learning: Recognizing Evidence of Conceptual Understanding

ERIC Educational Resources Information Center

Bartell, Tonya Gau; Webel, Corey; Bowen, Brian; Dyson, Nancy

2013-01-01

This study examined prospective teachers' (PSTs) ability to recognize evidence of children's conceptual understanding of mathematics in three content areas before and after an instructional intervention designed to support this ability. It also investigates the role PSTs' content knowledge plays in their ability to recognize children's…

Effects of Total SAT® Test Time on Performance and Fatigue. Research Notes. RN-37

ERIC Educational Resources Information Center

Ackerman, Phillip L.; Kanfer, Ruth; Wolman, Stacey D.

2005-01-01

The current study was designed to examine performance effects and fatigue effects associated with different total SAT testing times. In addition, the researchers examined personality, motivation, and other determinants of individual differences in examinee fatigue before, during, and after testing.

Patient engagement and the design of digital health

PubMed Central

Birnbaum, Faith; Lewis, Dana M.; Rosen, Rochelle; Ranney, Megan L.

2015-01-01

Digital health is an area of growing interest for physicians, patients, and technology companies alike. It promises the ability to engage patients in their care, before, during, and after an emergency department visit. Current efforts to create, study, and disseminate digital health have been limited by lack of user engagement. In this commentary, we outline the imperative for engaging end-users in each phase of digital health design, as well as a few techniques to facilitate better digital health design and implementation. PMID:25997375

Sentinel lymph node mapping reduces practice pattern variations in surgical staging for endometrial adenocarcinoma: A before and after study.

PubMed

Liu, Christina Y; Elias, Kevin M; Howitt, Brooke E; Lee, Larissa J; Feltmate, Colleen M

2017-05-01

To examine the effects of universal sentinel lymph node mapping on the use of nodal staging in endometrial adenocarcinoma. Two approaches to laparoscopic staging for endometrial adenocarcinoma were compared using a before and after study design. The before cohort underwent selective lymphadenectomy from January 1, 2014-October 1, 2015 while the after cohort underwent universal sentinel lymph node (SLN) mapping from October 2, 2015-September 29, 2016. The before cohort comprised 215 patients and the after cohort 166 patients. In women undergoing SLN mapping, a sentinel node was identified at least unilaterally in 146/153 cases (95.4%), and bilaterally in 114/153 (74.5%) of cases. Pelvic nodes were removed in 35.8% of the before cohort versus 92.2% of the after cohort (p<0.0001) with more nodal evaluation among both low risk (9.6% vs. 91%, p<0.0001) and high risk cases (66% vs. 94%, p<0.0001). While the proportion of low risk cases diagnosed with nodal involvement did not significantly change (0.9% to 3.1%, p=0.32), there was a trend toward more diagnoses of nodal involvement in high risk cases (5% to 13.2%, p=0.06). Mean number of pelvic lymph nodes removed (15 vs. 4, p<0.0001), mean operative time (181min vs. 137min, p<0.0001), estimated blood loss (80ml vs. 56ml, p=0.004), and rate of post-operative complications (13% vs. 5.2%, p=0.04) all decreased after the adoption of SLN dissection. Universal sentinel lymph node dissection for laparoscopic endometrial cancer staging reduces heterogeneity in surgeon staging practice, increases nodal detection, and lowers post-operative complications. Copyright © 2017 Elsevier Inc. All rights reserved.

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

PubMed

Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

2016-07-25

BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (p<0.001), increased ranges of motion and muscle strength, and reduced use of medicines (NASAIDs) (p<0.001). A correlation was found between the degree of degenerative deforming lesions and the effects of the treatment process (p<0.01). CONCLUSIONS 1. The rehabilitation program including water exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

Ergonomics intervention in a tile industry- case of manual material handling.

PubMed

Dormohammadi, Ali; Amjad Sardrudi, Hosein; Motamedzade, Majid; Dormohammadi, Reza; Musavi, Saeed

2012-12-13

Manual material handling is one of the major health and safety hazards in industry. This study aims to assess the lifting tasks, before and after intervention using NIOSH lifting equation and Manual Handling Assessment Charts (MAC). This interventional study was performed in 2011 in a tile manufacturing industry in Hamadan, located in the West of Iran. The prevalence of musculoskeletal discomfort was determined using Nordic musculoskeletal questionnaire. In order to assess the risk factors related to lifting and identify the high-risk activities, MAC and NIOSH lifting equation were used. In intervention phase, we designed a load-carrying cart with shelves capable of moving vertically up and down, similar to scissor lifts. After intervention, the reassessment of risk factors was conducted to determine the success of the intervention and to compare risk levels before and after intervention using t-test. The outputs of MAC and NIOSH lifting equation assessments before intervention revealed that all activities were at high-risk level. After intervention, the risk level decreased to average level. In conclusion, the results of intervention revealed a considerable decrease in risk level. It may be concluded that the given intervention was acceptable and favorably effective in preventing musculoskeletal disorders especially low back pain.

Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

PubMed

Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

2014-08-01

The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.

Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism.

PubMed

Bilgir, Oktay; Bilgir, Ferda; Topcuoglu, Tuba; Calan, Mehmet; Calan, Ozlem

2014-03-01

This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment.

Facilities for music education and their acoustical design.

PubMed

Koskinen, Heli; Toppila, Esko; Olkinuora, Pekka

2010-01-01

Good rehearsal facilities for musicians are essential. Directive 2003/10/EC necessitates that musicians are protected from noise exposure. A code of conduct gives the guidelines how this should be done. This study examines room acoustics recommendations provided by the Finnish code of conduct, and discusses whether they are adequate. Small teaching facilities were measured after renovation and compared to earlier measurements. Teachers' opinions were inquired about the facilities before and after. The renovation did not decrease the noise exposure of the teachers. However, the majority preferred the facilities after the renovation. The Finnish code of conduct is not sufficient for facilities where loud instruments are played, or band practise. Good facilities can be designed but they must be specified at the designing stage for their intended use.

Case Studies of Three African-American Families Use of Literacy during Nonschool Hours

ERIC Educational Resources Information Center

Walker, Patricia A.

2011-01-01

The use of literacy during non-school hours of three African-American families was examined. This study used a qualitative research design to probe the meanings and value of literacy in the homes of three African-American families during nonschool hours, including before school, after school, weekends, holidays, and summer breaks. The structure…

Turkish Foreign Language Learners' Roles and Outputs: Introducing an Innovation and Role-Playing in Second Life

ERIC Educational Resources Information Center

Ozbek, Cigdem; Comoglu, Irem; Baran, Bahar

2017-01-01

This study aims to design of the two activities "introducing an innovation" and "role playing" in Second Life (SL) and to evaluate qualitatively Turkish foreign language learner's roles and outputs before, while, and after the implementation of the activities. The study used community of inquiry model consisting of cognitive…

Acoustic Wave Treatment For Cellulite—A New Approach

NASA Astrophysics Data System (ADS)

Russe-Wilflingseder, Katharina; Russe, Elisabeth

2010-05-01

Background and Objectives: Cellulite is a biological caused modification of the female connective tissue. In extracorporeal shockwave therapy (ESWT) pulses are penetrating into the tissue without causing a thermal effect or micro lesions, but leading to a stimulation of tissue metabolism and blood circulation, inducing a natural repair process with cell activation and stem cells proliferation. Recently ESWT treatment showed evidence of remodelling collagen within the dermis and of stimulating microcirculation in fatty tissue. Study Design and Methods: The study was designed to assess acoustic wave treatment for cellulite by comparison treated vs. untreated side (upper-leg and buttock). Each individual served as its own control. 11 females with a BMI less then 30 and an age over 18 years were included. 6 treatments were given weekly with radial acoustic waves. Documentation was done before and 1, 4, 12 weeks after last treatment by standardized photo documentation, relaxed and with muscle contraction, measurement of body weight and circumference of the thigh, pinch test, and evaluation of hormonal status and lifestyle. The efficacy of AWT/EPAT was evaluated before and 1, 4, 12 weeks after last treatment. Patients rated the improvement of cellulite, overall satisfaction and acceptance. The therapist assessed improvement of cellulite, side effects and photo documentation treated vs. untreated side, before vs. after treatment. The blinded investigator evaluated the results using photo documentation right vs. left leg, before vs. after treatment in a frontal, lateral and dorsal view, relaxed and with muscle contraction. Results: The improvement of cellulite at the treated side was rated by patients with 27,3% at week 4 and 12, by the therapist with 34,1% at week 4 and 31,2% at week 12 after the last treatment The blinded investigator could verify an improvement of cellulite in an increasing number of patients with increasing time interval after treatment. No side effects were seen. Conclusion: Radial acoustic waves are effective and safe to treat cellulite. The effect of treatment begins delayed and is first seen after 5 treatments. The improvement of cellulite increases continual up to 3 months. Patients' satisfaction and acceptance is high

Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis

PubMed Central

Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R

2003-01-01

Objective: To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries. Design: Systematic review and meta-analysis. Data sources: Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked. Inclusion criteria: Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads. Methods: Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model. Findings: Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries. Conclusion: Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries. PMID:12966005

The design, fate and impact of a hospital-wide training program in evidence-based medicine for physicians - an observational study.

PubMed

Thor, Johan; Olsson, Daniel; Nordenström, Jörgen

2016-03-08

Many doctors fail to practice Evidence-Based Medicine (EBM) effectively, in part due to insufficient training. We report on the design, fate and impact of a short learner-centered EBM train-the-trainer program aimed at all 2400 doctors at the Karolinska University Hospital in Sweden on the heels of a tumultuous merger, focusing particularly on whether it affected the doctors' knowledge, attitudes and skills regarding EBM. We used a validated EBM instrument in a before-and-after design to assess the impact of the training. Changes in responses were analyzed at the individual level using the Wilcoxon matched pairs test. We also reviewed documentation from the program - including the modular EBM training schedule and the template for participants' Critically Appraised Topic reports - to describe the training's content, design, conduct, and fate. The training, designed to be delivered in modules of 45 min totaling 1.5 days, failed to reach most doctors at the hospital, due to cost cutting pressures and competing demands. Among study participants (n = 174), many reported suboptimal EBM knowledge and skills before the training. Respondents' strategies for solving clinical problems changed after the training: the proportion of respondents reporting to use (or intend to use) secondary sources "Often/very often" changed from 5 % before the training to 76 % after the training; in parallel, reliance on textbooks and on colleagues fell (48 to 23 % and 79 to 65 %, respectively). Participants' confidence in assessing scientific articles increased and their attitudes toward EBM became more positive. The proportion of correct answers in the EBM knowledge test increased from 52 to 71 %. All these changes were statistically significant at p < 0.05. Many study participants, despite working at a university hospital, lacked basic EBM knowledge and skills and used the scientific literature suboptimally. The kind of short learner-centered EBM training evaluated here brought significant improvements among the minority of hospital doctors who were able to participate and, if applied widely, could contribute to better, safer and more cost-effective care.

Research and Teaching: Think before (and after) You Speak: Practice and Self-Reflection Bolster Oral Communication Skills

ERIC Educational Resources Information Center

Sterling, Eleanor; Bravo, Adriana; Porzecanski, Ana Luz; Burks, Romi L.; Linder, Joshua; Langen, Tom; Fernandez, Denny; Ruby, Douglas; Bynum, Nora

2016-01-01

In this study, conservation biology faculty and practitioners from across the United States designed classroom exercises and teaching interventions intended to bolster oral communication skills. Through repeated oral presentation assignments integrated into course requirements, the authors examined individual student learning gains via…

Dismantling Bilingual Education Implementing English Immersion: The California Initiative.

ERIC Educational Resources Information Center

Rossell, Christine H.

This study explored bilingual education in California, analyzing California law on instruction for English Learners before and after Proposition 227. Proposition 227 required that all English Learners (EL) participate in a sheltered English immersion program in which most instruction was in English with curriculum and presentation designed for…

Assessing Knowledge Change in Computer Science

ERIC Educational Resources Information Center

Nash, Jane Gradwohl; Bravaco, Ralph J.; Simonson, Shai

2006-01-01

The purpose of this study was to assess structural knowledge change across a two-week workshop designed to provide high-school teachers with training in Java and Object Oriented Programming. Both before and after the workshop, teachers assigned relatedness ratings to pairs of key concepts regarding Java and Object Oriented Programming. Their…

Relationships among Dispositional Ability Conceptions, Intrinsic Motivation, Perceived Competence, Experience, Persistance, and Performance

ERIC Educational Resources Information Center

Li, Weidong; Lee, Amelia M.; Solmon, Melinda A.

2005-01-01

This study was designed to explore the relationships among individuals' dispositional ability conceptions, intrinsic motivation, experience, perceived competence, persistence, and performance. Participants practiced a novel task, completed surveys before instruction and after practicing the task, and completed a skill test. The results indicated…

Promoting Resiliency in Adolescent Girls through Adventure Programming

ERIC Educational Resources Information Center

Whittington, Anja; Aspelmeier, Jeffery E.; Budbill, Nadine W.

2016-01-01

This study examined whether participation in an adventure program increased the resiliency of adolescent girls. Eighty-seven girls who participated in Dirt Divas, a non-profit, adventure program, completed the Resiliency Scale for Children and Adolescents® before and after their experience. Means-comparison tests for within-subjects designs were…

Mental work demands, retirement, and longitudinal trajectories of cognitive functioning.

PubMed

Fisher, Gwenith G; Stachowski, Alicia; Infurna, Frank J; Faul, Jessica D; Grosch, James; Tetrick, Lois E

2014-04-01

Age-related changes in cognitive abilities are well-documented, and a very important indicator of health, functioning, and decline in later life. However, less is known about the course of cognitive functioning before and after retirement and specifically whether job characteristics during one's time of employment (i.e., higher vs. lower levels of mental work demands) moderate how cognition changes both before and after the transition to retirement. We used data from n = 4,182 (50% women) individuals in the Health and Retirement Study, a nationally representative panel study in the United States, across an 18 year time span (1992-2010). Data were linked to the O*NET occupation codes to gather information about mental job demands to examine whether job characteristics during one's time of employment moderates level and rate of change in cognitive functioning (episodic memory and mental status) both before and after retirement. Results indicated that working in an occupation characterized by higher levels of mental demands was associated with higher levels of cognitive functioning before retirement, and a slower rate of cognitive decline after retirement. We controlled for a number of important covariates, including socioeconomic (education and income), demographic, and health variables. Our discussion focuses on pathways through which job characteristics may be associated with the course of cognitive functioning in relation to the important transition of retirement. Implications for job design as well as retirement are offered.

Mental Work Demands, Retirement, and Longitudinal Trajectories of Cognitive Functioning

PubMed Central

Fisher, Gwenith G.; Stachowski, Alicia; Infurna, Frank J.; Faul, Jessica D.; Grosch, James; Tetrick, Lois E.

2015-01-01

Age-related changes in cognitive abilities are well-documented, and a very important indicator of health, functioning, and decline in later life. However, less is known about the course of cognitive functioning before and after retirement and specifically whether job characteristics during one's time of employment (i.e., higher vs. lower levels of mental work demands) moderate how cognition changes both before and after the transition to retirement. We used data from n = 4,182 (50% women) individuals in the Health and Retirement Study, a nationally representative panel study in the United States, across an 18 year time span (1992–2010). Data were linked to the O'NET occupation codes to gather information about mental job demands to examine whether job characteristics during one's time of employment moderates level and rate of change in cognitive functioning (episodic memory and mental status) both before and after retirement. Results indicated that working in an occupation characterized by higher levels of mental demands was associated with higher levels of cognitive functioning before retirement, and a slower rate of cognitive decline after retirement. We controlled for a number of important covariates, including socioeconomic (education and income), demographic, and health variables. Our discussion focuses on pathways through which job characteristics may be associated with the course of cognitive functioning in relation to the important transition of retirement. Implications for job design as well as retirement are offered. PMID:24635733

Home Care before and after the Balanced Budget Act of 1997: Shifts in Financing and Services

ERIC Educational Resources Information Center

Spector, William D.; Cohen, Joel W.; Pesis-Katz, Irena

2004-01-01

Purpose: This article describes the pattern of change in home-care use and expenditures, the distribution of payments by source, and the mix of skilled versus nonskilled services before and after 1996. Design and Methods: The analysis is based on tabulations of the 1987 National Medical Expenditure Survey and the 1996, 1998, and 1999 Medical…

Heat shock protein 70 enhanced deoxyribonucleic acid base excision repair in human leukemic cells after ionizing radiation

PubMed Central

Bases, Robert

2006-01-01

Base excision repair (BER) of DNA damage in irradiated THP1 human leukemic cells was stimulated by pretreating the cells with exogenous recombinant Hsp70. The treatment of THP1 cells with recombinant Hsp70 in cell culture promoted repair by reducing the frequency of apurinic, apyrimidinic (AP) sites in DNA before and after 1.3 Gy of radiation. However, by 30 minutes after 2.6 Gy, accelerated repair of abasic sites supervened, which may contribute to the loss of the very-low-dose cell hypersensitivity seen in clonogenic studies of other laboratories. After irradiation with 2.6 Gy, the crucial initial glycosylase step was markedly incomplete when cells had been transfected 24 hours before with a small interfering RNA (siRNA) designed to inhibit synthesis of Hsp70. In confirmation, lysates from irradiated siRNA-treated cells after 2.6 Gy were deficient in uracil glycosylase activity (UDG). Transfection with a scrambled RNA of the same size did not interfere with the glycosylase step, ie, the prompt conversion of damaged pyrimidine sites to abasic sites as well as the subsequent repair of those sites. BER measured by reduction of DNA AP sites before and after low-dose radiation was also deficient in THP1 cells that had been transfected with the siRNA designed to inhibit synthesis of Hsp70. These results implicate BER and the participation of Hsp70 in the repair of DNA in human leukemic cells with the doses of ionizing radiation used in clinical regimens. PMID:17009597

Does organisational justice protect from sickness absence following a major life event? A Finnish public sector study.

PubMed

Elovainio, M; Kivimäki, M; Linna, A; Brockner, J; van den Bos, K; Greenberg, J; Pentti, J; Virtanen, M; Vahtera, J

2010-05-01

It has been shown that fairness perceptions have a strong impact on health, especially under conditions of great work stress. The aim of this study was to extend previous research in studying whether working in high justice workplace would protect from health effects following environmental stressors outside work. Using a prospective longitudinal design, the relationships between organisational justice and sickness-related absences both before and after a major life event among 25 459 public sector employees working in 2551 work units were studied. Sickness absences covered the period from 36 months before the event until 30 months after the event. The increase in sickness absences after the event was larger and stayed at a higher level even 30 months after the event, among those who perceived the management practices in their work unit to be relatively unfair. Similar patterns were found for each of the distributive, procedural and interactional dimensions of organisational justice. Fair organisational and managerial procedures may buffer the negative health effects of psychosocial health risks outside work.

A Study of Stranding of Juvenile Salmon by Ship Wakes Along the Lower Columbia River Using a Before-and-After Design: Before-Phase Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pearson, Walter H.; Skalski, J R.; Sobocinski, Kathryn L.

2006-02-01

Ship wakes produced by deep-draft vessels transiting the lower Columbia River have been observed to cause stranding of juvenile salmon. Proposed deepening of the Columbia River navigation channel has raised concerns about the potential impact of the deepening project on juvenile salmon stranding. The Portland District of the U.S. Army Corps of Engineers requested that the Pacific Northwest National Laboratory design and conduct a study to assess stranding impacts that may be associated with channel deepening. The basic study design was a multivariate analysis of covariance of field observations and measurements under a statistical design for a before and aftermore » impact comparison. We have summarized field activities and statistical analyses for the ?before? component of the study here. Stranding occurred at all three sampling sites and during all three sampling seasons (Summer 2004, Winter 2005, and Spring 2005), for a total of 46 stranding events during 126 observed vessel passages. The highest occurrence of stranding occurred at Barlow Point, WA, where 53% of the observed events resulted in stranding. Other sites included Sauvie Island, OR (37%) and County Line Park, WA (15%). To develop an appropriate impact assessment model that accounted for relevant covariates, regression analyses were conducted to determine the relationships between stranding probability and other factors. Nineteen independent variables were considered as potential factors affecting the incidence of juvenile salmon stranding, including tidal stage, tidal height, river flow, current velocity, ship type, ship direction, ship condition (loaded/unloaded), ship speed, ship size, and a proxy variable for ship kinetic energy. In addition to the ambient and ship characteristics listed above, site, season, and fish density were also considered. Although no single factor appears as the primary factor for stranding, statistical analyses of the covariates resulted in the following equations: (1) Stranding Probability {approx} Location + Kinetic Energy Proxy + Tidal Height + Salmonid Density + Kinetic energy proxy ? Tidal Height + Tidal Height x Salmonid Density. (2) Stranding Probability {approx} Location + Total Wave Distance + Salmonid Density Index. (3) Log(Total Wave Height) {approx} Ship Block + Tidal Height + Location + Ship Speed. (4) Log(Total Wave Excursion Across the Beach) {approx} Location + Kinetic Energy Proxy + Tidal Height The above equations form the basis for a conceptual model of the factors leading to salmon stranding. The equations also form the basis for an approach for assessing impacts of dredging under the before/after study design.« less

Pain and sensory disturbances following surgical repair of pectus carinatum.

PubMed

Knudsen, Marie Veje; Pilegaard, Hans K; Grosen, Kasper

2018-04-01

The purpose of this study was to assess the characteristics of persistent postoperative pain and sensory disturbances following surgical repair of pectus carinatum. Using a prospective observational design, 28 patients were assessed before, 6 weeks and 6 months after a modified Ravitch operation for pectus carinatum. Postoperative pain was assessed using the Short Form McGill Pain Questionnaire. Sensory testing was conducted to detect brush-evoked allodynia and pinprick hyperalgesia. Additionally, generic and disease-specific quality of life was assessed using the Short Form-36 Health Survey and the Nuss Questionnaire Modified for Adults before and after surgery. Six weeks after surgery, ten patients reported mild pain or discomfort. Six months after surgery, four patients reported only mild pain. Allodynia was detected in two patients 6 weeks and 6 months after surgery. Hyperalgesia was detected in eight patients 6 weeks after surgery, and in six patients 6 months after surgery. Generic quality of life was significantly improved over time. The study showed no significant pain problems, a tendency to reduced sensory disturbances and significant improvements in quality of life 6 months after surgical repair of pectus carinatum. Future studies should include a longer follow-up period to determine if these positive results are persistent. 1 (Prognosis Study). Copyright © 2017 Elsevier Inc. All rights reserved.

Emotion and Time Perception: Effects of Film-Induced Mood

PubMed Central

Droit-Volet, Sylvie; Fayolle, Sophie L.; Gil, Sandrine

2011-01-01

Previous research into emotion and time perception has been designed to study the time perception of emotional events themselves (e.g., facial expression). Our aim was to investigate the effect of emotions per se on the subsequent time judgment of a neutral, non-affective event. In the present study, the participants were presented with films inducing a specific mood and were subsequently given a temporal bisection task. More precisely, the participants were given two temporal bisection tasks, one before and the other after viewing the emotional film. Three emotional films were tested: one eliciting fear, another sadness, and a neutral control film. In addition, the direct mood experience was assessed using the Brief Mood Introspective Scale that was administered to the participants at the beginning and the end of the session. The results showed that the perception of time did not change after viewing either the neutral control films or the sad films although the participants reported being sadder and less aroused after than before watching the sad film clips. In contrast, the stimulus durations were judged longer after than before viewing the frightening films that were judged to increase the emotion of fear and arousal level. In combination with findings from previous studies, our data suggest that the selective lengthening effect after watching frightening films was mediated by an effect of arousal on the speed of the internal clock system. PMID:21886610

[Comparison of participative educative strategy versus traditional educative strategy in health personnel].

PubMed

Barrera de León, Juan Carlos; Barajas-Serrano, Tanya Lizbeth; Jiménez-Hernández, Jacive Elizabeth; Barrera-López, Efrén; González-Bernal, Cesáreo; Higareda-Almaraz, Martha Alicia

2015-01-01

To compare the clinical aptitude in neonatal resuscitation with participative educative strategy versus traditional educative strategy in health personnel. Quasi-experimental study design including physicians and nurses distributed in two groups: (i) participative educative strategies n=156, and (ii) traditional n=158, were imparted in 12 sessions. Evaluation of clinical aptitude evaluated with validated questionnaire. Descriptive and interferential statistical inter- and intragroup. Clinical aptitude median score before/after: participative educative strategy 25.0/36.5 (p=0.000) and traditional 24.5/31.0 (p=0.000); differences between intergroup p=0.040. Changes to higher category according to the score before/after in participative 114 (73%) vs. traditional 65 (41%); p=0.010. There were no significant differences in the intergroup results in the category of evaluation of clinical aptitude, but there were differences in the intragroup when we evaluated median before and after with both strategies. Increase of clinical aptitude in neonatal resuscitation in health personnel,with both educative strategies being higher with participative strategy.

Effect of high negative incidence on the performance of a centrifugal compressor stage with conventional vaned diffusers

NASA Astrophysics Data System (ADS)

Jaatinen, Ahti; Grönman, Aki; Turunen-Saaresti, Teemu; Backman, Jari

2011-06-01

Three vaned diffusers, designed to have high negative incidence (-8°) at the design operating point, are studied experimentally. The overall performance (efficiency and pressure ratio) are measured at three rotational speeds, and flow angles before and after the diffuser are measured at the design rotational speed and with three mass flow rates. The results are compared to corresponding results of the original vaneless diffuser design. Attention is paid to the performance at lower mass flows than the design mass flow. The results show that it is possible to improve the performance at mass flows lower than the design mass flow with a vaned diffuser designed with high negative incidence. However, with the vaned diffusers, the compressor still stalls at higher mass flow rates than with the vaneless one. The flow angle distributions after the diffuser are more uniform with the vaned diffusers.

[Time perception, maternal tasks, and maternal role behavior among pregnant Japanese women].

PubMed

Yamamoto, A

1996-01-01

The relationship of time perception, maternal tasks, and maternal role behavior was examined in 140 pregnant Japanese women with a short-term longitudinal design. A model developed by Rubin provided the conceptual framework for this research. The Time Perception Scale. Time Production Method, and the Prefatory Maternal Response measured the study variables. Study results revealed significant differences in duration of time, time production, maternal-fetal attachment, and maternal role behavior before and after quickening(fetal movement)occurred. Medium to strong positive relationships among time orientation, maternal-fetal attachment, gratification, and maternal role behavior were found before and after movement. After quickening, a weak relationship between time orientation and duration was found. After controlling maternal-fetal attachment and gratification in pregnancy and maternal role, orientation in time perception accounted for significant amounts of variance in maternal role behavior before and after fetal movement. Results show that the process of becoming a mother, which started before quickening, increased in magnitude after fetal movement. The function of fetal movement is important in developing motherhood. In the process of becoming a mother, cognitive, emotional, and behavioral aspects in becoming a mother are inseparable from each other. Future orientation of time perception contributes to development of maternal role behavior. Having a future orientation during pregnancy may indicate hope or positive expectation. Based on these findings, several recommendations were proposed: (a)to study further the general process of becoming a mother and the role of time perception in developing motherhood, (b)to disseminate information to the general public about the process in development of motherhood, (c)to construct theory to explain the process of becoming a mother, and(d)to conduct future research to clarify the construct of time perception and attachment.

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

PubMed Central

van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-01-01

Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

A study on the effect of self bedside exercise program on resilience and activities of daily living for patients with hemiplegia

PubMed Central

Lee, Yang-Chool; Yi, Eun-Surk; Choi, Won-Ho; Lee, Byung-Mun; Cho, Sung-Bo; Kim, Ji-Youn

2015-01-01

The purpose of this study was to design a repeatable universal rehabilitation program in which patients with hemiplegia can participate voluntarily, complementing physical and occupational therapies to increase voluntary exercise practice rate. Also, this study attempted to identify the relationship between psychological resilience due to the implementation of self-bedside exercise and functional recovery of activity of daily living (ADL). 12 patients with hemiplegia voluntarily participated in 8 weeks of self-bedside exercise 5 times a day and more than 5 days a week. Their program implementation, resilience, activities of daily living (MBI), upper limb motor functions (MFT), and balance ability (BBS) were analyzed and compared before and after the program. Compared to before implementing the program, significant increases were found in resilience, MBI, BBS, and MFT in the affected side after the implementation, and the resilience scores showed statistically positive correlation in MBI and MFT. Also, the change in resilience before and after the program implementation showed a statistically positive correlation. Therefore, it can be concluded that the self-bedside exercise developed in this study had a positive effect on voluntary participation in exercise as well as resilience and ADL. However, many studies which complement the psychological aspects of hemiparetic patients with stroke are still needed. PMID:25830141

Group cognitive and behavioural treatment for hypochondriasis.

PubMed Central

Stern, R; Fernandez, M

1991-01-01

OBJECTIVE--To assess the feasibility of carrying out group cognitive and behavioural treatment for hypochondriasis in a general hospital setting. DESIGN--Assessment of patients referred for therapy. SETTING--District general hospital. PATIENTS--Six patients aged 35 to 55 (mean 43) years with a mean duration of symptoms of 12 years who fulfilled the Diagnostic and Statistical Manual for Mental Disorders (DSM III-R) criteria for hypochondriasis. MAIN OUTCOME MEASURES--Number of visits to their doctors, time spent thinking about illness, and scores on the hospital anxiety and depression scales. RESULTS--The mean number of visits to a doctor fell significantly after treatment (3 before treatment v 0.8 after treatment; p = 0.03) as did the time spent thinking about illness (57.3 v 40.6; p = 0.14). The depression and anxiety scores also fell, although the differences were not significant (depression: 9.5 before v 8.5 after; anxiety: 13 before v 12 after). CONCLUSION--It is feasible to carry out group cognitive and behavioural treatment in patients with hypochondriasis, and controlled studies are now indicated. PMID:1747641

A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons.

PubMed

Ge, Weiqing; Roth, Emily; Sansone, Alyssa

2017-04-01

[Purpose] Instrument Assisted Soft Tissue Mobilization (IASTM) is a form of manual therapy. Despite its growing popularity and an increasing number of patients receiving IASTM each year, there is a lack of high-level evidence to elucidate its therapeutic mechanisms and to support its clinical applications. The purpose of this research project was to determine the effects of IASTM on activities of mechanosensitive neurons in skin. [Subjects and Methods] Twenty-three subjects, 9 females and 14 males, mean age 25.7 (SD 6.4) years old were recruited through a convenience sampling on the university campus. The study design was a quasi-experimental study using single group pretest-posttest design. The activities of mechanosensitive neurons were measured before and after the application of IASTM. [Results] The mean 2-point discrimination was 40.2 (SD 9.4) mm before IASTM and increased to 44.9 (SD 12.0) mm after IASTM. The increase was statistically significant pre and post IASTM. The mean pain threshold was 18.2 (SD 6.6) lb and increased slightly to 18.7 (SD 6.8) lb after IASTM; however, no statistical significance was found pre and post IASTM. [Conclusion] The data indicates that IASTM changes the neural activities in 2-point discrimination but not in pain threshold.

The Long-Term Effect of an Independent Capacity Protocol on Emergency Department Length of Stay: A before and after Study.

PubMed

Cha, Won Chul; Song, Kyoung Jun; Cho, Jin Sung; Singer, Adam J; Shin, Sang Do

2015-09-01

In this study, we determined the long-term effects of the Independent Capacity Protocol (ICP), in which the emergency department (ED) is temporarily used to stabilize patients, followed by transfer of patients to other facilities when necessary, on crowding metrics. A before and after study design was used to determine the effects of the ICP on patient outcomes in an academic, urban, tertiary care hospital. The ICP was introduced on July 1, 2007 and the before period included patients presenting to the ED from January 1, 2005 to June 31, 2007. The after period began three months after implementing the ICP from October 1, 2007 to December 31, 2010. The main outcomes were the ED length of stay (LOS) and the total hospital LOS of admitted patients. The mean number of monthly ED visits and the rate of inter-facility transfers between emergency departments were also determined. A piecewise regression analysis, according to observation time intervals, was used to determine the effect of the ICP on the outcomes. During the study period the number of ED visits significantly increased. The intercept for overall ED LOS after intervention from the before-period decreased from 8.51 to 7.98 hours [difference 0.52, 95% confidence interval (CI): 0.04 to 1.01] (p=0.03), and the slope decreased from -0.0110 to -0.0179 hour/week (difference 0.0069, 95% CI: 0.0012 to 0.0125) (p=0.02). Implementation of the ICP was associated with a sustainable reduction in ED LOS and time to admission over a six-year period.

Quality Improvement in Surgery Combining Lean Improvement Methods with Teamwork Training: A Controlled Before-After Study

PubMed Central

Robertson, Eleanor; Morgan, Lauren; New, Steve; Pickering, Sharon; Hadi, Mohammed; Collins, Gary; Rivero Arias, Oliver; Griffin, Damian; McCulloch, Peter

2015-01-01

Background To investigate the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. We conducted a controlled interrupted time series study in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention) and an Orthopaedic theatre team acting as a control. Study Design We used a 3 month intervention with 3 months data collection period before and after it. A combined teamwork training and lean process improvement intervention was delivered by an experienced specialist team. Before and after the intervention we evaluated team non-technical skills using NOTECHS II, technical performance using the glitch rate and WHO checklist compliance using a simple 3 point scale. We recorded complication rate, readmission rate and length of hospital stay data for 6 months before and after the intervention. Results In the active group, but not the control group, full compliance with WHO Time Out (T/O) increased from 14 to 71% (p = 0.032), Sign Out attempt rate (S/O) increased from 0% to 50% (p<0.001) and Oxford NOTECHS II scores increased after the intervention (P = 0.058). Glitch rate decreased in the active group and increased in the control group (p = 0.001). Complications and length of stay appeared to rise in the control group and fall in the active group. Conclusions Combining teamwork training and systems improvement enhanced both technical and non-technical operating team process measures, and were associated with a trend to better safety outcome measures in a controlled study comparison. We suggest that approaches which address both system and culture dimensions of safety may prove valuable in reducing risks to patients. PMID:26381643

Knee Extensor Rate of Torque Development Before and After Arthroscopic Partial Meniscectomy, With Analysis of Neuromuscular Mechanisms.

PubMed

Cobian, Daniel G; Koch, Cameron M; Amendola, Annunziato; Williams, Glenn N

2017-12-01

Study Design Descriptive, prospective single-cohort longitudinal study. Background Though rapid torque development is essential in activities of daily living and sports, it hasn't been specifically tested by most physical therapists or incorporated into rehabilitation programs until late in the treatment process. Little evidence is available on quadriceps torque development capacity before and after arthroscopic knee surgery. Objectives To study knee extensor rate of torque development, contributing mechanisms, and associations with strength and patient-reported outcomes before and during the first 6 weeks after arthroscopic partial meniscectomy. Methods Twenty subjects (mean ± SD age, 42.3 ± 13.7 years; body mass index, 26.6 ± 3.1 kg/m 2 ) were tested before surgery, and at 2 and 5 weeks after surgery. Quadriceps muscle volume, strength, activation, rate of torque development, and patient-reported outcomes were evaluated across the study period. Results Significant side-to-side differences in quadriceps strength and voluntary rate of torque development were observed at each time point (P<.05). Changes in muscle activity were associated with changes in rapid torque development capacity. Side-to-side rate of torque development deficits after surgery were associated with lower patient-reported outcomes scores. Conclusion Diminished rapid torque development capacity is common in arthroscopic meniscal debridement patients. This reduced capacity is associated with an inability to quickly recruit and drive the quadriceps muscles (neural mechanisms) and not muscle atrophy or other peripheral factors tested. Patient-reported outcomes are associated with quadriceps rate of torque development, but not strength or muscle size. Rapid torque development warrants greater attention in rehabilitation. J Orthop Sports Phys Ther 2017;47(12):945-956. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7310.

Knowledge translation studies in paediatric emergency medicine: A systematic review of the literature.

PubMed

Wilson, Catherine L; Johnson, David; Oakley, Ed

2016-02-01

Systematic review of knowledge translation studies focused on paediatric emergency care to describe and assess the interventions used in emergency department settings. Electronic databases were searched for knowledge translation studies conducted in the emergency department that included the care of children. Two researchers independently reviewed the studies. From 1305 publications identified, 15 studies of varied design were included. Four were cluster-controlled trials, two patient-level randomised controlled trials, two interrupted time series, one descriptive study and six before and after intervention studies. Knowledge translation interventions were predominantly aimed at the treating clinician, with some targeting the organisation. Studies assessed effectiveness of interventions over 6-12 months in before and after studies, and 3-28 months in cluster or patient level controlled trials. Changes in clinical practice were variable, with studies on single disease and single treatments in a single site showing greater improvement. Evidence for effective methods to translate knowledge into practice in paediatric emergency medicine is fairly limited. More optimal study designs with more explicit descriptions of interventions are needed to facilitate other groups to effectively apply these procedures in their own setting. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

An evaluation of an airline cabin safety education program for elementary school children.

PubMed

Liao, Meng-Yuan

2014-04-01

The knowledge, attitude, and behavior intentions of elementary school students about airline cabin safety before and after they took a specially designed safety education course were examined. A safety education program was designed for school-age children based on the cabin safety briefings airlines given to their passengers, as well as on lessons learned from emergency evacuations. The course is presented in three modes: a lecture, a demonstration, and then a film. A two-step survey was used for this empirical study: an illustrated multiple-choice questionnaire before the program, and, upon completion, the same questionnaire to assess its effectiveness. Before the program, there were significant differences in knowledge and attitude based on school locations and the frequency that students had traveled by air. After the course, students showed significant improvement in safety knowledge, attitude, and their behavior intention toward safety. Demographic factors, such as gender and grade, also affected the effectiveness of safety education. The study also showed that having the instructor directly interact with students by lecturing is far more effective than presenting the information using only video media. A long-term evaluation, the effectiveness of the program, using TV or video accessible on the Internet to deliver a cabin safety program, and a control group to eliminate potential extraneous factors are suggested for future studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Early effects of modern electroconvulsive therapy on subjective memory in patients with mania or depression

PubMed Central

Bag, Sevda; Canbek, Ozge; Atagun, Ilhan Murat; Kutlar, Tarik Mehmet

2016-01-01

Context: Although electroconvulsive therapy (ECT) is considered a very effective tool for the treatment of psychiatric diseases, memory disturbances are among the most important adverse effects. Aims: This study aimed to assess prospectively early subjective memory complaints in depressive and manic patients due to bilateral, brief-pulse ECT, at different stages of the treatment, compare the associations between psychiatric diagnosis, sociodemographic characteristics, and ECT characteristics. Settings and Design: This prospective study was done with patients undergoing ECT between November 2008 and April 2009 at a tertiary care psychiatry hospital of 2000 beds. Materials and Methods: A total of 140 patients, scheduled for ECT with a diagnosis of bipolar disorder (depressive or manic episode) or unipolar depression according to Diagnostic and Statistical Manual of Mental Disorders IV diagnostic criteria, were included in the study and invited to complete the Squire Subjective Memory Questionnaire (SSMQ) before ECT, after the first and third sessions and end of ECT treatment. Statistical Analysis: Mean values were compared with the Kruskal–Wallis test and comparison of the longitudinal data was performed with a nonparametric longitudinal data analysis method, F1_LD_F1 design. Results: SSMQ scores of the patients before ECT were zero. SSMQ scores showed a decrease after the first and third ECT sessions and before discharge, showing a memory disturbance after ECT and were significantly less severe in patients with mania in comparison to those with depression. Conclusions: These findings suggest an increasing degree of subjective memory complaints with bilateral brief-pulse ECT parallel to the increasing number of ECT sessions. PMID:27385854

Interactive music as a treatment for pain and stress in children during venipuncture: a randomized prospective study.

PubMed

Caprilli, Simona; Anastasi, Francesca; Grotto, Rosa Pia Lauro; Scollo Abeti, Marianna; Abeti, Mariana Scollo; Messeri, Andrea

2007-10-01

The experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization. Children experience anxiety both before and during the procedure. Therefore, any intervention aiming to prevent or reduce distress should focus on the entire experience of the procedure, including waiting, actual preparation, and conclusion. This study was designed to determine whether the presence of musicians, who had attended specific training to work in medical settings, could reduce distress and pain in children undergoing blood tests. Our sample population was composed of 108 unpremedicated children (4-13 years of age) undergoing blood tests. They were randomly assigned to a music group (n=54), in which the child underwent the procedure while interacting with the musicians in the presence of a parent or to a control group (n=54), in which only the parent provided support to the child during the procedure. The distress experienced by the child before, during and after the blood test was assessed with the Amended Form of the Observation Scale of Behavioral Distress, and pain experience with FACES scale (Wong Baker Scale) only after the venipuncture. Our results show that distress and pain intensity was significantly lower (p<.001; p<.05) in the music group compared with the control group before, during, and after blood sampling. This controlled study demonstrates that songs and music, performed by "professional" musicians, have a beneficial effect in reducing distress before, during, and after blood tests. This study shows, moreover, that the presence of musicians has a minor, but yet significant, effect on pain due to needle insertion.

Febrile urinary tract infection after pediatric kidney transplantation: a multicenter, prospective observational study.

PubMed

Weigel, Friederike; Lemke, Anja; Tönshoff, Burkhard; Pape, Lars; Fehrenbach, Henry; Henn, Michael; Hoppe, Bernd; Jungraithmayr, Therese; Konrad, Martin; Laube, Guido; Pohl, Martin; Seeman, Tomáš; Staude, Hagen; Kemper, Markus J; John, Ulrike

2016-06-01

Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx. Ninety-eight children (58 boys and 40 girls) ≤ 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up. Posttransplant, 38.7% of patients had at least one fUTI compared with 21.4% before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38% vs. 12%; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7% vs. 32.2%; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58%. This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.

Long-term efficacy of a self-disinfecting coating in an intensive care unit.

PubMed

Tamimi, Akrum H; Carlino, Sheri; Gerba, Charles P

2014-11-01

Cleaning and disinfecting fomites can effectively remove/kill pathogens on surfaces, but studies have shown that more than one-half the time, surfaces are not adequately cleaned or are recontaminated within minutes. This study evaluated a product designed to create a long-lasting surface coating that provides continuous disinfecting action. This study was performed in an intensive care unit (ICU) in a major hospital. Various sites within the ICU were cultured before treatment and then at 1, 2, 4, 8, and 15 weeks after application of an antimicrobial coating. Samples were cultured for total bacteria, as well as Clostridium difficile, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococcus, and carbapenemase-resistant Enterobacteriaceae. The average bacterial count on all treated surfaces was reduced by >99% (2 logs) for at least 8 weeks after treatment. Overall, average levels of bacteria never returned to those observed before treatment even after 15 weeks. Antibiotic-resistant bacteria were found on 25% of the sites tested before treatment, but were isolated at only 1 site during the 15 weeks after treatment. The product assessed in this study was found to have persisted over 15 weeks in reducing the total number of bacteria and antibiotic resistant bacteria on surfaces within an ICU. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Relevance of I-BMIPP delayed scintigraphic imaging for patients with angina pectoris - a pilot study.

PubMed

Koyama, Kohei; Akashi, Yoshihiro J; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

2011-06-01

The study was designed to clarify the role of (123)I-β-methyl-iodophenylpentadecanoic acid ((123)I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). TEN CONTROLS (MEAN AGE: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic images were acquired at 30 min and at 4 h after (123)I-BMIPP injection to determine early and delayed BMIPP uptake, respectively. The heart-to-mediastinum (H/M) ratio and the washout rate (WR) were calculated from the planar images. All patients underwent scintigraphy one day before PCI and again 1 month after successful PCI. NO SIGNIFICANT DIFFERENCES IN THE EARLY OR DELAYED H/M RATIOS WERE OBSERVED BETWEEN THE PATIENTS AND THE CONTROLS BEFORE PCI (EARLY: 2.70 ±0.36 vs. 2.73 ±0.57; delayed: 2.26 ±0.33 vs. 2.40 ±0.43; p > 0.2 for both). The early and delayed H/M ratios remained unchanged with the comparison with before PCI (early: 2.72 ±0.27, delayed: 2.23 ±0.22; p > 0.2 for both). The global WR before PCI was significantly higher in the patients than in the control group (36.7 ±9.3%, vs. 28.1 ±8.2%, p = 0.02). However, the WR after PCI did not significantly differ between the patients and the controls (34.3 ±7.8% vs. 28.1 ±8.2%, p = 0.1). These data may suggest that the WR of (123)I-BMIPP determined from the planar images enhances the presence of myocardial ischaemia.

Can a barcode scanner for blood collection improve patient identification integrity in the emergency department? A prospective before-and-after study.

PubMed

Spain, David; Crilly, Julia; Pierce, John; Steele, Michael; Scuffham, Paul; Keijzers, Gerben

2015-02-01

To describe the effect of interventions designed to improve patient identification (PI) during pathology collection in the ED. A prospective before-and-after intervention study was conducted between June 2009 and June 2010 in a regional ED in Queensland, Australia. Interventions aimed to improve PI and specimen labelling, and consisted of: (i) education alone; and (ii) education plus an armband scanner that voice-prompted collector behaviour. Main outcomes measured included: frequency of correct key behaviours (KBs) during specimen collection, pathology integrity errors and cost of interventions. Data from 282 ED pathology collections were analysed (before: n = 115, after with education: n = 95, after with education plus armband scanner: n = 72). KBs for PI and labelling improved significantly following education plus armband scanner use. Application of armbands before sample collection increased (36% vs 90%, P < 0.001), as did asking the patient to state their name (25% vs 93%, P < 0.001) and date of birth (22% vs 93%, P < 0.001). These results were similar, albeit less pronounced, when the effect of education only was assessed. No primary patient misidentification was detected in this small study. The annual costs for a hospital to adopt the education programme with and without the armband scanner were $104,045 and $5330 respectively. ED staff had poor behaviours for identifying patients and labelling pathology specimens before intervention. These safety behaviours were considered an assumed skill. Education alone improved critical KBs markedly that was further augmented by the armband scanner. The cost to adopt education alone is relatively low compared to the addition of armband scanner technology. © 2015 The Authors. Emergency Medicine Australasia published by Wiley Publishing Asia Pty Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Increase in teachers' knowledge about ADHD after a week-long training program: a pilot study.

PubMed

Syed, Ehsan Ullah; Hussein, Sajida Abdul

2010-01-01

ADHD affects 3% to 5% of school-age children. Clinical and community based epidemiological studies in Pakistan have shown a high prevalence of ADHD among school going children. A thorough review of literature shows that no studies of teachers' training programs regarding ADHD have been published in Pakistani research literature. The aim of the present study is the development and evaluation of an ADHD training program for teachers. A teachers' training program for ADHD was designed and a pilot run in 3 schools of Karachi, Pakistan. Teachers knowledge regarding signs and symptoms of ADHD was tested before and after the workshop and then again after 6 months using an ADHD knowledge questionnaire. Forty-nine teachers, all of them women, completed the questionnaires before and after the training program, and 35 of them filled it out at the 6-month interval. Mean scores of these tests were compared using a paired t test. The authors found the difference of mean score of 1.48 +/- 2.95, and this was statistically significant (p < .005). The authors conclude that the workshop improved the knowledge of the school teachers regarding ADHD symptomatology, and it remained significant even after 6 months of training.

The effects of acute oral antioxidants on diving-induced alterations in human cardiovascular function

PubMed Central

Obad, Ante; Palada, Ivan; Valic, Zoran; Ivančev, Vladimir; Baković, Darija; Wisløff, Ulrik; Brubakk, Alf O; Dujić, Željko

2007-01-01

Diving-induced acute alterations in cardiovascular function such as arterial endothelial dysfunction, increased pulmonary artery pressure (PAP) and reduced heart function have been recently reported. We tested the effects of acute antioxidants on arterial endothelial function, PAP and heart function before and after a field dive. Vitamins C (2 g) and E (400 IU) were given to subjects 2 h before a second dive (protocol 1) and in a placebo-controlled crossover study design (protocol 2). Seven experienced divers performed open sea dives to 30 msw with standard decompression in a non-randomized protocol, and six of them participated in a randomized trial. Before and after the dives ventricular volumes and function and pulmonary and brachial artery function were assessed by ultrasound. The control dive resulted in a significant reduction in flow-mediated dilatation (FMD) and heart function with increased mean PAP. Twenty-four hours after the control dive FMD was still reduced 37% below baseline (8.1 versus 5.1%, P = 0.005), while right ventricle ejection fraction (RV-EF), left ventricle EF and endocardial fractional shortening were reduced much less (∼2–3%). At the same time RV end-systolic volume was increased by 9% and mean PAP by 5%. Acute antioxidants significantly attenuated only the reduction in FMD post-dive (P < 0.001), while changes in pulmonary artery and heart function were unaffected by antioxidant ingestion. These findings were confirmed by repeating the experiments in a randomized study design. FMD returned to baseline values 72 h after the dive with pre-dive placebo, whereas for most cardiovascular parameters this occurred earlier (24–48 h). Right ventricular dysfunction and increased PAP lasted longer. Acute antioxidants attenuated arterial endothelial dysfunction after diving, while reduction in heart and pulmonary artery function were unchanged. Cardiovascular changes after diving are not fully reversed up to 3 days after a dive, suggesting longer lasting negative effects. PMID:17110413

The effects of acute oral antioxidants on diving-induced alterations in human cardiovascular function.

PubMed

Obad, Ante; Palada, Ivan; Valic, Zoran; Ivancev, Vladimir; Baković, Darija; Wisløff, Ulrik; Brubakk, Alf O; Dujić, Zeljko

2007-02-01

Diving-induced acute alterations in cardiovascular function such as arterial endothelial dysfunction, increased pulmonary artery pressure (PAP) and reduced heart function have been recently reported. We tested the effects of acute antioxidants on arterial endothelial function, PAP and heart function before and after a field dive. Vitamins C (2 g) and E (400 IU) were given to subjects 2 h before a second dive (protocol 1) and in a placebo-controlled crossover study design (protocol 2). Seven experienced divers performed open sea dives to 30 msw with standard decompression in a non-randomized protocol, and six of them participated in a randomized trial. Before and after the dives ventricular volumes and function and pulmonary and brachial artery function were assessed by ultrasound. The control dive resulted in a significant reduction in flow-mediated dilatation (FMD) and heart function with increased mean PAP. Twenty-four hours after the control dive FMD was still reduced 37% below baseline (8.1 versus 5.1%, P = 0.005), while right ventricle ejection fraction (RV-EF), left ventricle EF and endocardial fractional shortening were reduced much less (approximately 2-3%). At the same time RV end-systolic volume was increased by 9% and mean PAP by 5%. Acute antioxidants significantly attenuated only the reduction in FMD post-dive (P < 0.001), while changes in pulmonary artery and heart function were unaffected by antioxidant ingestion. These findings were confirmed by repeating the experiments in a randomized study design. FMD returned to baseline values 72 h after the dive with pre-dive placebo, whereas for most cardiovascular parameters this occurred earlier (24-48 h). Right ventricular dysfunction and increased PAP lasted longer. Acute antioxidants attenuated arterial endothelial dysfunction after diving, while reduction in heart and pulmonary artery function were unchanged. Cardiovascular changes after diving are not fully reversed up to 3 days after a dive, suggesting longer lasting negative effects.

A systematic change in dreams after 9/11/01.

PubMed

Hartmann, Ernest; Brezler, Tyler

2008-02-01

Previous studies of dreams after trauma and stress have found increases in the power of the central image of the dream. However, it has been difficult to perform properly controlled studies of dreams before and after trauma. The present study is designed to compare dreams before and after 9/11/01 in the same persons. The assumption is that the events of 9/11 produced mild trauma or at the very least emotional arousal in everyone living in the United States. Forty-four persons in the United States who had been recording all their dreams for years each provided 20 consecutive dreams from their records--the last 10 recorded before 9/11 and the first 10 after 9/11. These dreams were assigned random numbers and scored on a blind basis using a number of rating scales with established reliability. Dreams after 9/11 showed a highly significant increase in central image intensity, as well as central image proportion (number of dreams with scorable central images) but no change in dream length, dream-likeness, overall vividness, or content involving airplanes or tall buildings. There were no "exact replay" dreams picturing the actual events of 9/11 seen repeatedly on TV. These results are consistent with the Contemporary Theory of Dreaming, which emphasizes the role of underlying emotion in producing central dream imagery and suggests that the intensity of the central dream imagery is related to the power of the underlying emotion.

Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis.

PubMed

Liberato, Isabella Ramos de Oliveira; Lopes, Edmundo Pessoa de Almeida; Cavalcante, Maria Alina Gomes de Mattos; Pinto, Tiago Costa; Moura, Izolda Fernades; Loureiro Júnior, Luiz

2012-01-01

The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit. In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session), and the levels were also significantly lower before hemodialysis compared with after hemodialysis. The aminotransferase levels in the patients who were undergoing peritoneal dialysis were slightly higher compared with the samples collected before the hemodialysis session, whereas the aminotransferase levels were slightly lower compared with the samples collected after the session. The hematocrits and the aminotransferase and gamma-glutamyl transferase levels of the samples collected after the hemodialysis session were significantly higher than the samples collected before the session. Taken together, the present data suggest that hemodilution could alter the serum levels of liver enzymes.

Focus and Planning Skills Can Be Improved "before" a Child Enters School. Science Brief

ERIC Educational Resources Information Center

National Scientific Council on the Developing Child, 2008

2008-01-01

This brief describes the findings of a study that tested preschoolers' executive function skills after participating in a program designed to enhance them vs. a standard curriculum. A total of 147 5-year-olds in their second year of preschool from a lower-income, urban school district participated in this study. The preschoolers were in 18…

Designing a Digital Teaching Resource to Explain Phases of the Moon: A Case Study of Preservice Elementary Teachers Making a Slowmation

ERIC Educational Resources Information Center

Nielsen, Wendy; Hoban, Garry

2015-01-01

This research studied a group of three preservice elementary teachers creating a narrated stop-motion animation (Slowmation) from start to finish in 3?hours to explain the challenging concept of "phases of the moon" to elementary school children. The research questions investigated the preservice teachers' learning before and after the…

Developing Basic Mathematical Skills of Pre-School Children by Using Plasticized Clay

ERIC Educational Resources Information Center

Chumark, Charung; Puncreobutr, Vichian

2016-01-01

The main objective of this research was to study the development of basic mathematical skills in preschool children by using plasticized clay. A pre-test and post-test design was adopted for the study to compare the difference before and after the art activity. The experimental group of 15 preschool children of 3-4 years old, attending…

The Effect of Professional Development on Teacher Attitudes toward Online Learning in K-12 Education

ERIC Educational Resources Information Center

Savakinas, Christy A.

2012-01-01

The purpose of this study was to examine how teacher attitudes toward online learning in K-12 education vary before, during, and after participation in a professional development program focused on ePedagogy and online course development. The study also examined which Key Design Factors, as identified by Wells (2007), influence teachers'…

The Relationship between Attitudes and Perspectives of American Sign Language University Students towards Deaf People

ERIC Educational Resources Information Center

Brightman, Beth Lilessie Cagle

2013-01-01

The purpose of this study was to analyze attitudes and perspectives of university students towards D/deafness before and after studying American Sign Language, ASL, and to determine if any relationship between them exists. A double pre-test quasi-experiment design was used with participants who were students enrolled in a basic ASL course at a…

The Effects of Process-Centered and Form-Centered Instruction on the Coherence of College Freshman Writing.

ERIC Educational Resources Information Center

Davis, Wesley K.

This comparative study evaluated the writing growth of 97 college freshman before and after instruction to determine if a process-centered mode of teaching had a more significant impact than a traditional form-centered mode of instruction on discourse coherence in composition. The study used a pretest/posttest, quasi-experimental design with both…

Development of Managers' Emotional Competencies: Mind-Body Training Implication

ERIC Educational Resources Information Center

Gruicic, Dusan; Benton, Stephen

2015-01-01

Purpose: This paper aims to research about the effect of mind-body training on the development of emotional competencies of managers. Design/methodology/approach: Quasi-experimental design, i.e. before and after (test-retest). Findings: Results showed that the experimental group, after training, achieved around 15 per cent higher scores compared…

The effects of a designed program on oxygen saturation and heart rate of premature infants hospitalized in neonatal intensive care unit of Al-Zahra Hospital in Isfahan in 2008-2009.

PubMed

Taheri, Parvin; Abbasi, Eidan; Abdeyazdan, Zahra; Fathizadeh, Nahid

2010-01-01

Prematurity is the main cause of death in infants under one year of age and is the main reason for neonatal intensive care unit (NICU) hospitalization. The stressful environment of NICU exposes preterm infants to inappropriate stimuli. This study aimed to determine and compare the mean heart rate and oxygen saturation of premature infants before and during a designed program in NICU. In a clinical trial study (before-after intervention) on a single group, 31 hospitalized premature newborns in NICU of Al-Zahra Hospital in Isfahan were selected by simple continuous sampling method. Data were collected through interview, observation and checklist records. The data were analyzed using SPSS and descriptive and inferential statistics. Out of 31 premature infants in the study, 60% were boys and 35% were girls. The mean (standard deviation) of oxygen saturation before and during the designed program were 92.80 (2.54) and 94.22 (2.59) percent, respectively. The results of paired t test showed a significant difference between the means of oxygen saturation of the infants before and during the program (p = 0.048), but there was no significant difference between the mean of the infants' heart beat before and during the intervention. The findings showed that applying daily silence periods can greatly help to increase oxygen saturation and can improve the growth of premature infants. Therefore, by providing more facilities in clinical environments of NICU, conducting programs to reduce light and noise in these wards would be possible.

Lasting impact of an implemented self-management programme for people with type 2 diabetes referred from primary care: a one-group, before-after design.

PubMed

Fløde, Mari; Iversen, Marjolein M; Aarflot, Morten; Haltbakk, Johannes

2017-12-01

Research interventions in uniform clinical settings and in patients fulfilling well-defined inclusion criteria might show a more pronounced effect than implementing the same intervention in existing practice. Diabetes Self-Management Education (DSME) is complex, and should be assessed in existing practice as it is an intervention widely implemented. To examine the impact of an established group-based DSME in unselected people with type 2 diabetes referred from primary care. A one-group, before-after design was used for assessments before, immediately after, and 3 months after participation in a group-based DSME programme conducted at two Learning and Mastering Centres in Norway between November 2013 and June 2014. Participants completed a questionnaire before (n = 115), immediately after (n = 95) and 3 months after (n = 42) the DSME programme. Primary outcome measure was diabetes knowledge (Michigan Diabetes Knowledge Test). Also patient activation (Patient Activation Measure [PAM]) and self-efficacy (General Self-Efficacy scale [GSE]) were measured. Changes in outcome measures were analysed using paired t-tests for normally distributed data and Wilcoxon signed-rank test for skewed data. Mean knowledge improved significantly from baseline (p < 0.001). Changes persisted at the 3-month assessment. Mean PAM scores improved significantly from baseline (p < 0.001), and changes persisted for 3 months. Mean GSE scores improved from baseline (p = 0.022) and persisted for 3 months. However, when results were stratified for participants who responded at all three time points, GSE showed no change during the study period. The complexity self-management in the individual is challenging to reflect in DSME. This implemented DSME programme for people with type 2 diabetes improved levels of diabetes knowledge and patient activation, persisting for at least 3 months. Hence, the DSME programme appears to be robust beyond standardised research settings, in educating unselected diabetes patients referred from primary care. © 2017 Nordic College of Caring Science.

Effect of the Crystallization Process on the Marginal and Internal Gaps of Lithium Disilicate CAD/CAM Crowns.

PubMed

Kim, Jae-Hong; Oh, Seunghan; Uhm, Soo-Hyuk

2016-01-01

The aim of this study is to quantify the effect of the crystallization process on lithium disilicate ceramic crowns fabricated using a computer-aided design/computer-aided manufacturing (CAD/CAM) system and to determine whether the effect of crystallization is clinically acceptable by comparing values of fit before and after the crystallization process. The mandibular right first molar was selected as the abutment for the experiments. Fifteen working models were prepared. Lithium disilicate crowns appropriate for each abutment were prepared using a commercial CAD/CAM system. Gaps in the marginal area and 4 internal areas of each crown were measured twice-before and after crystallization-using the silicone replica technique. The mean values of fit before and after crystallization were analyzed using a paired t-test to examine whether the conversion that occurred during crystallization affected marginal and internal gaps (α = 0.05). Gaps increased in the marginal area and decreased in the internal areas after crystallization. There were statistically significant differences in all of the investigated areas (P < 0.05). None of the values for marginal and internal fit of lithium disilicate CAD/CAM crowns after crystallization exceeded 120 μm, which is the clinically acceptable threshold.

Impact of prolonged oocyte incubation time before vitrification on oocyte survival, embryo formation, and embryo quality in mice.

PubMed

Karami, Azade; Bakhtiari, Mitra; Azadbakht, Mehri; Ghorbani, Rostam; Khazaei, Mozafar; Rezaei, Mansour

2017-06-01

Oocyte incubation time before freezing is one of the factors affecting oocyte vitrification. In the assisted reproductive technology (ART) clinics, it is sometimes decided to perform oocyte vitrification after a long period of incubation time due to various conditions, such as inability to collect semen samples, unsuccessful urological interventions (PESA, TESE, etc.), or unexpected conditions. A time factor of up to 6 h has been studied in the available reports. Therefore, this study was designed to evaluate oocyte incubation time before freezing at 0, 6, 12, 18, and 24 h after retrieval. Metaphase II (MII) oocytes were obtained from NMRI female mice after being randomly divided into the five groups of 0, 6, 12, 18, and 24 h of freezing via hormonal stimulation following retrieval and entered into the vitrification-warming process. The thawed oocytes were evaluated according to the survival criteria and then inseminated with the sperms of male mice for in vitro fertilization. The next day, the embryo formation rate and embryo quality were assessed. Our results demonstrated that even after 24 h of incubation, the survival rate of oocytes was 51.35% with the embryo formation rate of 73.21%. However, the survival and embryo formation rates significantly decreased within 12, 18, and 24 h after retrieval compared to the groups vitrified at 0 h. The embryo quality was significantly reduced by vitrification at 0 to 24 h after retrieval. According to our data, although a prolonged incubation time before freezing reduced the survival rate, there was still a chance for oocytes to stay alive with acceptable embryo formation and quality rates after vitrification warming of oocytes.

Organophosphate flame retardants in household dust before and after introduction of new furniture.

PubMed

Keimowitz, A R; Strunsky, N; Wovkulich, K

2016-04-01

Flame retardant compounds originating from household items collect in household dust, a reasonable proxy for human exposure. Contributions of specific items or behaviors to dust are difficult to separate. This study examined standardized college housing before and after the introduction of new, flame retardant couches in order to explore any effect that changing upholstered furniture may have on flame retardant concentrations in dust. Two contradictory hypotheses were posited: (1) that new furniture might increase flame retardant releases immediately after introduction due to initial off-gassing of new materials or (2) that older furniture would release more flame retardants due to mechanical breakdown of polyurethane foam. This study was designed to determine which of these processes dominated. Prior to the introduction of new furniture, TDCIPP was detected in 12/20 samples at a median concentration of 22 μg/g and TCEP was detected in 1/20 samples at a concentration of 16 μg/g. TDCIPP and TCEP were not detected in any samples (N = 29) after the introduction of new couches. TPHP was detected both before (in 11/20 samples) and after (in 5/29 samples) introduction of new couches; the median concentrations before and after were 63 ± 49 and 16 ± 11 μg/g (standard deviation shown). Introduced couches contained TDCIPP (and not TPHP) at ∼1.25% (w/w). These data support the second hypothesis and indicate that removal of older furniture decreases TDCIPP and TCEP concentrations in dust and may potentially reduce total flame retardant concentrations in dust, at least immediately after introduction of the new furniture. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexual Violence Prevention through Bystander Education: An Experimental Evaluation

ERIC Educational Resources Information Center

Banyard, Victoria L.; Moynihan, Mary M.; Plante, Elizabethe G.

2007-01-01

The current study used an experimental design to evaluate a sexual violence prevention program based on a community of responsibility model that teaches women and men how to intervene safely and effectively in cases of sexual violence before, during, and after incidents with strangers, acquaintances, or friends. It approaches both women and men as…

Training Verbal and Nonverbal Communication Interview Skills to Adolescents

ERIC Educational Resources Information Center

Olszewski, Abbie; Panorska, Anna; Gillam, Sandra Laing

2017-01-01

Adolescents' verbal and nonverbal communication skills were compared before and after training in a workforce readiness training program, Language for Scholars (LFS), and a study skills program, Ideal Student Workshop (ISW). A cross-over design was used, ensuring that 44 adolescents received both programs and acted as their own control. The LFS…

Using Blogs to Improve Students' Summary Writing Abilities

ERIC Educational Resources Information Center

Kitchakarn, Orachorn

2012-01-01

The research compared students' summary writing ability before and after they were taught through blog, a new medium or tool for written communication and interaction in many different languages around the world. The research design is a kind of one group pretest posttest. Participants were 33 first-year students who studied EN 011 course (English…

Influence of the onsite experience on recreation experience preference judgments

Treesearch

William P. Stewart

1992-01-01

This study was designed to investigate the impact of actual experience on experience preference. Experience preference measurements were taken before and after a hiking experience. A shift between pre-activity and post-activity experience preference judgments was hypothesized due to the effect of psychological adjustment to reduce dissonance between pre-activity...

Students' Positions and Considerations of Scientific Evidence about a Controversial Socioscientific Issue

ERIC Educational Resources Information Center

Albe, Virginie

2008-01-01

Efforts have been devoted to introduce in science curricula direct instruction for evaluating scientific reports on socioscientific issues. In this study, students' opinions on the SSI of mobile telephones effects have been investigated before and after a classroom activity designed to enable students to assess scientific data. Aspects of the…

Quantitative Analysis of Standardized Dress Code and Minority Academic Achievement

ERIC Educational Resources Information Center

Proctor, J. R.

2013-01-01

This study was designed to investigate if a statistically significant variance exists in African American and Hispanic students' attendance and Texas Assessment of Knowledge and Skills test scores in mathematics before and after the implementation of a standardized dress code. For almost two decades supporters and opponents of public school…

An Evaluation of Collaborative Interventions to Improve Chronic Illness Care: Framework and Study Design

ERIC Educational Resources Information Center

Cretin, Shan; Shortell, Stephen M.; Keeler, Emmett B.

2004-01-01

The authors' dual-purpose evaluation assesses the effectiveness of formal collaboratives in stimulating organizational changes to improve chronic illness care (the chronic care model or CCM). Intervention and comparison sites are compared before and after introduction of the CCM. Multiple data sources are used to measure the degree of…

Effects of Online/Face-to-Face Professional Development on College Faculty Perceptions of Disabilities

ERIC Educational Resources Information Center

Buss, Jennifer

2015-01-01

This study was designed to assess the effects of participating in a professional development model that include a face-to-face and online module components. To measure the participants' self-reported knowledge and attitude before and after the professional development would provide information about possible effects of the professional…

Students and Scientists Connect with Nature in Uganda, East Africa

ERIC Educational Resources Information Center

Johnson-Pynn, Julie S.; Johnson, Laura R.; Kityo, Robert; Lugumya, Douglas

2014-01-01

We studied the impact of environmental education (EE) workshops on Ugandan youth's (N = 84) perceptions of their relationship with nature, self efficacy, and civic attitudes and skills. Two nature-related measures and two measures related to social competencies were administered before and after EE workshops that were designed to educate youth…

Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention.

PubMed

Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi

2016-01-01

Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.

Evaluating Effectiveness of a Frigate in an Anti-Air Warfare (AAW) Environment

DTIC Science & Technology

2016-06-01

missions to accomplish. Both studies are used in ship design to determine the ship’s required combat capabilities before finalizing the hull design. This...accomplish. Both studies are used in ship design to determine the ship’s required combat capabilities before finalizing the hull design. This...capabilities should be determined before the ship’s hull design is complete to make operational effectiveness independent from physical design considerations

A Systematic Change in Dreams after 9/11/01

PubMed Central

Hartmann, Ernest; Brezler, Tyler

2008-01-01

Objective: Previous studies of dreams after trauma and stress have found increases in the power of the central image of the dream. However, it has been difficult to perform properly controlled studies of dreams before and after trauma. The present study is designed to compare dreams before and after 9/11/01 in the same persons. The assumption is that the events of 9/11 produced mild trauma or at the very least emotional arousal in everyone living in the United States. Methods: Forty-four persons in the United States who had been recording all their dreams for years each provided 20 consecutive dreams from their records—the last 10 recorded before 9/11 and the first 10 after 9/11. These dreams were assigned random numbers and scored on a blind basis using a number of rating scales with established reliability. Results: Dreams after 9/11 showed a highly significant increase in central image intensity, as well as central image proportion (number of dreams with scorable central images) but no change in dream length, dream-likeness, overall vividness, or content involving airplanes or tall buildings. There were no “exact replay” dreams picturing the actual events of 9/11 seen repeatedly on TV. Conclusions: These results are consistent with the Contemporary Theory of Dreaming, which emphasizes the role of underlying emotion in producing central dream imagery and suggests that the intensity of the central dream imagery is related to the power of the underlying emotion. Citation: Hartmann E; Brezler T. A systematic change in dreams after 9/11/01. SLEEP 2008;31(2):213-218. PMID:18274268

Informing the design of a randomised controlled trial of an exercise-based programme for long term stroke survivors: lessons from a before-and-after case series study

PubMed Central

2013-01-01

Background To inform the design of a randomised controlled trial (RCT) of an exercise-based programme for long term stroke survivors, we conducted a mixed methods before-and-after case series with assessment at three time points. We evaluated Action for Rehabilitation from Neurological Injury (ARNI), a personalised, functionally-focussed programme. It was delivered through 24 hours of one-to-one training by an Exercise Professional (EP), plus at least 2 hours weekly unsupervised exercise, over 12- 14 weeks. Assessment was by patient-rated questionnaires addressing function, physical activity, confidence, fatigue and health-related quality of life; objective assessment of gait quality and speed; qualitative individual interviews conducted with participants. Data were collected at baseline, 3 months and 6 months. Fidelity and acceptability was assessed by participant interviews, audit of participant and EP records, and observation of training. Findings Four of six enrolled participants completed the exercise programme. Quantitative data demonstrated little change across the sample, but marked changes on some measures for some individuals. Qualitative interviews suggested that small benefits in physical outcomes could be of great psychological significance to participants. Participant-reported fatigue levels commonly increased, and non-completers said they found the programme too demanding. Most key components of the intervention were delivered, but there were several potentially important departures from intervention fidelity. Discussion The study provided data and experience that are helping to inform the design of an RCT of this intervention. It suggested the need for a broader recruitment strategy; indicated areas that could be explored in more depth in the qualitative component of the trial; and highlighted issues that should be addressed to enhance and evaluate fidelity, particularly in the preparation and monitoring of intervention providers. The experience illustrates the value of even small sample before-and-after studies in the development of trials of complex interventions. PMID:23941470

Response of benthic macroinvertebrate communities to highway construction in an Appalachian watershed

USGS Publications Warehouse

Hedrick, Lara B.; Welsh, S.A.; Anderson, James T.; Lin, L.-S.; Chen, Y.; Wei, X.

2010-01-01

Highway construction in mountainous areas can result in sedimentation of streams, negatively impacting stream habitat, water quality, and biotic communities. We assessed the impacts of construction of a segment of Corridor H, a four-lane highway, in the Lost River watershed, West Virginia, by monitoring benthic macroinvertebrate communities and water quality, before, during, and after highway construction and prior to highway use at upstream and downstream sites from 1997 through 2007. Data analysis of temporal impacts of highway construction followed a Before-After-Control-Impact (BACI) study design. Highway construction impacts included an increase in stream sedimentation during the construction phase. This was indicated by an increase in turbidity and total suspended solids. Benthic macroinvertebrate metrics indicated a community more tolerant during and after construction than in the period before construction. The percent of Chironomidae and the Hilsenhoff Biotic Index (HBI) increased, while percent of Ephemeroptera, Plecoptera, and Trichoptera (EPT) decreased. Our 10-year study addressed short-term impacts of highway construction and found that impacts were relatively minimal. A recovery of the number of EPT taxa collected after construction indicated that the benthic macroinvertebrate community may be recovering from impacts of highway construction. However, this study only addressed a period of 3 years before, 3 years during, and 4 years post construction. Inferences cannot be made concerning the long-term impacts of the highway, highway traffic, runoff, and other factors associated with highway use. Continual monitoring of the watershed is necessary to determine if the highway has a continual impact on stream habitat, water quality, and biotic integrity. ?? 2010 Springer Science+Business Media B.V.

Kangaroo care by fathers and mothers: comparison of physiological and stress responses in preterm infants.

PubMed

Srinath, B K; Shah, J; Kumar, P; Shah, P S

2016-05-01

To compare physiological and biochemical responses in stable preterm neonates and their parents following kangaroo mother care (KMC) and kangaroo father care (KFC). We conducted a prospective cross-over design study of stable preterm neonates of <35 weeks gestation in a tertiary Neonatal Unit in Toronto. All neonates received KMC and KFC for 1 h on consecutive days in a random order. Heart rate, temperature, blood pressure, oxygen saturation and salivary cortisol in infants before and after kangaroo care and heart rate, temperature and salivary cortisol in parents before and after kangaroo care were measured. Pairwise comparisons of changes in these measures were analyzed. Twenty-six sets of neonates and their parents were studied for physiological parameters, of which 19 had adequate samples for salivary cortisol assessment. The infants had a mean birth weight of 1096 g (s.d.=217) and a mean postmenstrual age at study of 32 weeks (s.d.=2). There were no significant differences in the changes in mean heart rate (P=0.51), temperature (P=0.37), oxygen saturation (P=0.50), systolic blood pressure (P=0.32), mean blood pressure (0.10) and salivary cortisol (P=0.50) before and after KMC or KFC in the neonates. The changes in mean heart rate (P=0.62), temperature (P=0.28) and salivary cortisol (P=0.59) before and after kangaroo care were similar between mothers and fathers. No significant differences in physiological and stress responses were identified following KMC or KFC in preterm neonates. KFC may be as safe and as effective as KMC.

Use of the dye stain assay and ultraviolet light test for assessing vaginal insertion of placebo-filled applicators before and after sex.

PubMed

Keller, Marla J; Buckley, Niall; Katzen, Lauren L; Walsh, Jennifer; Friedland, Barbara; Littlefield, Sarah; Lin, Juan; Xue, Xiaonan; Cornelison, Terri; Herold, Betsy C; Einstein, Mark H

2013-12-01

Applicator dye staining and ultraviolet (UV) light have been used in trials to measure adherence, but not in the setting of before and after sex gel dosing (BAT-24). This study was designed to determine if semen or presex gel dosing impacts the sensitivity and specificity of a dye stain assay (DSA) for measuring vaginal insertion of placebo-filled applicators with BAT-24 dosing. Healthy monogamous couples received Microlax-type applicators (Tectubes, Åstorp, Sweden) filled with hydroxyethylcelluose placebo gel. Women were instructed to vaginally insert 1 dose of gel before and a second dose after sex and to return applicators within 48 hours after sex. Applicators were stained to detect semen, followed by UV then DSA, and scored by 2 readers. Positive and negative controls were randomly included in applicator batches. Fifteen couples completed the study. Each woman returned at least 6 applicators over a 30-day period. The sensitivity for insertion of postsex applicators was higher for UV (97%) compared with DSA (90%), and the specificity was similar (≥96%). For presex applicators, the sensitivity and specificity were higher for DSA (100%) compared with UV testing (87% sensitivity, 96% specificity). Among returned postsex applicators, 95% tested positive by UV compared with 87% by DSA. Agreement between readers was significantly better on the presex applicators for DSA than for UV, and for postsex readings, agreement was less than half that for UV, although the results were not statistically significant. Applicator tests are feasible for measuring adherence in trials with gel dosing before and after sex.

Warming Up With an Ice Vest: Core Body Temperature Before and After Cross-Country Racing

PubMed Central

Hunter, Iain; Hopkins, J. Ty; Casa, Douglas J

2006-01-01

Context: Athletes running in a hot, humid environment may have an increased risk of heat illness. In the 2004 Olympic Games, American and Australian athletes were provided with ice vests designed to cool their bodies before performance. The vest appeared to be effective in keeping body temperatures down and improving the performance of the marathoners. However, body temperatures have not been reported when the vest was used before an actual competition. Objective: To determine if wearing the Nike Ice-Vest decreased core temperature (Tc) before and during athletic performance in warm (26°C to 27°C), humid (relative humidity = 50% to 75%) conditions. Design: A 2 × 3 mixed-model design was used to compare groups (ice vest, no ice vest) across changes in temperature from baseline (10 minutes and 1 minute before the race and immediately after the race). Setting: 2005 Big Wave Invitational 4-km race in Hawaii and 2005 Great American 5-km race in North Carolina. Patients or Other Participants: Eighteen women from a National Collegiate Athletic Association Division I cross-country team who participated in either the Big Wave Invitational or the Great American Race. Intervention(s): Four hours before the start of the race, the athletes ingested radiotelemetry temperature sensors. One hour before the start of the race, Tc was recorded, and half of the athletes donned a Nike Ice-Vest, which was removed immediately before the race. Main Outcome Measure(s): Additional Tc readings were taken at 10 minutes and 1 minute before the start of the race and immediately after the race. Results: Ten minutes before the start of the race, Tc was elevated by 0.84°C ± 0.37°C in the no-vest group, compared with 0.29°C ± 0.56°C in the ice-vest group ( P < .01). This difference in Tc persisted at 1 minute before the start. Immediately after the finish, the increase in Tc averaged 2.75°C ± 0.62°C in the no-vest group and 2.12°C ± 0.62°C in the ice-vest group ( P < .01). Conclusions: Wearing an ice vest before cross-country performance in warm, humid conditions allowed athletes to start and finish the competition with a lower Tc than did those who did not wear a vest. PMID:17273460

Simulation-Based Abdominal Ultrasound Training - A Systematic Review.

PubMed

Østergaard, M L; Ewertsen, C; Konge, L; Albrecht-Beste, E; Bachmann Nielsen, M

2016-06-01

The aim is to provide a complete overview of the different simulation-based training options for abdominal ultrasound and to explore the evidence of their effect. This systematic review was performed according to the PRISMA guidelines and Medline, Embase, Web of Science, and the Cochrane Library was searched. Articles were divided into three categories based on study design (randomized controlled trials, before-and-after studies and descriptive studies) and assessed for level of evidence using the Oxford Centre for Evidence Based Medicine (OCEBM) system and for bias using the Cochrane Collaboration risk of bias assessment tool. Seventeen studies were included in the analysis: four randomized controlled trials, eight before-and-after studies with pre- and post-test evaluations, and five descriptive studies. No studies scored the highest level of evidence, and 14 had the lowest level. Bias was high for 11 studies, low for four, and unclear for two. No studies used a test with established evidence of validity or examined the correlation between obtained skills on the simulators and real-life clinical skills. Only one study used blinded assessors. The included studies were heterogeneous in the choice of simulator, study design, participants, and outcome measures, and the level of evidence for effect was inadequate. In all studies simulation training was equally or more beneficial than other instructions or no instructions. Study designs had significant built-in bias and confounding issues; therefore, further research should be based on randomized controlled trials using tests with validity evidence and blinded assessors. © Georg Thieme Verlag KG Stuttgart · New York.

A Study of Changes in Dental Health Care Behavior of 4-H Youth in Selected Louisiana Parishes. R and T--Summary 51.

ERIC Educational Resources Information Center

Jones, Michael Alan

The effectiveness of the Dental Hygiene Education Program in changing the dental health care practices of 4-H club youth in four Louisiana parishes and youth knowledge of dental care principles were studied in this before-after experimental design. The study sample consisted of 258 youth from 10 4-H clubs. Subjects completed a four-item…

Impact of an inquiry unit on grade 4 students' science learning

NASA Astrophysics Data System (ADS)

Di Mauro, María Florencia; Furman, Melina

2016-09-01

This paper concerns the identification of teaching strategies that enhance the development of 4th grade students' experimental design skills at a public primary school in Argentina. Students' performance in the design of relevant experiments was evaluated before and after an eight-week intervention compared to a control group, as well as the persistence of this learning after eight months. The study involved a quasi-experimental longitudinal study with pre-test/post-test/delayed post-test measures, complemented with semi-structured interviews with randomly selected students. Our findings showed improvement in the experimental design skills as well as its sustainability among students working with the inquiry-based sequence. After the intervention, students were able to establish valid comparisons, propose pertinent designs and identify variables that should remain constant. Contrarily, students in the control group showed no improvement and continued to solve the posed problems based on prior beliefs. In summary, this paper shows evidence that implementing inquiry-based units involving problems set in cross-domain everyday situations that combine independent student work with teacher guidance significantly improves the development of scientific skills in real classroom contexts.

Effect of weight loss and ketosis on postprandial cholecystokinin and free fatty acid concentrations.

PubMed

Chearskul, Supornpim; Delbridge, Elizabeth; Shulkes, Arthur; Proietto, Joseph; Kriketos, Adamandia

2008-05-01

Weight regain after weight loss may not be due primarily to voluntary return to social habits but may be explained by changes in peripheral hormonal signals activating hunger and encouraging feeding behavior. The objective of this study was to investigate physiologic adaptations to weight loss that may encourage weight regain. The study had a within-subject repeated-measure design [12 healthy, obese men, 33-64 y, body mass index (in kg/m(2)) 30-46] and was a clinical intervention investigation of circulating metabolites and hunger-satiety responses before and after weight loss. Measures included anthropometry (bioelectrical impedance, body weight, and waist circumference), concentrations of circulating hormones and metabolites [ketone bodies, free fatty acids (FFAs), insulin, leptin, glucose, and cholecystokinin (CCK)], and measures of hunger and satiety at baseline, 8 wk after weight loss with a very-low-energy diet, and 1 wk after weight maintenance. Weight loss led to a reduction in postprandial CCK secretion (P = 0.016). However, when subjects were ketotic (elevated circulating beta-hydroxybutyrate concentrations), CCK secretion was sustained at concentrations before weight loss. After weight loss, there were reduced postprandial FFA concentrations (P = 0.0005). The presence of ketosis sustained FFA to concentrations before weight loss (P = 0.60). Rapid weight loss of approximately 10% of initial body weight results in a reduction in postprandial CCK and FFA concentrations.

High-Risk Medication Use by Nursing Home Residents Before and After Hospitalization

PubMed Central

Stevenson, David G.; Dusetzina, Stacie B.; O’Malley, A. James; Mitchell, Susan L.; Zarowitz, Barbara J.; Chernew, Michael E.; Newhouse, Joseph P.; Huskamp, Haiden A.

2014-01-01

Background Two prominent challenges in nursing home care are ensuring appropriate medication use and achieving high quality care as residents transition from the hospital to the nursing home and back. Research about prescribing practices at this important clinical juncture is limited. Objective To analyze the use of high-risk medications by nursing home residents before and after being hospitalized. We define high-risk medications using the Beers criteria for potentially inappropriate medication use. Research Design, Subjects, Measures Using a dataset with Medicare claims for inpatient and skilled nursing facility stays, and pharmacy claims for all medications dispensed in the nursing home setting, we examine high-risk medication use for hospitalized nursing home residents before and after being hospitalized. Our study population includes 52,559 dual-eligible nursing home residents aged 65 and older who are hospitalized and then readmitted to the same nursing home in 2008. Our primary outcome of interest is the use of high-risk medications in the 30 days before hospitalization and the 30 days following readmission to the same nursing home. We define high-risk medications using the Beers criteria for potentially inappropriate medication use. Results Around one in five hospitalized nursing home residents (21%) used at least one high-risk medication the day before hospitalization. Among individuals with high-risk medication use at hospitalization, the proportion using these medications dropped to 45% after nursing home readmission but increased thereafter, to 59% by the end of the 30-day period. Conclusion We found moderate levels of high-risk medication use by hospitalized nursing home residents before and after their hospital stays, constituting an important clinical and policy challenge. PMID:25185637

The Impact of a Summer Institute on Inservice Early Childhood Teachers' Knowledge of Earth and Space Science Concepts

ERIC Educational Resources Information Center

Sackes, Mesut; Trundle, Kathy Cabe; Krissek, Lawrence A.

2011-01-01

This study investigated inservice PreK to Grade two teachers' knowledge of some earth and space science concepts before and after a short-term teacher institute. A one-group pre-test-post-test design was used in the current study. Earth science concepts targeted during the professional development included properties of rocks and soils, and the…

Endocrine, electrolyte, and fluid volume changes associated with Apollo missions

NASA Technical Reports Server (NTRS)

Leach, C. S.; Alexander, W. C.; Johnson, P. C.

1975-01-01

The endocrine and metabolic results obtained before and after the Apollo missions and the results of the limited in-flight sampling are summarized and discussed. The studies were designed to evaluate the biochemical changes in the returning Apollo crewmembers, and the areas studied included balance of fluids and electrolytes, regulation of calcium metabolism, adaptation to the environment, and regulation of metabolic processes.

Travel by Walking Before and After School Increases Physical Activity among Adolescent Girls

PubMed Central

Catellier, Diane J.; Pfeiffer, Karin; Schmitz, Kathryn H.; Conway, Terry; Going, Scott; Ward, Dianne; Strikmiller, Patty; Treuth, Margarita S.

2008-01-01

Objective To examine how travel by walking before and after school contributes to total physical activity of adolescent girls. Design Cross-sectional sample. Setting 36 middle schools from Arizona, Maryland, Minnesota, New Orleans, San Diego and South Carolina participating in the Trial of Activity for Adolescent Girls (TAAG). Participants 1721 6th grade girls consented to participate; adequate information was available for 1596 (93%) of participants. Main outcome measure Travel by walking before school, after school, and before and after school combined, assessed from the 3-Day Physical Activity Recall (3DPAR). Mean minutes of physical activity, measured by accelerometry, were estimated for total physical activity (light, moderate, vigorous), moderate to vigorous activity (MVPA), and MVPA (3 MET). Results Travel by walking was reported by 14% of participants before and 18% after school. Girls who reported “travel by walking” before and after school (combined) had 13.7 (95% confidence interval [CI], 1.2 – 26.3) more minutes of total PA and 4.7 (95% CI, 2.2 – 7.2) more minutes of MVPA than girls who did not report this activity. Before school and after school walkers (but not both) accumulated 2.5 (95% CI, 0.10 – 4.9) and 2.2 (95% CI, 0.24 – 4.2) more minutes of MVPA on an average weekday, respectively, than non-walkers. Conclusions Our results provide evidence that walking for transportation before and after school increases weekday minutes of total physical activity and MVPA for middle school girls. PMID:17283300

Distal radius osteotomy with volar locking plates based on computer simulation.

PubMed

Miyake, Junichi; Murase, Tsuyoshi; Moritomo, Hisao; Sugamoto, Kazuomi; Yoshikawa, Hideki

2011-06-01

Corrective osteotomy using dorsal plates and structural bone graft usually has been used for treating symptomatic distal radius malunions. However, the procedure is technically demanding and requires an extensive dorsal approach. Residual deformity is a relatively frequent complication of this technique. We evaluated the clinical applicability of a three-dimensional osteotomy using computer-aided design and manufacturing techniques with volar locking plates for distal radius malunions. Ten patients with metaphyseal radius malunions were treated. Corrective osteotomy was simulated with the help of three-dimensional bone surface models created using CT data. We simulated the most appropriate screw holes in the deformed radius using computer-aided design data of a locking plate. During surgery, using a custom-made surgical template, we predrilled the screw holes as simulated. After osteotomy, plate fixation using predrilled screw holes enabled automatic reduction of the distal radial fragment. Autogenous iliac cancellous bone was grafted after plate fixation. The median volar tilt, radial inclination, and ulnar variance improved from -20°, 13°, and 6 mm, respectively, before surgery to 12°, 24°, and 1 mm, respectively, after surgery. The median wrist flexion improved from 33° before surgery to 60° after surgery. The median wrist extension was 70° before surgery and 65° after surgery. All patients experienced wrist pain before surgery, which disappeared or decreased after surgery. Surgeons can operate precisely and easily using this advanced technique. It is a new treatment option for malunion of distal radius fractures.

The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.

PubMed

Van Lierde, Kristiane M; De Bodt, Marc; Dhaeseleer, Evelien; Wuyts, Floris; Claeys, Sofie

2010-05-01

The purpose of the present study is to measure the effectiveness of two treatment techniques--vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)--in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The effects of smokeless cookstoves on peak expiratory flow rates in rural Honduras.

PubMed

Rennert, W P; Porras Blanco, R M; Muniz, G B

2015-09-01

The use of biomass fuel for cooking in traditional cookstove designs negatively affects respiratory health of communities in developing countries. Indoor pollution affects particularly women and children, who are participating in food preparation. The effects of smokeless cookstove designs on indoor pollution are well documented, but few studies exist to assess the effects of improved stove designs on the respiratory health of community members. This study uses peak expiratory flow rate (PEFR) measurements in a before-and-after format to assess respiratory function of inhabitants of all 30 houses of Buenas Noches in central Honduras. PEFRs are measured before and 6 months after the installation of Justa stoves in people's homes. Health behaviors, respiratory symptoms and fire wood use are evaluated in a door-to-door survey format. A total of 137 eligible women and children between 6 and 14 years participated in the study. PEFR improved by 9.9-18.5% (P < 0.001) depending on the participants' exposure to indoor pollution. Health complaints like cough and behaviors like clinic visits did not change with the introduction of smokeless cookstove technology. Smokeless stoves improve respiratory health in an environment of high levels of indoor pollution. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of effect between group discussion and educational booklet on Iranian nursing students' attitude and practice toward patient privacy.

PubMed

Adib-Hajbaghery, Mohsen; Faraji, Mona

2016-01-01

This study aimed to compare the effects between group discussion and educational booklet on nursing students' attitude and practice toward patient privacy in Iran. A two-group, pre-test and post-test design study was conducted in 2015. The study was conducted on 60 nursing students in Kashan, Iran who were randomly allocated into two groups to be trained on patient privacy either through group discussion or by an educational booklet. The students' attitude and practice was assessed before and after the education using a questionnaire and a checklist. Data analysis was performed through paired t-test, Wilcoxon signed ranks test, and independent samples t-tests. Before the intervention, no significant difference was found between the group designated to group discussion and that designated to the educational booklet in the mean overall score of attitude (P=0.303) and practice (P=0.493) toward patient privacy. After the intervention, the mean attitude score significantly increased in the two groups (P=0.001). Moreover, the students' practice score increased in the discussion group while it did not significantly change in the booklet group (P=0.001). Both methods were effective on the students' attitude; however, the educational booklet did not affect their practice toward patient privacy. Group discussion can effectively improve the students' attitude and practice toward patient privacy.

Factors Affecting Drug Use During Incarceration: A Cross-Sectional Study of Opioid-Dependent Persons from India.

PubMed

Rao, Ravindra; Mandal, Piyali; Gupta, Rishab; Ramshankar, Prashanth; Mishra, Ashwani; Ambekar, Atul; Jhanjee, Sonali; Dhawan, Anju

2016-02-01

Substance abuse and criminality share a complex relationship. The rates of substance use among the prisoners, and that of criminal acts among substance users in community setting are high. Data from South Asian countries, including from India are inadequate. This study aimed to assess the pattern of criminal acts among opioid-dependent subjects and their substance use pattern in the month before, during and after imprisonment. Using a cross-sectional study design and purposive sampling, opioid-dependent subjects (n=101) attending two community drug treatment clinics who have had any contact with the law were assessed using a specifically-designed tool to record criminal acts and substance use before, during and after last imprisonment. Most subjects (93%) had committed illegal acts in their lifetime. Physical assault was the most common illegal act, while 23% reported selling drugs and 9% reported committing serious crimes. About 95% were arrested and 92% had spent time in police lockups. About 29% were arrested for drugs possession or drug use, and 3% of injecting drug users arrested for carrying injection equipment. About 85% had been imprisoned at least once, of whom 88% used psychoactive substances in the 1-month period before their last imprisonment. Opioids were the most common substances used daily (68%), followed by cannabis (34%) and alcohol (22%). Ninety-seven percent reported the availability of substances in prisons, and 65% also used substances during their last imprisonment. Cannabis (35%) was the most common substances used in prison followed by opioids (19%). Seventy-six percent used substances soon after prison release, and 13% of opioid users experienced opioid overdose soon after prison release. Use of cannabis, injecting drugs, and opioid use before imprisonment were predictors of substance use in prison. Opioid-dependent people have various contacts with the law, including imprisonment. Many users are dependent on substances during prison-entry, which is an important reason for their continued substance use in prisons. There is a need to provide substance abuse treatment across all stages of criminal justice system. Copyright © 2015 Elsevier Inc. All rights reserved.

[Intraocular pressure after ND: YAG laser capsulotomy in pseudophakic patients with glaucoma].

PubMed

Sesar, Antonio; Petric, Irena; Sesar, Ivanka; Lacmnovic-Loncar, Valentina; Jurisić, Darija; Tomić, Zeljka; Mandić, Zdravko

2006-01-01

The aim of the study was to analyze changes in intraocular pressure after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma. Intraocular pressure was recorded before, and 1 and 3 hours after YAG laser capsulotomy in 69 pseudophakic patients with glaucoma. Twenty eight patients received no therapy before capsulotomy, 21 patients received topical brimonidine 0.2%, and 20 patients received topical dorzolamide 2% 1 hour before laser capsulotomy. All patients received topical tropicamide 1% and tetracaine 0.5%. Nd: YAG laser posterior capsulotomy was performed using inverted-U technique to make a 3-4 mm diameter capsulotomy. After capsulotomy, all eyes received topical fluorometholone for 10 days. A pressure rise was greater in patients without any therapy before YAG laser capsulotomy. Eight patients with glaucoma showed intraocular pressure rise of 5 mm Hg, and 2 patients pressure rise of 10 mm Hg after laser capsulotomy. A reduction of intraocular pressure rise was found in patients who received dorzolamide 2% or brimonidine 0.2%, only 1 patient in each group developed a pressure rise of 5 mm Hg. In all patients a significant pressure rise developed within the first hour. It is difficult to compare different studies due to different techniques of cataract surgery and different intraocular lense material and design. Barnes showed that 6 of 29 (21%) developed a pressure rise of 5 mm Hg, and 1 of 29 (3%) patients a pressure rise of 10 mm Hg. In our study, 29% of patients had a pressure rise of > or =5 mm Hg, and 7% of patients had a rise of > or =10 mm Hg after laser capsulotomy. These results may be associated with a large proportion of extracapsular cataract extraction (71%) versus phacoemulsification (29%) in our patients. Pretreatment with dorzolamide 2% or brimonidine 0.2% reduce the intraocular pressure rise after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma.

Comparing Alternative Slashing Techniques on a Mixed Hardwood Forest: 2-Year Results

Treesearch

Donald G. Hodges; Richard M. Evans; Wayne K. Clatterbuck

2002-01-01

Regenerating commercially important species following the harvest of an existing mixed hardwood stand requires adequate advance regeneration of the desired species and control of competing vegetation. These objectives can be achieved by removing the noncommercial stems before or after harvesting. This study was designed to evaluate the efficacy of pre- and post...

Learning for All: The Value of Field Experience in Training a New Generation of Program Evaluators

ERIC Educational Resources Information Center

Buitrag, Carolina

2015-01-01

Professionals in various fields have the opportunity to train in real-life situations before they take on a job by themselves. In program evaluation, however, preservice training usually focuses on coursework oriented to research design and methods. After completing these studies, evaluators go off to conduct evaluations guided primarily by their…

Preservice Elementary Teachers' Knowledge of Observable Moon Phases and Pattern of Change in Phases

ERIC Educational Resources Information Center

Trundle, Kathy Cabe; Atwood, Ronald K.; Christopher, John E.

2006-01-01

The purpose of this study was to describe selected content knowledge held by 52 preservice elementary teachers about the observable phases of the moon and the monthly pattern of change in observable phases. Data were obtained from participants in a physics course before and after they received inquiry-based instruction designed to promote…

Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

ERIC Educational Resources Information Center

Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

2010-01-01

Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

Multi-Level Assessment of Scientific Content Knowledge Gains Associated with Socioscientific Issues-Based Instruction

ERIC Educational Resources Information Center

Klosterman, Michelle L.; Sadler, Troy D.

2010-01-01

This study explored the impact of using a socioscientific issue (SSI) based curriculum on developing science content knowledge. Using a multi-level assessment design, student content knowledge gains were measured before and after implementation of a three-week unit on global warming (a prominent SSI) that explored both the relevant science content…

Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes towards the Elderly

ERIC Educational Resources Information Center

Duke, Pamela; Cohen, Diane; Novack, Dennis

2009-01-01

This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year.…

Gender Differences between Graphical User Interfaces and Command Line Interfaces in Computer Instruction.

ERIC Educational Resources Information Center

Barker, Dan L.

This study focused primarily on two types of computer interfaces and the differences in academic performance that resulted from their use; it was secondarily designed to examine gender differences that may have existed before and after any change in interface. Much of the basic research in computer use was conducted with command line interface…

The Influence of Literacy-Enriched Play Settings on Preschoolers' Conceptions of Print.

ERIC Educational Resources Information Center

Neuman, Susan B.; Roskos, Kathy

This study examined the influence of literacy-enriched play centers on preschoolers' conceptions of print. Subjects, 25 boys and 12 girls aged 4 and 5 years from 2 urban preschool classes, were systematically observed before and after 5 basic design changes were made in the classrooms. Four distinct play centers (post office, library, office, and…

The patient safety culture as perceived by staff at two different emergency departments before and after introducing a flow-oriented working model with team triage and lean principles: a repeated cross-sectional study.

PubMed

Burström, Lena; Letterstål, Anna; Engström, Marie-Louise; Berglund, Anders; Enlund, Mats

2014-07-09

Patient safety is of the utmost importance in health care. The patient safety culture in an institution has great impact on patient safety. To enhance patient safety and to design strategies to reduce medical injuries, there is a current focus on measuring the patient safety culture. The aim of the present study was to describe the patient safety culture in an ED at two different hospitals before and after a Quality improvement (QI) project that was aimed to enhance patient safety. A repeated cross-sectional design, using the Hospital Survey On Patient Safety Culture questionnaire before and after a quality improvement project in two emergency departments at a county hospital and a university hospital. The questionnaire was developed to obtain a better understanding of the patient safety culture of an entire hospital or of specific departments. The Swedish version has 51 questions and 15 dimensions. At the county hospital, a difference between baseline and follow-up was observed in three dimensions. For two of these dimensions, Team-work within hospital and Communication openness, a higher score was measured at the follow-up. At the university hospital, a higher score was measured at follow-up for the two dimensions Team-work across hospital units and Team-work within hospital. The result showed changes in the self-estimated patient safety culture, mainly regarding team-work and communication openness. Most of the improvements at follow-up were seen by physicians, and mainly at the county hospital.

Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

PubMed Central

Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak

2015-01-01

Background Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students’ motivation to study. Design and methods An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students’ academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS). Cronbach’s alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance. Results Students’ academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students’ self-esteem and feeling of self-worth (P<0.001). Moreover, intrinsic motivation toward accomplishment increased significantly (P<0.001). This is related to the enjoyment of passing academic milestones, and a step ahead of autonomous motivation. Amotivation level declined significantly (P<0.001). The change of academic motivational constructs before and after the intervention was altogether significant (P=0.036, multivariate analysis of variance). Conclusion After experiencing a three-day intervention, the new students’ motivation advanced along the continuum of self-determination toward autonomous motivation. Therefore, it is considered to be worthwhile conducting an academic intervention to catalyze the evolution of preclinical year medical students’ academic motivation. Moreover, educators and faculties should evaluate the impact of interventions in evidence-based approaches to secure both controlled and autonomous types of motivation. PMID:26719719

Masturbation to Orgasm Stimulates the Release of the Endocannabinoid 2-Arachidonoylglycerol in Humans.

PubMed

Fuss, Johannes; Bindila, Laura; Wiedemann, Klaus; Auer, Matthias K; Briken, Peer; Biedermann, Sarah V

2017-11-01

Endocannabinoids are critical for rewarding behaviors such as eating, physical exercise, and social interaction. The role of endocannabinoids in mammalian sexual behavior has been suggested because of the influence of cannabinoid receptor agonists and antagonists on rodent sexual activity. However, the involvement of endocannabinoids in human sexual behavior has not been studied. To investigate plasma endocannabinoid levels before and after masturbation in healthy male and female volunteers. Plasma levels of the endocannabinoids 2-arachidonoylglycerol (2-AG), anandamide, the endocannabinoid-like lipids oleoyl ethanolamide and palmitoyl ethanolamide, arachidonic acid, and cortisol before and after masturbation to orgasm. In study 1, endocannabinoid and cortisol levels were measured before and after masturbation to orgasm. In study 2, masturbation to orgasm was compared with a control condition using a single-blinded, randomized, 2-session crossover design. In study 1, masturbation to orgasm significantly increased plasma levels of the endocannabinoid 2-AG, whereas anandamide, oleoyl ethanolamide, palmitoyl ethanolamide, arachidonic acid, and cortisol levels were not altered. In study 2, only masturbation to orgasm, not the control condition, led to a significant increase in 2-AG levels. Interestingly, we also found a significant increase of oleoyl ethanolamide after masturbation to orgasm in study 2. Endocannabinoids might play an important role in the sexual response cycle, leading to possible implications for the understanding and treatment of sexual dysfunctions. We found an increase of 2-AG through masturbation to orgasm in 2 studies including a single-blinded randomized design. The exact role of endocannabinoid release as part of the sexual response cycle and the biological significance of the finding should be studied further. Cannabis and other drug use and the attainment of orgasm were self-reported in the present study. Our data indicate that the endocannabinoid 2-AG is involved in the human sexual response cycle and we hypothesize that 2-AG release plays a role in the rewarding consequences of sexual arousal and orgasm. Fuss J, Bindila L, Wiedemann K, et al. Masturbation to Orgasm Stimulates the Release of the Endocannabinoid 2-Arachidonoylglycerol in Humans. J Sex Med 2017;14:1372-1379. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Strategic Design Inquiry: A Formal Methodology For Approaching, Designing, Integrating, And Articulating National Strategy

DTIC Science & Technology

2014-04-01

15 Figure 4: Example cognitive map ... map , aligning planning efforts throughout the government. Even after strategy implementation, SDI calls for continuing, iterative learning and...the design before total commitment to it. Capturing this analysis on a cognitive map allows strategists to articulate a design to government

[Assesing the effect of Lepidium meyenii "Maca" on the gastric mucosa in patients with functional dyspepsia].

PubMed

Benites Goñi, Harold Eduardo; Cok García, Jaime; Bussalleu Cavero, Alejandra; Bustamente Robles, Katherine Yelenia; Zegarra Chang, Arturo; Bravo, Eduar; Bussalleu Rivera, Alejandro

2014-01-01

The present study was designed to determine the histological effect of Lepidium meyenii "Maca" on the gastric mucosa in patients with functional dyspepsia. This study consists of a clinical case series, in which the effect of Maca on the gastric histopathology of 29 Peruvian patients diagnosed with functional dyspepsia was examined. The presence of H. pylori, as well as the degree and depth of the gastric mucosa inflammation was evaluated from biopsies obtained before and after the treatment based solely of Maca 3 grams per day for four weeks. Average values of the degree and depth of mucosal inflammation before and after the treatment were compared showing no statistical difference among the samples. Sixteen patients were infected with H. pylori, and they remained infected after the treatment with Maca. A four week long treatment with Maca does not produce significant changes on gastric mucosa of patients with functional dyspepsia, neither on H. pylori eradication.

Effects of a Brief Team Training Program on Surgical Teams' Nontechnical Skills: An Interrupted Time-Series Study.

PubMed

Gillespie, Brigid M; Harbeck, Emma; Kang, Evelyn; Steel, Catherine; Fairweather, Nicole; Panuwatwanich, Kriengsak; Chaboyer, Wendy

2017-04-27

Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program. We observed 179 surgical procedures with cardiac, vascular, upper gastrointestinal, and hepatobiliary teams. Mean posttest NOTECHS scores increased across teams, showing special cause variation. There were also significant before and after improvements in NOTECHS scores in respect to professional role and in the use of the Surgical Safety Checklist. Our results suggest associated improvements in teams' NOTSS after implementation of the team training program.

Educational software and improvement of first grade school students' knowledge about prevention of overweight and obesity.

PubMed

Santos Vital Alves Coelho, Luana; Roner Vilanova Novais, Felipe; Armaneli Macedo, Giulia; Nunes Neves Dos Santos, Júlia; Lara Sousa, Vinícius; Mattos Mendes, Luis Augusto; Morais Dos Reis, Daniel; Caetano Romano, Márcia Christina

2016-06-01

To evaluate the effects of educational software to improve first grade school students' knowledge about prevention of overweight and obesity. This non-controlled trial with a before-and-after evaluation was carried out in an school located in the municipality of Divinópolis (Brazil) among 71 students aged 6 to 10 years. The educational software about prevention of overweight and obesity was designed and then validated. The educational intervention comprised the use of the software. Before and after of the intervention we applied a questionnaire based on the Ten Steps to Healthy Eating for Children, proposed by the Brazilian Ministry of Health. Comparing the times before and after application of the educational software, we observed statistically significant differences in proportion of questions answered correctly by first grade school students, mainly concerning daily eating of healthy and unhealthy food, adequate preparation of food and importance of exercise. This study highlights the importance of educational actions using software to build knowledge of first grade school students about prevention of overweight and obesity.

14 CFR 91.819 - Civil supersonic airplanes that do not comply with part 36.

Code of Federal Regulations, 2011 CFR

2011-01-01

... in the United States: (1) Regardless of whether a type design change approval is applied for under... the type design is changed, after July 31, 1978, in a manner constituting an “acoustical change” under... scheduled, or otherwise planned, for takeoff or landing after 10 p.m. and before 7 a.m. local time. ...

Plasma Rich in Growth Factors for the Treatment of Dry Eye after LASIK Surgery.

PubMed

Sanchez-Avila, Ronald Mauricio; Merayo-Lloves, Jesus; Fernandez, Maria Laura; Rodriguez-Gutierrez, Luis Alberto; Jurado, Nancy; Muruzabal, Francisco; Orive, Gorka; Anitua, Eduardo

2018-06-08

The aim of this study was to evaluate the use of plasma rich in growth factors (PRGF) eye drops in patients with dry eye disease after laser-assisted in situ keratomileusis (LASIK) surgery. This is a longitudinal, retrospective, comparative, and descriptive study of 77 eyes of 42 patients with dry eye disease following LASIK surgery. This study was designed to evaluate the efficacy of PRGF treatment compared to conventional therapy (control group). Outcome measures including signs and symptoms of dry eye disease were evaluated before and after treatment. The percentage of change before and after treatment for each clinical variable measured was compared between both groups. There were 1-4 treatment cycles with PRGF eye drops (1 cycle = 6 weeks). Results showed a statistically significant improvement in the Ocular Surface Disease Index (38.12%), visual analogue scale scores for frequency (41.89%) and severity (42.47%), and the Schirmer test scores (88.98%) after PRGF treatment (p < 0.05). No adverse events were reported after PRGF treatment. These results suggest that PRGF eye drops are effective for the improvement of dry eye symptoms in patients who underwent LASIK surgery in comparison to the conventional therapy. The treatment with PRGF is an alternative for patients who suffer from postoperative dry eye. © 2018 S. Karger AG, Basel.

In vivo optical coherence tomography of stimulus-evoked intrinsic optical signals in mouse retinas

NASA Astrophysics Data System (ADS)

Wang, Benquan; Lu, Yiming; Yao, Xincheng

2016-09-01

Intrinsic optical signal (IOS) imaging promises a noninvasive method for advanced study and diagnosis of eye diseases. Before pursuing clinical applications, it is essential to understand anatomic and physiological sources of retinal IOSs and to establish the relationship between IOS distortions and eye diseases. The purpose of this study was designed to demonstrate the feasibility of in vivo IOS imaging of mouse models. A high spatiotemporal resolution spectral domain optical coherence tomography (SD-OCT) was employed for depth-resolved retinal imaging. A custom-designed animal holder equipped with ear bar and bite bar was used to minimize eye movements. Dynamic OCT imaging revealed rapid IOS from the photoreceptor's outer segment immediately after the stimulation delivery, and slow IOS changes were observed from inner retinal layers. Comparative photoreceptor IOS and electroretinography recordings suggested that the fast photoreceptor IOS may be attributed to the early stage of phototransduction before the hyperpolarization of retinal photoreceptor.

Presymptomatic atrophy in autosomal dominant Alzheimer's disease: A serial magnetic resonance imaging study.

PubMed

Kinnunen, Kirsi M; Cash, David M; Poole, Teresa; Frost, Chris; Benzinger, Tammie L S; Ahsan, R Laila; Leung, Kelvin K; Cardoso, M Jorge; Modat, Marc; Malone, Ian B; Morris, John C; Bateman, Randall J; Marcus, Daniel S; Goate, Alison; Salloway, Stephen P; Correia, Stephen; Sperling, Reisa A; Chhatwal, Jasmeer P; Mayeux, Richard P; Brickman, Adam M; Martins, Ralph N; Farlow, Martin R; Ghetti, Bernardino; Saykin, Andrew J; Jack, Clifford R; Schofield, Peter R; McDade, Eric; Weiner, Michael W; Ringman, John M; Thompson, Paul M; Masters, Colin L; Rowe, Christopher C; Rossor, Martin N; Ourselin, Sebastien; Fox, Nick C

2018-01-01

Identifying at what point atrophy rates first change in Alzheimer's disease is important for informing design of presymptomatic trials. Serial T1-weighted magnetic resonance imaging scans of 94 participants (28 noncarriers, 66 carriers) from the Dominantly Inherited Alzheimer Network were used to measure brain, ventricular, and hippocampal atrophy rates. For each structure, nonlinear mixed-effects models estimated the change-points when atrophy rates deviate from normal and the rates of change before and after this point. Atrophy increased after the change-point, which occurred 1-1.5 years (assuming a single step change in atrophy rate) or 3-8 years (assuming gradual acceleration of atrophy) before expected symptom onset. At expected symptom onset, estimated atrophy rates were at least 3.6 times than those before the change-point. Atrophy rates are pathologically increased up to seven years before "expected onset". During this period, atrophy rates may be useful for inclusion and tracking of disease progression. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

The optimal design of stepped wedge trials with equal allocation to sequences and a comparison to other trial designs.

PubMed

Thompson, Jennifer A; Fielding, Katherine; Hargreaves, James; Copas, Andrew

2017-12-01

Background/Aims We sought to optimise the design of stepped wedge trials with an equal allocation of clusters to sequences and explored sample size comparisons with alternative trial designs. Methods We developed a new expression for the design effect for a stepped wedge trial, assuming that observations are equally correlated within clusters and an equal number of observations in each period between sequences switching to the intervention. We minimised the design effect with respect to (1) the fraction of observations before the first and after the final sequence switches (the periods with all clusters in the control or intervention condition, respectively) and (2) the number of sequences. We compared the design effect of this optimised stepped wedge trial to the design effects of a parallel cluster-randomised trial, a cluster-randomised trial with baseline observations, and a hybrid trial design (a mixture of cluster-randomised trial and stepped wedge trial) with the same total cluster size for all designs. Results We found that a stepped wedge trial with an equal allocation to sequences is optimised by obtaining all observations after the first sequence switches and before the final sequence switches to the intervention; this means that the first sequence remains in the control condition and the last sequence remains in the intervention condition for the duration of the trial. With this design, the optimal number of sequences is [Formula: see text], where [Formula: see text] is the cluster-mean correlation, [Formula: see text] is the intracluster correlation coefficient, and m is the total cluster size. The optimal number of sequences is small when the intracluster correlation coefficient and cluster size are small and large when the intracluster correlation coefficient or cluster size is large. A cluster-randomised trial remains more efficient than the optimised stepped wedge trial when the intracluster correlation coefficient or cluster size is small. A cluster-randomised trial with baseline observations always requires a larger sample size than the optimised stepped wedge trial. The hybrid design can always give an equally or more efficient design, but will be at most 5% more efficient. We provide a strategy for selecting a design if the optimal number of sequences is unfeasible. For a non-optimal number of sequences, the sample size may be reduced by allowing a proportion of observations before the first or after the final sequence has switched. Conclusion The standard stepped wedge trial is inefficient. To reduce sample sizes when a hybrid design is unfeasible, stepped wedge trial designs should have no observations before the first sequence switches or after the final sequence switches.

HATS: A Design Procedure for Routine Business Documents.

ERIC Educational Resources Information Center

Baker, William H.

2001-01-01

Describes an approach to teaching students a basic design process for routine business documents like memos, letters, and reports. Outlines the design principles of HATS (Headings, Access, Typography, and Spacing), how they apply in before-and-after fashion to various documents, and discusses an assignment in which students redesign an existing…

Using Design Principles to Teach Technical Communication.

ERIC Educational Resources Information Center

Markel, Mike

1995-01-01

Compares the writing of two students--a competent writer and a weak one--in a technical communication course before and after discussion of design principles. Finds that a basic understanding of design principles helped them improve document macrostructure but had little effect on document microstructure. Suggests that integrating document design…

The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria.

PubMed

Chigbu, Chibuike O; Onyebuchi, Azubuike K; Onyeka, Tonia C; Odugu, Boniface U; Dim, Cyril C

2017-06-01

To determine the impact of trained community health educators on the uptake of cervical and breast cancer screening, and HPV vaccination in rural communities in southeast Nigeria. A prospective population-based intervention study, with a before-and-after design, involved four randomly selected communities in southeast Nigeria from February 2014 to February 2016. Before the intervention, baseline data were collected on the uptake of cervical and breast cancer prevention services. The intervention was house-to-house education on cervical cancer and breast cancer prevention. Postintervention outcome measures included the uptake of cervical and breast cancer screening, and HPV vaccination within 6 months of intervention. In total, 1327 women were enrolled. Before the intervention, 42 (3.2%) women had undergone cervical cancer screening; afterwards, 897 (67.6%) women had received screening (P<0.001). Clinical breast examination was performed for 59 (4.4%) women before and 897 (67.6%) after the intervention (P<0.001). Only 2 (0.9%) of 214 children eligible for HPV vaccination had received the vaccine before versus 71 (33.2%) after the intervention (P<0.001). The use of community health educators for house-to-house cervical and breast cancer prevention education was associated with significant increases in the uptake of cervical cancer screening, clinical breast examination, and HPV vaccination. © 2017 International Federation of Gynecology and Obstetrics.

Salivary Secretory Immunoglobulin a secretion increases after 4-weeks ingestion of chlorella-derived multicomponent supplement in humans: a randomized cross over study

PubMed Central

2011-01-01

Background Chlorella, a unicellular green alga that grows in fresh water, contains high levels of proteins, vitamins, minerals, and dietary fibers. Some studies have reported favorable immune function-related effects on biological secretions such as blood and breast milk in humans who have ingested a chlorella-derived multicomponent supplement. However, the effects of chlorella-derived supplement on mucosal immune functions remain unclear. The purpose of this study was to investigate whether chlorella ingestion increases the salivary secretory immunoglobulin A (SIgA) secretion in humans using a blind, randomized, crossover study design. Methods Fifteen men took 30 placebo and 30 chlorella tablets per day for 4 weeks separated by a 12-week washout period. Before and after each trial, saliva samples were collected from a sterile cotton ball that was chewed after overnight fasting. Salivary SIgA concentrations were measured using ELISA. Results Compliance rates for placebo and chlorella ingestions were 97.0 ± 1.0% and 95.3 ± 1.6%, respectively. No difference was observed in salivary SIgA concentrations before and after placebo ingestion (P = 0.38). However, salivary SIgA concentrations were significantly elevated after chlorella ingestion compared to baseline (P < 0.01). No trial × period interaction was identified for the saliva flow rates. Although the SIgA secretion rate was not affected by placebo ingestion (P = 0.36), it significantly increased after 4-week chlorella ingestion than before intake (P < 0.01). Conclusions These results suggest 4-week ingestion of a chlorella-derived multicomponent supplement increases salivary SIgA secretion and possibly improves mucosal immune function in humans. PMID:21906314

Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets.

PubMed

Bergamo, Ana Zn; Nelson-Filho, Paulo; Romano, Fábio L; da Silva, Raquel Ab; Saraiva, Maria Cp; da Silva, Lea Ab; Matsumoto, Mirian An

2016-12-01

The aim of this study was to evaluate the alterations on plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and gingival crevicular fluid (GCF) volume after use of three different brackets types for 60 days. Setting Participants: The sample comprised 20 patients of both sexes aged 11-15 years (mean age: 13.3 years), with permanent dentition, adequate oral hygiene, and mild tooth crowding, overjet, and overbite. A conventional metallic bracket Gemini™, and two different brands of self-ligating brackets - In-Ovation ® R and SmartClip™ - were bonded to the maxillary incisors and canines. PI, GI, GBI scores, and GCF volume were measured before and 30 and 60 days after bonding of the brackets. Data were analysed statistically using non-parametric tests coefficient at a 5% significance level. There was no statistically significant correlation (P > 0.05) between tooth crowding, overjet, and overbite and the PI, GI, GBI scores, and GCF volume before bonding, indicating no influence of malocclusion on the clinical parameters. Regardless of the bracket design, no statistically significant difference (P > 0.05) was found for GI, GBI scores. PI and GCF volume showed a significant difference among the brackets in different periods. In pairwise comparisons a significant difference was observed when compared before with 60 days after bonding, for the teeth bonded with SmartClip™ self-ligating bracket, (PI P = 0.009; GCF volume P = 0.001). There was an increase in PI score and GCF volume 60 days after bonding of SmartClip™ self-ligating brackets, indicating the influence of bracket design on these clinical parameters.

16 CFR 1632.2 - Purpose, scope, and applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... prototype designs of mattresses and mattress pads before the sale in commerce or the introduction in... of a mattress prototype or a mattress pad prototype. (b) Scope. (1) All mattresses, as defined in... each mattress prototype before or after the effective date of this amendment using the test procedure...

Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention

PubMed Central

Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi

2016-01-01

Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Method. Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Results. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Conclusion. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program. PMID:27239339

Evaluation of road expansion and connectivity mitigation for wildlife in southern California

USGS Publications Warehouse

Alonso, Robert S.; Lyren, Lisa M.; Boydston, Erin E.; Haas, Christopher D.; Crooks, Kevin R.

2014-01-01

We designed a remote-camera survey to study how the expansion of California State Route 71 (CA-71) and implementation of connectivity mitigation affected the use of underpasses by large mammals in southern California. Based on detections by cameras, the use of underpasses by bobcats (Lynx rufus) was higher within the area of expansion and mitigation after construction than before, but there was no difference in use of underpasses in the impact zone compared to the control zone before or after construction. Use of underpasses by coyotes (Canis latrans) was higher in the control zone than in the impact zone, but there was no difference in use before and after construction. Small numbers of detections of mule deer (Odocoileus hemionus) at only a few underpasses precluded comparison between control and impact zones. However, a comparison of use before and after construction revealed that use of underpasses by mule deer was slightly higher post-construction. We cannot fully attribute increased detections post-construction to mitigative efforts, because other factors, such as availability of habitat, urbanization, or demography, also may have influenced use of underpasses along CA-71. Nonetheless, even with the expansion of the freeway and subsequent increase in volume of traffic, mitigative structures along CA-71 did allow for continued movement and, hence, connectivity across the roadway for large mammals.

Effect of the Crystallization Process on the Marginal and Internal Gaps of Lithium Disilicate CAD/CAM Crowns

PubMed Central

Kim, Jae-Hong; Oh, Seunghan; Uhm, Soo-Hyuk

2016-01-01

The aim of this study is to quantify the effect of the crystallization process on lithium disilicate ceramic crowns fabricated using a computer-aided design/computer-aided manufacturing (CAD/CAM) system and to determine whether the effect of crystallization is clinically acceptable by comparing values of fit before and after the crystallization process. The mandibular right first molar was selected as the abutment for the experiments. Fifteen working models were prepared. Lithium disilicate crowns appropriate for each abutment were prepared using a commercial CAD/CAM system. Gaps in the marginal area and 4 internal areas of each crown were measured twice—before and after crystallization—using the silicone replica technique. The mean values of fit before and after crystallization were analyzed using a paired t-test to examine whether the conversion that occurred during crystallization affected marginal and internal gaps (α = 0.05). Gaps increased in the marginal area and decreased in the internal areas after crystallization. There were statistically significant differences in all of the investigated areas (P < 0.05). None of the values for marginal and internal fit of lithium disilicate CAD/CAM crowns after crystallization exceeded 120 μm, which is the clinically acceptable threshold. PMID:27123453

Exploring the influence of sterilisation and storage on some physicochemical properties of coconut (Cocos nucifera L.) water.

PubMed

Awua, Adolf K; Doe, Edna D; Agyare, Rebecca

2011-10-27

Fresh coconut (Cocos nucifera L) water is a clear, sterile, colourless, slightly acidic and naturally flavoured drink, mostly consumed in tropical areas. It is a rich source of nutrients and has been used for medical purposes. This study was designed to investigate changes in selected characteristics of coconut water after autoclaving, gamma irradiation and storage. Also, the study was designed for assessing the possibility of measuring the growth of bacterial in fresh, stored or sterilised coconut water using turbidity measurements (at wavelengths between 600 nm and 800 nm) or by dry biomass determinations. Portions of coconut water aseptically extracted from the matured fruit, (average pH of 6.33 ± 0.17) were either stored at 4°C, autoclaved at 121°C for 20 min., or irradiated with gamma rays at 5 kGy. Subsequent changes in selected characteristics were determined. Autoclaving, gamma irradiation and long term storage of coconut water at 4°C resulted both in the development of a pale to intense yellow colour and changes in turbidity. After storage, the dry matter content of fresh, autoclaved and irradiated coconut water by 52.0%, 23.5% and 5.0% respectively. There were also significant differences in the UV spectra before and after sterilisation and during the storage of the coconut water. Although changes in total carbohydrates were observed, they were not significant (p > 0.05). The enormous differences in the characteristics before and after storage suggests that the use of turbidity and dry biomass measurements for measuring the growth of bacteria in fresh, autoclaved and gamma irradiated coconut water before storage is practicable without any possibility of interference by the innate turbidity, colour and dry matter of the coconut water. However, this is not practicable after storing the coconut waters at 4°C, since there were increases in the turbidity and dry matter of the coconut water to levels that will mask the turbidity of a growing bacteria culture.

Intravitreal aflibercept versus intravitreal ranibizumab in patients with age-related macular degeneration: a comparative effectiveness study.

PubMed

Smit, Cornelis; Wiertz-Arts, Karin; van de Garde, Ewoudt Mw

2018-06-01

A hospital-wide, unselected switch of ranibizumab to aflibercept in treatment of age-related macular degeneration (AMD) allowed us to compare the clinical effectiveness of these agents. In a single-center before-after, observational study design new AMD-patients started with aflibercept treatment in 2013-2014 were compared with a control group of AMD-patients on ranibizumab before the switch. The mean difference in visual acuity (in logMAR units) after 1 year was comparable (+0.012 [aflibercept, n = 37] vs +0.17 [ranibizumab, n = 30], p = 0.154). However, the aflibercept-group did receive more intravitreal injections (5.8 vs 4.7 injections, p = 0.004) and were treated longer (265.7 vs 197.7 days; p = 0.011). With no difference in clinical effectiveness, longer treatment intervals for aflibercept should be investigated.

Impact of USPSTF recommendations for aspirin for prevention of recurrent preeclampsia.

PubMed

Tolcher, Mary Catherine; Chu, Derrick M; Hollier, Lisa M; Mastrobattista, Joan M; Racusin, Diana A; Ramin, Susan M; Sangi-Haghpeykar, Haleh; Aagaard, Kjersti M

2017-09-01

The US Preventive Services Task Force recommends low-dose aspirin for the prevention of preeclampsia among women at high risk for primary occurrence or recurrence of disease. Recommendations for the use of aspirin for preeclampsia prevention were issued by the US Preventive Services Task Force in September 2014. The objective of the study was to evaluate the incidence of recurrent preeclampsia in our cohort before and after the US Preventive Services Task Force recommendation for aspirin for preeclampsia prevention. This was a retrospective cohort study designed to evaluate the rates of recurrent preeclampsia among women with a history of preeclampsia. We utilized a 2-hospital, single academic institution database from August 2011 through June 2016. We excluded multiple gestations and included only the first delivery for women with multiple deliveries during the study period. The cohort of women with a history of preeclampsia were divided into 2 groups, before and after the release of the US Preventive Services Task Force 2014 recommendations. Potential confounders were accounted for in multivariate analyses, and relative risk and adjusted relative risk were calculated. A total of 17,256 deliveries occurred during the study period. A total of 417 women had a documented history of prior preeclampsia: 284 women before and 133 women after the US Preventive Services Task Force recommendation. Comparing the before and after groups, the proportion of Hispanic women in the after group was lower and the method of payment differed between the groups (P <.0001). The prevalence of type 1 diabetes was increased in the after period, but overall rates of pregestational diabetes were similar (6.3% before vs 5.3% after [P > .05]). Risk factors for recurrent preeclampsia included maternal age >35 years (relative risk, 1.83; 95% confidence interval, 1.34-2.48), Medicaid insurance (relative risk, 2.08; 95% confidence interval, 1.15-3.78), type 2 diabetes (relative risk, 2.13; 95% confidence interval, 1.37-3.33), and chronic hypertension (relative risk, 1.96; 95% confidence interval, 1.44-2.66). The risk of recurrent preeclampsia was decreased by 30% in the after group (adjusted relative risk, 0.70; 95% confidence interval, 0.52-0.95). Rates of recurrent preeclampsia among women with a history of preeclampsia decreased by 30% after release of the US Preventive Services Task Force recommendation for aspirin for preeclampsia prevention. Future prospective studies should include direct measures of aspirin compliance, gestational age at initiation, and explore the influence of race and ethnicity on the efficacy of this primary prevention. Copyright © 2017 Elsevier Inc. All rights reserved.

Immediate Effects of Kinesiology Taping of Quadriceps on Motor Performance after Muscle Fatigued Induction.

PubMed

Ahn, Ick Keun; Kim, You Lim; Bae, Young-Hyeon; Lee, Suk Min

2015-01-01

Objectives. The purpose of this cross-sectional single-blind study was to investigate the immediate effects of Kinesiology taping of quadriceps on motor performance after muscle fatigued induction. Design. Randomized controlled cross-sectional design. Subjects. Forty-five subjects participated in this study. Participants were divided into three groups: Kinesiology taping group, placebo taping group, and nontaping group. Methods. Subjects performed short-term exercise for muscle fatigued induction, followed by the application of each intervention. Peak torque test, one-leg single hop test, active joint position sense test, and one-leg static balance test were carried out before and after the intervention. Results. Peak torque and single-leg hopping distance were significantly increased when Kinesiology taping was applied (p < 0.05). But there were no significant effects on active joint position sense and single-leg static balance. Conclusions. We proved that Kinesiology taping is effective in restoring muscle power reduced after muscle fatigued induction. Therefore, we suggest that Kinesiology taping is beneficial for fatigued muscles.

Sit-to-stand movement changes in preschool-aged children with spastic diplegia following one neurodevelopmental treatment session--a pilot study.

PubMed

Yonetsu, Ryo; Iwata, Akira; Surya, John; Unase, Kazunori; Shimizu, Junichi

2015-01-01

This study was designed to provide a better understanding of how a single neurodevelopmental treatment (NDT) session affects sit-to-stand (STS) movements in children with cerebral palsy (CP). Eight children with spastic diplegia and five typically developing children, aged 4-6 years, participated in this study. The CP participants performed STS movements immediately before and after a 40-min NDT session. Using a three-dimensional, four-camera analysis system, angular movements involving the hip, knee and ankle joints of the participants were obtained. During forward tilt of the trunk, the maximum and final angles after the NDT session significantly decreased compared with those before the session (p < 0.05, p < 0.01). Moreover, the final hip flexion after the session also significantly decreased compared with that before the session (p < 0.01). On the other hand, the initial, maximum and final ankle dorsiflexion angles after the session were significantly greater (p < 0.05, p < 0.01 and p < 0.05, respectively) than before the session. These findings suggest that a single NDT session enables children with CP to stand from a seated position without using some atypical movement patterns. Preschool-aged children with spastic diplegia, with limited ability to independently transfer from a sitting position, and dependent on a wheelchair for mobility experience obstacles to enhanced activities of daily life and social participation. A single neurodevelopmental treatment session would enable children with spastic diplegia to perform sit-to-stand movements more efficiently, with selective muscle control. Understanding how a single neurodevelopmental treatment session affects sit-to-stand movements in children with spastic diplegia is invaluable for therapists planning more efficient therapeutic programs and may enable children with spastic diplegia to develop improved mobility.

Design of prospective study of acute coronary syndrome hospitalization after smoking ban in public places in Hyogo prefecture: comparison with Gifu, a prefecture without a public smoking ban.

PubMed

Sato, Yukihito; Minatoguchi, Shinya; Nishigaki, Kazuhiko; Hirata, Ken-ichi; Masuyama, Tohru; Furukawa, Yutaka; Uematsu, Masaaki; Yoshikawa, Junichi; Otsuji, Satoru; Iida, Mami; Fujiwara, Hisayoshi

2014-02-01

Hyogo is the second prefecture, after Kanagawa, to enact a smoking ban in public places in Japan. The effect of this smoking ban on acute coronary syndrome (ACS) has not been evaluated. Changes in the annual number of ACS hospital cases in Hyogo Prefecture, before and after the enactment of the prefectural legislative ban on smoking in public places, are to be compared with those in Gifu Prefecture, where there is no smoking-ban legislation. Consecutive Hyogo residents with ACS, admitted to 33 major hospitals in the Hanshin-Awaji-Kobe district, which covers 56% of the population, during the 12 months before implementation of the legislation (April 2012 through March 2013) and during the same 24 months thereafter (April 2013 through March 2015) will be enrolled. Consecutive patients with ACS, who are Gifu residents, treated at the 20 major hospitals in Gifu Prefecture will be enrolled as geographical controls. The primary endpoint is the change in number of ACS admissions from April 2012 through March 2015, considering the periods before and after the smoking-ban legislation in Hyogo prefecture. Our study has certain strengths: (1) This is the first large Japanese study of ACS registry with smoking-ban legislation. (2) Major hospitals in the Hanshin-Awaji-Kobe district are included. (3) The data will cover 3 years including 1 year before legislation enactment. (4) The data will be compared with those of Gifu Prefecture, where smoking-ban legislation will not be enacted. (5) The very large database makes possible analysis of subgroups based on age and gender. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Surface characterization of current composites after toothbrush abrasion.

PubMed

Takahashi, Rena; Jin, Jian; Nikaido, Toru; Tagami, Junji; Hickel, Reinhard; Kunzelmann, Karl-Heinz

2013-01-01

The present study was designed to evaluate the surface roughness and the gloss of current composites before and after toothbrush abrasion. We assessed forty dimensionally standardized composite specimens (n=8/group) from five composites: two nanohybrids (i. e., IPS Empress Direct Enamel and IPS Empress Direct Dentin), two microhybrids (i. e., Clearfil AP-X and Filtek Z250) and one organically modified ceramics (Admira). All of the specimens were polished with 4000-grid silicon carbide papers. Surface roughness was measured with a profilometer and gloss was measured with a glossmeter before and after powered toothbrush abrasion with a 1:1 slurry (dentifrice/tap water) at 12,000 strokes in a toothbrush simulator. There was a significant increase in the surface roughness and a reduction in gloss after toothbrush abrasion in all of the composites except Clearfil AP-X (p<0.05). Simple regression analysis showed that there was not an association between the surface roughness and the gloss (R(2)=0.191, p<0.001).

Use of the Dye Stain Assay and Ultraviolet Light Test for Assessing Vaginal Insertion of Placebo-filled Applicators Before and After Sex

PubMed Central

Keller, Marla J.; Buckley, Niall; Katzen, Lauren L.; Walsh, Jennifer; Friedland, Barbara; Littlefield, Sarah; Lin, Juan; Xue, Xiaonan; Cornelison, Terri; Herold, Betsy C.; Einstein, Mark H.

2014-01-01

Background Applicator dye staining and ultraviolet (UV) light have been used in trials to measure adherence, but not in the setting of before and after sex gel dosing (BAT-24). This study was designed to determine if semen or pre-sex gel dosing impacts the sensitivity and specificity of a dye stain assay (DSA) for measuring vaginal insertion of placebo-filled applicators with BAT-24 dosing. Methods Healthy monogamous couples received Microlax®-type applicators filled with hydroxyethylcelluose placebo gel. Women were instructed to vaginally insert one dose of gel before and a second dose after sex and to return applicators within 48 hours after sex. Applicators were stained to detect semen followed by UV then DSA and scored by two readers. Positive and negative controls were randomly included in applicator batches. Results Fifteen couples completed the study. Each female returned at least six applicators over a 30-day period. The sensitivity for insertion of post-sex applicators was higher for UV (97%) compared to DSA (90%) and the specificity was similar (≥96%). For pre-sex applicators, the sensitivity and specificity were higher for DSA (100%) compared to UV testing (87% sensitivity, 96% specificity). Among returned post-sex applicators, 95% tested positive by UV compared to 87% by DSA. Agreement between readers was significantly better on the pre-sex applicators for DSA than for UV and for post-sex readings agreement was less than half that for UV, although the results were not statistically significant. Conclusions Applicator tests are feasible for measuring adherence in trials with gel dosing before and after sex. PMID:24220355

Erythropoiesis-stimulating agent use among non-dialysis-dependent CKD patients before and after the trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) using a large US health plan database.

PubMed

Thamer, Mae; Zhang, Yi; Kshirsagar, Onkar; Cotter, Dennis J; Kaufman, James S

2014-11-01

In a landmark study, TREAT (Trial to Reduce Cardiovascular Events With Aranesp Therapy) examined the use of erythropoiesis-stimulating agent (ESA) therapy to treat anemia among patients with chronic kidney disease (CKD) and found no benefit compared to placebo. A retrospective observational design was used to determine the impact of TREAT on clinical practice. A large US health plan database with more than 1.2 million claims for patients with non-dialysis-dependent CKD stages 3 and 4. ESA prescribing 2 years before and after publication of TREAT. Rate of ESA prescribing for ESA-naive and -prevalent cohorts. (1) Monthly ESA prescribing in the 2 years before and after publication of TREAT (ordinary least squares regression), (2) adjusted likelihood of prescribing ESA after TREAT (clustered logistic regression), and (3) probability of receiving ESA therapy based on anemia status (χ(2) test). For patients with CKD stage 3, the proportion prescribed ESA therapy declined from 17% pre-TREAT to 11% post-TREAT (a 38% decline), and for those with CKD stage 4, from 34% to 27% (a 22% decline). Prescribing of ESA therapy was declining even before TREAT, but the decline accelerated in the post-TREAT period (stage 3: change of slope, -0.08 [P<0.001]; stage 4: change of slope, -0.16 [P<0.001]). ESA prescribing declined after TREAT regardless of anemia status; among patients with hemoglobin levels <10g/dL, only 25% of patients with CKD stage 3 and 33% of patients with stage 4 were prescribed ESAs 2 years after TREAT, a notable 50% decline. After adjusting for all covariates, the probability of prescribing ESAs was 35% lower during the 2-year period after versus before publication of TREAT (OR, 0.65; 95% CI, 0.63-0.67). The cumulative effect of adverse safety concerns in the period before TREAT also influenced physician prescribing of ESA therapy and could not be separated from the influence of TREAT. TREAT appears to be a watershed study that was followed by a marked decline in ESA prescribing for patients with CKD. Copyright © 2014 National Kidney Foundation, Inc. All rights reserved.

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

PubMed Central

Grace, Blair S.; McDonald, Stephen P.

2014-01-01

Summary Background and objectives Pregnancy in ESRD is rare and poses substantial risk for mother and baby. This study describes a large series of pregnancies in women undergoing long-term dialysis treatment and reviews maternal and fetal outcomes. Specifically, women who had conceived before and after starting long-term dialysis are compared. Design, setting, participants, & measurement All pregnancies reported to the Australian and New Zealand Dialysis and Transplantation Registry from 2001 to 2011 (n=77), following the introduction of specific parenthood data collection, were analyzed. Results Between 2001 and 2011, there were 77 pregnancies among 73 women. Of these, 53 pregnancies were in women who conceived after long-term dialysis was established and 24 pregnancies occurred before dialysis began. The overall live birth rate (after exclusion of elective terminations) was 73%. In pregnancies reaching 20 weeks gestation, the live birth rate was 82%. Women who conceived before dialysis commenced had significantly higher live birth rates (91% versus 63%; P=0.03), but infants had similar birthweight and gestational age. This difference in live birth rate was primarily due to higher rates of early pregnancy loss before 20 weeks in women who conceived after dialysis was established. In pregnancies that reached 20 weeks or more, the live birth rate was higher in women with conception before dialysis commenced (91% versus 76%; P=0.28). Overall, the median gestational age was 33.8 weeks (interquartile range, 30.6–37.6 weeks) and median birthweight was 1750 g (interquartile range, 1130–2417 g). More than 40% of pregnancies reached >34 weeks’ gestation; prematurity at <28 weeks was 11.4% and 28-day neonatal survival rate was 98%. Conclusions Women with kidney disease who start long-term dialysis after conception have superior live birth rates compared with those already established on dialysis at the time of conception, although these pregnancies remain high risk. PMID:24235285

An evaluation of service use outcomes in a Recovery College.

PubMed

Bourne, Philippa; Meddings, Sara; Whittington, Adrian

2017-12-23

Recovery Colleges offer educational courses about recovery and mental health which are co-produced by mental health professionals and experts by lived experience. Previous evaluations have found positive effects of Recovery Colleges on a range of outcomes including wellbeing, recovery and quality of life. To evaluate service use outcomes for Sussex Recovery College students who use mental health services. The study used a controlled-before-and-after design. It used archival data to analyse service use before and after participants registered with the Recovery College (n = 463). Participants acted as their own control. Students used mental health services less after attending the Recovery College than before. Students who attended the Recovery College showed significant reductions in occupied hospital bed days, admissions, admissions under section and community contacts in the 18 months post compared with the 18 months before registering. Reductions in service use were greater for those who completed a course than those who registered but did not complete a course. These findings suggest that attending Recovery College courses is associated with reduced service use. The reductions equate to non-cashable cost-savings of £1200 per registered student and £1760 for students who completed a course. Further research is needed to investigate causality.

The Effect of Integration of Self-Management Web Platforms on Health Status in Chronic Obstructive Pulmonary Disease Management in Primary Care (e-Vita Study): Interrupted Time Series Design

PubMed Central

Verdijk, Noortje A; Kasteleyn, Marise J; Harmans, Lara M; Talboom, Irvin JSH; Looijmans-van den Akker, Ingrid; van Geloven, Nan; Numans, Mattijs E; Chavannes, Niels H

2017-01-01

Background Worldwide nearly 3 million people die from chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves quality of life for COPD patients and can reduce hospitalization. Self-management of COPD through eHealth is an effective method to improve IDM and clinical outcomes. Objectives The objective of this implementation study was to investigate the effect of 3 chronic obstructive pulmonary disease eHealth programs applied in primary care on health status. The e-Vita COPD study compares different levels of integration of Web-based self-management platforms in IDM in 3 primary care settings. Patient health status is examined using the Clinical COPD Questionnaire (CCQ). Methods The parallel cohort design includes 3 levels of integration in IDM (groups 1, 2, 3) and randomization of 2 levels of personal assistance for patients (group A, high assistance, group B, low assistance). Interrupted time series (ITS) design was used to collect CCQ data at multiple time points before and after intervention, and multilevel linear regression modeling was used to analyze CCQ data. Results Of the 702 invited patients, 215 (30.6%) registered to a platform. Of these, 82 participated in group 1 (high integration IDM), 36 in group 1A (high assistance), and 46 in group 1B (low assistance); 96 participated in group 2 (medium integration IDM), 44 in group 2A (high assistance) and 52 in group 2B (low assistance); also, 37 participated in group 3 (no integration IDM). In the total group, no significant difference was found in change in CCQ trend (P=.334) before (–0.47% per month) and after the intervention (–0.084% per month). Also, no significant difference was found in CCQ changes before versus after the intervention between the groups with high versus low personal assistance. In all subgroups, there was no significant change in the CCQ trend before and after the intervention (group 1A, P=.237; 1B, P=.991; 2A, P=.120; 2B, P=.166; 3, P=.945). Conclusions The e-Vita eHealth-supported COPD programs had no beneficial impact on the health status of COPD patients. Also, no differences were found between the patient groups receiving different levels of personal assistance. Trial Registration Netherlands Trial Registry NTR4098; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4098 (Archived by WebCite at http://www.webcitation.org/6sbM5PayG) PMID:28814380

Improving discharge care: the potential of a new organisational intervention to improve discharge after hospitalisation for acute stroke, a controlled before-after pilot study.

PubMed

Cadilhac, Dominique A; Andrew, Nadine E; Stroil Salama, Enna; Hill, Kelvin; Middleton, Sandy; Horton, Eleanor; Meade, Ian; Kuhle, Sarah; Nelson, Mark R; Grimley, Rohan

2017-08-04

Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes. Clinicians from a 'top-ranked' hospital participated in a focus group to elicit their success factors. Two pilot hospitals then participated in the organisational intervention that was designed with experts and consumers. Hospital clinicians involved in discharge care for stroke and patients admitted with acute stroke or transient ischaemic attack. A four-stage, multifaceted organisational intervention that included data reviews, education and facilitated action planning. Three discharge processes collected in Queensland hospitals within the Australian Stroke Clinical Registry were used to select study hospitals: (1) discharge care plan; (2) antihypertensive medication prescription and (3) antiplatelet medication prescription (ischaemic events only). Primary measure: composite outcome. Secondary measures: individual adherence changes for each discharge process; sensitivity analyses. The performance outcomes were compared 3 months before the intervention (preintervention), 3 months postintervention and at 12 months (sustainability). Data from 1289 episodes of care from the two pilot hospitals were analysed. Improvements from preintervention adherence were: antiplatelet therapy (88%vs96%, p=0.02); antihypertensive prescription (61%vs79%, p<0.001); discharge planning (72%vs94%, p<0.001); composite outcome (73%vs89%, p<0.001). There was an insignificant decay effect over the 12-month sustainability period (composite outcome: 89% postintervention vs 85% sustainability period, p=0.08). Discharge care in hospitals may be effectively improved and sustained through a staged and peer-informed, organisational intervention. The intervention warrants further application and trialling on a larger scale. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Toothbrushing before or after an acidic challenge to minimize tooth wear? An in situ/ex vivo study.

PubMed

Wiegand, Annette; Egert, Sebastian; Attin, Thomas

2008-02-01

To evaluate whether patients should be advised to perform toothbrushing before or after an acidic challenge to minimize enamel and dentin wear by brushing abrasion. The study was a two-period crossover design (A and B, each 14 days) in which three enamel and dentin specimens were fixed in intraoral appliances of 10 volunteers. The following regimens were performed three times a day with at least 4 hours in between: A: 20-second brushing treatment in an automatic brushing machine, 5 minutes intraoral exposure of the specimens, extraoral erosion of enamel and dentin specimens for 40 seconds or B: Extraoral erosion for 40 seconds, 5 minutes intraoral exposure of the specimens, 20-second brushing treatment in an automatic brushing machine. Enamel and dentin loss at the end of each 14-day regimen was assessed by profilometry and statistically analyzed by t-test. For all volunteers, mean enamel and dentin wear was significantly lower when brushing treatment was performed before erosion (A: enamel: 2.3 +/- 1.0 microm, dentin: 4.1 +/- 1.6 microm) than when brushing was applied after erosion (B: enamel: 6.4 +/- 3.0 microm, dentin: 15.3 +/- 6.8 microm). It was concluded that patients awaiting an erosive attack should perform toothbrushing prior to rather than after an acidic challenge to minimize enamel and dentin wear.

Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center.

PubMed

Tsuburaya, Akira; Soma, Takahiro; Yoshikawa, Takaki; Cho, Haruhiko; Miki, Tamotsu; Uramatsu, Masashi; Fujisawa, Yoshikazu; Youngson, George; Yule, Steven

2016-12-01

Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the "non-technical skills for surgeons" (NOTSS) rating system in a major Japanese cancer center. Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and "observational teamwork assessment for surgery" (OTAS) rating systems, before and after their education. Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees' education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the "teamwork and communication" and "leadership" categories. These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

Enhancing Emotion Recognition in Children with Autism Spectrum Conditions: An Intervention Using Animated Vehicles with Real Emotional Faces

ERIC Educational Resources Information Center

Golan, Ofer; Ashwin, Emma; Granader, Yael; McClintock, Suzy; Day, Kate; Leggett, Victoria; Baron-Cohen, Simon

2010-01-01

This study evaluated "The Transporters", an animated series designed to enhance emotion comprehension in children with autism spectrum conditions (ASC). n = 20 children with ASC (aged 4-7) watched "The Transporters" everyday for 4 weeks. Participants were tested before and after intervention on emotional vocabulary and emotion recognition at three…

Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

ERIC Educational Resources Information Center

Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

2012-01-01

Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

Assessing the Effects of a "Personal Effectiveness" Training on Psychological Capital, Assertiveness and Self-Awareness Using Self-Other Agreement

ERIC Educational Resources Information Center

Demerouti, Evangelia; van Eeuwijk, Erik; Snelder, Margriet; Wild, Ulrike

2011-01-01

Purpose: This study seeks to examine the effects of a "personal effectiveness" training on both assertiveness and Psychological Capital (PsyCap) that were monitored before and after the training. Design/methodology/approach: In addition to self-ratings, other-ratings were assembled to explore two ways in which they can contribute to the…

An Examination of Important Competencies Necessary for Vocational Agriculture in Selected Senior Secondary Students in Ijebu North Local Government Area, Nigeria

ERIC Educational Resources Information Center

Onanuga, Peter Abayomi

2015-01-01

The study analyses the relationship existing between some specified competencies important to vocational agriculture and preparation for occupation between male and female students in senior secondary schools in Ijebu-North Local Government Area, Nigeria. It adopted the classical design for change experiment (i.e. before and after measures) with…

The Effects of an Energy-Environment Simulator Upon Selected Energy-Related Attitudes of Science Students and In-Service Teachers.

ERIC Educational Resources Information Center

Dunlop, David L.

This document is the outcome of a study designed to investigate the energy-related attitudes of several different groups of science students and science teachers both before and after working with an energy-environment simulator for approximately an hour. During the interaction with the simulator, the participants decided upon the variables they…

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

ERIC Educational Resources Information Center

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Innovative tools for quality assessment: integrated quality criteria for review of multiple study designs (ICROMS).

PubMed

Zingg, W; Castro-Sanchez, E; Secci, F V; Edwards, R; Drumright, L N; Sevdalis, N; Holmes, A H

2016-04-01

With the aim to facilitate a more comprehensive review process in public health including patient safety, we established a tool that we have termed ICROMS (Integrated quality Criteria for the Review Of Multiple Study designs), which unifies, integrates and refines current quality criteria for a large range of study designs including qualitative research. Review, pilot testing and expert consensus. The tool is the result of an iterative four phase process over two years: 1) gathering of established criteria for assessing controlled, non-controlled and qualitative study designs; 2) pilot testing of a first version in two systematic reviews on behavioural change in infection prevention and control and in antibiotic prescribing; 3) further refinement and adding of additional study designs in the context of the European Centre for Disease Prevention and Control funded project 'Systematic review and evidence-based guidance on organisation of hospital infection control programmes' (SIGHT); 4) scrutiny by the pan-European expert panel of the SIGHT project, which had the objective of ensuring robustness of the systematic review. ICROMS includes established quality criteria for randomised studies, controlled before-and-after studies and interrupted time series, and incorporates criteria for non-controlled before-and-after studies, cohort studies and qualitative studies. The tool consists of two parts: 1) a list of quality criteria specific for each study design, as well as criteria applicable across all study designs by using a scoring system; 2) a 'decision matrix', which specifies the robustness of the study by identifying minimum requirements according to the study type and the relevance of the study to the review question. The decision matrix directly determines inclusion or exclusion of a study in the review. ICROMS was applied to a series of systematic reviews to test its feasibility and usefulness in the appraisal of multiple study designs. The tool was applicable across a wide range of study designs and outcome measures. ICROMS is a comprehensive yet feasible appraisal of a large range of study designs to be included in systematic reviews addressing behaviour change studies in patient safety and public health. The tool is sufficiently flexible to be applied to a variety of other domains in health-related research. Beyond its application to systematic reviews, we envisage that ICROMS can have a positive effect on researchers to be more rigorous in their study design and more diligent in their reporting. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effect of endoskeleton stent graft design on pulse wave velocity in patients undergoing endovascular repair of the aortic arch.

PubMed

Hori, Daijiro; Akiyoshi, Kei; Yuri, Koichi; Nishi, Satoshi; Nonaka, Takao; Yamamoto, Takahiro; Imamura, Yusuke; Matsumoto, Harunobu; Kimura, Naoyuki; Yamaguchi, Atsushi

2017-09-01

Pulse wave velocity (PWV), which measures vascular stiffness, is a powerful predictor of cardiovascular event. Treatment of aneurysms with endovascular prosthesis has been reported to increase PWV. The purpose of this study was to evaluate whether an endoskeleton stent graft design has less effect on PWV than the exoskeleton stent graft design. Between July 2008 and September 2016, 74 patients underwent endovascular treatment of aortic arch aneurysm in our institution. PWV before and after surgery were compared between those who underwent treatment with Najuta, an endoskeleton stent graft (n = 51), and those treated with other commercially available exoskeleton stent grafts (n = 23). Preoperative PWV (endoskeleton: 2004 ± 379.2 cm/s vs. exoskeleton: 2083 ± 454.5 cm/s, p = 0.47) was similar between the two groups. Factors that were associated with preoperative PWV were age (r = 0.37, 95% CI 0.15-0.56, p = 0.002) and mean arterial pressure (r = 0.53, 95% CI 0.34-0.68, p < 0.001). There was a significant increase in PWV in patients treated by exoskeleton stent grafts (before: 2083 ± 454.5 cm/s vs. after: 2305 ± 479.7 cm/s, p = 0.023) while endoskeleton stent graft showed no change in PWV (before: 2003 ± 379.2 vs. after: 2010 ± 521.1, p = 0.56). In a multivariate analysis, mean arterial pressure (coef 17.5, 95% CI 6.48-28.59, p = 0.002) and exoskeleton stent graft (coef 359.4, 95% CI 89.36-629.43, p = 0.010) were independently associated with PWV after surgery. Physiological changes after endovascular treatment should be considered including effect on vascular stiffness. Endoskeleton stent graft may provide aneurysm repair with minimum effect in PWV after surgery.

The Role of Nursing Home Admission and Dementia Status on Care for Diabetes Mellitus

PubMed Central

Quinn, Charlene C.; Gruber-Baldini, Ann L.; Port, Cynthia L.; May, Conrad; Stuart, Bruce; Hebel, J. Richard; Zimmerman, Sheryl; Burton, Lynda; Zuckerman, Ilene H.; Fahlman, Cheryl; Magaziner, Jay

2010-01-01

Objectives To study the role of nursing home (NH) admission and dementia status on the provision of five procedures related to diabetes mellitus. Design Retrospective cohort study using data from a large prospective study in which an expert panel determined the prevalence of dementia. Setting Fifty-nine Maryland NHs. Participants Three hundred ninety-nine new admission NH patients with diabetes mellitus. Measurements Medicare administrative claims records matched to the NH medical record data were used to measure procedures related to diabetes mellitus received in the year before NH admission and up to a year after admission (and before discharge). Procedures included glycosylated hemoglobin, fasting blood glucose, dilated eye examination, lipid profile, and serum creatinine. Results For all but dilated eye examinations, higher rates of procedures related to diabetes mellitus were seen in the year after NH admission than in the year before. Residents without dementia received more procedures than those with dementia, although this was somewhat attenuated after controlling for demographic, health, and healthcare utilization variables. Persons without dementia experience greater increases in procedure rates after admission than those with dementia. Conclusion The structured environment of care provided by the NH may positively affect monitoring procedures provided to elderly persons with diabetes mellitus, especially those without dementia. Medical decisions related to the risks and benefits of intensive treatment for diabetes mellitus to patients of varying frailty and expected longevity may lead to lower rates of procedures for residents with dementia. PMID:19682125

Comparative assessment of marginal accuracy of grade II titanium and Ni–Cr alloy before and after ceramic firing: An in vitro study

PubMed Central

Patil, Abhijit; Singh, Kishan; Sahoo, Sukant; Suvarna, Suraj; Kumar, Prince; Singh, Anupam

2013-01-01

Objective: The aims of the study are to assess the marginal accuracy of base metal and titanium alloy casting and to evaluate the effect of repeated ceramic firing on the marginal accuracy of base metal and titanium alloy castings. Materials and Methods: Twenty metal copings were fabricated with each casting material. Specimens were divided into 4 groups of 10 each representing base metal alloys castings without (Group A) and with metal shoulder margin (Group B), titanium castings without (Group C) and with metal shoulder margin (Group D). The measurement of fit of the metal copings was carried out before the ceramic firing at four different points and the same was followed after porcelain build-up. Results: Significant difference was found when Ni–Cr alloy samples were compared with Grade II titanium samples both before and after ceramic firings. The titanium castings with metal shoulder margin showed highest microgap among all the materials tested. Conclusions: Based on the results that were found and within the limitations of the study design, it can be concluded that there is marginal discrepancy in the copings made from Ni–Cr and Grade II titanium. This marginal discrepancy increased after ceramic firing cycles for both Ni–Cr and Grade II titanium. The comparative statistical analysis for copings with metal-collar showed maximum discrepancy for Group D. The comparative statistical analysis for copings without metal-collar showed maximum discrepancy for Group C. PMID:24926205

The Effects of Ramadan Intermittent Fasting (RIF) on Spirometric Data of Stable COPD Patients: A Pilot Study.

PubMed

Zouari, Hajer; Latiri, Imed; Mahjoub, Mohamed; Boussarsar, Mohamed; Benzarti, Mohamed; Abdelghani, Ahmed; Ben Saad, Helmi

2018-03-01

No previous study has raised the effects of RIF on lung function data of chronic obstructive pulmonary disease (COPD) patients. The objective of the present study was to assess the effects of RIF on spirometric data measured in male patients with a stable COPD. Sixteen patients with stable COPD (mean ± SD of age: 64 ± 7 years) who fasted during Ramadan volunteered to the study. Three sessions (Before-R, End-R, and After-R) were selected for spirometry tests that were consistently performed 2.5-4.5 hr before fasting break. Assessment sessions comprised: forced vital capacity (FVC), 1st s forced expiratory volume (FEV 1 ), FEV 1 /FVC, peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEFx%). A reversibility test was performed only during the Before-Ramadan session. Spirometric data were expressed in percentages of local reference values. Findings were analyzed by applying repeated measures analysis of variance. The mean ± SD of the postbronchodilator FEV 1 /FVC ratio and the FEV 1 were, respectively, 0.52 ± 0.14 and 48 ± 19%. The mean ± SD of FEV 1 (Before-R: 47 ± 19, End-R: 45 ± 18, After-R: 44 ± 19%), FVC (Before-R: 73 ± 18, End-R: 71 ± 16, After-R: 69 ± 17%), FEV 1 /FVC (Before-R: 67 ± 16, End-R: 66 ± 16, After-R: 65 ± 16%), PEF (Before-R: 46 ± 19, End-R: 47 ± 22, After-R: 45 ± 21%), MMEF (Before-R: 19 ± 10, End-R: 18 ± 8, After-R: 18 ± 9%), FEF 25% (Before-R: 16 ± 6, End-R: 16 ± 5, After-R: 15 ± 5%), FEF 50% (Before-R: 21 ± 14, End-R: 20 ± 12, After-R: 20 ± 12%) and FEF 75% (Before-R: 27 ± 19, End-R: 27 ± 19, After-R: 27 ± 19%) were not significantly influenced by RIF. RIF did not bring about any significant changes in the spirometric data of stable COPD male patients fasting the 2016 holy month of Ramadan.

Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris – a pilot study

PubMed Central

Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

2011-01-01

Introduction The study was designed to clarify the role of 123I-β-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic images were acquired at 30 min and at 4 h after 123I-BMIPP injection to determine early and delayed BMIPP uptake, respectively. The heart-to-mediastinum (H/M) ratio and the washout rate (WR) were calculated from the planar images. All patients underwent scintigraphy one day before PCI and again 1 month after successful PCI. Results No significant differences in the early or delayed H/M ratios were observed between the patients and the controls before PCI (early: 2.70 ±0.36 vs. 2.73 ±0.57; delayed: 2.26 ±0.33 vs. 2.40 ±0.43; p > 0.2 for both). The early and delayed H/M ratios remained unchanged with the comparison with before PCI (early: 2.72 ±0.27, delayed: 2.23 ±0.22; p > 0.2 for both). The global WR before PCI was significantly higher in the patients than in the control group (36.7 ±9.3%, vs. 28.1 ±8.2%, p = 0.02). However, the WR after PCI did not significantly differ between the patients and the controls (34.3 ±7.8% vs. 28.1 ±8.2%, p = 0.1). Conclusions These data may suggest that the WR of 123I-BMIPP determined from the planar images enhances the presence of myocardial ischaemia. PMID:22295024

Student perceptions towards interprofessional education: Findings from a longitudinal study based in a Middle Eastern university.

PubMed

Zeeni, Nadine; Zeenny, Rony; Hasbini-Danawi, Tala; Asmar, Nadia; Bassil, Maya; Nasser, Soumana; Milane, Aline; Farra, Anna; Habre, Maha; Khazen, Georges; Hoffart, Nancy

2016-01-01

The Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students' perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students' perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.

Scapular-Muscle Performance: Two Training Programs in Adolescent Swimmers

PubMed Central

Van de Velde, Annemie; De Mey, Kristof; Maenhout, Annelies; Calders, Patrick; Cools, Ann M.

2011-01-01

Abstract Context: Swimming requires well-balanced scapular-muscle performance. An additional strength-training program for the shoulders is pursued by swimmers, but whether these muscle-training programs need to be generic or specific for endurance or strength is unknown. Objective: To evaluate isokinetic scapular-muscle performance in a population of adolescent swimmers and to compare the results of training programs designed for strength or muscle endurance. Design: Controlled laboratory study. Setting: University human research laboratory. Patients or Other Participants: Eighteen adolescent swimmers. Intervention(s): Each participant pursued a 12-week scapular-training program designed to improve either muscle strength or muscle endurance. Main Outcome Measure(s): Bilateral peak force, fatigue index, and protraction/retraction strength ratios before and after the scapular-training program. Results: Scapular protraction/retraction ratios were slightly higher than 1 (dominant side  =  1.08, nondominant side  =  1.25, P  =  .006). Side-to-side differences in retraction strength were apparent both before and after the training program (P  =  .03 and P  = .05, respectively). After the training program, maximal protraction (P < .05) and retraction (P < .01) strength improved on the nondominant side. Peak force and fatigue index were not different between the training groups. The fatigue indexes for protraction on both sides (P < .05) and retraction on the nondominant side (P  =  .009) were higher after the training program. Conclusions: We describe the scapular-muscle characteristics of a group of adolescent swimmers. Both muscle-strength and muscle-endurance programs improved absolute muscle strength. Neither of the strength programs had a positive effect on scapular-muscle endurance. Our results may be valuable for coaches and physiotherapists when they are designing exercise programs for swimmers. PMID:21391801

A Test Study to Display Buried Anti-Tank Landmines with GPR and Research Soil Characteristics with CRS

NASA Astrophysics Data System (ADS)

Kadioglu, Selma; Kagan Kadioglu, Yusuf

2014-05-01

An anti-tank mine (AT mine) is a type of land mine designed to damage or destroy vehicles including tanks and armored fighting vehicles. Anti-tank mines typically have a much larger explosive charge, and a fuze designed only to be triggered by vehicles or, in some cases, tampering with the mine. There are a lot of AT mine types. In our test study, MK4 and MK5 AT mine types has been used. The Mk 5 was a cylindrical metal cased U.K. anti-tank blast mine that entered service in 1943, during the Second World War. General Specifications of them are 203 mm diameter, 127 mm height, 4.4-5.7 kg weight, 2.05-3.75 kg of TNT explosive content and 350 lbs operating pressure respectively. The aims of the test study were to image anti-tank landmine with GPR method and to analyse the soil characteristics before the mines made explode and after made be exploded and determine changing of the soil characteristics. We realized data measurement on the real 6 unexploded anti-tank landmine buried approximately 15 cm in depth. The mines spaced 3 m were buried in two lines. Space between lines was 1.5 m. We gathered data on the profiles, approximately 7 m, with a Ramac CUII system and 800 MHz shielded antenna. We collected soil samples on the mines, near and around the mines, on the area in village. We collected soil samples before exploding and after exploding mines. We imaged anti-tank landmines on the depth slices of the GPR data and in their interactive transparent 3D subsets successfully. We used polarized microscope and confocal Raman spectroscopy (CRS) to identify soil characteristic before and after exploitation. The results presented that GPR method and its 3D imaging were successful to determine AT mines, and there was no important changing on mineralogical and petrographical characterization of the soil before and after exploding processing. This project has been supported by Ankara University under grant no 11B6055002. The study is a contribution to the EU funded COST action TU1208, "Civil Engineering Applications of Ground penetrating Radar".

Yoga therapy for promoting emotional sensitivity in University students.

PubMed

Ganpat, Tikhe Sham; Dash, Sasmita; Ramarao, Nagendra Hongasandra

2014-01-01

Students need emotional intelligence (EI) for their better academic excellence. There are three important psychological dimensions of EI: Emotional sensitivity (ES), emotional maturity (EM) and emotional competency (EC), which motivate students to recognize truthfully, interpret honestly and handle tactfully the dynamics of their behavioral pattern. The study was designed to assess ES in the students undergoing yoga therapy program in the form of yoga instructor's course (YIC) module. One hundred and eighty four YIC students with 25.77 ± 4.85 years of mean age participated in this study of 21 days duration (a single group pre-post design). The ES data was collected before (pre) and after (post) YIC module using Emotional Quotient test developed by Dr Dalip Singh and Dr N K Chadha. Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used for analyzing the data with the help of SPSS 16. The data analysis showed 3.63% significant increase (P < 0.01) in ES. The present study suggests that YIC module can result in improvement of ES among university students, thus paving the way for their academic success. Additional well-designed studies are needed before a strong recommendation can be made.

Baseline performance of solar collectors for NASA Langley solar building test facility

NASA Technical Reports Server (NTRS)

Knoll, R. H.; Johnson, S. M.

1977-01-01

The solar collector field contains seven collector designs. Before operation in the field, the experimental performances (thermal efficiencies) of the seven collector designs were measured in an indoor solar simulator. The resulting data provided a baseline for later comparison with actual field test data. The simulator test results are presented for the collectors as received, and after several weeks of outdoor exposure with no coolant (dry operation). Six of the seven collector designs tested showed substantial reductions in thermal efficiency after dry operation.

A systematic review and meta-analysis of the effectiveness of food safety education interventions for consumers in developed countries.

PubMed

Young, Ian; Waddell, Lisa; Harding, Shannon; Greig, Judy; Mascarenhas, Mariola; Sivaramalingam, Bhairavi; Pham, Mai T; Papadopoulos, Andrew

2015-08-26

Foodborne illness has a large public health and economic burden worldwide, and many cases are associated with food handled and prepared at home. Educational interventions are necessary to improve consumer food safety practices and reduce the associated burden of foodborne illness. We conducted a systematic review and targeted meta-analyses to investigate the effectiveness of food safety education interventions for consumers. Relevant articles were identified through a preliminary scoping review that included: a comprehensive search in 10 bibliographic databases with verification; relevance screening of abstracts; and extraction of article characteristics. Experimental studies conducted in developed countries were prioritized for risk-of-bias assessment and data extraction. Meta-analysis was conducted on data subgroups stratified by key study design-intervention-population-outcome categories and subgroups were assessed for their quality of evidence. Meta-regression was conducted where appropriate to identify possible sources of between-trial heterogeneity. We identified 79 relevant studies: 17 randomized controlled trials (RCTs); 12 non-randomized controlled trials (NRTs); and 50 uncontrolled before-and-after studies. Several studies did not provide sufficient details on key design features (e.g. blinding), with some high risk-of-bias ratings due to incomplete outcome data and selective reporting. We identified a moderate to high confidence in results from two large RCTs investigating community- and school-based educational training interventions on behaviour outcomes in children and youth (median standardized mean difference [SMD] = 0.20, range: 0.05, 0.35); in two small RCTs evaluating video and written instructional messaging on behavioural intentions in adults (SMD = 0.36, 95% confidence interval [CI]: 0.02, 0.69); and in two NRT studies for university-based education on attitudes of students and staff (SMD = 0.26, 95% CI: 0.10, 0.43). Uncontrolled before-and-after study outcomes were very heterogeneous and we have little confidence that the meta-analysis results reflect the true effect. Some variation in outcomes was explained in meta-regression models, including a dose effect for behaviour outcomes in RCTs. In controlled trials, food safety education interventions showed significant effects in some contexts; however, many outcomes were very heterogeneous and do not provide a strong quality of evidence to support decision-making. Future research in this area is needed using more robust experimental designs to build on interventions shown to be effective in uncontrolled before-and-after studies.

Evaluation of the ThinkFirst Canada, Smart Hockey, brain and spinal cord injury prevention video

PubMed Central

Cook, D; Cusimano, M; Tator, C; Chipman, M; Macarthur, C

2003-01-01

Objective: The ThinkFirst Canada Smart Hockey program is an educational injury prevention video that teaches the mechanisms, consequences, and prevention of brain and spinal cord injury in ice hockey. This study evaluates knowledge transfer and behavioural outcomes in 11–12 year old hockey players who viewed the video. Design: Randomized controlled design. Setting: Greater Toronto Minor Hockey League, Toronto Ontario. Subjects: Minor, competitive 11–12 year old male ice hockey players and hockey team coaches. Interventions: The Smart Hockey video was shown to experimental teams at mid-season. An interview was conducted with coaches to understand reasons to accept or refuse the injury prevention video. Main outcome measures: A test of concussion knowledge was administered before, immediately after, and three months after exposure to the video. The incidence of aggressive penalties was measured before and after viewing the video. Results: The number of causes and mechanisms of concussion named by players increased from 1.13 to 2.47 and from 0.67 to 1.22 respectively. This effect was maintained at three months. There was no significant change in control teams. There was no significant change in total penalties after video exposure; however, specific body checking related penalties were significantly reduced in the experimental group. Conclusion: This study showed some improvements in knowledge and behaviours after a single viewing of a video; however, these findings require confirmation with a larger sample to understand the sociobehavioural aspects of sport that determine the effectiveness and acceptance of injury prevention interventions. PMID:14693901

40 CFR 60.32e - Designated facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... individual HMIWI: (1) For which construction was commenced on or before June 20, 1996, or for which modification was commenced on or before March 16, 1998. (2) For which construction was commenced after June 20... an exemption claim; and (2) Keeps records on a calendar quarter basis of the periods of time when...

40 CFR 60.32e - Designated facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... individual HMIWI: (1) For which construction was commenced on or before June 20, 1996, or for which modification was commenced on or before March 16, 1998. (2) For which construction was commenced after June 20... an exemption claim; and (2) Keeps records on a calendar quarter basis of the periods of time when...

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate.

PubMed

Shaffer, Amber D; Ford, Matthew D; Choi, Sukgi S; Jabbour, Noel

2017-09-01

Objective Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children's hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age. Data from 152 patients with isolated cleft palate and 166 patients with cleft lip and palate were analyzed using Wilcoxon rank-sum, χ 2 , and Fisher exact test and logistic regression. Results Most patients (242, 76.1%) received tubes before palatoplasty. Hearing loss after tubes, but not before, was associated with speech/language delays at 24 months ( P = .005) and language delays ( P = .048) and speech sound production disorders (SSPDs, P = .040) at 5 years. Receiving tubes before palatoplasty was associated with failed newborn hearing screen ( P = .001) and younger age at first posttubes type B tympanogram with normal canal volume ( P = .015). Hearing loss after tubes ( P = .021), language delays ( P = .025), SSPDs ( P = .003), and velopharyngeal insufficiency ( P = .032) at 5 years and speech surgery ( P = .022) were associated with more tubes. Conclusion Continued middle ear disease, reflected by hearing loss and multiple tubes, may impair speech and language development. Inserting tubes before palatoplasty did not mitigate these impairments better than later tube placement.

Using a data entry clerk to improve data quality in primary care electronic medical records: a pilot study.

PubMed

Greiver, Michelle; Barnsley, Jan; Aliarzadeh, Babak; Krueger, Paul; Moineddin, Rahim; Butt, Debra A; Dolabchian, Edita; Jaakkimainen, Liisa; Keshavjee, Karim; White, David; Kaplan, David

2011-01-01

The quality of electronic medical record (EMR) data is known to be problematic; research on improving these data is needed. The primary objective was to explore the impact of using a data entry clerk to improve data quality in primary care EMRs. The secondary objective was to evaluate the feasibility of implementing this intervention. We used a before and after design for this pilot study. The participants were 13 community based family physicians and four allied health professionals in Toronto, Canada. Using queries programmed by a data manager, a data clerk was tasked with re-entering EMR information as coded or structured data for chronic obstructive pulmonary disease (COPD), smoking, specialist designations and interprofessional encounter headers. We measured data quality before and three to six months after the intervention. We evaluated feasibility by measuring acceptability to clinicians and workload for the clerk. After the intervention, coded COPD entries increased by 38% (P = 0.0001, 95% CI 23 to 51%); identifiable data on smoking categories increased by 27% (P = 0.0001, 95% CI 26 to 29%); referrals with specialist designations increased by 20% (P = 0.0001, 95% CI 16 to 22%); and identifiable interprofessional headers increased by 10% (P = 0.45, 95 CI -3 to 23%). Overall, the intervention was rated as being at least moderately useful and moderately usable. The data entry clerk spent 127 hours restructuring data for 11 729 patients. Utilising a data manager for queries and a data clerk to re-enter data led to improvements in EMR data quality. Clinicians found this approach to be acceptable.

[Direct health care costs in patients with type 2 diabetes mellitus six months after starting insulin treatment in Spain: the INSTIGATE study].

PubMed

Costi, María; Smith, Helen; Reviriego, Jesús; Castell, Conxa; Goday, Alberto; Dilla, Tatiana

2011-01-01

The INSTIGATE study was designed to assess direct health care costs incurred by patients with type 2 diabetes mellitus (T2DM) who start insulin therapy in Spain. It was a multicenter, observational, non-interventional, prospective study. Direct costs per patient in standard clinical practice were assessed for 6 months before and after the start of insulin therapy from the perspective of the Spanish health care system perspective. A total of 188 patients (42.6% women) with a mean age of 65.3 years, a mean body mass index of 29.7 kg/m(2), and a mean disease duration of 10.7 years were assessed. Before insulin therapy was started, mean (standard deviation) values of various clinical parameters were: hemoglobin A(1c) (%), 9.22 (1.58); fasting plasma glucose (mmol/L), 12.03 (3.62); and total cholesterol (mmol/L), 4.90 (1.1). These values decreased after insulin therapy was started. Mean total direct health care costs per patient 6 months before and after insulin start were €639 and €1,110, respectively. Mean total costs 6 months after insulin was started included costs of hospitalization (30.5%, €339), insulin (16.2%, €180), primary care (14.3%, €159), blood glucose monitoring (13.8%, €153), specialized care (13.3%, €148), oral antidiabetics (7.8%, €87), and other diabetes-related treatments (3.9%, €43). The clinical outcomes of T2DM patients improved after insulin therapy was started. This improvement was associated to increases in resource utilization and direct health care costs in the first 6 months of insulin therapy. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

Warming up with an ice vest: core body temperature before and after cross-country racing.

PubMed

Hunter, Iain; Hopkins, J Ty; Casa, Douglas J

2006-01-01

Athletes running in a hot, humid environment may have an increased risk of heat illness. In the 2004 Olympic Games, American and Australian athletes were provided with ice vests designed to cool their bodies before performance. The vest appeared to be effective in keeping body temperatures down and improving the performance of the marathoners. However, body temperatures have not been reported when the vest was used before an actual competition. To determine if wearing the Nike Ice-Vest decreased core temperature (Tc) before and during athletic performance in warm (26 degrees C to 27 degrees C), humid (relative humidity = 50% to 75%) conditions. A 2 x 3 mixed-model design was used to compare groups (ice vest, no ice vest) across changes in temperature from baseline (10 minutes and 1 minute before the race and immediately after the race). 2005 Big Wave Invitational 4-km race in Hawaii and 2005 Great American 5-km race in North Carolina. Eighteen women from a National Collegiate Athletic Association Division I cross-country team who participated in either the Big Wave Invitational or the Great American Race. Four hours before the start of the race, the athletes ingested radiotelemetry temperature sensors. One hour before the start of the race, Tc was recorded, and half of the athletes donned a Nike Ice-Vest, which was removed immediately before the race. Additional Tc readings were taken at 10 minutes and 1 minute before the start of the race and immediately after the race. Ten minutes before the start of the race, Tc was elevated by 0.84 degrees C +/- 0.37 degrees C in the no-vest group, compared with 0.29 degrees C +/- 0.56 degrees C in the ice-vest group ( P < .01). This difference in Tc persisted at 1 minute before the start. Immediately after the finish, the increase in Tc averaged 2.75 degrees C +/- 0.62 degrees C in the no-vest group and 2.12 degrees C +/- 0.62 degrees C in the ice-vest group ( P < .01). Wearing an ice vest before cross-country performance in warm, humid conditions allowed athletes to start and finish the competition with a lower Tc than did those who did not wear a vest.

Effect of Honey and Royal Jelly against Cisplatin-Induced Nephrotoxicity in Patients with Cancer.

PubMed

Osama, Hasnaa; Abdullah, Aya; Gamal, Bassma; Emad, Dina; Sayed, Doha; Hussein, Eman; Mahfouz, Eman; Tharwat, Joy; Sayed, Sally; Medhat, Shrouk; Bahaa, Treza; Abdelrahim, Mohamed E A

2017-07-01

Cisplatin constitutes one of the most potent antineoplastic drugs; however, nephrotoxicity limited its eligibility for optimal clinical use. This study was designed to evaluate the role of honey and royal jelly with antioxidant properties in the protection of cisplatin-induced acute kidney injury in patients with cancer. Patients with cancer assigned for cisplatin chemotherapy were randomly divided into bee honey and royal jelly groups pretreated before the initiation and during cisplatin chemotherapeutic regimen and control group on cisplatin only. Serum creatinine and urea levels were measured before and after the chemotherapeutic cycle and over 2 cycles. Patients on crude bee honey and royal jelly capsules showed lower serum levels of renal injury products (creatinine and urea) compared to those in the control group. The changes in kidney parameters were significantly (p < 0.05) lower when compared within the bee honey group before and after cisplatin treatment. Royal jelly was found to be effective; however, the difference in creatinine and urea levels before and after chemotherapy was not statistically significant. The use of bee honey and royal jelly as natural compounds is effective in reducing cisplatin nephrotoxicity and may offer a promising chance for clinically meaningful prevention. This study has potentially important implications for the treatment of cisplatin kidney side effects and is considered to be the first to investigate this effect of honey and royal jelly in human subjects. However, due to its small sample size, we recommend further investigation using a larger sample size.

Baby-Friendly Practices Minimize Newborn Infants Weight Loss.

PubMed

Procaccini, Diane; Curley, Ann L Cupp; Goldman, Martha

2018-04-01

It is accepted that newborns lose weight in the first few days of life. Baby-Friendly practices that support breastfeeding may affect newborn weight loss. The objective of this study were: 1) To determine whether Baby-Friendly practices are associated with term newborn weight loss day 0-2 in three feeding categories (exclusively breastfed, mixed formula fed and breastfed, and formula fed). 2) To determine whether Baby-Friendly practices increase exclusive breast feeding rates in different ethnic populations. This was a retrospective case-control study. Term newborn birth weight, neonatal weights days 0-2, feeding type, type of birth, and demographic information were collected for 1,000 births for the year before Baby-Friendly designation (2010) and 1,000 in 2013 (after designation). Ultimately 683 in the first group and 518 in the second met the inclusion criteria. Mean weight loss decreased day 0-2 for infants in all feeding types after the initiation of Baby-Friendly practices. There was a statistically significant effect of Baby-Friendly designation on weight loss for day 0-2 in exclusively breastfed infants (p < 0.01) after controlling for birth weight. Exclusive breast feeding increased in all ethnic groups after Baby-Friendly practices were put in place. There was a decrease in mean weight loss day 0-2 regardless of feeding type after Baby-Friendly designation. Exclusive breast feeding increased in the presence of Baby-Friendly practices.

Experimental Study of Flow Through Carotid Aneurysms

NASA Astrophysics Data System (ADS)

Masoomi, Faezeh; Mejia-Alvarez, Ricardo

2017-11-01

There is evidence that traditional endovascular techniques like coiling are not effective for treatment of wide-neck cerebral aneurysms. Flow Diverter Stents (FDS) have emerged as promising devices for treating complex aneurysms since they enable treatment of aneurysms that were considered untreatable before. Recent studies suggest a number of associated risks with FDS, including in-stent thrombosis, perianeurysmal edema, delayed hemorrhage, and perforator occlusions. Chong et al. simulated hemodynamic behavior using patient-specific data. From their study, it is possible to infer that the standard deviation of energy loss could be a good predictor for intervention success. The aim of this study is to investigate the flow in models of cerebral aneurysms before and after FDS insertion using PIV. These models will be based on actual clinical studies and will be fabricated with advanced additive manufacturing techniques. These data will then be used to explore flow parameters that could inform the likelihood of post-intervention aneurysm rupture, and help determine FDS designs that better suit any particular patient before its procedure.

The Effects of Ramadan Fasting on the Spirometric Data of Healthy Adult Males.

PubMed

Latiri, Imed; Sandid, Siwar; Fennani, Mohamed Amine; Hadrich, Mohamed; Masmoudi, Tasnim; Maatoug, Chiraz; Zammit-Chatti, Makrem; Chamari, Karim; Ben Saad, Helmi

2017-07-01

The few studies carried out on the effects of Ramadan fasting (RF) on spirometric values present contradictory conclusions. This study aimed at assessing whether RF affects healthy adults' spirometric values. Twenty-nine nonsmoking healthy males ( M ± standard error of mean [ SEM] of age: 27 ± 1 years) who fasted during Ramadan (June 29-July 28, 2014) volunteered to the study. Three periods (before-Ramadan [June 23-25], mid-Ramadan [July 14-16] and after-Ramadan [August 11-14]) were selected for spirometry measurements that were consistently performed 5.5 to 3.5 hours (between 15:00 and 17:00 hours) before fasting break. Assessment sessions comprised following: weight (kg), forced vital capacity (FVC), first second expiratory volume (FEV 1 ), FEV 1 /FVC, peak expiratory flow (PEF), maximal mid expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEF x% ). Spirometric data were expressed in percentages of reference values. Results were analyzed by applying repeated measures analysis of variance. The M ± SEM of weight (before-R: 81.6 ± 2.8 kg, mid-R: 80.8 ± 2.9 kg, after-R: 81.2 ± 2.9 kg), FEV 1 (before-R: 99 ± 2%, mid-R: 98 ± 2%, after-R: 98 ± 2%), FVC (before-R: 103 ± 2%, mid-R: 101 ± 2%, after-R: 101 ± 2%), PEF (before-R: 112 ± 3%, mid-R: 113 ± 2%, after-R: 114 ± 3%), MMEF (before-R: 83 ± 3%, mid-R: 83 ± 3%, after-R: 82 ± 3%), FEF 25% (before-R: 90 ± 5%, mid-R: 89 ± 6%, after-R: 87 ± 6%), FEF 50% (before-R: 94 ± 4%, mid-R: 91 ± 4%, after-R: 93 ± 3%), and FEF 75% (before-R: 108 ± 3%, mid-R: 111 ± 2%, after-R:111 ± 3%) were not significantly influenced by RF. To conclude, RF did not bring about any significant changes in the spirometric values of nonsmoking healthy adult males.

Do kidney transplantations save money? A study using a before-after design and multiple register-based data from Sweden.

PubMed

Jarl, Johan; Desatnik, Peter; Peetz Hansson, Ulrika; Prütz, Karl Göran; Gerdtham, Ulf-G

2018-04-01

The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. A before-after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression. Altogether 66-79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample. Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy.

Do active design buildings change health behaviour and workplace perceptions?

PubMed

Engelen, L; Dhillon, H M; Chau, J Y; Hespe, D; Bauman, A E

2016-07-01

Occupying new, active design office buildings designed for health promotion and connectivity provides an opportunity to evaluate indoor environment effects on healthy behaviour, sedentariness and workplace perceptions. To determine if moving to a health-promoting building changed workplace physical activity, sedentary behaviour, workplace perceptions and productivity. Participants from four locations at the University of Sydney, Australia, relocated into a new active design building. After consent, participants completed an online questionnaire 2 months before moving and 2 months after. Questions related to health behaviours (physical activity and sitting time), musculoskeletal issues, perceptions of the office environment, productivity and engagement. There were 34 participants (60% aged 25-45, 78% female, 84% employed full-time); 21 participants provided complete data. Results showed that after the move participants spent less work time sitting (83-70%; P < 0.01) and more time standing (9-21%; P < 0.01), while walking time remained unchanged. Participants reported less low back pain (P < 0.01). Sixty per cent of participants in the new workplace were in an open-plan office, compared to 16% before moving. Participants perceived the new work environment as more stimulating, better lit and ventilated, but noisier and providing less storage. No difference was reported in daily physical activity, number of stairs climbed or productivity. Moving to an active design building appeared to have physical health-promoting effects on workers, but workers' perceptions about the new work environment varied. These results will inform future studies in other new buildings. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Pilot Study of a Mindfulness Intervention for Adolescents and the Potential Role of Self-Compassion in Reducing Stress.

PubMed

Bluth, Karen; Roberson, Patricia N E; Gaylord, Susan A

2015-01-01

In this pilot study, we sought to investigate the effects of a mindfulness intervention for adolescents on a community sample of teens. Specifically, we explored the effects of mindfulness training on emotional well-being outcomes. Also, we examined the relationship between mindfulness and self-compassion at baseline-predicted outcome measures. This design was a pre-/post-pilot intervention study. Paired t-tests were conducted to examine change in outcome measures before and after the mindfulness intervention. Multiple regression was also conducted to investigate the influence of baseline mindfulness and self-compassion on outcome measures. The study took place after school in a classroom at a local university. Overall 28 adolescents age 10-18 years from two different cohorts participated in this study. Learning to BREATHE, a mindfulness curriculum designed specifically for adolescents and taught in six 1.5h sessions, was implemented. The outcome measures, life satisfaction and perceived stress, were included in an online survey before and after the mindfulness intervention. Results indicated that mindfulness, self-compassion, perceived stress, and life satisfaction improved from pre-intervention to post-intervention. Further, self-compassion (taught within the mindfulness intervention) was negatively related to perceived stress post-intervention while controlling for baseline stress. These findings suggest that mindfulness may be an effective intervention for improving indicators of emotional well-being among an adolescent population. Additionally, self-compassion may be a pathway through which youth can lower stress. Future research should examine self-compassion as a potential factor in promoting emotional well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

Memory-For-Designs Test: Comparison of Performance of Young and Old Adults.

ERIC Educational Resources Information Center

Dustman, Robert E.; Beck, Edward C.

1980-01-01

No significant decline in performance occurred before age 50. Decline in Memory-For-Designs Test performance after age 60 is sufficient to suggest caution in the use of the test for evaluation of brain damage in the older patient. (Author)

Designing and Implementation of a Course on Successful Dental Practice for Dentists

PubMed Central

Safi, Yaser; Razeghi, Samaneh; Shamloo, Nafiseh; Soroush, Mahdi; Akhgari, Ensieh; Moscowchi, Anahita

2015-01-01

Objectives: We aimed to design, implement and evaluate the efficacy of a comprehensive course on non-clinical competencies that dentists must possess for a successful dental practice. Materials and Methods: In this interventional before-after study an expert panel of five academic staff members and five general practitioners derived the topics for a course on successful dental practice, and aggregated them in the form of a two-day course. It was held for 46 randomly selected dentists in January 2010, at the School of Dentistry, Tehran University of Medical Sciences. The participants completed an anonymous questionnaire asking about their self-perceived need to receive training in each of the proposed topics and their self-assessed knowledge about each topic before and after attending the course. Results: Participants gave a higher priority to the necessity of training on “ergonomics and professional health” and communication skills in post-test compared to pre-test (P<0.05). The self-assessed knowledge of dentists improved significantly after attending the course in seven domains: ergonomics and occupational health, workplace design, documentation principles and IT applications in dentistry, national rules and regulations of dental practice, medical emergencies, dental ethics and communication skills (P<0.05). More than 70% of the participants were completely satisfied or satisfied with practical implication of the course, conformity of the contents with the title and course settings. Conclusion: The designed course seemed to be successful in revealing the need of participants for further education. Considering the high satisfaction rate of the attendants, this course can serve as a model for continuing education purposes. PMID:26884779

Assembly and evaluation of a training module and dataset with feedback for improved interpretation of digital breast tomosynthesis examinations

NASA Astrophysics Data System (ADS)

Gur, David; Zuley, Margarita L.; Sumkin, Jules H.; Hakim, Christiane M.; Chough, Denise M.; Lovy, Linda; Sobran, Cynthia; Logue, Durwin; Zheng, Bin; Klym, Amy H.

2012-02-01

The FDA recently approved Digital Breast Tomosynthesis (DBT) for use in screening for the early detection of breast cancer. However, MQSA qualification for interpreting DBT through training was noted as important. Performance issues related to training are largely unknown. Therefore, we assembled a unique computerized training module to assess radiologists' performances before and after using the training module. Seventy-one actual baseline mammograms (no priors) with FFDM and DBT images were assembled to be read before and after training with the developed module. Fifty examinations of FFDM and DBT images enriched with positive findings were assembled for the training module. Depicted findings were carefully reviewed, summarized, and entered into a specially designed training database where findings were identified by case number and synchronized to the display of the related FFDM plus DBT examinations on a clinical workstation. Readers reported any findings using screening BIRADS (0, 1, or 2) followed by instantaneous feedback of the verified truth. Six radiologists participated in the study and reader average sensitivity and specificity were compared before and after training. Average sensitivity improved and specificity remained relatively the same after training. Performance changes may be affected by disease prevalence in the training set.

Operationally Comparable Effect Sizes for Quantifying Changes in Behavior, with Application to Meta-Analysis of Single-Case Studies

ERIC Educational Resources Information Center

Pustejovsky, James E.

2013-01-01

Single-case designs (SCDs) are a class of research methods for evaluating intervention effects by taking repeated measurements of an outcome over time on a single case, both before and after the deliberate introduction of a treatment. SCDs are used heavily in fields such as special education, school psychology, social work, and applied behavior…

The Impact of WIC Food Package Changes on Access to Healthful Food in 2 Low-Income Urban Neighborhoods

ERIC Educational Resources Information Center

Hillier, Amy; McLaughlin, Jacqueline; Cannuscio, Carolyn C.; Chilton, Mariana; Krasny, Sarah; Karpyn, Allison

2012-01-01

Objective: To evaluate the impact of the 2009 food package changes for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the availability of healthful food. Design: Survey of all food stores in the study area before and after the changes were implemented. Setting: Two low-income neighborhoods in Philadelphia, 1…

Does a competitive voucher program for adolescents improve the quality of reproductive health care? A simulated patient study in Nicaragua.

PubMed

Meuwissen, Liesbeth E; Gorter, Anna C; Kester, Arnold D M; Knottnerus, J Andre

2006-08-07

Little is known about how sexual and reproductive (SRH) health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the usefulness of the simulated patient (SP) method for such evaluation. 28,711 vouchers were distributed to adolescents in disadvantaged areas of Managua that gave free-of-charge access to SRH care in 4 public, 10 non-governmental and 5 private clinics. Providers received training and guidelines, treatment protocols, and financial incentives for each adolescent attended. All clinics were visited by female adolescent SPs requesting contraception. SPs were sent one week before, during (with voucher) and one month after the intervention. After each consultation they were interviewed with a standardized questionnaire. Twenty-one criteria were scored and grouped into four categories. Clinics' scores were compared using non-parametric statistical methods (paired design: before-during and before-after). Also the influence of doctors' characteristics was tested using non-parametric statistical methods. Some aspects of service quality improved during the voucher program. Before the program started 8 of the 16 SPs returned 'empty handed', although all were eligible contraceptive users. During the program 16/17 left with a contraceptive method (p = 0.01). Furthermore, more SPs were involved in the contraceptive method choice (13/17 vs.5/16, p = 0.02). Shared decision-making on contraceptive method as well as condom promotion had significantly increased after the program ended. Female doctors had best scores before- during and after the intervention. The improvements were more pronounced among male doctors and doctors older than 40, though these improvements did not sustain after the program ended. This study illustrates provider-related obstacles adolescents often face when requesting contraception. The care provided during the voucher program improved for some important outcomes. The improvements were more pronounced among providers with the weakest initial performance. Shared decision-making and condom promotion were improvements that sustained after the program ended. The SP method is suitable and relatively easy to apply in monitoring clinics' performance, yielding important and relevant information. Objective assessment of change through the SP method is much more complex and expensive.

Commercialization of biomass projects: A case study of the design, development, and application of a biomass gasifier to a large retrofit market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woerner, W.L.

1994-12-31

The steam production potential of older biomass-fired boilers currently in operation may be significantly increased through the application of a commercially available gasifier. A large percentage of boiler systems in lumber mills and similar applications were initially designed to generate steam through convection heat transfer, and have been horse power rated at approximately 7 to 10 square feet of heating surface to the horse power. This paper deals with the before and after performance characteristics of the first gasifier retrofit installation based on an AED designed unit currently commercially available.

The Effect of Holy Quran Voice on Mental Health.

PubMed

Mahjoob, Monireh; Nejati, Jalil; Hosseini, Alireaza; Bakhshani, Noor Mohammad

2016-02-01

This study was designed to determine the effect of Quran listening without its musical tone (Tartil) on the mental health of personnel in Zahedan University of Medical Sciences, southeast of Iran. The results showed significant differences between the test and control groups in their mean mental health scores after Quran listening (P = 0.037). No significant gender differences in the test group before and after intervention were found (P = 0.806). These results suggest that Quran listening could be recommended by psychologists for improving mental health and achieving greater calm.

The F-MARC study on Ramadan and football: research design, population, and environmental conditions.

PubMed

Leiper, John B; Maughan, Ronald J; Kirkendall, Donald T; Bartagi, Zakia; Zerguini, Yacine; Junge, Astrid; Dvorak, Jiri

2008-12-01

Ramadan is a month of penance during which Muslims take food or drink only after sunset and before the sun rises. This fast can present a considerable challenge to the Muslim athlete. Sports performance in those who observe Ramadan and those who do not has not been formally compared. Four Tunisian junior football squads participated in the study, and it was the individual's choice whether they observed the Ramadan fast. In this study, 64 players fasted while 36 players did not. Players completed daily questionnaires on perception of training difficulty before and during Ramadan. Anthropometric data were recorded 3 weeks before Ramadan, during the second and fourth weeks of Ramadan, and into the third week after Ramadan. Performance tests (sprint, leg power, agility, aerobic endurance, football-specific skills) were also measured on these test days. Nutritional intake was recorded by recall three times during each phase of the study. Haematological and biochemical analyses were performed on a 7-ml blood sample taken from each participant on each of the test days. Sweat samples were collected during a training session in the third week of Ramadan, when heart rate was also measured. The data analyses are presented and discussed elsewhere in this issue.

In vivo nuclear magnetic resonance imaging

NASA Astrophysics Data System (ADS)

Leblanc, A.

1986-05-01

During the past year the Woodlands Baylor Magnetic Resonance Imaging (MRI) facility became fully operational. A detailed description of this facility is given. One significant instrument addition this year was the 100 MHz, 40cm bore superconducting imaging spectrometer. This instrument gives researchers the capability to acquire high energy phosphate spectra. This will be used to investigate ATP, phosphocreatinine and inorganic phosphate changes in normal and atrophied muscle before, during and after exercise. An exercise device for use within the bore of the imaging magnet is under design/construction. The results of a study of T sub 1 and T sub 2 changes in atrophied muscle in animals and human subjects are given. The imaging and analysis of the lower leg of 15 research subjects before and after 5 weeks of complete bedrest was completed. A compilation of these results are attached.

In vivo nuclear magnetic resonance imaging

NASA Technical Reports Server (NTRS)

Leblanc, A.

1986-01-01

During the past year the Woodlands Baylor Magnetic Resonance Imaging (MRI) facility became fully operational. A detailed description of this facility is given. One significant instrument addition this year was the 100 MHz, 40cm bore superconducting imaging spectrometer. This instrument gives researchers the capability to acquire high energy phosphate spectra. This will be used to investigate ATP, phosphocreatinine and inorganic phosphate changes in normal and atrophied muscle before, during and after exercise. An exercise device for use within the bore of the imaging magnet is under design/construction. The results of a study of T sub 1 and T sub 2 changes in atrophied muscle in animals and human subjects are given. The imaging and analysis of the lower leg of 15 research subjects before and after 5 weeks of complete bedrest was completed. A compilation of these results are attached.

Reaching back: the relative strength of the retroactive emotional attentional blink

PubMed Central

Ní Choisdealbha, Áine; Piech, Richard M.; Fuller, John K.; Zald, David H.

2017-01-01

Visual stimuli with emotional content appearing in close temporal proximity either before or after a target stimulus can hinder conscious perceptual processing of the target via an emotional attentional blink (EAB). This occurs for targets that appear after the emotional stimulus (forward EAB) and for those appearing before the emotional stimulus (retroactive EAB). Additionally, the traditional attentional blink (AB) occurs because detection of any target hinders detection of a subsequent target. The present study investigated the relations between these different attentional processes. Rapid sequences of landscape images were presented to thirty-one male participants with occasional landscape targets (rotated images). For the forward EAB, emotional or neutral distractor images of people were presented before the target; for the retroactive EAB, such images were also targets and presented after the landscape target. In the latter case, this design allowed investigation of the AB as well. Erotic and gory images caused more EABs than neutral images, but there were no differential effects on the AB. This pattern is striking because while using different target categories (rotated landscapes, people) appears to have eliminated the AB, the retroactive EAB still occurred, offering additional evidence for the power of emotional stimuli over conscious attention. PMID:28255172

Effects of regular aerobic exercise on visual perceptual learning.

PubMed

Connell, Charlotte J W; Thompson, Benjamin; Green, Hayden; Sullivan, Rachel K; Gant, Nicholas

2017-12-02

This study investigated the influence of five days of moderate intensity aerobic exercise on the acquisition and consolidation of visual perceptual learning using a motion direction discrimination (MDD) task. The timing of exercise relative to learning was manipulated by administering exercise either before or after perceptual training. Within a matched-subjects design, twenty-seven healthy participants (n = 9 per group) completed five consecutive days of perceptual training on a MDD task under one of three interventions: no exercise, exercise before the MDD task, or exercise after the MDD task. MDD task accuracy improved in all groups over the five-day period, but there was a trend for impaired learning when exercise was performed before visual perceptual training. MDD task accuracy (mean ± SD) increased in exercise before by 4.5 ± 6.5%; exercise after by 11.8 ± 6.4%; and no exercise by 11.3 ± 7.2%. All intervention groups displayed similar MDD threshold reductions for the trained and untrained motion axes after training. These findings suggest that moderate daily exercise does not enhance the rate of visual perceptual learning for an MDD task or the transfer of learning to an untrained motion axis. Furthermore, exercise performed immediately prior to a visual perceptual learning task may impair learning. Further research with larger groups is required in order to better understand these effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy.

PubMed

Kundra, Pankaj; Vitheeswaran, Madhurima; Nagappa, Mahesh; Sistla, Sarath

2010-06-01

This study was designed to compare the effects of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy in 50 otherwise normal healthy adults. Patients were randomized into a control group (group PO, n=25) and a study group (group PR, n=25). Patients in group PR were instructed to carry out incentive spirometry before the surgery 15 times, every fourth hourly, for 1 week whereas in group PO, incentive spirometry was carried out during the postoperative period. Lung functions were recorded at the time of preanesthetic evaluation, on the day before the surgery, postoperatively at 6, 24, and 48 hours, and at discharge. Significant improvement in the lung functions was seen after preoperative incentive spirometry (group PR), P<0.05. The lung functions were significantly reduced till the time of discharge in both the groups. However, lung functions were better preserved in group PR at all times when compared with group PO; P<0.05. To conclude, lung functions are better preserved with preoperative than postoperative incentive spirometry.

A practice-based comparison of brief cognitive behavioural treatment, two kinds of hypnosis and general anaesthesia in dental phobia.

PubMed

Wannemueller, André; Joehren, Peter; Haug, Simon; Hatting, Mathias; Elsesser, Karin; Sartory, Gudrun

2011-01-01

A practice-based study was carried out to assess the comparative effectiveness and acceptability of standardised hypnosis, hypnosis with individualised imagery, cognitive behavioural treatment (CBT) and general anaesthesia (GA) in the treatment of dental phobia. A 4-group design was used with 4 repeated measurement occasions. Of an initial total of 137 dental phobics, 77 completed the study with sample sizes of between 14 and 29 patients in the 4 groups. Participants completed questionnaires of dental anxiety at the beginning of the trial, before and after the first dental appointment and again before the second dental appointment a week later. Standardised hypnosis evidenced a significantly higher rate of premature termination of treatment than CBT. The completer analysis showed a significant reduction of dental anxiety after CBT and individualised hypnosis compared to the GA condition. The intent-to-treat analysis showed significant improvement only after CBT. The results suggest that CBT is the treatment of choice in dental phobia when taking both effectiveness and acceptability into account. Copyright © 2011 S. Karger AG, Basel.

Use of complementary and alternative medicine before and after organ removal due to urologic cancer

PubMed Central

Mani, Jens; Juengel, Eva; Arslan, Ilhan; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

2015-01-01

Objective Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. Methods From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. Results From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. Conclusion The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling. PMID:26491269

Improved Guideline Adherence With Integrated Sickle Cell Disease and Asthma Care.

PubMed

McClain, Brandi L; Ivy, Zalaya K; Bryant, Valencia; Rodeghier, Mark; DeBaun, Michael R

2016-07-01

In children with sickle cell disease (SCD), concomitant asthma is associated with increased morbidity and mortality when compared with children with SCD without asthma. Despite the well-established burden of asthma in children with SCD, no paradigm of care exists for the co-management of these two diseases. To address this gap, an integrated SCD and asthma clinic was created in a community health center that included (1) a dual respiratory therapist/asthma case manager; (2) an SCD nurse practitioner with asthma educator certification; (3) an onsite pulmonary function test laboratory; (4) a pediatric hematologist with expertise in managing SCD and asthma; and (5) application of the National Asthma Education and Prevention Program guidelines. A before (2010-2012) and after (2013-2014) study design was used to assess for improved quality of care with implementation of an integrative care model among 61 children with SCD and asthma followed from 2010 to 2014. Asthma action plan utilization after initial diagnosis increased with the integrative care model (n=16, 56% before, 100% after, p=0.003), as did the use of spirometry in children aged ≥5 years (n=41, 65% before, 95% after, p<0.001) and correction of lower airway obstruction (n=10, 30% before, 80% after, p=0.03). Although the use of an integrative care model for SCD and asthma improved evidence-based asthma care, longer follow-up and evaluation will be needed to determine the impact on SCD-related morbidity. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

PubMed

Fernández, Esteve; Fu, Marcela; Pascual, José A; López, María J; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.

Acute effects of static and dynamic stretching on jump performance after 15 min of reconditioning shooting phase in basketball players.

PubMed

Annino, Giuseppe; Ruscello, Bruno; Lebone, Pietro; Palazzo, Francesco; Lombardo, Mauro; Padua, Elvira; Verdecchia, Luca; Tancredi, Virginia; Iellamo, Ferdinando

2017-04-01

The aim of this study was to assess the effects of static (SS) and dynamic stretching (DS) on vertical jump performance executed before, immediately after and at the end of the shooting phase (i.e., 15 min later), as to simulate the actual conditions preceding a match, in professional basketball players. Ten elite basketball players (age: 29±6.73 years, height: 194.67±7.75 cm, weight: 91±8.17 kg and BMI 23.8±7.91 kg.m-2) participated to the study. SS and DS protocols were administered during the first training session of the week, 48 hours after the championship match. Stretching protocols consisted in ~7 minutes of general warm-up phase followed by ~8 minutes of SS and DS, performed with a cross-over design., and ~15 minutes of a specific warm-up shooting phase (SP). Vertical jump tests consisted in counter movement jump (CMJ) and CMJ with arm swings (CMJas) and were performed immediately after the end of each stretching phase (preS, postS, postSP). A significant decrease (P=0.05; η2partial=0.29) in jumping tests height occurred in CMJas, when performed after the SS (i.e., PostS). However, no significant differences in jumping performances, occurred after the general warm phase and the specific warm-up shooting phase, between the two stretching protocols. These results would indicate that, overall, stretching routines either dynamic or static, performed before a basketball match are transient and affect only marginally leg muscles performance. Stretching routines, particularly the dynamic ones, may be useful to maintain muscle performance before a competition, provided that this latter begins shortly after.

Do celebrity endorsements matter? Observational study of BRCA gene testing and mastectomy rates after Angelina Jolie’s New York Times editorial

PubMed Central

Desai, Sunita

2016-01-01

Objective To examine the effect on BRCA testing and mastectomy rates of a widely viewed 2013 New York Times editorial by public figure Angelina Jolie that endorsed BRCA testing and announced Jolie’s decision to undergo preventive mastectomy. Design Observational study with difference-in-difference analysis. Setting Commercially insured US population. Participants Women aged 18-64 years with claims in the Truven MarketScan commercial claims database (n=9 532 836). Main outcome measures Changes in BRCA testing rates in the 15 business days before versus after 14 May 2013 (editorial date) compared with the change in the same period in 2012; mastectomy rates in the months before and after publication, both overall and within 60 days of BRCA testing among women who were tested; national estimates of incremental tests and expenditures associated with Jolie’s article in the 15 days after publication. Results Daily BRCA test rates increased immediately after the 2013 editorial, from 0.71 tests/100 000 women in the 15 business days before to 1.13 tests/100 000 women in the 15 business days after publication. In comparison, daily test rates were similar in the same period in 2012 (0.58/100 000 women in the 15 business days before 14 May versus 0.55/100 000 women in the 15 business days after), implying a difference-in-difference absolute daily increase of 0.45 tests/100 000 women or a 64% relative increase (P<0.001). The editorial was associated with an estimated increase of 4500 BRCA tests and $13.5m (£10.8m; €12.8) expenditure nationally among commercially insured adult women in those 15 days. Increased BRCA testing rates were sustained throughout 2013. Overall mastectomy rates remained unchanged in the months after publication, but 60 day mastectomy rates among women who had a BRCA test fell from 10% in the months before publication to 7% in the months after publication, suggesting that women who underwent tests as a result of to the editorial had a lower pre-test probability of having the BRCA mutation than women tested before the editorial. Conclusions Celebrity endorsements can have a large and immediate effect on use of health services. Such announcements can be a low cost means of reaching a broad audience quickly, but they may not effectively target the subpopulations that are most at risk for the relevant underlying condition. PMID:27974323

[Effects of the new comprehensive system for designating illegal drug components on the abuse of designer drugs and future problems based on an online questionnaire].

PubMed

Morino, Taichi; Okazaki, Mitsuhiro; Toda, Takaki; Yokoyama, Takashi

2015-12-01

Recently, the abuse of designer drugs has become a social problem. Designer drugs are created by modifying part of the chemical structure of drugs that have already been categorized as illegal, thereby creating a different chemical compound in order to evade Pharmaceutical Affairs Law regulations. The new comprehensive system for designating illegal drug components has been in effect since March 2013, and many designer drugs can now be regulated. We conducted an online questionnaire survey of people with a history of designer drug use to elucidate the effects of the new system on the abuse of designer drugs and to identify potential future problems. Over half the subjects obtained designer drugs only before the new system was implemented. Awareness of the system was significantly lower among subjects who obtained designer drugs for the first time after its introduction than those who obtained the drugs only before its implementation. Due to the new system, all methods of acquiring designer drugs saw decreases in activity. However, the ratio of the acquisition of designer drugs via the Internet increased. Since over 50% of the subjects never obtained designer drugs after the new system was introduced, goals that aimed to make drug procurement more difficult were achieved. However, awareness of the new system among subjects who obtained designer drugs after the new system was introduced was significantly low. Therefore, fostering greater public awareness of the new system is necessary. The results of the questionnaire also suggested that acquiring designer drugs through the Internet has hardly been affected by the new system. We strongly hope that there will be a greater push to restrict the sale of designer drugs on the Internet in the near future.

An interventional skin care protocol (InSPiRE) to reduce incontinence-associated dermatitis in critically ill patients in the intensive care unit: A before and after study.

PubMed

Coyer, Fiona; Gardner, Anne; Doubrovsky, Anna

2017-06-01

This study aimed to test the effectiveness of a bundle combining best available evidence to reduce the incidence of incontinence-associated dermatitis occurrences in critically ill patients. The study used a before and after design and was conducted in an adult intensive care unit of an Australian quartenary referral hospital. Data, collected by trained research nurses, included demographic and clinical variables, skin assessment, incontinence-associated dermatitis presence and severity. Data were analysed using descriptive and inferential statistics. Of the 207 patients enrolled, 146 patients were mechanically ventilated and incontinent thus eligible for analysis, 80 with 768days of observation in the after/intervention group and 66 with 733days of observation in the before group. Most patients were men, mean age 53 years. Groups were similar on demographic variables. Incontinence-associated dermatitis incidence was lower in the intervention group (15%; 12/80) compared to the control group (32%; 21/66) (p=0.016). Incontinence-associated dermatitis events developed later in the intensive care unit stay in the intervention group (Logrank=5.2, p=<0.022). This study demonstrated that the use of a bundle combining best available evidence reduced the incidence and delayed the development of incontinence-associated dermatitis occurrences in critically ill patients. Systematic ongoing patient assessments, combined with tailored prevention measures are central to preventing incontinence-associated dermatitis in this vulnerable patient group. Copyright © 2016 Elsevier Ltd. All rights reserved.

Donor Cell Composition and Reactivity Predict Risk of Acute Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation.

PubMed

Sairafi, Darius; Stikvoort, Arwen; Gertow, Jens; Mattsson, Jonas; Uhlin, Michael

2016-01-01

Background . Graft-versus-host disease (GVHD) is a serious complication after allogeneic hematopoietic stem cell transplantation (HSCT). We designed a functional assay for assessment of individual risk for acute GVHD. Study Design and Methods . Blood samples were collected from patients and donors before HSCT. Two groups of seven patients each were selected, one in which individuals developed acute GVHD grades II-IV and one in which none showed any clinical signs of GVHD. Peripheral blood mononuclear cells (PBMCs) isolated from donors were incubated in mixed lymphocyte cultures (MLCs) with recipient PBMCs. The cells were characterized by flow cytometry before and after MLC. Results . Samples from donors in the GVHD group contained significantly lower frequencies of naïve γδ T-cells and T-cells expressing NK-cell markers CD56 and CD94. Donor samples in this group also exhibited lower frequencies of naïve CD95 + T-cells compared to controls. After MLC, there were dissimilarities in the CD4/CD8 T-cell ratio and frequency of CD69 + T-cells between the two patient groups, with the non-GVHD group showing higher frequencies of CD8 + and CD69 + T-cells. Conclusion . We conclude that a thorough flow cytometric analysis of donor cells for phenotype and allogeneic reactivity may be of value when assessing pretransplant risk for severe acute GVHD.

Why crying does and sometimes does not seem to alleviate mood: a quasi-experimental study.

PubMed

Gračanin, Asmir; Vingerhoets, Ad J J M; Kardum, Igor; Zupčić, Marina; Šantek, Maja; Šimić, Mia

Whereas retrospective studies suggest that crying can be beneficial in terms of mood enhancement, results of quasi-experimental laboratory studies consistently demonstrate its negative effects on mood. The present study was specifically designed to evaluate a parsimonious explanation for this paradox by assessing mood after crying in a laboratory, both immediately and at follow up. Mood ratings of 28 objectively established criers and 32 non-criers were compared before and immediately after the exposure to an emotional movie, as well as 20 and 90 min later. As expected, immediately after the film, negative mood significantly increased in criers, while it did not change in non-criers. This mood deterioration was followed by a recovery that resulted in return to the baseline mood levels at the third measurement. Criers subsequently reported mood enhancements at the final measurement compared to the pre-film measurement. Crying frequency did not predict mood changes above those predicted by the presence of crying. The observed relation between crying and more long-term mood recovery reconciles seemingly contrasting earlier results and provides a simple and obvious explanation. After the initial deterioration of mood following crying that was observed in laboratory studies, it apparently takes some time for the mood, not just to recover, but also to become even less negative than before the emotional event, which corresponds to the results of retrospective studies.

How soon they forget: changes to beliefs after learning about tobacco.

PubMed

Wisniewski, Matthew G; Bartone, Anne; Hastrup, Janice L; Coutinho, Mariana V C; Geer, Micah; Simms, Leonard J

2013-01-01

University students' beliefs about tobacco and nicotine were assessed before an educational intervention aimed at correcting tobacco-related misinformation. Beliefs were again measured immediately after the intervention, and then again after a 2-, 4-, 6-, or 8-week retention interval. Initially, participants showed significantly more accurate beliefs about tobacco than pre-intervention, but this improvement decreased after the retention interval. Results suggest that methods currently used in an attempt to alleviate tobacco misinformation in the public may be effective for short-term, but not long-term retention. The current study accents the need to design tobacco programs that optimize retention of belief change so that people may use that knowledge confidently in future health-related decisions.

Do recommended protein intakes improve neurodevelopment in extremely preterm babies?

PubMed

Cester, E A; Bloomfield, F H; Taylor, J; Smith, S; Cormack, B E

2015-05-01

To determine whether achieving recommended protein intakes for extremely low birthweight (ELBW; birth weight <1000 g) babies, resulting in better growth, improves neurodevelopmental outcomes. A prospective cohort study of ELBW babies before and after the introduction of a new nutritional policy designed to meet international consensus protein recommendations. Forty-five children born 'before' and 42 born 'after' the policy change were assessed at 2 years' corrected age (CA). Associations between nutritional intakes, growth and neurodevelopmental outcome (Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III), motor and sensory impairment) were assessed using univariate and multivariate analyses. Bayley-III cognitive (mean (SD) 96 (12) vs 96 (15)), motor (96 (13) vs 95 (15)) or language scores (89 (11) vs 91 (17)) were not different between the 'before' and 'after' cohorts. In the 'before' cohort, motor scores were positively associated with enteral nutrition intakes and growth velocity. Neither were sensory impairments different between groups (visual impairment 4 vs 2, hearing impairment 2 vs 0) nor was the gross motor function classification score (any cerebral palsy 2 vs 1). In this prospective cohort study, increasing intravenous and enteral protein intakes to recommended levels in the first month after birth was not associated with improved cognitive, language or motor scores or decreased sensory impairments at 2 years' CA despite significantly improved early growth and reduced postnatal faltering growth. Appropriate randomised controlled trials are needed to answer definitively whether higher early protein intakes improve neurodevelopmental outcome in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evaluation of World Health Organization Multi-Professional Patient Safety Curriculum Topics in Nursing Education: Pre-test, post-test, none-experimental study.

PubMed

Mansour, Mansour; Skull, Alice; Parker, Michael

2015-01-01

The Multi-professional Patient Safety Curriculum Guide was launched by the World Health Organization to develop a patient safety-friendly curriculum in health education. The aim of this study was to evaluate the impact of teaching related to two topics from the Patient Safety Curriculum Guide on student nurses' knowledge and attitudes toward patient safety. A pretest, posttest, nonexperimental design was used. Patient safety education questionnaires were distributed to a convenience sample of 181 nursing students before the intervention, and 141 questionnaires after the intervention in one university in the East of England. The intervention consisted of two face-to-face lectures and one facilitated group work discussion. Seventy-one responses from pre- and posttest stages were matched. Paired t test, McNemar's test, and frequency measures were used for data analysis. The findings suggest that there are statistically significant differences in the subscales of the error and patient safety and personal influence over safety. The differences in the students' answers on patient safety knowledge before and after the interventions were not statistically significant. Although the student nurses highly commended the teaching delivered in this study, the use of experimental design in future curriculum evaluation may provide a more complementary insight to the findings of this study. Copyright © 2015 Elsevier Inc. All rights reserved.

A combined study of heat and mass transfer in an infant incubator with an overhead screen.

PubMed

Ginalski, Maciej K; Nowak, Andrzej J; Wrobel, Luiz C

2007-06-01

The main objective of this study is to investigate the major physical processes taking place inside an infant incubator, before and after modifications have been made to its interior chamber. The modification involves the addition of an overhead screen to decrease radiation heat losses from the infant placed inside the incubator. The present study investigates the effect of these modifications on the convective heat flux from the infant's body to the surrounding environment inside the incubator. A combined analysis of airflow and heat transfer due to conduction, convection, radiation and evaporation has been performed, in order to calculate the temperature and velocity fields inside the incubator before and after the design modification. Due to the geometrical complexity of the model, computer-aided design (CAD) applications were used to generate a computer-based model. All numerical calculations have been performed using the commercial computational fluid dynamics (CFD) package FLUENT, together with in-house routines used for managing purposes and user-defined functions (UDFs) which extend the basic solver capabilities. Numerical calculations have been performed for three different air inlet temperatures: 32, 34 and 36 degrees C. The study shows a decrease of the radiative and convective heat losses when the overhead screen is present. The results obtained were numerically verified as well as compared with results available in the literature from investigations of dry heat losses from infant manikins.

Structural Design Strategies for Improved Small Overlap Crashworthiness Performance.

PubMed

Mueller, Becky C; Brethwaite, Andrew S; Zuby, David S; Nolan, Joseph M

2014-11-01

In 2012, the Insurance Institute for Highway Safety (IIHS) began a 64 km/h small overlap frontal crash test consumer information test program. Thirteen automakers already have redesigned models to improve test performance. One or more distinct strategies are evident in these redesigns: reinforcement of the occupant compartment, use of energy-absorbing fender structures, and the addition of engagement structures to induce vehicle lateral translation. Each strategy influences vehicle kinematics, posing additional challenges for the restraint systems. The objective of this two-part study was to examine how vehicles were modified to improve small overlap test performance and then to examine how these modifications affect dummy response and restraint system performance. Among eight models tested before and after design changes, occupant compartment intrusion reductions ranged from 6 cm to 45 cm, with the highest reductions observed in models with the largest number of modifications. All redesigns included additional occupant compartment reinforcement, one-third added structures to engage the barrier, and two modified a shotgun load path. Designs with engagement structures produced greater glance-off from the barrier and exhibited lower delta Vs but experienced more lateral outboard motion of the dummy. Designs with heavy reinforcement of the occupant compartment had higher vehicle accelerations and delta V. In three cases, these apparent trade-offs were not well addressed by concurrent changes in restraint systems and resulted in increased injury risk compared with the original tests. Among the 36 models tested after design changes, the extent of design changes correlated to structural performance. Half of the vehicles with the lowest intrusion levels incorporated aspects of all three design strategies. Vehicle kinematics and dummy and restraint system characteristics were similar to those observed in the before/after pairs. Different combinations of structural improvement strategies for improving small overlap test performance were found to be effective in reducing occupant compartment intrusion and improving dummy kinematics in the IIHS small overlap test with modest weight increase.

The effect of a neurocritical care service without a dedicated neuro-ICU on quality of care in intracerebral hemorrhage.

PubMed

Burns, Joseph D; Green, Deborah M; Lau, Helena; Winter, Michael; Koyfman, Feliks; DeFusco, Christina M; Holsapple, James W; Kase, Carlos S

2013-06-01

Introduction of neurocritical care services to dedicated neuro-ICUs is associated with improved quality of care. The impact of a neurocritical care service without a dedicated neuro-ICU has not been studied. We retrospectively identified all patients admitted to our institution with intracerebral hemorrhage (ICH) in two 12-month periods: immediately before the arrival of the first neurointensivist ("before") and after the neurocritical care service was established ("after"). There was no nursing team, ICU housestaff/physician extender team, or physical unit dedicated to the care of patients with critical neurologic illness during either period. Using an uncontrolled before-after design, we compared clinical outcomes and performance on quality metrics between groups. We included 74 patients with primary supratentorial ICH. Mortality, length of stay (LOS), proportion of patients with modified Rankin Score 0-3, and destination on discharge did not differ between groups when adjusted for confounders. Time to first two consecutive systolic blood pressure (SBP) measurements <180 mmHg was shorter in the "after" cohort (mean 4.5 vs. 3.2 h, p = 0.001). Area under the curve measurement for change in SBP from baseline over the first 24 h after ED arrival demonstrated greater, sustained SBP reduction in the "after" cohort (mean -187.9 vs. -720.9, p = 0.04). A higher proportion of patients were fed without passing a dysphagia screen in the "before" group (45 vs. 0%, p < 0.001). Introduction of a neurocritical service without a neuro-ICU at our institution was associated with a trend toward longer ICU LOS and improvement in some key metrics of quality of care for patients with ICH.

Intraoperative optical coherence tomography and ab interno trabecular meshwork surgery with the Trabectome

PubMed Central

Junker, Bernd; Jordan, Jens F; Framme, Carsten; Pielen, Amelie

2017-01-01

Importance This study is the first description of the use of the intraoperative optical coherence tomography (iOCT) for trabecular meshwork surgery with the Trabectome in a regular clinical setting. Background The aim of this study is to evaluate intraoperatively the immediate success of ab interno trabeculotomy with the Trabectome defined as a removal of the trabecular meshwork. Design This is a retrospective clinical study performed in the University Eye Hospital, Medical School Hannover. Participants A total of nine consecutive Caucasian patients suffering from primary open angle glaucoma, pigment dispersion glaucoma, or pseudoexfoliation glaucoma took part in the study. Methods All patients underwent ab interno trabeculotomy surgery with the Trabectome using a commercially available iOCT to visualize the anterior chamber angle (ACA) before and after the procedure. The visualization was done using a modified Swan-Jacobs lens (all nine patients) or without lens (view from above, five patients). Main outcome measures The main outcome of this study is the success of visualization of the ACA on iOCT, especially the postprocedural visualization of the wound gap after removal of the trabecular meshwork. Results Using the view from above, the ACA could be visualized before and after the procedure in only two of the five cases. Using the modified Swan-Jacobs lens, the ACA could be visualized before the procedure and the trabecular meshwork opening after the procedure in all nine patients. Conclusion The iOCT can be used to objectify the immediate success of the surgical procedure, ie, the removal of the trabecular meshwork, of ab interno trabeculotomy with the Trabectome. The procedure itself cannot be captured sufficiently via iOCT. PMID:29026286

Effects of chemical disinfectant solutions on the stability and accuracy of the dental impression complex.

PubMed

Rios, M P; Morgano, S M; Stein, R S; Rose, L

1996-10-01

Currently available impression materials were not designed for disinfection or sterilization, and it is conceivable that disinfectants may adversely affect impressions. This study evaluated the accuracy and dimensional stability of polyether (Permadyne/Impregum) and polyvinyl siloxane (Express) impression materials retained by their adhesives in two different acrylic resin tray designs (perforated and nonperforated) when the materials were immersed for either 30 or 60 minutes in three high-level disinfectants. Distilled water and no solution served as controls. A stainless steel test analog similar to ADA specification No. 19 was used. A total of 400 impressions were made with all combinations of impression materials, tray designs, disinfectant, and soaking times. Samples were evaluated microscopically before and after immersion and 48 hours after soaking. Results indicated that these two impression materials were dimensionally stable. Because the results emphasized the stability and accuracy of the impression complex under various conditions, dentists can perform disinfection procedures similar to the protocol of this study without concern for clinically significant distortion of the impression.

An empirical examination of the impacts of decentralized nursing unit design.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Redden, Pamela; Summers, Barbara; Pati, Sipra

2015-01-01

The objective of the study was to examine the impact of decentralization on operational efficiency, staff well-being, and teamwork on three inpatient units. Decentralized unit operations and the corresponding physical design solution were hypothesized to positively affect several concerns-productive use of nursing time, staff stress, walking distances, and teamwork, among others. With a wide adoption of the concept, empirical evidence on the impact of decentralization was warranted. A multimethod, before-and-after, quasi-experimental design was adopted for the study, focusing on five issues, namely, (1) how nurses spend their time, (2) walking distance, (3) acute stress, (4) productivity, and (5) teamwork. Data on all five issues were collected on three older units with centralized operational model (before move). The same set of data, with identical tools and measures, were collected on the same units after move in to new physical units with decentralized operational model. Data were collected during spring and fall of 2011. Documentation, nurse station use, medication room use, and supplies room use showed consistent change across the three units. Walking distance increased (statistically significant) on two of the three units. Self-reported level of collaboration decreased, although assessment of the physical facility for collaboration increased. Decentralized nursing and physical design models potentially result in quality of work improvements associated with documentation, medication, and supplies. However, there are unexpected consequences associated with walking, and staff collaboration and teamwork. The solution to the unexpected consequences may lie in operational interventions and greater emphasis on culture change. © The Author(s) 2015.

The effect of Hurricane Katrina: births in the U.S. Gulf Coast region, before and after the storm.

PubMed

Hamilton, Brady E; Sutton, Paul D; Mathews, T J; Martin, Joyce A; Ventura, Stephanie J

2009-08-28

This report presents birth data for the region affected by Hurricane Katrina, which made landfall along the Gulf Coast of the United States on August 29, 2005, comparing the 12-month periods before and after the storm according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, race, Hispanic origin, marital status, and educational attainment; medical care utilization by pregnant women (prenatal care and method of delivery); and infant characteristics or birth outcomes (period of gestation and birthweight). Descriptive tabulations of data reported on the birth certificates of residents of the 91 Federal Emergency Management Agency (FEMA)-designated counties and parishes of Alabama, Louisiana, and Mississippi are presented for the 12-month periods before and after Hurricane Katrina struck, from August 29, 2004, through August 28, 2006. Detailed data are shown separately for 14 selected, FEMA-designated coastal counties and parishes within a 100-mile radius of the Hurricane Katrina storm path, the area hit very hard by the storm and subsequent flooding. These 14 selected coastal counties and parishes are a subset of the 91 FEMA-designated counties and parishes. The total number of births in the 14 selected FEMA-designated counties and parishes decreased 19 percent in the 12 months after Hurricane Katrina compared with the 12 months before, with births declining in the selected counties and parishes of Louisiana and Mississippi and rising in the counties of Alabama. The number of births to non-Hispanic black women in the selected parishes of Louisiana fell substantially after Hurricane Katrina; births declined for non-Hispanic white, Hispanic, and Asian or Pacific Islander women in these selected parishes as well. The percentage of births to women under age 20 years for the selected counties and parishes after the storm was essentially unchanged in Alabama and Mississippi, but decreased in Louisiana. The proportion of births to unmarried women decreased in the selected parishes of Louisiana, but increased in the selected counties elsewhere. Large decreases were observed in very preterm and very low birthweight rates for the selected parishes of Louisiana following Hurricane Katrina, whereas a large increase was observed in very preterm births for the selected counties of Alabama.

49 CFR 173.5b - Portable and mobile refrigeration systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... operations. These refrigeration systems are used at field sites to cool (pre-cool) produce before the produce... pressure vessel must be designed, manufactured, and maintained in accordance with applicable requirements... initial pressure test performed after manufacture. Additional pressure tests must be performed after any...

49 CFR 173.5b - Portable and mobile refrigeration systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... operations. These refrigeration systems are used at field sites to cool (pre-cool) produce before the produce... pressure vessel must be designed, manufactured, and maintained in accordance with applicable requirements... initial pressure test performed after manufacture. Additional pressure tests must be performed after any...

EFFECTS OF HOME-CARE TRAINING ON THE SELF-EFFICACY OF PATIENTS WITH BETA THALASSEMIA MAJOR

PubMed Central

Moghadam, Mahdieh Poodineh; Nourisancho, Hajar; Shahdadi, Hossein; Shahraki, Sohila; Azarkish, Batoul; Balouchi, Abbas

2016-01-01

Background: The self-efficacy of thalassemia patients is an important factor in creating behavioral changes in such patients. Home-care training reduces hospitalization duration as well as relevant costs and improves disease outcomes. This study was designed to assess the effect of home-care training on the self-efficacy of patients with beta thalassemia major. Methodology: This was a quasi-experimental, case-control, before and after intervention study conducted on 136 thalassemia cases from January 2014 to October 2015. Data was collected through Shere general self-efficacy questionnaire (SGSES). Home-care trainings were provided in the form of training courses with respect to the training needs of thalassemia major cases. Two (2) months after the end of training courses, SGSES questionnaire was filled again and the obtained data was analyzed by SPSS 21 as well as descriptive-inferential statistics (significance level=P≤0.05). Results: The results of this study revealed that the mean self-efficacy score of control group was 48.69±6.82 before intervention which increased to 46.69±6.81 after intervention. The mean self-efficacy score of case group was 44.58±5.23 before intervention which increased to 49.5±6.66 after intervention. The rise of self-efficacy score, after intervention, was significantly higher in the case group compared with the control group (P≤.001). Conclusion: According to results, home-care training can develop self-efficacy in thalassemia patients. In home-care training procedure patients play an active role. By providing home-care trainings, therefore, an effective step should be taken to promote the self-efficacy of the patients and to decrease associated problems. PMID:27999484

Quality of life before hyperhidrosis treatment as a predictive factor for oxybutynin treatment outcomes in palmar and axillary hyperhidrosis.

PubMed

Wolosker, Nelson; Krutman, Mariana; Teivelis, Marcelo P; Campbell, Taiz P D A; Kauffman, Paulo; de Campos, José Ribas M; Puech-Leão, Pedro

2014-05-01

Studies have suggested that quality of life (QOL) evaluation before video-assisted thoracoscopic sympathectomy for patients with hyperhidrosis may serve as a predictive factor for positive postoperative outcomes. Our study aims to analyze if this tendency is also observed in patients treated with oxybutynin for palmar and axillary hyperhidrosis. Five hundred sixty-five patients who submitted to a protocol treatment with oxybutynin were retrospectively analyzed between January 2007 and January 2012 and were divided into 2 groups according to QOL assessment before treatment. The groups consisted of 176 patients with "poor" and 389 patients with "very poor" QOL evaluation before oxybutynin treatment. Outcomes involving improvements in QOL and clinical progression of hyperhidrosis were evaluated using a validated clinical questionnaire that was specifically designed to assess satisfaction in patients with excessive sweating. Improvements in hyperhidrosis after oxybutynin were observed in 65.5% of patients with very poor pretreatment QOL scores and in 75% of patients with poor pretreatment QOL scores, and the only adverse event associated with oxybutynin treatment was dry mouth, which was observed with greater intensity in patients with very poor initial QOL evaluation. Improvements in hyperhidrosis after oxybutynin treatment were similar in both groups, suggesting that QOL before treatment is not a predictive factor for clinical outcomes, contrasting with surgical results that disclose significantly better results in patients with initially poorer QOL analysis. Copyright © 2014 Elsevier Inc. All rights reserved.

Stethoscope disinfection campaign in a Nigerian teaching hospital:results of a before-and-after study.

PubMed

Uneke, Chigozie J; Ndukwe, Chinwendu D; Nwakpu, Kingsley O; Nnabu, Richard C; Ugwuoru, Cletus D; Prasopa-Plaizier, Nittita

2014-01-15

This study aimed to assess the impact of a stethoscope disinfection sensitization campaign among doctors and nurses in a Nigerian teaching hospital. The design was a before-and-after study. Pre-program measurements were used to provide a baseline against which the post-program results were compared. Interventions that promoted compliance with stethoscope disinfection practice that were implemented included training and education on stethoscope disinfection and introduction of 70% isopropyl alcohol disinfectant at points-of-care places. Microbiological assessment of stethoscopes used by health workers was conducted after the intervention and the outcome was compared with the pilot study results. After the intervention, of the 89 stethoscopes screened, 18 (20.2%) were contaminated with bacterial agents. A higher prevalence of stethoscope contamination was observed among stethoscopes from the intensive care unit (66.7%), the VIP unit (50%), and the antenatal unit (37.5%). The main isolates were Staphylococcus aureus (44.4%) and Escherichia coli (50%). The antibiotic sensitivity assessment indicated that the bacterial isolates were resistant to nearly all the antibiotics tested. All the 89 health workers whose stethoscopes were screened after the intervention admitted to cleaning their stethoscopes after seeing each patient, representing a compliance rate of 100%, unlike the 15% compliance at the pilot phase. The baseline stethoscope contamination rate was 78.5% versus 20.2% post-intervention. Training and education and introduction of alcohol-based disinfectants inexpensive but very effective methods to improve stethoscope disinfection compliance among health workers in low-income settings.

Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis.

PubMed

Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R

2003-09-01

To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries. Systematic review and meta-analysis. Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked. Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads. Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model. Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries. Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries.

Prevalence of surgical site infections before and after the implementation of a multimodal infection control programme.

PubMed

Barchitta, Martina; Matranga, Domenica; Quattrocchi, Annalisa; Bellocchi, Patrizia; Ruffino, Maria; Basile, Guido; Agodi, Antonella

2012-03-01

In order to assess the prevalence of surgical site infections (SSIs) before and after the implementation of a multimodal infection control programme including the realization of a campaign to increase compliance with guidelines for antimicrobial prophylaxis, we designed and conducted the present study involving all 20 of the surgical departments of a large teaching hospital in Catania, Italy. SSI definitions of the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol were used in four 1 day point-prevalence surveys. After the first survey, an infection control programme was implemented involving the active commitment of surgeons and infection control staff. Overall, a total of 600 surgical patients were enrolled. A significant decreasing trend in the SSI rate (from 16.4 to 8.2 per 100 surgical patients, P=0.018) was shown. After multivariate analysis, significant risk factors for SSI were identified: age >31 years, kidney insufficiency and infection at admission. Taking into account the indication and the timing of administration of antibiotic prophylaxis, in the four surveys prophylaxis was administered inappropriately in 55.3% of surgical procedures. The approach used in this study remains a feasible method of evaluating the burden of SSIs using repeated prevalence surveys. The results provide evidence of a significant decreasing trend in the SSI rate following the infection control intervention. Furthermore, our study underlines the need to develop evidence-based guidelines in collaboration with surgeons, to achieve consensus before implementation in order to improve compliance with antimicrobial prophylaxis and, finally, decrease SSI rates.

The effect of meditation on shooting performance.

PubMed Central

Solberg, E E; Berglund, K A; Engen, O; Ekeberg, O; Loeb, M

1996-01-01

OBJECTIVE: To study effects of meditation on the shooting performance. METHODS: 25 elite shooters were investigated in an independent groups design. The results in standardised test shootings indoors and in ordinary competitions outdoors were assessed before and after regular meditation training for the experimental group. The experience of tension during the test shootings was self recorded on a visual analogue scale (VAS). RESULTS: The competition results in the outdoor season (1993), just after the meditation training period, compared with the results the previous season (1992), were better in the meditation group (P < 0.05). No significant difference between the groups was observed in the test shootings before and after the relaxation intervention. A significant association was shown between low tension and the results in the test shootings (correlation r = 0.42, P < 0.0001; Wilcoxon rank sum test, z = -3.36, P < 0.001); 18% (= r2) of the variance in performance was explained by tension. CONCLUSIONS: Meditation may enhance competitive shooting performance. PMID:9015599

Sleep and daytime sleepiness of patients with left ventricular assist devices: a longitudinal pilot study.

PubMed

Casida, Jesus M; Davis, Jean E; Brewer, Robert J; Smith, Cheryl; Yarandi, Hossein

2011-06-01

No empirical longitudinal data on sleep and daytime sleepiness patterns in patients with an implantable left ventricular assist device (LVAD) exist. (1) To describe the sleep patterns (sleep onset latency, sleep efficiency, sleep fragmentation index, total sleep time, and wake after sleep onset), sleep quality, and daytime sleepiness variables and (2) to determine the change in the pattern of these variables before and up to 6 months after LVAD implantation. A longitudinal descriptive repeated-measures design was used. Patients wore wrist actigraphs (AW64 Actiwatch), which objectively measured sleep, for 3 consecutive days and nights before LVAD implant and at the first and second week and first, third, and sixth month after implantation. During these periods, patients also completed questionnaires on sleep quality and daytime sleepiness. Patients-Twelve of 15 patients completed the 6-month data. Data were analyzed by using descriptive statistics and repeated-measures analysis of variance. We found long sleep onset latencies and low sleep efficiency across time periods. High sleep fragmentation index was noted at baseline and 1 week after LVAD. Short total sleep times, long wake-after-sleep-onset durations, and poor sleep quality were evident at baseline and persisted up to 6 months after LVAD implantation. Low alertness level, a manifestation of sleepiness, was common during late morning to early evening hours. However, only sleep efficiency and wake after sleep onset showed significant changes in pattern (P < .05). Sleep disturbance and daytime sleepiness may be prevalent before and up to 6 months after LVAD implantation, warranting further investigation.

A method for improving arrival-to-electrocardiogram time in emergency department chest pain patients and the effect on door-to-balloon time for ST-segment elevation myocardial infarction.

PubMed

Takakuwa, Kevin M; Burek, Gregory A; Estepa, Adrian T; Shofer, Frances S

2009-10-01

The objectives were to determine if an emergency department (ED) could improve the adherence to a door-to-electrocardiogram (ECG) time goal of 10 minutes or less for patients who presented to an ED with chest pain and the effect of this adherence on door-to-balloon (DTB) time for ST-segment elevation myocardial infarction (STEMI) cardiac catheterization (cath) alert patients. This was a planned 1-month before-and-after interventional study design for implementing a new process for obtaining ECGs in patients presenting to the study ED with chest pain. Prior to the change, patients were registered and triaged before an ECG was obtained. The new procedure required registration clerks to identify those with chest pain and directly overhead page or call a designated ECG technician. This technician had other ED duties, but prioritized performing ECGs and delivering them to attending physicians. A full registration process occurred after the clinical staff performed their initial assessment. The primary outcome was the total percentage of patients with chest pain who received an ECG within 10 minutes of ED arrival. The secondary outcome was DTB time for patients with STEMI who were emergently cath alerted. Data were analyzed using mean differences, 95% confidence intervals (CIs), and relative risk (RR) regression to adjust for possible confounders. A total of 719 patients were studied: 313 before and 405 after the intervention. The mean (+/-standard deviation [SD]) age was 50 (+/-16) years, 54% were women, 57% were African American, and 36% were white. Patients walked in 89% of the time; 11% arrived by ambulance. Thirty-nine percent were triaged as emergent and 61% as nonemergent. Patients presented during daytime 68% of the time, and 32% presented during the night. Before the intervention, 16% received an ECG at 10 minutes or less. After the intervention, 64% met the time requirement, for a mean difference of 47.3% (95% CI = 40.8% to 53.3%, p < 0.0001). Results were not affected by age, sex, race, mode of arrival, triage classification, or time of arrival. For patients with STEMI cath alerts, four were seen before and seven after the intervention. No patients before the intervention had ECG time within 10 minutes, and one of four had DTB time of <90 minutes. After the intervention, all seven patients had ECG time within 10 minutes; the three arriving during weekday hours when the cath team was on site had DTB times of <90 minutes, but the four arriving at night and on weekends when the cath team was off site had DTB times of >90 minutes. The overall percentage of patients with a door-to-ECG time within 10 minutes improved without increasing staffing. An ECG was performed within 10 minutes of arrival for all patients who were STEMI cath alerted, but DTB time under 90 minutes was achieved only when the cath team was on site.

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review

PubMed Central

de Oliveira, Lucia Helena; Camacho, Luiz Antonio B.; Coutinho, Evandro S. F.; Martinez-Silveira, Martha S.; Carvalho, Ana Flavia; Ruiz-Matus, Cuauhtemoc; Toscano, Cristiana M.

2016-01-01

Background Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs. Objectives We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region. Methods We conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis. We searched Medline, WoS, Lilacs, Scopus, Central and gray literature published in any language from 2009 to January 2016. We included studies addressing the outcomes of interest in children in the target age group, and with the following designs: randomized trials, cohort or case-control, interrupted time series with at least three data points before and after the intervention, and before-after studies. Screening of citations, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers, according to the study protocol registered on PROSPERO. Descriptive analysis of the effectiveness measurements and sensitivity analysis were conducted. Effectiveness is reported as 1-OR or 1-RR for case control or cohort/clinical trials, and as percent change of disease incidence rates for before-after studies. Results We identified 1,085 citations, 892 from databases and 193 from other sources. Of these, 22 were further analyzed. Studies were from Brazil, Chile, Uruguay, Argentina, Peru and Nicaragua. Effectiveness ranged from 8.8–37.8% for hospitalizations due to X-ray confirmed pneumonia, 7.4–20.6% for clinical pneumonia, and 13.3–87.7% for meningitis hospitalizations, and 56–83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design. Conclusions Available evidence to date indicates significant impact of both PCV-10 and PCV-13 in the outcomes studied, with no evidence of the superiority of one vaccine over the other on pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old. PMID:27941979

Incidence and Clinical Presentation of Moderate to Severe Graves' Orbitopathy in a Danish Population before and after Iodine Fortification of Salt

PubMed Central

Berman, Dalia C.; Bülow Pedersen, Inge; Andersen, Stig; Carlé, Allan

2012-01-01

Context: Population-based data on the incidence and clinical presentation of moderate to severe Graves' orbitopathy (GO) are scarce, and virtually nothing is known on the effect of an iodization program on the incidence and presentation of GO. Objective: The objective of the study was to characterize incident moderate to severe GO in North Jutland County, Denmark, during the period 1992–2009, before and after the Danish salt iodization program. Design and Patients: The design of the study was a prospective register of patients with incident moderate to severe GO in a population during 8.9 million persons × years of observation. Setting: The study was conducted at a thyroid-eye clinic of university hospital. Main Outcome Measures: Clinical presentation and incidence before and after the year 2000 initiation of the mandatory Danish iodization of salt were measured. The incidence of GO was related to the incidence of Graves' hyperthyroidism (GH) in the same population. Results: The incidence rate of moderate to severe GO was 16.1/million per year (women: 26.7; men: 5.4), with no change associated with iodization of salt. The moderate to severe GO incidence was 4.9% of the incidence of GH. The incidence rate ratio between women and men with GO (4.9) was not different from the ratio in GH. Compared with GH, only a few patients (<2%) suffered from moderate and severe GO below the age of 40 yr, whereas GO was relatively common in age groups 40–60 yr (∼8%). Conclusions: Approximately 5% of the patients with Graves' disease develop moderate to severe GO, with a similar risk in women and men with Graves' disease. The risk of GO is much higher in patients aged 40–60 yr than in young patients with Graves' disease. Salt iodization was not associated with a change in the incidence of GO. PMID:22518849

Beyond Who, What, Where, When, Why, and How: Preparing Students to Generate Questions in the Age of Common Core Standards

ERIC Educational Resources Information Center

Humphries, Jean; Ness, Molly

2015-01-01

Using a case study design, our research explored question generation as a reading comprehension strategy, focusing on the types of questions 4th- and 5th-grade students posed before, during, and after reading narrative text. The authors aimed to determine whether their participants are ready to pose the higher-level questions expected of them by…

Computer-Enriched Instruction (CEI) Is Better for Preview Material Instead of Review Material: An Example of a Biostatistics Chapter, the Central Limit Theorem

ERIC Educational Resources Information Center

See, Lai-Chu; Huang, Yu-Hsun; Chang, Yi-Hu; Chiu, Yeo-Ju; Chen, Yi-Fen; Napper, Vicki S.

2010-01-01

This study examines the timing using computer-enriched instruction (CEI), before or after a traditional lecture to determine cross-over effect, period effect, and learning effect arising from sequencing of instruction. A 2 x 2 cross-over design was used with CEI to teach central limit theorem (CLT). Two sequences of graduate students in nursing…

Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

PubMed

Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

2016-04-01

A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P < .05). The result of patient satisfaction for the multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

Home Care Learning Model for Medical Students in Chile: A Mixed Methods Study

PubMed Central

Gonzalez, Carolina

2014-01-01

Introduction. The relevance of home care training is not questioned. However, there are no reported learning models to teach in this setting. Aims. To develop and evaluate a learning model to teach home care to medical students. Methods. Stage 1: Learning Model Design. Tutors teaching home care and a sample of medical students were invited to focus groups analyzed according to the grounded theory. Later, the researchers designed the learning model, which was approved by all participants. Stage 2: Learning Assessment. All students in their family medicine internship at Pontificia Universidad Catolica de Chile were invited to participate in a nonrandomized before-and-after pilot trial, assessing changes in their perception towards home care and satisfaction with the learning model. Results. Stage 1: Six tutors and eight students participated in the focus groups. The learning model includes activities before, during, and after the visits. Stage 2: 105 students (88.2%) participated. We observed improvement in all home care training domains (P ≤ 0.001) and a high satisfaction with the model. Students with previous home visit experiences and who participated with nurses and social workers reported more learning. Conclusions. We report an effective learning model to train medical students in home care. Limitations and recommendations for future studies are discussed. PMID:24967327

Skin cancer preventive behaviors among rural farmers: An intervention based on protection motivation theory.

PubMed

Babazadeh, Towhid; Kamran, Aziz; Dargahi, Abdollah; Moradi, Fatemeh; Shariat, Fariba; Rezakhani Moghaddam, Hamed

2016-01-01

Background: Skin cancer is a serious public health problem in the world. Its prevalence in many countries has been increased in recent years. This study aimed to assess the effects of a theory-based educational intervention to promote skin cancer preventive behaviors (SCPBs) among rural farmers in Chalderan County, Iran. Methods: This was a quasi-randomized controlled field trial study conducted on 238 rural farmers. The data were collected by a questionnaire containing the constructs of the Protection Motivation Theory (PMT) as well as the items of SCPBs. The differences between the groups before and 3 months after the intervention were determined by independent t-test, paired t-test, and chi-square applying SPSS software. Results: Before the intervention, no significant difference was found in the scores of the PMT constructs between the two groups (p>0.05). However, significant differences were found between the scores of all the variables, as well as SCPBs, in the two groups after the intervention (p<0.05). Conclusion: The PMT was found to be an appropriate framework for designing educational interventions aiming at promoting SCPBs among rural farmers. It was concluded that designing an educational program with a focus on promoting perceived susceptibility increased the level of performing SCPBs among the rural farmers.

Skin cancer preventive behaviors among rural farmers: An intervention based on protection motivation theory

PubMed Central

Babazadeh, Towhid; Kamran, Aziz; Dargahi, Abdollah; Moradi, Fatemeh; Shariat, Fariba; Rezakhani Moghaddam, Hamed

2016-01-01

Background: Skin cancer is a serious public health problem in the world. Its prevalence in many countries has been increased in recent years. This study aimed to assess the effects of a theory-based educational intervention to promote skin cancer preventive behaviors (SCPBs) among rural farmers in Chalderan County, Iran. Methods: This was a quasi-randomized controlled field trial study conducted on 238 rural farmers. The data were collected by a questionnaire containing the constructs of the Protection Motivation Theory (PMT) as well as the items of SCPBs. The differences between the groups before and 3 months after the intervention were determined by independent t-test, paired t-test, and chi-square applying SPSS software. Results: Before the intervention, no significant difference was found in the scores of the PMT constructs between the two groups (p>0.05). However, significant differences were found between the scores of all the variables, as well as SCPBs, in the two groups after the intervention (p<0.05). Conclusion: The PMT was found to be an appropriate framework for designing educational interventions aiming at promoting SCPBs among rural farmers. It was concluded that designing an educational program with a focus on promoting perceived susceptibility increased the level of performing SCPBs among the rural farmers. PMID:28210609

Steps to Enhance Early Recovery After Hematopoietic Stem Cell Transplantation: Lessons Learned From a Physical Activity Feasibility Study.

PubMed

Hacker, Eileen Danaher; Peters, Tara; Patel, Pritesh; Rondelli, Damiano

This pilot study tested and refined a free-living physical activity intervention. The investigators evaluated the acceptability and feasibility of the intervention after hematopoietic stem cell transplantation and determined preliminary effects on physical activity, fatigue, muscle strength, functional ability, and quality of life. This pilot study used a 1-group, pretest-posttest design. The free-living physical activity intervention consisted of an education component and 6 weeks of gradually increasing physical activity after discharge from the hospital. The intervention was designed to increase steps by 10% weekly. Subjects were assessed before transplantation and during the seventh week after discharge from the hospital after completing the intervention. Pretest-posttest scores were analyzed with paired t tests. Subject wore the physical activity tracker for an average of 38 of 42 days and met their physical activity goals 57% of the time. Subjects reported significantly less physical fatigue after the free-living physical activity intervention compared with baseline (P = .05). Improvements in quality of life approached significance (P = .06). The findings demonstrate that the free-living physical activity intervention implemented during the very early recovery period after transplantation is feasible and acceptable. The intervention potentially reduces fatigue and improves quality of life. The positive results must be interpreted cautiously given the pilot nature of the study. The evidence supports continued investigation.

Faunal and vegetation monitoring in response to harbor dredging in the Port of Miami

USGS Publications Warehouse

Daniels, Andre; Stevenson, Rachael; Smith, Erin; Robblee, Michael

2018-04-11

Seagrasses are highly productive ecosystems. A before-after-control-impact (BACI) design was used to examine effects of dredging on seagrasses and the animals that inhabit them. The control site North Biscayne Bay and the affected site Port of Miami had seagrass densities decrease during both the before, Fish and Invertebrate Assessment Network 2006-2011, and after, Faunal Monitoring in Response to Harbor Dredging 2014-2016, studies. Turbidity levels increased at North Biscayne Bay and Port of Miami basins during the Faunal Monitoring in Response to Harbor Dredging study, especially in 2016. Animal populations decreased significantly in North Biscayne Bay and Port of Miami in the Faunal Monitoring in Response to Harbor Dredging study compared to the Fish and Invertebrate Assessment Network study. Predictive modeling shows that numbers of animal populations will likely continue to decrease if the negative trends in seagrass densities continue unabated. There could be effects on several fisheries vital to the south Florida economy. Additional research could determine if animal populations and seagrass densities have rebounded or continued to decrease.

Orbit on demand - Will cost determine best design?

NASA Technical Reports Server (NTRS)

Macconochie, J. O.; Mackley, E. A.; Morris, S. J.; Phillips, W. P.; Breiner, C. A.; Scotti, S. J.

1985-01-01

Eleven design concepts for vertical (V) and horizontal (H) take-off launch-on-demand manned orbital vehicles are discussed. Attention is given to up to three stages, Mach numbers (sub-, 2, or 3), expendable boosters, drop tanks (DT), and storable (S) or cryogenic fuels. All the concepts feature lifting bodies with circular cross-section and most have a 7 ft diam, 15 ft long payload bay as well as a crew compartment. Expendable elements impose higher costs and in some cases reduce all-azimuth launch capabilities. Single-stage vehicles simplify the logistics whether in H or V configuration. A two-stage H vehicle offers launch offset for the desired orbital plane before firing the rocket engines after take-off and subsonic acceleration. A two-stage fully reusable V form has the second lowest weight of the vehicles studied and an all-azimuth launch capability. Better definition of the prospective mission requirements is needed before choosing among the alternatives.

Plasma Cytokine Profiles in Long-Term Strenuous Exercise

PubMed Central

Nielsen, Hilde G.; Øktedalen, Olav; Opstad, Per-Kristian; Lyberg, Torstein

2016-01-01

The open window theory indicates altered immunity 3 to 72 hours after exercise. The J-curve describes the risk of illness in response to exercise. The aim of this study was to examine the secretion of proinflammatory and anti-inflammatory cytokines before and after long-term strenuous exercise. Fourteen marathon and 16 half-marathon runners and 10 military cadets participating in a military ranger-training course were recruited to this study. Within-subject design was used measuring levels of plasma cytokines before, during, and after exercise. Plasma cytokines were measured using Luminex multiplex technology and ELISA. Comparing pre/post plasma levels both the marathon- and the half-marathon runners showed heavily increased levels of IL-6, IL-10, and IL-8 (P < 0.001). LPS stimulation among the half-marathon runners decreased the postrace levels of IL-6, IL-1b, and TNFα by 45%, 24%, and 43%, respectively (P < 0.01). During the ranger training course the spontaneous and LPS-stimulated levels of IL-6, IL-8, IL-10, IL-1b, and TNFα changed in a similar fashion as in the half-marathon runners although the fluctuations were smaller. Our study supports the open window and the J-curve theory; the immune system is more activated and the subjects are more threatened to infectious pathogens after intensive physical activity and in the period after exercise. PMID:27239554

Effects of a multichannel dynamic functional electrical stimulation system on hemiplegic gait and muscle forces

PubMed Central

Qian, Jing-guang; Rong, Ke; Qian, Zhenyun; Wen, Chen; Zhang, Songning

2015-01-01

[Purpose] The purpose of the study was to design and implement a multichannel dynamic functional electrical stimulation system and investigate acute effects of functional electrical stimulation of the tibialis anterior and rectus femoris on ankle and knee sagittal-plane kinematics and related muscle forces of hemiplegic gait. [Subjects and Methods] A multichannel dynamic electrical stimulation system was developed with 8-channel low frequency current generators. Eight male hemiplegic patients were trained for 4 weeks with electric stimulation of the tibia anterior and rectus femoris muscles during walking, which was coupled with active contraction. Kinematic data were collected, and muscle forces of the tibialis anterior and rectus femoris of the affected limbs were analyzed using a musculoskelatal modeling approach before and after training. A paired sample t-test was used to detect the differences between before and after training. [Results] The step length of the affected limb significantly increased after the stimulation was applied. The maximum dorsiflexion angle and maximum knee flexion angle of the affected limb were both increased significantly during stimulation. The maximum muscle forces of both the tibia anterior and rectus femoris increased significantly during stimulation compared with before functional electrical stimulation was applied. [Conclusion] This study established a functional electrical stimulation strategy based on hemiplegic gait analysis and musculoskeletal modeling. The multichannel functional electrical stimulation system successfully corrected foot drop and altered circumduction hemiplegic gait pattern. PMID:26696734

Impact of presumed consent for organ donation on donation rates: a systematic review

PubMed Central

Rithalia, Amber; Suekarran, Sara; Myers, Lindsey; Sowden, Amanda

2009-01-01

Objectives To examine the impact of a system of presumed consent for organ donation on donation rates and to review data on attitudes towards presumed consent. Design Systematic review. Data sources Studies retrieved by online searches to January 2008 of Medline, Medline In-Process, Embase, CINAHL, PsycINFO, HMIC, PAIS International, and OpenSIGLE. Studies reviewed Five studies comparing donation rates before and after the introduction of legislation for presumed consent (before and after studies); eight studies comparing donation rates in countries with and without presumed consent systems (between country comparisons); 13 surveys of public and professional attitudes to presumed consent. Results The five before and after studies represented three countries: all reported an increase in donation rates after the introduction of presumed consent, but there was little investigation of any other changes taking place concurrently with the change in legislation. In the four best quality between country comparisons, presumed consent law or practice was associated with increased organ donation—increases of 25-30%, 21-26%, 2.7 more donors per million population, and 6.14 more donors per million population in the four studies. Other factors found to be important in at least one study were mortality from road traffic accidents and cerebrovascular causes, transplant capacity, gross domestic product per capita, health expenditure per capita, religion (Catholicism), education, public access to information, and a common law legal system. Eight surveys of attitudes to presumed consent were of the UK public. These surveys varied in the level of support for presumed consent, with surveys conducted before 2000 reporting the lowest levels of support (28-57%). The most recent survey, in 2007, reported that 64% of respondents supported a change to presumed consent. Conclusion Presumed consent alone is unlikely to explain the variation in organ donation rates between countries. Legislation, availability of donors, organisation and infrastructure of the transplantation service, wealth and investment in health care, and public attitudes to and awareness of organ donation may all play a part, but their relative importance is unclear. Recent UK surveys show support for presumed consent, though with variation in results that may reflect differences in survey methods. PMID:19147479

Empowerment-Based Diabetes Self-Management Education to Maintain Glycemic Targets During Ramadan Fasting in People With Diabetes Who Are on Conventional Insulin: A Feasibility Study

PubMed Central

Sahmoud, Sahar I.; Abdelsalam, Mona M.; Eichorst, Barbara

2017-01-01

Objective. This study aims to assess the feasibility of promoting safe Ramadan fasting through diabetes self-management education (DSME) and to determine the effect of such education on hypoglycemic episodes. Design and methods. This prospective study included subjects attending Ramadan reinforcement sessions for participants in the Educational Program for People with Diabetes (EPPWD) at the Ain-Shams University Diabetes Center in Cairo, Egypt. The DSME sessions started 2–3 weeks before Ramadan and included one experimental fasting day during the first week and one during the second week. Participants’ A1C and serum fructosamine levels were measured before and after Ramadan, and they completed weekly self-monitoring of blood glucose (SMBG) logs. Results. Among 21 participants who were intending to fast for Ramadan, 14 completed the program. Their mean A1C was 6.7 ± 1.6%, and SMBG results showed a statistically nonsignificant difference in mean blood glucose levels before and after Ramadan (123.84 ± 39.96 and 123.84 ± 25.92 mg/dL, respectively; P >0.05). Serum fructosamine after Ramadan declined by 10% from pre-Ramadan levels. The mean number of hypoglycemic events before Ramadan was 3 ± 1.04, which declined to 1.4 ± 0.5 during Ramadan. Differences between group 1 (those without hypoglycemia, n = 8) and group 2 (those with hypoglycemia, n = 6) were nonsignificant for all variables, including A1C. Conclusion. Ramadan fasting is feasible for people with diabetes who are on a multiple daily injection insulin regimen and participate in the EPPWD. The number of hypoglycemic events per month declined with the attainment of DSME. PMID:28270713

Systemic changes and adverse effects induced by retinopathy of prematurity screening.

PubMed

Jiang, Jing-Bo; Zhang, Zhi-Wei; Zhang, Jia-Wen; Wang, Yan-Li; Nie, Chuan; Luo, Xian-Qiong

2016-01-01

To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening. A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval. Totally 1254 prematurity babies receiving ROP screening during Jan. 1(st) 2013 to Dec. 31(th) 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (P<0.01) increase in systolic BP and a 7.24 mm Hg (P<0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm (P<0.01) higher than the 133.3±9.0 bpm control level. The oxygen saturation shared an average drop of 5% (P<0.01) during screening. In prematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01). In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.

Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.

PubMed

Helmons, Pieter J; Dalton, Ashley J; Daniels, Charles E

2012-10-01

The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form. ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p < 0.0001). The predominant error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program. A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.

Effects of Knowledge and Display Design on Comprehension of Complex Graphics

ERIC Educational Resources Information Center

Canham, Matt; Hegarty, Mary

2010-01-01

In two experiments, participants made inferences from weather maps, before and after they received instruction about relevant meteorological principles. Different versions of the maps showed either task-relevant information alone, or both task-relevant and task-irrelevant information. Participants improved on the inference task after instruction,…

40 CFR 60.32e - Designated facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... modification was commenced on or before March 16, 1998. (2) For which construction was commenced after June 20, 1996 but no later than December 1, 2008, or for which modification is commenced after March 16, 1998... only pathological waste, low-level radioactive waste, and/or chemotherapeutic waste (all defined in...

Is ACOG guideline helpful for encouraging pregnant women to do exercise during pregnancy?

PubMed

Davari Tanha, Fatemeh; Ghajarzadeh, Mahsa; Mohseni, Mona; Shariat, Mamak; Ranjbar, Maryam

2014-01-01

To evaluate physical activity of pregnant women before and after ACOG guideline study. Four hundred and eighty-five pregnant women enrolled in this before-after study. They were asked to study ACOG guideline. A structured questionnaire filled by women at first visit and the last visit in the prenatal clinic.Type, frequency, duration and anxiety about doing exercises during pregnancy period. Before education, 411 did exercises before pregnancy onset, among them, 346 were walking out and 65 did light exercises such as aerobics. After studying the protocol, 434 (89.4%) did walking during pregnancy period in comparison to 71% who did walking before pregnancy (P<0.001). Forty two (56.7%) out of 74 who had not done sport before, went for walking after the protocol reading, and nine continued not doing exercise. Among 74 participants who had not done exercise before the protocol reading, 16 (21%) were doing exercise three times a week and 11 (14%) changed their habit to daily exercise practice (P<0.001). Forty percent (195 women) were anxious about doing exercise during pregnancy before guideline study, while 116 reported that after the protocol reading, they had no anxiety about doing exercises during pregnancy (P<0.001). Guidelines providing information about physical activity during pregnancy will help pregnant women to do exercise during pregnancy with convenience and less anxiety.

The Effect of Integration of Self-Management Web Platforms on Health Status in Chronic Obstructive Pulmonary Disease Management in Primary Care (e-Vita Study): Interrupted Time Series Design.

PubMed

Talboom-Kamp, Esther Pwa; Verdijk, Noortje A; Kasteleyn, Marise J; Harmans, Lara M; Talboom, Irvin Jsh; Looijmans-van den Akker, Ingrid; van Geloven, Nan; Numans, Mattijs E; Chavannes, Niels H

2017-08-16

Worldwide nearly 3 million people die from chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves quality of life for COPD patients and can reduce hospitalization. Self-management of COPD through eHealth is an effective method to improve IDM and clinical outcomes. The objective of this implementation study was to investigate the effect of 3 chronic obstructive pulmonary disease eHealth programs applied in primary care on health status. The e-Vita COPD study compares different levels of integration of Web-based self-management platforms in IDM in 3 primary care settings. Patient health status is examined using the Clinical COPD Questionnaire (CCQ). The parallel cohort design includes 3 levels of integration in IDM (groups 1, 2, 3) and randomization of 2 levels of personal assistance for patients (group A, high assistance, group B, low assistance). Interrupted time series (ITS) design was used to collect CCQ data at multiple time points before and after intervention, and multilevel linear regression modeling was used to analyze CCQ data. Of the 702 invited patients, 215 (30.6%) registered to a platform. Of these, 82 participated in group 1 (high integration IDM), 36 in group 1A (high assistance), and 46 in group 1B (low assistance); 96 participated in group 2 (medium integration IDM), 44 in group 2A (high assistance) and 52 in group 2B (low assistance); also, 37 participated in group 3 (no integration IDM). In the total group, no significant difference was found in change in CCQ trend (P=.334) before (-0.47% per month) and after the intervention (-0.084% per month). Also, no significant difference was found in CCQ changes before versus after the intervention between the groups with high versus low personal assistance. In all subgroups, there was no significant change in the CCQ trend before and after the intervention (group 1A, P=.237; 1B, P=.991; 2A, P=.120; 2B, P=.166; 3, P=.945). The e-Vita eHealth-supported COPD programs had no beneficial impact on the health status of COPD patients. Also, no differences were found between the patient groups receiving different levels of personal assistance. Netherlands Trial Registry NTR4098; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4098 (Archived by WebCite at http://www.webcitation.org/6sbM5PayG). ©Esther PWA Talboom-Kamp, Noortje A Verdijk, Marise J Kasteleyn, Lara M Harmans, Irvin JSH Talboom, Ingrid Looijmans-van den Akker, Nan van Geloven, Mattijs E Numans, Niels H Chavannes. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.08.2017.

Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study

PubMed Central

Alfredsson, Lars; Sjölin-Forsberg, Gunilla; Gerdén, Barbro; Bergman, Ulf; Jokinen, Jussi

2010-01-01

Objective To assess the risk of attempted suicide before, during, and after treatment with isotretinoin for severe acne. Design Retrospective cohort study linking a named patient register of isotretinoin users (1980-9) to hospital discharge and cause of death registers (1980-2001). Setting Sweden, 1980-2001. Population 5756 patients aged 15 to 49 years prescribed isotretinoin for severe acne observed for 17 197 person years before, 2905 person years during, and 87 120 person years after treatment. Main outcome measures Standardised incidence ratio (observed number divided by expected number of suicide attempts standardised by sex, age, and calendar year), calculated up to three years before, during, and up to 15 years after end of treatment. Results 128 patients were admitted to hospital for attempted suicide. During the year before treatment, the standardised incidence ratio for attempted suicide was raised: 1.57 (95% confidence interval 0.86 to 2.63) for all (including repeat) attempts and 1.36 (0.65 to 2.50) counting only first attempts. The standardised incidence ratio during and up to six months after treatment was 1.78 (1.04 to 2.85) for all attempts and 1.93 (1.08 to 3.18) for first attempts. Three years after treatment stopped, the observed number of attempts was close to the expected number and remained so during the 15 years of follow-up: standardised incidence ratio 1.04 (0.74 to 1.43) for all attempts and 0.97 (0.64 to 1.40) for first attempts. Twelve (38%) of 32 patients who made their first suicide attempt before treatment made a new attempt or committed suicide thereafter. In contrast, 10 (71%) of the 14 who made their first suicide attempt within six months after treatment stopped made a new attempt or committed suicide during follow-up (two sample test of proportions, P=0.034). The number needed to harm was 2300 new six month treatments per year for one additional first suicide attempt to occur and 5000 per year for one additional repeat attempt. Conclusions An increased risk of attempted suicide was apparent up to six months after the end of treatment with isotretinoin, which motivates a close monitoring of patients for suicidal behaviour for up to a year after treatment has ended. However, the risk of attempted suicide was already rising before treatment, so an additional risk due to the isotretinoin treatment cannot be established. As patients with a history of suicide attempts before treatment made new attempts to a lesser extent than did patients who started such behaviour in connection with treatment, patients with severe acne should not automatically have isotretinoin treatment withheld because of a history of attempted suicide. PMID:21071484

Preparing Residents Effectively in Emergency Skills Training With a Serious Game

PubMed Central

Dankbaar, Mary E.W.; Roozeboom, Maartje Bakhuys; Oprins, Esther A.P. B.; Rutten, Frans; van Merrienboer, Jeroen J.G.; van Saase, Jan L.C.M.; Schuit, Stephanie C.E.

2017-01-01

Introduction Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game. Methods This was a quasi-experimental study with residents preparing for a rotation in the emergency department. The “reading” group received a course manual before classroom training; the “reading and game” group received this manual plus the game as preparation for the same training. Emergency skills were assessed before training (with residents who agreed to participate in an extra pretraining assessment), using validated competency scales and a global performance scale. We also measured motivation. Results All groups had comparable important characteristics (eg, experience with acute care). Before training, the reading and game group felt motivated to play the game and spent more self-study time (+2.5 hours) than the reading group. Game-playing residents showed higher scores on objectively measured and self-assessed clinical competencies but equal scores on the global performance scale and were equally motivated for training, compared with the reading group. After the 2-week training, no differences between groups existed. Conclusions After preparing training with an additional serious game, residents showed improved clinical competencies, compared with residents who only studied course material. After a 2-week training, this advantage disappeared. Future research should study the retention of game effects in blended designs. PMID:27764018

Preparing Residents Effectively in Emergency Skills Training With a Serious Game.

PubMed

Dankbaar, Mary E W; Roozeboom, Maartje Bakhuys; Oprins, Esther A P B; Rutten, Frans; van Merrienboer, Jeroen J G; van Saase, Jan L C M; Schuit, Stephanie C E

2017-02-01

Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game. This was a quasi-experimental study with residents preparing for a rotation in the emergency department. The "reading" group received a course manual before classroom training; the "reading and game" group received this manual plus the game as preparation for the same training. Emergency skills were assessed before training (with residents who agreed to participate in an extra pretraining assessment), using validated competency scales and a global performance scale. We also measured motivation. All groups had comparable important characteristics (eg, experience with acute care). Before training, the reading and game group felt motivated to play the game and spent more self-study time (+2.5 hours) than the reading group. Game-playing residents showed higher scores on objectively measured and self-assessed clinical competencies but equal scores on the global performance scale and were equally motivated for training, compared with the reading group. After the 2-week training, no differences between groups existed. After preparing training with an additional serious game, residents showed improved clinical competencies, compared with residents who only studied course material. After a 2-week training, this advantage disappeared. Future research should study the retention of game effects in blended designs.

47 CFR 1.748 - Dismissal of applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., and Reports Involving Common Carriers Applications § 1.748 Dismissal of applications. (a) Before... good cause shown. An application may be dismissed with prejudice after it has been designated for...

47 CFR 1.748 - Dismissal of applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., and Reports Involving Common Carriers Applications § 1.748 Dismissal of applications. (a) Before... good cause shown. An application may be dismissed with prejudice after it has been designated for...

Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics

PubMed Central

New, Steve; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Morgan, Lauren; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

2016-01-01

Objectives To examine the effectiveness of a “systems” approach using Lean methodology to improve surgical care, as part of a programme of studies investigating possible synergy between improvement approaches. Setting A controlled before-after study using the orthopaedic trauma theatre of a UK Trust hospital as the active site and an elective orthopaedic theatre in the same Trust as control. Participants All staff involved in surgical procedures in both theatres. Interventions A one-day “lean” training course delivered by an experienced specialist team was followed by support and assistance in developing a 6 month improvement project. Clinical staff selected the subjects for improvement and designed the improvements. Outcome Measures We compared technical and non-technical team performance in theatre using WHO checklist compliance evaluation, “glitch count” and Oxford NOTECHS II in a sample of directly observed operations, and patient outcome (length of stay, complications and readmissions) for all patients. We collected observational data for 3 months and clinical data for 6 months before and after the intervention period. We compared changes in measures using 2-way analysis of variance. Results We studied 576 cases before and 465 after intervention, observing the operation in 38 and 41 cases respectively. We found no significant changes in team performance or patient outcome measures. The intervention theatre staff focused their efforts on improving first patient arrival time, which improved by 20 minutes after intervention. Conclusions This version of “lean” system improvement did not improve measured safety processes or outcomes. The study highlighted an important tension between promoting staff ownership and providing direction, which needs to be managed in “lean” projects. Space and time for staff to conduct improvement activities are important for success. PMID:27124012

The Effects of Sleep and Touch Therapy on Symptoms of Fibromyalgia and Depression

PubMed Central

Demirbağ, BC; Erci, B

2012-01-01

Background Many alternative interventions are practiced in an effort to reduce symptoms of fibromiyalgia. The aim of this study was to determine the effects of sleep and touch therapy accompanied by music and aromatherapy on the symptoms of fibromyalgia and depression. Methods: The study was carried out between September 2009 and March 2011 in the Physical Medicine and Rehabilitation Polyclinic in Trabzon, Turkey. The sample consisted of 162 female patients and had been diagnosed with fibromyalgia at least 6 months prior to the study. Since the sample contains two intervention groups and one control group, each group was assigned 54 patients. Data were collected through a Personal Information Form, a Fibromyalgia Symptom Form and the Beck Depression Index. The study employed a pre-test/post-test control group design. A paired sample t-test was used in the comparisons of the in-group scale points; the chi-square in the intergroup comparisons, and the McNamer test in the in-group comparisons. Results: After the interventions, it was observed that the depression levels in the touch-music-aroma therapy group showed a larger decrease (before: 22.01±5.3; after: 14.52±3.7) than in the sleep-music-aroma therapy group (before: 24.81±5.1; after: 20.16±4.9) and control groups (before: 23.73±4.4; after: 21.05±2.6). Symptoms such as restless sleep, headache, morning fatigue, exhaustion, feeling like crying and bowel complaints were also significantly reduced (P<0.05). Conclusion: It is suggested that nurses providing healthcare to FMS patients should also offer these patients aromatherapy, sleep, music and touch therapies. PMID:23304675

Environmental Impact of Offshore Gas Activities on the Benthic Environment: A Case Study

NASA Astrophysics Data System (ADS)

Punzo, E.; Gomiero, A.; Tassetti, A. N.; Strafella, P.; Santelli, A.; Salvalaggio, V.; Spagnolo, A.; Scarcella, G.; De Biasi, A. M.; Kozinkova, L.; Fabi, G.

2017-08-01

Multidisciplinary monitoring of the impact of offshore gas platforms on northern and central Adriatic marine ecosystems has been conducted since 1998. Beginning in 2006, 4-5 year investigations spanning the period before, during, and after rig installation have explored the effects of its construction and presence on macrozoobenthic communities, sediment, water quality, pollutant bioaccumulation, and fish assemblages. In this study, sediment samples collected at increasing distance from an offshore gas platform before, during and after its construction were subjected to chemical analysis and assessment of benthic communities. Ecological indices were calculated to evaluate the ecological status of the area. Ecotoxicological analysis of sediment was performed to establish whether pollutants are transferred to biota. The study applied a before-after control-impact design to assess the effects of rig construction and presence and provide reference data on the possible impacts of any further expansion of the gas extraction industry in the already heavily exploited Adriatic Sea. Only some of the metals investigated (barium, chromium, cadmium, and zinc) showed a different spatial and/or temporal distribution that may be platform-related. In the early phases, the sediment concentrations of polycyclic aromatic hydrocarbons were below the detection limit at all sites; they then became detectable, but without significant spatial differences. The present findings suggest that the environmental effects of offshore gas platforms may be difficult to quantify, interpret, and generalize, because they are influenced by numerous, often local, abiotic, and biotic variables in different and unpredictable ways.

Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study.

PubMed

Zhu, Chunyan; Geng, Qingshan; Yang, Hongling; Chen, Li; Fu, Xianhua; Jiang, Wei

2013-07-23

Rural-to-urban female migrant workers have a lower quality of life compared to the general population. Improving these conditions remains highly challenging. This paper reports the health-related quality of life (HRQoL) of the female migrant workers in an educational project. In this before-and-after study, a community-based health education intervention was developed to improve female migrant workers' HRQoL and job satisfaction. A factory was selected as the location to implement the trial, using a before-and-after design. The education intervention included distribution and free access to study materials, monthly lectures, and counseling. The primary endpoint was HRQoL, and gynecological disease and job satisfaction were secondary endpoints. We assessed HRQoL at baseline and at 6-month follow-up using the Health Survey Short Form (SF-36). Compared to the baseline assessment, the participants at the 6-month survey reported higher General Health scores (standardized-β coefficients (Betas) of β = 0.056; P <0.001), Vitality scores (β = 0.066; P <0.001), Mental Health scores (β = 0.062; P <0.001), mental component summary scores (β = 0.040; P <0.001), and job satisfaction (Odds Ratio [OR] 2.104, 95% confidence interval [CI] 1.837-2.408; P <0.01). A community-based educational intervention, targeted at female migrant workers, appears effective in improving HRQoL and job satisfaction.

Environmental Impact of Offshore Gas Activities on the Benthic Environment: A Case Study.

PubMed

Punzo, E; Gomiero, A; Tassetti, A N; Strafella, P; Santelli, A; Salvalaggio, V; Spagnolo, A; Scarcella, G; De Biasi, A M; Kozinkova, L; Fabi, G

2017-08-01

Multidisciplinary monitoring of the impact of offshore gas platforms on northern and central Adriatic marine ecosystems has been conducted since 1998. Beginning in 2006, 4-5 year investigations spanning the period before, during, and after rig installation have explored the effects of its construction and presence on macrozoobenthic communities, sediment, water quality, pollutant bioaccumulation, and fish assemblages. In this study, sediment samples collected at increasing distance from an offshore gas platform before, during and after its construction were subjected to chemical analysis and assessment of benthic communities. Ecological indices were calculated to evaluate the ecological status of the area. Ecotoxicological analysis of sediment was performed to establish whether pollutants are transferred to biota. The study applied a before-after control-impact design to assess the effects of rig construction and presence and provide reference data on the possible impacts of any further expansion of the gas extraction industry in the already heavily exploited Adriatic Sea. Only some of the metals investigated (barium, chromium, cadmium, and zinc) showed a different spatial and/or temporal distribution that may be platform-related. In the early phases, the sediment concentrations of polycyclic aromatic hydrocarbons were below the detection limit at all sites; they then became detectable, but without significant spatial differences. The present findings suggest that the environmental effects of offshore gas platforms may be difficult to quantify, interpret, and generalize, because they are influenced by numerous, often local, abiotic, and biotic variables in different and unpredictable ways.

A study of design approach of spreading schemes for viral marketing based on human dynamics

NASA Astrophysics Data System (ADS)

Yang, Jianmei; Zhuang, Dong; Xie, Weicong; Chen, Guangrong

2013-12-01

Before launching a real viral marketing campaign, it is needed to design a spreading scheme by simulations. Based on a categorization of spreading patterns in real world and models, we point out that the existing research (especially Yang et al. (2010) Ref. [16]) implicitly assume that if a user decides to post a received message (is activated), he/she will take the reposting action promptly (Prompt Action After Activation, or PAAA). After a careful analysis on a real dataset however, it is found that the observed time differences between action and activation exhibit a heavy-tailed distribution. A simulation model for heavy-tailed pattern is then proposed and performed. Similarities and differences of spreading processes between the heavy-tailed and PAAA patterns are analyzed. Consequently, a more practical design approach of spreading scheme for viral marketing on QQ platform is proposed. The design approach can be extended and applied to the contexts of non-heavy-tailed pattern, and viral marketing on other instant messaging platforms.

Understanding the Effects of Long-duration Space Flight on Astronant Functional Task Performance

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob J.; Batson, Crystal D.; Buxton, Roxanne E.; Feiveson, Al H.; Kofman, Igor S.; Lee, Stuart M. C.; Miller, Chris A.; Mulavara, Ajitkumar P.; Peters, Brian T.; Phillips, Tiffany;

Spatial Frequency Domain Imaging of Port Wine Stain Biochemical Composition in Response to Laser Therapy: A Pilot Study

PubMed Central

Mazhar, Amaan; Sharif, Seyed A.; Cuccia, J. David; Nelson, J. Stuart; Kelly, Kristen M.; Durkin, Anthony J.

2012-01-01

Background and Objective Objective methods to assess port wine stain (PWS) response to laser treatment have been the subject of various research efforts for several years. Herein, we present a pilot study using a newly developed, light emitting diode (LED) based spatial frequency domain imaging (SFDI) device to record quantitatively biochemical compositional changes in PWS after laser therapy. Study Design/Patients and Methods A SFDI system was used to image before, and after, five PWS treatment sessions [n = 4 subjects (one subject was imaged before and after two consecutive laser treatments)]. SFDI derived wide-field optical properties (absorption and scattering) and tissue chromophore concentrations including oxy-hemoglobin (ctO2Hb), deoxy-hemoglobin (ctHHb), total hemoglobin (ctTHb), and tissue oxygen saturation (stO2) are presented for skin imaged prior to and immediately after laser treatment. The SFDI derived images were analyzed by comparing the above measurements in PWS to those of normal skin and tracking changes immediately after laser exposure. Results Elevated oxy-hemoglobin (>20%) and tissue oxygen saturation (>5%) were measured in all PWS lesions and compared to values for normal skin prior to treatment. Laser treatment resulted in an increase in deoxy-hemoglobin (>100%), decrease in tissue oxygen saturation (>10%), and reduced scattering (>15%) in all PWS lesions. One subject was followed before and after two consecutive laser treatments and the overall improvement in PWS lesion blanching was quantitatively assessed by measuring a 45% decrease in dermal blood volume. Conclusion SFDI is a rapid non-contact wide-field optical technique that shows potential as an imaging device that can be used to quantify biochemical compositional changes in PWS after laser therapy. Future work will investigate the potential of SFDI to provide intra-operative guidance for laser therapy of PWS lesions on an individual patient basis. PMID:22911574

Elections Have Consequences for Student Mental Health: An Accidental Daily Diary Study.

PubMed

Roche, Michael J; Jacobson, Nicholas C

2018-01-01

Polling suggested that the 2016 United States presidential election affected citizens' mood and stress levels. Yet, polling often fails to employ repeated measurement designs that can capture pre- and post-levels of change within the same person. In this study, undergraduate students ( N = 85) completed a 14-day daily diary where mood, stress, and mental health outcomes were assessed before and after the election. Multilevel modeling revealed an immediate upsurge in anxiety, stress, and poor sleep quality the day after the election, followed by a recovery period indicating these effects were short-lived. Other reactions (anger, fear, marginalization, and experiencing discrimination) evidenced a significant upsurge without a significant recovery. We consider how daily diary research designs like this one could be integrated into college settings to inform counseling center resource allocation, and we also comment on the promise of the daily diary methodology for political research.

Exploring the influence of sterilisation and storage on some physicochemical properties of coconut (Cocos nucifera L.) water

PubMed Central

2011-01-01

Background Fresh coconut (Cocos nucifera L) water is a clear, sterile, colourless, slightly acidic and naturally flavoured drink, mostly consumed in tropical areas. It is a rich source of nutrients and has been used for medical purposes. This study was designed to investigate changes in selected characteristics of coconut water after autoclaving, gamma irradiation and storage. Also, the study was designed for assessing the possibility of measuring the growth of bacterial in fresh, stored or sterilised coconut water using turbidity measurements (at wavelengths between 600 nm and 800 nm) or by dry biomass determinations. Results Portions of coconut water aseptically extracted from the matured fruit, (average pH of 6.33 ± 0.17) were either stored at 4°C, autoclaved at 121°C for 20 min., or irradiated with gamma rays at 5 kGy. Subsequent changes in selected characteristics were determined. Autoclaving, gamma irradiation and long term storage of coconut water at 4°C resulted both in the development of a pale to intense yellow colour and changes in turbidity. After storage, the dry matter content of fresh, autoclaved and irradiated coconut water by 52.0%, 23.5% and 5.0% respectively. There were also significant differences in the UV spectra before and after sterilisation and during the storage of the coconut water. Although changes in total carbohydrates were observed, they were not significant (p > 0.05). Conclusions The enormous differences in the characteristics before and after storage suggests that the use of turbidity and dry biomass measurements for measuring the growth of bacteria in fresh, autoclaved and gamma irradiated coconut water before storage is practicable without any possibility of interference by the innate turbidity, colour and dry matter of the coconut water. However, this is not practicable after storing the coconut waters at 4°C, since there were increases in the turbidity and dry matter of the coconut water to levels that will mask the turbidity of a growing bacteria culture. PMID:22032822

Criminal Behavior and Repeat Violent Trauma: A Case-Control Study.

PubMed

Nanney, John T; Conrad, Erich J; McCloskey, Michael; Constans, Joseph I

2015-09-01

Repeat violent injury is common among young urban men and is increasingly a focus of trauma center-based injury prevention efforts. Though understanding risk factors for repeat violent injury may be critical in designing such interventions, this knowledge is limited. This study aims to determine which criminal behaviors, both before and after the initial trauma, predict repeat violent trauma. Gun, violent, and drug crimes are expected to increase risk of subsequent violent injury among victims of violence. A case-control design examined trauma registry and publicly available criminal data for all male patients aged <40 years presenting for violent trauma between April 2006 and December 2011 (N=1,142) to the sole Level 1 trauma center in a city with high rates of violence. Logistic regression was used to determine criminal behaviors predictive of repeat violent injury. Data were obtained and analyzed between January 2013 and June 2014. Regarding crimes committed before the first injury, only drug crime (OR=5.32) predicted repeat violent trauma. With respect to crimes committed after the initial injury, illegal gun possession (OR=2.70) predicted repeat victimization. Initiating gun (OR=3.53) or drug crime (OR=5.12) was associated with increased risk. Prior drug involvement may identify young male victims of violence as at high risk of repeat violent injury. Gun carrying and initiating drug involvement after the initial injury may increase risk of repeat injury and may be important targets for interventions aimed at preventing repeat violent trauma. Published by Elsevier Inc.

Movement plans for posture selection do not transfer across hands

PubMed Central

Schütz, Christoph; Schack, Thomas

2015-01-01

In a sequential task, the grasp postures people select depend on their movement history. This motor hysteresis effect results from the reuse of former movement plans and reduces the cognitive cost of movement planning. Movement plans for hand trajectories not only transfer across successive trials, but also across hands. We therefore asked whether such a transfer would also be found in movement plans for hand postures. To this end, we designed a sequential, continuous posture selection task. Participants had to open a column of drawers with cylindrical knobs in ascending and descending sequences. A hand switch was required in each sequence. Hand pro/supination was analyzed directly before and after the hand switch. Results showed that hysteresis effects were present directly before, but absent directly after the hand switch. This indicates that, in the current study, movement plans for hand postures only transfer across trials, but not across hands. PMID:26441734

Students' Perspectives on Interprofessional Teamwork Before and After an Interprofessional Pain Education Course.

PubMed

Simko, Lynn Coletta; Rhodes, Diane C; McGinnis, Kathleen A; Fiedor, Jaclyn

2017-08-01

Objective. To evaluate changes in pharmacy and nursing student perspectives before and after completion of an interprofessional education (IPE) course. Methods. A pre- and post-perception scale descriptive prospective study design utilizing Interdisciplinary Education Perception Scale (IEPS) and Collaboration and Satisfaction about Care Decisions (CSACD) with self-reported statements of knowledge and importance of professional roles was used. Results. Significant improvement was shown for IEPS and CSACD overall and for both pharmacy and nursing students. Post-scores improved from 2013 to 2014, with significant improvements for IEPS. Pharmacy student findings show an increase in knowledge and importance of their roles and those of nursing students. Nursing students grew significantly in their knowledge of the pharmacist's role only. Conclusion. An IPE course for nursing and pharmacy students, taught by diverse health professionals with a care plan and simulation assignments, fosters the Interprofessional Education Collaborative panel's competencies for IPE.

Students’ Perspectives on Interprofessional Teamwork Before and After an Interprofessional Pain Education Course

PubMed Central

Rhodes, Diane C.; McGinnis, Kathleen A.; Fiedor, Jaclyn

2017-01-01

Objective. To evaluate changes in pharmacy and nursing student perspectives before and after completion of an interprofessional education (IPE) course. Methods. A pre- and post-perception scale descriptive prospective study design utilizing Interdisciplinary Education Perception Scale (IEPS) and Collaboration and Satisfaction about Care Decisions (CSACD) with self-reported statements of knowledge and importance of professional roles was used. Results. Significant improvement was shown for IEPS and CSACD overall and for both pharmacy and nursing students. Post-scores improved from 2013 to 2014, with significant improvements for IEPS. Pharmacy student findings show an increase in knowledge and importance of their roles and those of nursing students. Nursing students grew significantly in their knowledge of the pharmacist’s role only. Conclusion. An IPE course for nursing and pharmacy students, taught by diverse health professionals with a care plan and simulation assignments, fosters the Interprofessional Education Collaborative panel’s competencies for IPE. PMID:28970605

Highly Effective Birth Control Use Before and After Women's Incarceration

PubMed Central

Chen, Hsiang-Feng; Cropsey, Karen L.; Clarke, Jennifer G.; Kelly, Patricia J.

2015-01-01

Abstract Background: We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use. Methods: Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control. Results: Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail (p<0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control (p=0.001) and alcohol problems (p=0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies (p=0.012) were the only factor associated with utilization of highly effective birth control after release from jail. Conclusions: Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail. PMID:25555175

Highly Effective Birth Control Use Before and After Women's Incarceration.

PubMed

Ramaswamy, Megha; Chen, Hsiang-Feng; Cropsey, Karen L; Clarke, Jennifer G; Kelly, Patricia J

2015-06-01

We examined factors associated with women's use of highly effective birth control before and after incarceration, since women with ongoing criminal justice involvement bear a disproportionate burden of sexual and reproductive health problems, including high rates of unintended pregnancy and inconsistent contraceptive use. Using a longitudinal study design, we conducted surveys with 102 women in an urban midwestern jail and then followed up with 66 of them 6 months after incarceration. We used stepwise logistic regression to assess individual, interpersonal, resource-based, organizational, and environmental factors associated with utilizing highly effective birth control. Forty-two percent of women reported utilizing highly effective birth control (e.g., sterilization or other highly effective reversible methods) prior to incarceration, and 54% reported using these methods after release from jail (p<0.001). Ninety percent of women reported not wanting to get pregnant. Consistent use of birth control (p=0.001) and alcohol problems (p=0.027) were associated with utilization of highly effective birth control prior to incarceration. Previous pregnancies (p=0.012) were the only factor associated with utilization of highly effective birth control after release from jail. Clinicians and public health practitioners can use findings from this study to develop clinical and intervention efforts aimed at improving unintended-pregnancy prevention among incarcerated women both during their confinement and during the tumultuous period after their release from jail.

Equipoise, design bias, and randomized controlled trials: the elusive ethics of new drug development.

PubMed

Fries, James F; Krishnan, Eswar

2004-01-01

The concept of 'equipoise', or the 'uncertainty principle', has been represented as a central ethical principle, and holds that a subject may be enrolled in a randomized controlled trial (RCT) only if there is true uncertainty about which of the trial arms is most likely to benefit the patient. We sought to estimate the frequency with which equipoise conditions were met in industry-sponsored RCTs in rheumatology, to explore the reasons for any deviations from equipoise, to examine the concept of 'design bias', and to consider alternative ethical formulations that might improve subject safety and autonomy. We studied abstracts accepted for the 2001 American College of Rheumatology meetings that reported RCTs, acknowledged industry sponsorship, and had clinical end-points (n = 45), and examined the proportion of studies that favored the registration or marketing of the sponsor's drug. In every trial (45/45) results were favorable to the sponsor, indicating that results could have been predicted in advance solely by knowledge of sponsorship (P < 0.0001). Equipoise clearly was being systematically violated. Publication bias appeared to be an incomplete explanation for this dramatic result; this bias occurs after a study is completed. Rather, we hypothesize that 'design bias', in which extensive preliminary data are used to design studies with a high likelihood of being positive, is the major cause of the asymmetric results. Design 'bias' occurs before the trial is begun and is inconsistent with the equipoise principle. However, design bias increases scientific efficiency, decreases drug development costs, and limits the number of subjects required, probably reducing aggregate risks to participants. Conceptual and ethical issues were found with the equipoise principle, which encourages performance of negative studies; ignores patient values, patient autonomy, and social benefits; is applied at a conceptually inappropriate decision point (after randomization rather than before); and is in conflict with the Belmont, Nuremberg, and other sets of ethical principles, as well as with US Food and Drug Administration procedures. We propose a principle of 'positive expected outcomes', which informs the assessment that a trial is ethical, together with a restatement of the priority of personal autonomy.

Predictors of fat-free mass loss 1 year after laparoscopic sleeve gastrectomy.

PubMed

Guida, B; Cataldi, M; Busetto, L; Aiello, M L; Musella, M; Capone, D; Parolisi, S; Policastro, V; Ragozini, G; Belfiore, A

2018-03-24

Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric surgery interventions because of its safety and efficacy. Nevertheless, concerns have been raised on its detrimental effect on patient nutritional state that can ultimately lead to the loss of fat-free mass (FFM). There is interest in identifying predictors for the early identification of patients at risk of this highly unwanted adverse because they could benefit of nutritional preventive interventions. Therefore, we investigated whether anthropometric parameters, body composition or resting energy expenditure (REE) measured before surgery could predict FFM loss 1 year after LSG. Study design was retrospective observational. We retrieved data on body weight, BMI, body composition and REE before and 1 year after LSG from the medical files of 36 patients operated on by LSG at our institutions. Simple regression, the Oldham's method and multilevel analysis were used to identify predictors of FFM loss. Averaged percentage FFM loss 1 year after LSG was 17.0 ± 7.7% with significant differences between sexes (20.8 ± 6.6 in males and 12.2 ± 6.1% in females, p < 0.001). FFM loss was strongly predicted by pre-surgery FFM and this effect persisted also after correcting for the contribution of sex. High FFM values before surgery predict a more severe FFM loss after LSG. This factor could also account for the higher FFM loss in men than in women. Our finding could help in the early identification of patient requiring a nutritional support after LSG.

Treatment of temporomandibular myofascial pain with deep dry needling

PubMed Central

Gonzalez-Perez, Luis M.; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco J.

2012-01-01

Objectives: The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. Study Design: We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6,5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. Results: We found a statistically significant relationship (p<0,01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Conclusions: Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle. Key words:Temporomandibular joint, myofascial pain, external pterygoid muscle, trigger point, deep dry needling. PMID:22549679

Obesity in the Kidney Transplant Process.

PubMed

Ateş, Damla; Cebeci, Fatma

2018-03-01

Obesity, which has become an increasing problem worldwide, poses a risk for kidney transplant recipients both before and after surgery. In this literature review, we studied the effects of obesity before and after kidney transplant. There are numerous studies and different opinions on the effects of obesity on graft function before and after transplant. Obesity prolongs surgery time and the ischemic process. A large cohort study of 11 836 recipients noted a close association between body mass index and delayed renal transplant and delayed graft function. However, another study found that being overweight or obese before transplant did not have any effects over the medium and long term. A 20-year follow-up study indicated that the firstyear body mass index in recipients after renal transplant had a greater effect on graft function and survival than body mass index before transplant. Still, another study found that body mass index had no effects on graft function and survival. In the study, 3-year graft function and mortality rates of morbidly obese people without diabetes, the functional status without dialysis, and living-donor transplant were reported to be much lower than in those with normal weight. In conclusion, there is no consensus on the effects of obesity before and after transplant, and it has been pointed out that more research should be done on this subject.

The Effect of Foot Reflexology on Acute Pain in Infants: A Randomized Controlled Trial.

PubMed

Koç, Tuba; Gözen, Duygu

2015-10-01

This study was a randomized controlled trial designed to evaluate the effect of foot reflexology applied on infants on acute pain that may arise after vaccine injection. The sample consisted of 1- to 12-month-old infants registered in a family health center in Istanbul, Turkey, for healthcare follow-up. A total of 60 infants who met the criteria of the sample group were included in the study; 30 infants constituted the reflexology group and the other 30 constituted the control group. Although questionnaire forms were used to determine the descriptive characteristics of infant-mother pairs, the Face, Legs, Activity, Cry, Consolability (FLACC) Pain Assessment Scale was used to evaluate pain level. Infants in the reflexology group received reflexology treatment for an average of 20-30 minutes before vaccination, depending on the physical size of the infant's foot. Pain, heart rate, oxygen saturation levels, and crying periods of infants in the reflexology and control groups were evaluated before and after vaccination. The FLACC pain score was observed to be statistically similar between groups. After reflexology was applied to infants in the reflexology group before vaccination, it was determined that the pain score was reduced to .50 ± 1.14. In the examination performed after vaccination, FLACC pain score was found to be 5.47 ± 2.11 in the reflexology group and 9.63 ± .85 in the control group. A statistically significant difference was observed between the mean FLACC pain scores of infants in the reflexology and control groups (p = .000). The infants in the reflexology group also had lower heart rates, higher oxygen saturation, and shorter crying periods than the infants in the control group (p <.001). Reflexology before vaccine reduced the pain level experienced after vaccination. Future research needs to explore different interventional practices. © 2015 Sigma Theta Tau International.

Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register.

PubMed Central

Sonke, G. S.; Beaglehole, R.; Stewart, A. W.; Jackson, R.; Stewart, F. M.

1996-01-01

OBJECTIVE: To determine whether the reported higher case fatality in hospital after an acute cardiac event in women can be explained by sex differences in mortality before admission and in baseline risk factors. DESIGN: Analyses of data from a community based coronary heart disease register. SETTING: Auckland region, New Zealand. SUBJECTS: 5106 patients aged 25-64 years with an acute cardiac event leading to coronary death or definite myocardial infarction within 28 days of onset, occurring between 1986 and 1992. MAIN OUTCOME MEASURES: Case fatality before admission, 28 day case fatality for patients in hospital, and total case fatality after an acute cardiac event. RESULTS: Despite a more unfavourable risk profile women tended to have lower case fatality before admission than men (crude odds ratio 0.88; 95% confidence interval 0.77 to 1.02). Adjustment for age, living arrangements, smoking, medical history, and treatment increased the effect of sex (0.72; 0.60 to 0.86). After admission to hospital, women had a higher case fatality than men (1.76; 1.43 to 2.17), but after adjustment for confounders this was reduced to 1.18 (0.89 to 1.58). Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women (0.85; 0.70 to 1.02) CONCLUSIONS: The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by differences in living status, history, and medical treatment and is balanced by a lower case fatality before admission. PMID:8870571

A before and after study of medical students' and house staff members' knowledge of ACOVE quality of pharmacologic care standards on an acute care for elders unit.

PubMed

Jellinek, Samantha P; Cohen, Victor; Nelson, Marcia; Likourezos, Antonios; Goldman, William; Paris, Barbara

2008-06-01

The Assessing Care of Vulnerable Elders (ACOVE) comprehensive set of quality assessment tools for ill older persons is a standard designed to measure overall care delivered to vulnerable elders (ie, those aged > or =65 years) at the level of a health care system or plan. The goal of this research was to quantify the pretest and posttest results of medical students and house staff participating in a pharmacotherapist-led educational intervention that focused on the ACOVE quality of pharmacologic care standards. This was a before and after study assessing the knowledge ofACOVE standards following exposure to an educational intervention led by a pharmacotherapist. It was conducted at the 29-bed Acute Care for Elders (ACE) unit of Maimonides Medical Center, a 705-bed, independent teaching hospital located in Brooklyn, New York. Participants included all medical students and house staff completing a rotation on the ACE unit from August 2004 through May 2005 who completed both the pre-and posttests. A pharmacotherapist provided a 1-hour active learning session reviewing the evidence supporting the quality indicators and reviewed case-based questions with the medical students and house staff. Educational interventions also occurred daily through pharmacotherapeutic consultations and during work rounds. Medical students and house staff were administered the same 15-question, patient-specific, case-based, multiple-choice pre-and posttest to assess knowledge of the standards before and after receiving the intervention. A total of 54 medical students and house staff (median age, 28.58 years; 40 men, 14 women) completed the study. Significantly higher median scores were achieved on the multiple-choice test after the intervention than before (median scores, 14/15 [93.3%] vs 12/15 [80.0%], respectively; P = 0.001). A pharmacotherapist-led educational intervention improved the scores of medical students and house staff on a test evaluating knowledge of evidence-based recommendations for pharmacotherapy in the elderly.

Differences in gestational weight gain between pregnancies before and after maternal bariatric surgery correlate with differences in birth weight but not with scores on the body mass index in early childhood.

PubMed

Berglind, D; Willmer, M; Näslund, E; Tynelius, P; Sørensen, T I A; Rasmussen, F

2014-12-01

Large maternal gestational weight gain (GWG) is associated with increased birth weight and increased risk of obesity in offspring, but these associations may be confounded by genetic and environmental factors. The aim was to investigate the effects of differences in GWG in all three trimesters on differences in birth weight and in body mass index (BMI) scores at 4 and 6 years of age, within siblings born before and after bariatric surgery. Women with at least one child born before and one after bariatric surgery were identified in national Swedish registers. Series of weight (and height) measurements were collected from antenatal medical records, with data on the nearest pregnancies before and after bariatric surgery. The age-adjusted means of pre- and post-operative GWG of 124 women were 11.3 (standard deviation [SD] 7.2) and 8.3 (SD 6.4) kg, respectively (P = 0.01). Adjusted fixed effects regression models showed positive associations of differences in mean total GWG with differences in siblings' birth weight, 0.023 kg per 1-kg greater weight gain (95% confidence interval [CI]: 0.014-0.069) and for second trimester 0.53 kg for each 1-kg greater weight per week (95% CI: 0.32-1.61), whereas no associations were found with BMI in pre-school age. This study showed positive associations between differences in total and second trimester maternal GWG and differences in children's birth weight, but no association with BMI scores in pre-school age. Maternal genetic, social and lifestyle factors fixed from one pregnancy to the next were taken into account in the analyses by the study design. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Life-event stress induced by the Great East Japan Earthquake was associated with relapse in ulcerative colitis but not Crohn's disease: a retrospective cohort study

PubMed Central

Shiga, Hisashi; Miyazawa, Teruko; Kinouchi, Yoshitaka; Takahashi, Seiichi; Tominaga, Gen; Takahashi, Hiroki; Takagi, Sho; Obana, Nobuya; Kikuchi, Tatsuya; Oomori, Shinya; Nomura, Eiki; Shiraki, Manabu; Sato, Yuichirou; Takahashi, Shuichiro; Umemura, Ken; Yokoyama, Hiroshi; Endo, Katsuya; Kakuta, Yoichi; Aizawa, Hiroki; Matsuura, Masaki; Kimura, Tomoya; Kuroha, Masatake; Shimosegawa, Tooru

2013-01-01

Objective Stress is thought to be one of the triggers of relapses in patients with inflammatory bowel disease (IBD). We examined the rate of relapse in IBD patients before and after the Great East Japan Earthquake. Design A retrospective cohort study. Settings 13 hospitals in Japan. Participants 546 ulcerative colitis (UC) and 357 Crohn's disease (CD) patients who received outpatient and inpatient care at 13 hospitals located in the area that were seriously damaged by the earthquake. Data on patient's clinical characteristics, disease activity and deleterious effects of the earthquake were obtained from questionnaires and hospital records. Primary outcome We evaluated the relapse rate (from inactive to active) across two consecutive months before and two consecutive months after the earthquake. In this study, we defined ‘active’ as conditions with a partial Mayo score=2 or more (UC) or a Harvey-Bradshaw index=6 or more (CD). Results Among the UC patients, disease was active in 167 patients and inactive in 379 patients before the earthquake. After the earthquake, the activity scores increased significantly (p<0.0001). A total of 86 patients relapsed (relapse rate=15.8%). The relapse rate was about twice that of the corresponding period in the previous year. Among the CD patients, 86 patients had active disease and 271 had inactive disease before the earthquake. After the earthquake, the activity indices changed little. A total of 25 patients experienced a relapse (relapse rate=7%). The relapse rate did not differ from that of the corresponding period in the previous year. Multivariate analyses revealed that UC, changes in dietary oral intake and anxiety about family finances were associated with the relapse. Conclusions Life-event stress induced by the Great East Japan Earthquake was associated with relapse in UC but not CD. PMID:23396562

Prognostic significance of pleural lavage cytology after thoracotomy and before closure of the chest in lung cancer.

PubMed

Taniguchi, Yuji; Nakamura, Hiroshige; Miwa, Ken; Adachi, Yoshin; Fujioka, Shinji; Haruki, Tomohiro; Horie, Yasushi

2009-07-01

Some reports have described pleural lavage cytology (PLC) to be a prognostic factor for non-small cell lung cancer (NSCLC) patients. However, there have only been a few reports describing the findings both immediately after thoracotomy (PLC after thoracotomy) and before the closure of the chest (PLC before closure). From April 2002 to April 2008, both PLC after thoracotomy and PLC before closure were performed in 296 consecutive patients who underwent resections for NSCLC. PLC after thoracotomy was positive in 14 patients. The survival rate in the PLC after thoracotomy positive cases was significantly poorer than in PLC after thoracotomy negative cases (P=0.047). In contrast, there were 26 PLC before closure positive cases. The survival rate in the PLC before closure positive cases was significantly poorer than in the PLC before closure negative cases (P<0.0001). Multivariate analyses revealed that PLC after thoracotomy is not an independent prognostic factor in our study. However, PLC before closure was an independent prognostic factor based on multivariate analyses. We conclude that PLC before closure was found to be a better prognostic factor than PLC after thoracotomy for NSCLC patients.

Mechanism problems

NASA Technical Reports Server (NTRS)

Riedel, J. K.

1972-01-01

It is pointed out that too frequently during the design and development of mechanisms, problems occur that could have been avoided if the right question had been asked before, rather than after, the fact. Several typical problems, drawn from actual experience, are discussed and analyzed. The lessons learned are used to generate various suggestions for minimizing mistakes in mechanism design.

Natural streamflow simulation for two largest river basins in Poland: a baseline for identification of flow alterations

NASA Astrophysics Data System (ADS)

Piniewski, Mikołaj

2016-05-01

The objective of this study was to apply a previously developed large-scale and high-resolution SWAT model of the Vistula and the Odra basins, calibrated with the focus of natural flow simulation, in order to assess the impact of three different dam reservoirs on streamflow using the Indicators of Hydrologic Alteration (IHA). A tailored spatial calibration approach was designed, in which calibration was focused on a large set of relatively small non-nested sub-catchments with semi-natural flow regime. These were classified into calibration clusters based on the flow statistics similarity. After performing calibration and validation that gave overall positive results, the calibrated parameter values were transferred to the remaining part of the basins using an approach based on hydrological similarity of donor and target catchments. The calibrated model was applied in three case studies with the purpose of assessing the effect of dam reservoirs (Włocławek, Siemianówka and Czorsztyn Reservoirs) on streamflow alteration. Both the assessment based on gauged streamflow (Before-After design) and the one based on simulated natural streamflow showed large alterations in selected flow statistics related to magnitude, duration, high and low flow pulses and rate of change. Some benefits of using a large-scale and high-resolution hydrological model for the assessment of streamflow alteration include: (1) providing an alternative or complementary approach to the classical Before-After designs, (2) isolating the climate variability effect from the dam (or any other source of alteration) effect, (3) providing a practical tool that can be applied at a range of spatial scales over large area such as a country, in a uniform way. Thus, presented approach can be applied for designing more natural flow regimes, which is crucial for river and floodplain ecosystem restoration in the context of the European Union's policy on environmental flows.

Low typing endurance in keyboard workers with work-related upper limb disorder

PubMed Central

Povlsen, Bo

2011-01-01

Objective To compare results of typing endurance and pain before and after a standardized functional test. Design A standardized previously published typing test on a standard QWERTY keyboard. Setting An outpatient hospital environment. Participants Sixty-one keyboard and mouse operating patients with WRULD and six normal controls. Main outcome measure Pain severity before and after the test, typing endurance and speed were recorded. Results Thirty-two patients could not complete the test before pain reached VAS 5 and this group only typed a mean of 11 minutes. The control group and the remaining group of 29 patients completed the test. Two-tailed student T test was used for evaluation. The endurance was significantly shorter in the patient group that could not complete the test (P < 0.00001) and the pain levels were also higher in this group both before (P = 0.01) and after the test (P = 0.0003). Both patient groups had more pain in the right than the left hand, both before and after typing. Conclusions Low typing endurance correlates statistically with more resting pain in keyboard and mouse operators with work-related upper limb disorder and statistically more pain after a standardized typing test. As the right hands had higher pain levels, typing alone may not be the cause of the pain as the left hand on a QWERTY keyboard does relative more keystrokes than the right hand. PMID:21637395

Significant reduction of central line-associated bloodstream infection rates in a tertiary neonatal unit.

PubMed

Rallis, Dimitrios; Karagianni, Paraskevi; Papakotoula, Ifigeneia; Nikolaidis, Nikolaos; Tsakalidis, Christos

2016-04-01

To evaluate the effectiveness of a quality initiative in reducing central line-associated bloodstream infections (CLABSIs) in our neonatal intensive care unit, we designed a prospective study (January 2012-September 2013) estimating CLABSI incidence before and after our implementation. CLABSI rates were significantly decreased after our intervention, from 12 cases per 1,000 central vascular catheter (CVC) days during the preinterventional period to 3.4 cases per 1,000 CVC days during the postinterventional period (P = .004). Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Contribution of cone beam computed tomography to the detection of apical root resorption after orthodontic treatment in root-filled and vital teeth.

PubMed

Castro, Iury; Valladares-Neto, José; Estrela, Carlos

2015-09-01

To investigate whether root-filled teeth are similar to vital pulp teeth in terms of apical root resorption (ARR) after orthodontic treatment. An original sample of cone beam computed tomography (CBCT) images of 1256 roots from 30 orthodontic patients were analyzed. The inclusion criteria demanded root-filled teeth and their contralateral vital teeth, while teeth with history of trauma had to be excluded to comply with exclusion criteria. CBCT images of root-filled teeth were compared before and after orthodontic treatment in a split-mouth design study. Tooth measurements were made with multiplanar reconstruction using axial-guided navigation. The statistical difference between the treatment effects was compared using the paired t-test. Twenty posterior root-filled teeth and their contralaterals with vital pulp were selected before orthodontic treatment from six adolescents (two boys and four girls; mean [SD] age 12.8 [1.8] years). No differences were detected between filled and vital root lengths before treatment (P  =  .4364). The mean differences in root length between preorthodontic and postorthodontic treatment in filled- and vital roots were -0.30 mm and -0.16 mm, respectively, without any statistical difference (P  =  .4197) between them. There appears to be no increase in ARR after orthodontic treatment in root-filled teeth with no earlier ARR.

Does an educational intervention improve parents' knowledge about immunization? Experience from Malaysia.

PubMed

Awadh, Ammar Ihsan; Hassali, Mohamed Azmi; Al-Lela, Omer Qutaiba; Bux, Siti Halimah; Elkalmi, Ramadan M; Hadi, Hazrina

2014-10-06

Parents' knowledge about immunization is an important predictor factor for their children's immunization status. The aims of this study were to assess parents' knowledge and to evaluate the effect of a short educational intervention on improving parents' knowledge of childhood immunization. A cross-sectional study using a pre- and post-test intervention survey of a single group was conducted among Malaysian parents. Changes in total knowledge score before and after the intervention were measured using a validated questionnaire. The intervention consisted of an animated movie and lecture using simple understandable language. Wilcoxon signed ranks test and the McNemar x2 test were applied to compare the differences in knowledge before and after the intervention. Seventy-three parents were enrolled in this study; the majority were mothers (n = 64, 87.7%). Parents' knowledge about childhood immunization increased significantly after the intervention compared to the baseline results (p < 0.001). There were significant differences between parents' knowledge and their educational level and monthly income (p < 0.001 and p = 0.005), respectively. A short educational intervention designed for parents had a positive effect on their knowledge about immunization. Educational interventions targeting parents with low levels of education and income are needed. Further studies investigating the actual effectiveness of such interventions on immunization rates and statuses are required.

Executive Dysfunction in OSA Before and After Treatment: A Meta-Analysis

PubMed Central

Olaithe, Michelle; Bucks, Romola S.

2013-01-01

Study Objectives: Obstructive sleep apnea (OSA) is a frequent and often underdiagnosed condition that is associated with upper airway collapse, oxygen desaturation, and sleep fragmentation leading to cognitive dysfunction. There is meta-analytic evidence that subdomains of attention and memory are affected by OSA. However, a thorough investigation of the impact of OSA on different subdomains of executive function is yet to be conducted. This report investigates the impact of OSA and its treatment, in adult patients, on 5 theorized subdomains of executive function. Design: An extensive literature search was conducted of published and unpublished materials, returning 35 studies that matched selection criteria. Meta-analysis was used to synthesize the results from studies examining the impact of OSA on executive functioning compared to controls (21 studies), and before and after treatment (19 studies); 5 studies met inclusion in both categories. Measurements: Research papers were selected which assessed 5 subdomains of executive function: Shifting, Updating, Inhibition, Generativity, and Fluid Reasoning. Results: All 5 domains of executive function demonstrated medium to very large impairments in OSA independent of age and disease severity. Furthermore, all subdomains of executive function demonstrated small to medium improvements with CPAP treatment. Discussion: Executive function is impaired across all five domains in OSA; these difficulties improved with CPAP treatment. Age and disease severity did not moderate the effects found; however, further studies are needed to explore the extent of primary and secondary effects, and the impact of age and premorbid intellectual ability (cognitive reserve). Citation: Olaithe M; Bucks RS. Executive dysfunction in OSA before and after treatment: a meta-analysis. SLEEP 2013;36(9):1297-1305. PMID:23997362

Outcome based education enacted: teachers' tensions in balancing between student learning and bureaucracy.

PubMed

Barman, Linda; Silén, Charlotte; Bolander Laksov, Klara

2014-12-01

This paper reports on how teachers within health sciences education translate outcome-based education (OBE) into practice when they design courses. The study is an empirical contribution to the debate about outcome- and competency-based approaches in health sciences education. A qualitative method was used to study how teachers from 14 different study programmes designed courses before and after OBE was implemented. Using an interpretative approach, analysis of documents and interviews was carried out. The findings show that teachers enacted OBE either to design for more competency-oriented teaching-learning, or to further detail knowledge and thus move towards reductionism. Teachers mainly understood the outcome-based framework as useful to support students' learning, although the demand for accountability created tension and became a bureaucratic hindrance to design for development of professional competence. The paper shows variations of how teachers enacted the same outcome-based framework for instructional design. These differences can add a richer understanding of how outcome- or competency-based approaches relate to teaching-learning at a course level.

Process parameters in the manufacture of ceramic ZnO nanofibers made by electrospinning

NASA Astrophysics Data System (ADS)

Nonato, Renato C.; Morales, Ana R.; Rocha, Mateus C.; Nista, Silvia V. G.; Mei, Lucia H. I.; Bonse, Baltus C.

2017-01-01

Zinc oxide (ZnO) nanofibers were prepared by electrospinning under different conditions using a solution of poly(vinyl alcohol) and zinc acetate as precursor. A 23 factorial design was made to study the influence of the process parameters in the electrospinning (collector distance, flow rate and voltage), and a 22 factorial design was made to study the influence of the calcination process (time and temperature). SEM images were made to analyze the fiber morphology before and after calcination process, and the images were made to measure the nanofiber diameter. X-ray diffraction was made to analyze the total precursor conversion to ZnO and the elimination of the polymeric carrier.

Application of Student Book Based On Integrated Learning Model Of Networked Type With Heart Electrical Activity Theme For Junior High School

NASA Astrophysics Data System (ADS)

Gusnedi, G.; Ratnawulan, R.; Triana, L.

2018-04-01

The purpose of this study is to determine the effect of the use of Integrated Science IPA books Using Networked Learning Model of knowledge competence through improved learning outcomes obtained. The experimental design used is one group pre test post test design to know the results before and after being treated. The number of samples used is one class that is divided into two categories of initial ability to see the improvement of knowledge competence. The sample used was taken from the students of grade VIII SMPN 2 Sawahlunto, Indonesia. The results of this study indicate that most students have increased knowledge competence.

Recovery from depression among clients transitioning out of poverty.

PubMed

Ali, Alisha; Hawkins, Robert L; Chambers, Debbie Ann

2010-01-01

The objective of this study was to investigate whether a program designed to change the economic conditions of clients' lives could also have an impact on reducing their level of depression. The study focused on a sample of men and women attending a program designed to transition clients out of poverty through microlending and peer support. Results revealed that 40.5% of participants who met diagnostic criteria for major depression before beginning the program were no longer clinically depressed after participating in the program for 6 months. The results also revealed that the clients who reported that they felt a strong sense of interpersonal connection within the program were the most likely to recover from depression.

A comparative study of patients' activities and interactions in a stroke unit before and after reconstruction-The significance of the built environment.

PubMed

Anåker, Anna; von Koch, Lena; Sjöstrand, Christina; Bernhardt, Julie; Elf, Marie

2017-01-01

Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients' lounge was located in a far corner of the unit with a smaller entrance than the patients' lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients' activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.

Activating schoolyards: study design of a quasi-experimental schoolyard intervention study.

PubMed

Andersen, Henriette Bondo; Pawlowski, Charlotte Skau; Scheller, Hanne Bebendorf; Troelsen, Jens; Toftager, Mette; Schipperijn, Jasper

2015-05-31

The aim of the Activating Schoolyards Study is to develop, implement, document and assess a comprehensive schoolyard intervention to promote physical activity (PA) during school recess for primary school children (grade 4-8). The intervention is designed to implement organizational and structural changes in the physical environment. The study builds on a quasi-experimental study design using a mixed method approach including: 1) an exploratory study aimed at providing input for the developing process; 2) an evaluation of the effect of the interventions using a combination of accelerometer, GPS and GIS; 3) a process evaluation facilitating the intervention development process and identifying barriers and facilitators in the implementation process; 4) a post-intervention end-user evaluation aimed at exploring who uses the schoolyards and how the schoolyards are used. The seven project schools (cases) were selected by means of an open competition and the interventions were developed using a participatory bottom-up approach. The participatory approach and case selection strategy make the study design novel. The use of a mixed methods design including qualitative as well as quantitative methods can be seen as a strength, as the different types of data complement each other and results of one part of the study informed the following parts. A unique aspect of our study is the use of accelerometers in combination with GPS and GIS in the effect evaluation to objectively determine where and how active the students are in the schoolyard, before and after the intervention. This provides a type of data that, to our knowledge, has not been used before in schoolyard interventions. Exploring the change in behavior in relation to specific intervention elements in the schoolyard will lead to recommendations for schools undergoing schoolyard renovations at some point in the future.

What do parents learn by reading a DPT vaccine information form?

PubMed Central

Gold, Ronald; Bjornson, Gordean L

1994-01-01

Objective: Information forms are commonly used to inform parents about childhood vaccination. This study assessed the knowledge of mothers about pertussis and pertussis vaccine before and after reading a form about diphtheria-pertussis-tetanus (dpt) vaccine. Design: A test was administered to mothers before and after the first vaccination of their infant. By random allocation, one-half of the mothers received the form (study group) in addition to the routine counselling by a public health nurse given to the others (control group). Setting: Public health immunization clinics in suburban Vancouver, British Columbia. Subjects: One hundred and fifty-one mothers who were scheduled to bring their infant for the first dpt immunization were recruited, of whom 145 (96%) completed the study. Interventions: A test consisting of 20 true/false questions was administered by telephone two weeks before and two weeks after the first dpt vaccination. Additional data about sources of vaccine information, maternal education, number of children and maternal age were obtained. Outcome Measures: Mean scores and mean change in scores on test. Results: The mean changes in scores between tests 1 and 2 in study and control groups were +22.2% and +6.9%, respectively, on the disease-related questions (P<0.001) and +14.6% and +10.7%, respectively, on the vaccine-related questions (P=0.16). The forms were considered to be very useful by the mothers and clearly enabled them to score higher on a test of their knowledge of pertussis and pertussis vaccine. Conclusions: Reading a dpt vaccine form enabled mothers to improve their knowledge of pertussis and pertussis vaccine. PMID:22451768

The Effect of Aromatherapy Treatment on Fatigue and Relaxation for Mothers during the Early Puerperal Period in Japan: A Pilot Study.

PubMed

Asazawa, Kyoko; Kato, Yoshihiro; Yamaguchi, Atsuko; Inoue, Asako

2017-10-01

Early in the postpartum period, mothers are often nervous and tired from the delivery, breast-feeding and caring for a new-born. The aim of this study was to evaluate the process and outcome of using aromatherapy treatments to increase relaxation and decrease fatigue for mothers during the first to the seventh day of the postpartum period. This non-randomized controlled study with a quasi-experimental one-group pretest-posttest design was used to evaluate scores in relaxation and fatigue before and after the intervention. Aromatherapy hand treatments were performed on a purposive sample of 34 postpartum mothers in Tokyo, Japan, from May to July 2016. The single treatment included a choice of one of five essential aroma oils through hand and forearm massage. Relaxation and fatigue were measured by self-administered valid and reliable questionnaires. Wilcoxon signed-rank test was conducted to analyze the data before and after the intervention. The software programs SPSS, v. 23.0 (SPSS, Tokyo), was used to analyze the data, with the significance level set at 5%. Valid responses were obtained from 29 participants. A comparison of the scores before and after aroma treatment intervention indicated that the participants' relaxation scores increased significantly (P<0.001) and fatigue scores were significantly reduced (P<0.001). The majority of participants (77.8%) were satisfied with the treatment. The aroma treatments significantly improved relaxation and reduced fatigue for mothers in the early puerperal period and were well received. Therefore, a larger study using a pretest-posttest random control trial is recommended.

When truth is personally inconvenient, attitudes change: the impact of extreme weather on implicit support for green politicians and explicit climate-change beliefs.

PubMed

Rudman, Laurie A; McLean, Meghan C; Bunzl, Martin

2013-11-01

A naturalistic investigation of New Jersey residents, both before and after they experienced Hurricanes Irene and Sandy, examined support for politicians committed or opposed to policies designed to combat climate change. At Time 1, before both hurricanes, participants showed negative implicit attitudes toward a green politician, but at Time 2, after the hurricanes, participants drawn from the same cohort showed a reversed automatic preference. Moreover, those who were significantly affected by Hurricane Sandy were especially likely to implicitly prefer the green politician, and implicit attitudes were the best predictor of voting after the storms, whereas explicit climate-change beliefs was the best predictor before the storms. In concert, the results suggest that direct experience with extreme weather can increase pro-environmentalism, and further support conceptualizing affective experiences as a source of implicit attitudes.

Reduction in specimen labeling errors after implementation of a positive patient identification system in phlebotomy.

PubMed

Morrison, Aileen P; Tanasijevic, Milenko J; Goonan, Ellen M; Lobo, Margaret M; Bates, Michael M; Lipsitz, Stuart R; Bates, David W; Melanson, Stacy E F

2010-06-01

Ensuring accurate patient identification is central to preventing medical errors, but it can be challenging. We implemented a bar code-based positive patient identification system for use in inpatient phlebotomy. A before-after design was used to evaluate the impact of the identification system on the frequency of mislabeled and unlabeled samples reported in our laboratory. Labeling errors fell from 5.45 in 10,000 before implementation to 3.2 in 10,000 afterward (P = .0013). An estimated 108 mislabeling events were prevented by the identification system in 1 year. Furthermore, a workflow step requiring manual preprinting of labels, which was accompanied by potential labeling errors in about one quarter of blood "draws," was removed as a result of the new system. After implementation, a higher percentage of patients reported having their wristband checked before phlebotomy. Bar code technology significantly reduced the rate of specimen identification errors.

A study on chaos in crude oil markets before and after 2008 international financial crisis

NASA Astrophysics Data System (ADS)

Lahmiri, Salim

2017-01-01

The purpose of this study is to investigate existence of chaos in crude oil markets (Brent and WTI) before and after recent 2008 international financial crisis. Largest Lyapunov exponent is estimated for prices, returns, and volatilities. The empirical results show strong evidence that chaos does not exist in prices and returns in both crude oil markets before and after international crisis. However, we find strong evidence of chaotic dynamics in both Brent and WTI volatilities after international financial crisis.

Survival curves to support quality improvement in hospitals with excess 30-day mortality after acute myocardial infarction, cerebral stroke and hip fracture: a before-after study.

PubMed

Kristoffersen, Doris Tove; Helgeland, Jon; Waage, Halfrid Persdatter; Thalamus, Jacob; Clemens, Dirk; Lindman, Anja Schou; Rygh, Liv Helen; Tjomsland, Ole

2015-03-25

To evaluate survival curves (Kaplan-Meier) as a means of identifying areas in the clinical pathway amenable to quality improvement. Observational before-after study. In Norway, annual public reporting of nationwide 30-day in-and-out-of-hospital mortality (30D) for three medical conditions started in 2011: first time acute myocardial infarction (AMI), stroke and hip fracture; reported for 2009. 12 of 61 hospitals had statistically significant lower/higher mortality compared with the hospital mean. Three hospitals with significantly higher mortality requested detailed analyses for quality improvement purposes: Telemark Hospital Trust Skien (AMI and stroke), Østfold Hospital Trust Fredrikstad (stroke), Innlandet Hospital Trust Gjøvik (hip fracture). Survival curves, crude and risk-adjusted 30D before (2008-2009) and after (2012-2013). Unadjusted survival curves for the outlier hospitals were compared to curves based on pooled data from the other hospitals for the 30-day period 2008-2009. For patients admitted with AMI (Skien), stroke (Fredrikstad) and hip fracture (Gjøvik), the curves suggested increased mortality from the initial part of the clinical pathway. For stroke (Skien), increased mortality appeared after about 8 days. The curve profiles were thought to reflect suboptimal care in various phases in the clinical pathway. This informed improvement efforts. For 2008-2009, hospital-specific curves differed from other hospitals: borderline significant for AMI (p=0.064), highly significant (p≤0.005) for the remainder. After intervention, no difference was found (p>0.188). Before-after comparison of the curves within each hospital revealed a significant change for Fredrikstad (p=0.006). For the three hospitals, crude 30D declined and they were non-outliers for risk-adjusted 30D for 2013. Survival curves as a supplement to 30D may be useful for identifying suboptimal care in the clinical pathway, and thus informing design of quality improvement projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Finite element analysis on the bending condition of truck frame before and after opening

NASA Astrophysics Data System (ADS)

Cai, Kaiwu; Cheng, Wei; Lu, Jifu

2018-05-01

Based on the design parameters of a truck frame, the structure design and model of the truck frame are built. Based on the finite element theory, the load, the type of fatigue and the material parameters of the frame are combined with the semi-trailer. Using finite element analysis software, after a truck frame hole in bending condition for the finite element analysis of comparison, through the analysis found that the truck frame hole under bending condition can meet the strength requirements are very helpful for improving the design of the truck frame.

Effect of book reviewing workshop on awareness of, aptitude for and attitude toward book reviews in faculty members of faculty of management and medical information.

PubMed

Najafi, Nayere Sadat Soleimanzade; Ashrafi-Rizi, Hasan; Yarmohammadian, Mohammad Hossein; Shahrzadi, Leila; Hasanzade, Akbar

2014-01-01

Works evaluation and critique is one of the most important phases in scientific production cycle. Reviewers need some aptitude about rules and principles of writing good review. Considering the important role of books for storage and transferring the scientific findings, book reviewing is vital to scientific progress. Despite this fact, investigation of Isfahan University of Medical Science's journal, demonstrated the number of published book reviews to be very small. This study aims to investigate the influence of reviewing training courses on participants' book reviewing awareness, attitude, and aptitude. The study method is experimental with two group design (with pre-test and post-test) and applied. Statistical population is of all faculty members of the faculty of management and medical information of Isfahan University of Medical Science, including both hired and contracted employees, which, according to faculty's department of Education, consists of 86 people. The sampling method used in this study is random. Number of samples in case and control groups was calculated using the following equation of n= (z1 + z2) 2 (2s2)/d2 and is 15 people. One checklist and two questionnaires were the means of data collection. Data were analyzed using SPSS 18.0 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). Findings showed that the mean score of awareness of book reviews in case group increased meaningfully after the training course (55.7) compared to the score prior to the intervention (33.1), P < 0.001. On the other hand, the mean score of awareness of book reviews in control group remained mostly the same before (31.6) and after intervention (35.1), P = 0.35. The mean score of attitude toward book reviews showed no significant difference before and after intervention in both case group (71.4 before intervention and 74.4 after intervention, P = 0.11) and control group (70.9 before intervention and 74.4 after intervention, P = 0.91). The mean score of book reviewing aptitude in case group showed a significant increase from 10.2 ± 6.7 before intervention to 53.6 ± 26.3, showing a 43.4 increase (P < 0.001), while the control group's mean score showed no significant difference (8.5 before intervention and 8.6 after intervention, P = 0.996). This study showed a significant influence of training course on participants' book reviewing aptitude and awareness. But attitude toward book reviews was in good level from the beginning to the end and remained mostly unchanged.

Effect of book reviewing workshop on awareness of, aptitude for and attitude toward book reviews in faculty members of faculty of management and medical information

PubMed Central

Najafi, Nayere Sadat Soleimanzade; Ashrafi-rizi, Hasan; Yarmohammadian, Mohammad Hossein; Shahrzadi, Leila; Hasanzade, Akbar

2014-01-01

Introduction: Works evaluation and critique is one of the most important phases in scientific production cycle. Reviewers need some aptitude about rules and principles of writing good review. Considering the important role of books for storage and transferring the scientific findings, book reviewing is vital to scientific progress. Despite this fact, investigation of Isfahan University of Medical Science's journal, demonstrated the number of published book reviews to be very small. This study aims to investigate the influence of reviewing training courses on participants’ book reviewing awareness, attitude, and aptitude. Materials and Methods: The study method is experimental with two group design (with pre-test and post-test) and applied. Statistical population is of all faculty members of the faculty of management and medical information of Isfahan University of Medical Science, including both hired and contracted employees, which, according to faculty's department of Education, consists of 86 people. The sampling method used in this study is random. Number of samples in case and control groups was calculated using the following equation of n= (z1 + z2) 2 (2s2)/d2 and is 15 people. One checklist and two questionnaires were the means of data collection. Data were analyzed using SPSS 18.0 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). Results: Findings showed that the mean score of awareness of book reviews in case group increased meaningfully after the training course (55.7) compared to the score prior to the intervention (33.1), P < 0.001. On the other hand, the mean score of awareness of book reviews in control group remained mostly the same before (31.6) and after intervention (35.1), P = 0.35. The mean score of attitude toward book reviews showed no significant difference before and after intervention in both case group (71.4 before intervention and 74.4 after intervention, P = 0.11) and control group (70.9 before intervention and 74.4 after intervention, P = 0.91). The mean score of book reviewing aptitude in case group showed a significant increase from 10.2 ± 6.7 before intervention to 53.6 ± 26.3, showing a 43.4 increase (P < 0.001), while the control group's mean score showed no significant difference (8.5 before intervention and 8.6 after intervention, P = 0.996). Conclusion: This study showed a significant influence of training course on participants’ book reviewing aptitude and awareness. But attitude toward book reviews was in good level from the beginning to the end and remained mostly unchanged. PMID:25250344

Thinking about the weather: How display salience and knowledge affect performance in a graphic inference task.

PubMed

Hegarty, Mary; Canham, Matt S; Fabrikant, Sara I

2010-01-01

Three experiments examined how bottom-up and top-down processes interact when people view and make inferences from complex visual displays (weather maps). Bottom-up effects of display design were investigated by manipulating the relative visual salience of task-relevant and task-irrelevant information across different maps. Top-down effects of domain knowledge were investigated by examining performance and eye fixations before and after participants learned relevant meteorological principles. Map design and knowledge interacted such that salience had no effect on performance before participants learned the meteorological principles; however, after learning, participants were more accurate if they viewed maps that made task-relevant information more visually salient. Effects of display design on task performance were somewhat dissociated from effects of display design on eye fixations. The results support a model in which eye fixations are directed primarily by top-down factors (task and domain knowledge). They suggest that good display design facilitates performance not just by guiding where viewers look in a complex display but also by facilitating processing of the visual features that represent task-relevant information at a given display location. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Pizza and Pasta Help Students Learn Metabolism

ERIC Educational Resources Information Center

Passos, Renato M.; Se, Alexandre B.; Wolff, Vanessa L.; Nobrega, Yanna K. M.; Hermes-Lima, Marcelo

2006-01-01

In this article, we report on an experiment designed to improve the learning of metabolic biochemistry by nutrition and medical undergraduate students. Twelve students participated in a monitored lunch and had their blood extracted for analysis: (1) before lunch; (2) 30 min after lunch; and (3) 3 h after lunch. The subjects were divided in two…

40 CFR 146.22 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... caliper logs before casing is installed; and (B) A cement bond, temperature, or density log after the...; and (C) A cement bond, temperature, or density log after the casing is set and cemented. (g) At a... drinking water. The casing and cement used in the construction of each newly drilled well shall be designed...

The effect of porcelain firing and type of finish line on the marginal fit of zirconia copings.

PubMed

Vojdani, Mahroo; Safari, Anahita; Mohaghegh, Mina; Pardis, Soheil; Mahdavi, Farideh

2015-06-01

Although all-ceramic restorations are broadly used, there is a lack of information concerning how their fit is affected by fabrication procedure and marginal configuration. The purpose of this study was to evaluate the marginal fit of zirconia CAD/CAM ceramic crowns before and after porcelain firing. The influence of finish line configuration on the marginal fit was also evaluated. Twenty standardized zirconia CAD/CAM copings were fabricated for chamfer and shoulder finish line designs (n=10). The marginal fit of specimens was measured on 18 points, marked on the master metal die by using a digital microscope. After the crowns were finalized by porcelain veneering, the measurements of marginal fit were performed again. The means and standard deviations were calculated and data were analyzed using student's t-test and paired t-test (α=0.05). There were significant differences between marginal fit of chamfer and shoulder finish line groups before and after porcelain firing (p= 0.014 and p= 0.000, respectively). The marginal gap of copings with shoulder finish line was significantly smaller than those with chamfer configuration (p= 0.000), but there were no significant differences between the two marginal designs, after porcelain firing (p= 0.341). Porcelain veneering was found to have a statistically significant influence on the marginal fit of zirconia CAD/CAM crowns. Both margin configurations showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.

Effectiveness of foot and hand massage in postcesarean pain control in a group of Turkish pregnant women.

PubMed

Degirmen, Nuriye; Ozerdogan, Nebahat; Sayiner, Deniz; Kosgeroglu, Nedime; Ayranci, Unal

2010-08-01

The aim of this study was to determine the efficiency of foot and hand massage on reducing postoperative pain in patients who had cesarean operation. This pretest-posttest design study was planned as a randomized controlled experimental study. In the light of the results, it was reported that the reduction in pain intensity was significantly meaningful in both intervention groups when compared to the control group. It was also noted that vital findings were measured comparatively higher before the massage in the test groups, and they were found to be relatively lower in the measurements conducted right before and after the massage, which was considered to be statistically meaningful. Foot and hand massage proved useful as an effective nursing intervention in controlling postoperative pain. 2010 Elsevier Inc. All rights reserved.

Optimal capacity design of LID facility for conserving natural water cycle and its sensitivity analysis

NASA Astrophysics Data System (ADS)

Lee, O.; Choi, J.; Lee, J.; Kim, S.

2017-12-01

Since the 20th century, urbanization has resulted in increased impermeable land surface and reduced infiltration capacity in catchment scale. Especially, when agriculture area or forest area would be developed into urban area, it can cause more runoff in the same climate condition. Such urbanization causes problems such as changes in hydrological cycle and ecosystem disturbance. Various methods have been proposed worldwide to reduce the impact of such urbanization. Among the various strategies, the low-impact development is a development strategy that aims to return to pre-development state by minimizing the change of the hydrological cycle due to urbanization. In this strategy, the infiltration and/or surface storage of stormwater runoff can be increased through the installation of various facilities. In this study, a facility capacity design strategy is proposed to return into the natural water cycle through the installation of various LID facilities. This is accomplished by determining the optimal LID facility design capacity through which flow duration curves remain the same before and after urban development. For this purpose, EPA-SWMM is constructed with a part of Busan Metropolitan City Noksan Industrial Complex as a virtual processing area. Under the various land-use scenarios, the optimum design capacity of various LID facilities capable of retaining the flow duration curve before and after development is determined. In addition, the sensitivity of the optimal design capacity of LID facilities is analyzed according to the design specifications of various LID facilities, the local rainfall characteristics, and the size of the treatment area. Acknowledgement This research was supported by a grant (2016000200002) from Public Welfare Technology Development Program funded by Ministry of Environment of Korean government.

Masticatory function and temporomandibular disorders in patients with dentofacial deformities.

PubMed

Abrahamsson, Cecilia

2013-01-01

About 30% of individuals in the Swedish population will at some stage during life have treatment with orthodontic appliances. In more severe cases, when orthodontic treatment is not considered sufficient enough to correct the malocclusion, the orthodontic treatment is combined with orthognathic surgery. For these cases, a satisfying jaw relation is achieved by surgically moving the maxilla and/or the mandible into a pre-planned position. Patients due to be treated with orthognathic surgery often suffer from an impaired masticatory function, symptoms from the masticatory muscles or temporomandibular joints (temporomandibular disorders), headaches as well as dissatisfaction with their facial aesthetics. Since orthognathic treatment is expensive, in many cases arduous to the patient and not without complications, it is important to assess the treatment outcome and if this is satisfying for the patients. Previous studies that have examined the outcome after orthognathic treatment have had diverging study designs and have come to different conclusions with regard to both temporomandibular disorders and masticatory function. The overall aim of this thesis was to assess and compare the frequencies of temporomandibular disorders and the masticatory function in patients with dentofacial deformities before and after orthognathic treatment. THE THESIS IS BASED ON THE FOLLOWING STUDIES: Paper I is a systematic literature review aiming to, in an evidence-based approach, answer the question whether orthognathic treatment affects the prevalence of signs and symptoms of temporomandibular disorders. The review encompasses the period from January 1966 to April 2006 and was further extended to May 2013 in the frame story of this thesis. CONCLUSIONS IN PAPER I AND THE COMPLEMENTARY SURVEY: There is insufficient scientific evidence for a decrease of sub diagnoses of temporomandibular disorders after orthognathic treatment. There is limited scientific evidence for a reduction of masticatory muscle pain on palpation after orthognathic treatment. There is insufficient scientific evidence for an effect on temporomandibular joint pain on palpation and temporomandibular joint sounds from orthognathic surgery. Further controlled, well-designed studies assessing temporomandibular disorders before and after orthognathic treatment are needed to consolidate strong evidence considering treatment outcomes. Papers II and III are studies comparing frequencies of temporomandibular disorders in patients with dentofacial deformities with a control group. The patients were referred for a combined orthodontic and orthognathic treatment to correct their malocclusion. The control group comprised individuals with normal occlusion or minor malocclusion traits not in need of orthodontic treatment. In Paper III, temporomandibular disorders were longitudinally analysed by assessing and comparing frequencies before and after orthognathic treatment. All individuals in the studies were diagnosed according to the research diagnostic criteria for temporomandibular disorders. CONCLUSIONS IN PAPERS II AND III: Patients due to be treated with orthognathic surgery had more signs and symptoms of temporomandibular disorders and a higher frequency of diagnosed temporomandibular disorders compared with the age- and gender matched control group. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, had a positive treatment outcome in respect of myofascial pain and arthralgia. After treatment the frequency of temporomandibular disorders . in the treatment group was low and at an equivalent level of that in the control group. Paper IV evaluates the self-estimated masticatory ability and the masticatory performance before and after orthognathic treatment in the same individuals as in Paper II and III. CONCLUSIONS IN PAPER IV: Masticatory ability and performance increased after orthognathic treatment. The number of occlusal contacts and severity of overall symptoms of TMD influenced both the masticatory ability and performance. Open bite had a negative effect on masticatory performance.

Teaching renewable energy using online PBL in investigating its effect on behaviour towards energy conservation among Malaysian students: ANOVA repeated measures approach

NASA Astrophysics Data System (ADS)

Nordin, Norfarah; Samsudin, Mohd Ali; Hadi Harun, Abdul

2017-01-01

This research aimed to investigate whether online problem based learning (PBL) approach to teach renewable energy topic improves students’ behaviour towards energy conservation. A renewable energy online problem based learning (REePBaL) instruction package was developed based on the theory of constructivism and adaptation of the online learning model. This study employed a single group quasi-experimental design to ascertain the changed in students’ behaviour towards energy conservation after underwent the intervention. The study involved 48 secondary school students in a Malaysian public school. ANOVA Repeated Measure technique was employed in order to compare scores of students’ behaviour towards energy conservation before and after the intervention. Based on the finding, students’ behaviour towards energy conservation improved after the intervention.

Does orthodontic treatment before the age of 18 years improve oral health-related quality of life? A systematic review and meta-analysis.

PubMed

Javidi, Hanieh; Vettore, Mario; Benson, Philip E

2017-04-01

Orthodontics aims to improve oral health-related quality of life (OHRQoL). In this systematic review, we examined the evidence for changes in OHRQoL after orthodontic treatment for patients treated before they were 18 years old. The participants were patients aged less than 18 years. The interventions were nonorthognathic and cleft orthodontic treatment. The comparisons were before and after orthodontic treatment, or nonorthodontic control. The outcomes were validated measures of OHRQoL. The study designs were randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional or case-control studies. Multiple electronic databases were searched, with no language restrictions; authors were contacted, and reference lists screened. The Newcastle-Ottawa scale was used for quality assessments. Screening, data extraction, and quality assessments were performed by 2 investigators independently. We found 1590 articles and included 13 studies (9 cohort, 3 cross sectional, and 1 case control), with 6 in the meta-analyses. All were judged of low or moderate quality. A moderate improvement in OHRQoL was observed before and after orthodontic treatment (n = 243 participants; standardized mean difference, -0.75; 95% CI, -1.15 to -0.36) particularly in the dimensions of emotional well-being (n = 213 participants; standardized mean difference, -0.61; 95% CI, -0.80 to -0.41) and social well-being (n = 213 participants; standardized mean difference, -0.62; 95% CI, -0.82 to -0.43). Orthodontic treatment during childhood or adolescence leads to moderate improvements in the emotional and social well-being dimensions of OHRQoL, although the evidence is of low and moderate quality. More high quality, longitudinal, prospective studies are needed. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Design and validation of scales to measure adolescent attitude toward eating and toward physical activity].

PubMed

Lima-Serrano, Marta; Lima-Rodríguez, Joaquín Salvador; Sáez-Bueno, Africa

2012-01-01

Different authors suggest that attitude is a mediator in behavior change, so it is a predictor of behavior practice. The main of this study was to design and to validate two scales for measure adolescent attitude toward healthy eating and adolescent attitude toward healthy physical activity. Scales were design based on a literature review. After, they were validated using an on-line Delphi Panel with eighteen experts, a pretest, and a pilot test with a sample of 188 high school students. Comprehensibility, content validity, adequacy, as well as the reliability (alpha of Cronbach test), and construct validity (exploratory factor analysis) of scales were tested. Scales validated by experts were considered appropriate in the pretest. In the pilot test, the ten-item Attitude to Eating Scale obtained α=0.72. The eight-item Attitude to Physical Activity Scale obtained α=0.86. They showed evidence of one-dimensional interpretation after factor analysis, a) all items got weights r>0.30 in first factor before rotations, b) the first factor explained a significant proportion of variance before rotations, and c) the total variance explained by the main factors extracted was greater than 50%. The Scales showed their reliability and validity. They could be employed to assess attitude to these priority intervention areas in Spanish adolescents, and to evaluate this intermediate result of health interventions and health programs.

The Effect of Helicobacter pylori Eradication on the Levels of Essential Trace Elements

PubMed Central

Wu, Meng-Chieh; Huang, Chun-Yi; Kuo, Fu-Chen; Hsu, Wen-Hung; Wang, Sophie S. W.; Shih, Hsiang-Yao; Liu, Chung-Jung; Chen, Yen-Hsu; Wu, Deng-Chyang; Huang, Yeou-Lih; Lu, Chien-Yu

2014-01-01

Objective. This study was designed to compare the effect of Helicobacter pylori (H. pylori) infection treatment on serum zinc, copper, and selenium levels. Patients and Methods. We measured the serum zinc, copper, and selenium levels in H. pylori-positive and H. pylori-negative patients. We also evaluated the serum levels of these trace elements after H. pylori eradication. These serum copper, zinc, and selenium levels were determined by inductively coupled plasma mass spectrometry. Results. Sixty-three H. pylori-positive patients and thirty H. pylori-negative patients were studied. Serum copper, zinc, and selenium levels had no significant difference between H. pylori-positive and H. pylori-negative groups. There were 49 patients with successful H. pylori eradication. The serum selenium levels were lower after successful H. pylori eradication, but not significantly (P = 0.06). There were 14 patients with failed H. pylori eradication. In this failed group, the serum selenium level after H. pylori eradication therapy was significantly lower than that before H. pylori eradication therapy (P < 0.05). The serum zinc and copper levels had no significant difference between before and after H. pylori eradication therapies. Conclusion. H pylori eradication regimen appears to influence the serum selenium concentration (IRB number: KMUH-IRB-20120327). PMID:25548772

Effect of maltitol-containing chewing gum use on the composition of dental plaque microbiota in subjects with active dental caries.

PubMed

Prosdocimi, Erica M; Kistler, James O; Moazzez, Rebecca; Thabuis, Clementine; Perreau, Caroline; Wade, William G

2017-01-01

Background : Sugar alcohols such as xylitol are incorporated in a number of oral hygiene products for their anti-cariogenic properties while chewing gum is known to be beneficial to oral hygiene. Objective : The aim of this study was to determine the composition of the dental plaque microbiota in patients with active caries before and after using a chewing gum supplemented with maltitol. Design : Forty subjects with active caries were randomly allocated to chew maltitol gum or gum base for two weeks. A healthy control group used gum base for two weeks. Plaque samples were collected before and after treatment and the microbiota analysed by pyrosequencing of 16S rRNA genes. Results : A total of 773,547 sequences were obtained from 117 samples. There was no difference in structure of the bacterial communities between groups (AMOVA). There was a significant difference in community membership between groups, (AMOVA, p=0.009). There was a significant difference between the control group after treatment and the maltitol patient group after treatment (p<0.001). A. naeslundii HOT-176 and Actinomyces HOT-169 were significantly reduced following use of maltitol chewing gum in patients. Conclusions : This study has shown that chewing gum containing maltitol had minor effects on the composition of the plaque microbiome.

Listening to Music during Warming-Up Counteracts the Negative Effects of Ramadan Observance on Short-Term Maximal Performance.

PubMed

Aloui, Asma; Briki, Walid; Baklouti, Hana; Chtourou, Hamdi; Driss, Tarak; Chaouachi, Anis; Chamari, Karim; Souissi, Nizar

2015-01-01

The aim of the present study was to examine whether listening to music during warming-up might influence short-term maximal performance (STMP), cognitive anxiety, self-confidence, and enjoyment during Ramadan, and whether these affects might predict STMP. Nine male physical education students (age: 21 ± 1.1 years; height: 1.8 ± 0.04 m; body mass: 83 ± 5 kg) volunteered to participate in the present study. A within-subjects design consisted of four experimental sessions: Two sessions occurred one week before Ramadan and two others took place during Ramadan. They were scheduled at 5 p.m. and were conducted as follows: After a 10-minute warm-up either with or without listening to music, each participant performed a 5-m multiple shuttle run test, after which he was asked to answer items intended to assess his affective state during the experimental task. Our findings revealed that STMP was lower during Ramadan than before Ramadan in the no-music condition. Additionally, it was found that STMP was higher in the music condition than in the no-music condition during Ramadan, and that STMP measured before Ramadan did not differ from that measured during Ramadan in the music condition. Regarding affects, the findings revealed that enjoyment was lower during Ramadan than before Ramadan in the music condition, and that cognitive anxiety was lower in the music condition than in the no-music condition before Ramadan. Self-confidence was not influenced by the experimental conditions. This study showed that listening to music during warming-up not only would be beneficial for STMP in Ramadan fasters, but also would counteract the negative effects of Ramadan observance on STMP.

Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform.

PubMed

Pennington, Kelly M; Dong, Yue; Coville, Hongchuan H; Wang, Bo; Gajic, Ognjen; Kelm, Diana J

2018-12-01

The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics. The study design was a prospective study evaluating team dynamics before and after remote simulation. Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses). The study was conducted at nine training sites in eight countries. Study subjects completed 2-3 simulation scenarios of acute crises before and after training with the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). Pre- and post-CERTAIN training simulations were evaluated by two independent reviewers utilizing the Team Emergency Assessment Measure (TEAM), which is a 11-item questionnaire that has been validated for assessing teamwork in the intensive care unit. Any discrepancies of greater than 1 point between the two reviewers on any question on the TEAM assessment were sent to a third reviewer to judge. The score that was deemed discordant by the third judge was eliminated. Pre- and post-CERTAIN training TEAM scores were averaged and compared. Of the nine teams evaluated, six teams demonstrated an overall improvement in global team performance following CERTAIN virtual training. For each of the 11 TEAM assessments, a trend toward improvement following CERTAIN training was noted; however, no assessment had universal improvement. 'Team composure and control' had the least absolute score improvement following CERTAIN training. The greatest improvement in the TEAM assessment scores was in the 'team's ability to complete tasks in a timely manner' and in the 'team leader's communication to the team'. The assessment of team dynamics using long distance, virtual simulation training appears to be feasible and may result in improved team performance during simulated patient crises; however, language and video quality were the two largest barriers noted during the review process.

Time Series Analysis on the Impact of Generic Substitution and Reference Pricing on Antipsychotic Costs in Finland.

PubMed

Koskinen, Hanna; Mikkola, Hennamari; Saastamoinen, Leena K; Ahola, Elina; Martikainen, Jaana E

2015-12-01

To analyze the medium- to long-term impact of generic substitution and the reference price system on the daily cost of antipsychotics in Finland. The additional impact of reference pricing over and above previously implemented generic substitution was also assessed. An interrupted time series design with a control group and segmented regression analysis was used to estimate the effect of the implementation of generic substitution and the reference price system on the daily cost of antipsychotics. The data have 69 monthly values of the average daily cost for each of the studied antipsychotics: 39 months before and 30 months after the introduction of reference pricing. For one of the studied antipsychotic, the time before the introduction of reference pricing could be further divided into time before and after the introduction of generic substitution. According to the model, 2.5 years after the implementation of reference pricing, the daily cost of the studied antipsychotics was 24.6% to 50.6% lower than it would have been if reference pricing had not been implemented. Two and a half years after the implementation of the reference price system, however, the additional impact of reference pricing over and above previously implemented generic substitution was modest, less than 1 percentage point. Although the price competition induced by reference pricing decreased the prices of antipsychotics in Finland in the short-term, the prices had a tendency to stagnate or even to turn in an upward direction in the medium- to long-term. Furthermore, the additional impact of reference pricing over and above previously implemented generic substitution remained quite modest. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Evaluating a family-centred intervention for infant sleep problems.

PubMed

Thome, Marga; Skuladottir, Arna

2005-04-01

This paper reports a study to describe changes in parents' distress after a family-centred intervention for sleep problems of infants. Infant sleep problems are common and are related to depressive symptoms in mothers, but their impact on fathers has rarely been studied. Because childhood sleep problems and parental distress are associated, their interdependence should be recognized in research and in paediatric sleep practice. All children hospitalized for sleep problems in a hospital in Iceland in 1997-1998 and their parents were studied using a pre- and post-test quasi-experimental design. The sample consisted of 33 infants (6-23 months of age), 33 mothers and 30 fathers. Parents' distress was assessed before and after treatment with regard to: (1) fatigue and resulting symptom distress; (2) parenting stress; (3) state-anxiety; and (4) depressive symptoms. Infants were treated for a variety of sleep problems by a paediatric nurse. The parents were simultaneously treated for distress by either the paediatric nurse or a specialist, depending on the nature of their problems. Mothers and fathers experienced a high degree of distress before the intervention, with no significant difference between them. Two months after the intervention both parents' distress had significantly improved. Parents' degree of distress was at a psychopathological level before the intervention but was reduced to population norms 2 months after the intervention. The paediatric nurse intervention was sufficient to reduce distress for 83% of parents. Health care professionals who care for infants with sleep problems should pay attention to the distressed responses of parents and support their recovery. An intervention such as that described here could be used by nurses for this purpose.

Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study

PubMed Central

2013-01-01

Background Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. Methods/design This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. Discussion This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries as well. PMID:23561032

Initial experience with the unrestricted introduction of sugammadex at a large academic medical center: a retrospective observational study examining postoperative mechanical ventilation and efficiency outcomes.

PubMed

Reilly-Shah, Vikas N O'; Lynde, Grant C; Mitchell, Matthew L; Maffeo, Carla L; Jabaley, Craig S; Wolf, Francis A

2018-05-30

Sugammadex can rapidly reverse deep neuromuscular blockade, but due to cost questions remain as to its optimal utilization. After introduction for unrestricted use at an academic medical center, we hypothesized that reductions would be demonstrated in the primary outcome of post-anesthesia care unit (PACU) mechanical ventilation (MV) and secondary outcomes of PACU length of stay (LOS), and emergence time (surgery end to anesthesia end time in PACU). We conducted a retrospective observational study of patients undergoing general anesthesia over a 12-month period. Using multiple variable penalized logistic regression in a one group before-and-after design, we compared categorized rates of PACU MV to examine the effect of sugammadex introduction following a post-hoc chart review to ascertain the reason for postoperative MV. Additionally, multiple variable linear regression was used to assess for differences in PACU LOS and emergence time within a propensity matched set of patients receiving neostigmine or sugammadex. 7,217 cases met inclusion criteria: 3,798 before and 3,419 after the introduction of sugammadex. The incidence of PACU MV was 2.3% before and 1.8% after (p=0.118). PACU MV due to residual neuromuscular blockade (rNMB) decreased from 0.63% to 0.20% (p=0.005). Ventilation due to other causes was unchanged. PACU LOS and emergence time were unchanged in a propensity matched set of 1,444 cases. We identified rNMB as an important contributor to PACU MV utilization and observed a significant decrease after sugammadex was introduced. The selected efficiency measures may not have been sufficiently granular to identify improvements following introduction.

Early repolarization in Wolff-Parkinson-White syndrome: prevalence and clinical significance.

PubMed

Mizumaki, Koichi; Nishida, Kunihiro; Iwamoto, Jotaro; Nakatani, Yosuke; Yamaguchi, Yoshiaki; Sakamoto, Tamotsu; Tsuneda, Takayuki; Inoue, Hiroshi; Sakabe, Masao; Fujiki, Akira

2011-08-01

Idiopathic ventricular fibrillation (IVF) with early repolarization (ER) has recently been reported; however, ER is a common finding in healthy subjects and is also found sporadically in patients with Wolff-Parkinson-White (WPW) syndrome. The present study was designed to evaluate the prevalence and clinical significance of ER in patients with WPW syndrome. One hundred and eleven patients with WPW syndrome were studied retrospectively. Early repolarization was defined as QRS slurring or notching with J-point elevation ≥ 1 mm. The prevalence of ER was determined before and after successful catheter ablation. Before ablation, ER was found in 35 of 75 patients with a left free wall, 6 of 23 with a right free wall, and 7 of 13 with a septal accessory pathway (48 of 111, 43% as a whole). Early repolarization was always observed in leads with positive deflection of the initial part of the delta wave. After successful ablation of accessory pathways, ER was preserved in 28 (25%), disappeared in 20 (18%), and newly developed in 8 (7%) patients. In the remaining 55 (50%) patients, ER was not observed either before or after ablation. In patients with persistent ER, the amplitude and width of ER were significantly decreased 3-7 days after the ablation (1.7 ± 0.7 vs. 1.4 ± 0.6 mm, P < 0.005 and 42 ± 11 vs. 34 ± 9 ms, P < 0.001, respectively). In patients with WPW syndrome, ER could be partly related to early depolarization through the accessory pathway. However, persistent ER and new ER appearing after the ablation were frequently found. Therefore, in these patients, mechanisms other than early depolarization may be involved in the genesis of ER.

Smoke-free laws in bars and restaurants: does support among teens and young adults change after a statewide smoke-free law?

PubMed

Fabian, Lindsey E A; Bernat, Debra H; Lenk, Kathleen M; Shi, Qun; Forster, Jean L

2011-01-01

We assessed changes in levels of support for smoke-free bars and restaurants among teens and young adults before and after implementation of a statewide smoke-free law. We measured support for smoke-free bars and restaurants among teens and young adults aged 16-24 years living in Minnesota (n=2,785) and five comparison states (n=404), up to 12 months before and up to six months after Minnesota's smoke-free law went into effect in October 2007. We compared changes in support among three subgroups-Minnesota participants who lived with a previous local smoke-free law, Minnesota participants who did not live with a previous local smoke-free law, and participants from the comparison states-before and after Minnesota's statewide smoke-free law went into effect. Support for smoke-free restaurants and bars among participants in Minnesota and comparison states increased after Minnesota's smoke-free law went into effect. Minnesotans, both those living with and without a previous local smoke-free law, showed similar increases in support for smoke-free restaurants as participants in comparison states. However, Minnesotans living without a previous local law showed larger increases in support for smoke-free bars than both those in comparison states and those living in Minnesota with a previous local smoke-free law. Our study employed a more robust design than similar studies and focused on the teen and young adult population. Our results will help advocates and policy makers demonstrate how public support for smoke-free laws increases following smoke-free legislation, particularly among those who were not previously living with a local smoke-free law.

Smoke-Free Laws in Bars and Restaurants: Does Support Among Teens and Young Adults Change After a Statewide Smoke-Free Law?

PubMed Central

Fabian, Lindsey E. A.; Bernat, Debra H.; Lenk, Kathleen M.; Shi, Qun; Forster, Jean L.

2011-01-01

Objective We assessed changes in levels of support for smoke-free bars and restaurants among teens and young adults before and after implementation of a statewide smoke-free law. Methods We measured support for smoke-free bars and restaurants among teens and young adults aged 16–24 years living in Minnesota (n=2,785) and five comparison states (n=404), up to 12 months before and up to six months after Minnesota's smoke-free law went into effect in October 2007. We compared changes in support among three subgroups—Minnesota participants who lived with a previous local smoke-free law, Minnesota participants who did not live with a previous local smoke-free law, and participants from the comparison states—before and after Minnesota's statewide smoke-free law went into effect. Results Support for smoke-free restaurants and bars among participants in Minnesota and comparison states increased after Minnesota's smoke-free law went into effect. Minnesotans, both those living with and without a previous local smoke-free law, showed similar increases in support for smoke-free restaurants as participants in comparison states. However, Minnesotans living without a previous local law showed larger increases in support for smoke-free bars than both those in comparison states and those living in Minnesota with a previous local smoke-free law. Conclusions Our study employed a more robust design than similar studies and focused on the teen and young adult population. Our results will help advocates and policy makers demonstrate how public support for smoke-free laws increases following smoke-free legislation, particularly among those who were not previously living with a local smoke-free law. PMID:21886327

Standardized approach to training for cataract surgery skill evaluation.

PubMed

Pittner, Andrew; Nolan, Michael; Traish, Aisha; Farooq, Asim; Feder, Robert; Hill, Geoff; Dwarakanathan, Surendar; McGaghie, William; Bouchard, Charles

2016-06-01

To assess interrater reliability in grading cataract surgery performance of ophthalmology residents and attending physicians before and after rater skill training. Metropolitan Chicago, Illinois, USA. Prospective interventional test design. Video versions of a previously validated scoring key for rating cataract surgery were created for participant training. All participants received 2 frame-of-reference training sessions lasting 2 hours each. Participants graded 4 videorecorded cataract surgeries before training (pretest) and 4 more after training (posttest). Intraclass correlation coefficients (ICCs), which measured the degree of rater agreement, were calculated before and after training. Participants completed a subjective confidence questionnaire at the beginning and at the end of the study. The study participants included 9 postgraduate year (PGY)-3 residents, 8 PGY-4 residents, and 5 ophthalmology attending physicians from 4 medical centers in metropolitan Chicago. The rater training sessions had the greatest increase in ICCs among PGY-3 residents. The ICC improvement between the PGY-4 residents and attending physicians was uneven. After training, all residents felt more confident about their ability to rate and to perform cataract surgery. Learning to effectively grade performance of cataract surgery by reviewing video clips has the potential to be an important part of ophthalmology residency education. The benefit of such a protocol was greatest in the early stages of residency education and might provide a guideline for quality assessment that accelerates surgical skill development. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Usability and Visual Communication for Southern California Tsunami Evacuation Information: The importance of information design in disaster risk management

NASA Astrophysics Data System (ADS)

Jaenichen, C.; Schandler, S.; Wells, M.; Danielsen, T.

2015-12-01

Evacuation behavior, including participation and response, is rarely an individual and isolated process and the outcomes are usually systemic. Ineffective evacuation information can easily attribute to delayed evacuation response. Delays increase demands on already extended emergency personal, increase the likelihood of traffic congestion, and can cause harm to self and property. From an information design perspective, addressing issues in cognitive recall and emergency psychology, this case study examines evacuation messaging including written, audio, and visual presentation of information, and describes the application of design principles and role of visual communication for Southern California tsunami evacuation outreach. The niche of this project is the inclusion of cognitive processing as the driving influence when making formal design decisions and measurable data from a 4-year cognitive recall study to support the solution. Image included shows a tsunami evacaution map before and after the redesign.

Nonparametric change point estimation for survival distributions with a partially constant hazard rate.

PubMed

Brazzale, Alessandra R; Küchenhoff, Helmut; Krügel, Stefanie; Schiergens, Tobias S; Trentzsch, Heiko; Hartl, Wolfgang

2018-04-05

We present a new method for estimating a change point in the hazard function of a survival distribution assuming a constant hazard rate after the change point and a decreasing hazard rate before the change point. Our method is based on fitting a stump regression to p values for testing hazard rates in small time intervals. We present three real data examples describing survival patterns of severely ill patients, whose excess mortality rates are known to persist far beyond hospital discharge. For designing survival studies in these patients and for the definition of hospital performance metrics (e.g. mortality), it is essential to define adequate and objective end points. The reliable estimation of a change point will help researchers to identify such end points. By precisely knowing this change point, clinicians can distinguish between the acute phase with high hazard (time elapsed after admission and before the change point was reached), and the chronic phase (time elapsed after the change point) in which hazard is fairly constant. We show in an extensive simulation study that maximum likelihood estimation is not robust in this setting, and we evaluate our new estimation strategy including bootstrap confidence intervals and finite sample bias correction.

The effects of the application of SIMPRO on the completeness and time efficiency of nursing documentation in the outpatient instalation at Dompet Dhuafa Hospital Parung

NASA Astrophysics Data System (ADS)

Dwisatyadini, M.; Hariyati, R. T. S.; Afifah, E.

2018-03-01

Nursing documentation is clinical information that has a vital role in nursing services. The nursing process includes assessment, diagnosis, intervention, implementation, and evaluation. The purpose of this study was to determine the effects of the application of SIMPRO on the completeness and the efficiency of nursing documentation in the outpatient installation at Dompet Dhuafa Hospital Parung. This study used quantitative method with pre experimental (pre and posttest without control group) design. The mean of the documentation completeness marks before the application of SIMPRO was 1.87 (SD 0.922), and after SIMPRO was applied increased to 3.61 (0.588). This increase indicated an improvement of the nursing documentation completeness after the implementation of SIMPRO. The mean of time needed by nurses in documenting the nursing care before the application of SIMPRO was 476.13 seconds (SD 78.896). The mean of documenting time decreased more than a half after the application of SIMPRO which was 202.52 seconds (SD 196.723). SIMPRO made a nurse easier to take a decision analysis and decision support system to nursing care plan and documentation.

The effect of a researcher designated music intervention on hospitalised psychiatric patients with different levels of anxiety.

PubMed

Yang, Chyn-Yng; Miao, Nae-Fang; Lee, Tso-Ying; Tsai, Jui-Chen; Yang, Hui-Ling; Chen, Wen-Chun; Chung, Min-Huey; Liao, Yuan-Mei; Chou, Kuei-Ru

2016-03-01

The purpose of this study was to investigate the effects of a music intervention on hospitalised psychiatric patients with different levels of anxiety. In clinical practice, psychiatric inpatients and nurses routinely suffer from anxiety. A music intervention may possibly be useful, but knowledge as to how useful and how effective it is in patients with different levels of anxiety is limited. The study design was a three-group, repeated-measures experimental study. Subjects were 22 psychiatric patients who were divided into three groups based on their level of anxiety. They listened to 20 minutes of music each day for 10 days and were assessed using the Beck Anxiety Inventory before and after the music intervention and at a one-week follow-up; an electroencephalogram and finger temperature were monitored before and during the music intervention. Anxiety levels of all three groups showed a significant difference (p = 0·0339) after the intervention. The difference alpha and beta electroencephalogram percentages for all three groups showed a significant difference (p = 0·04; p = 0·01). The finger temperature showed a non-significant difference (p = 0·41). A music intervention can effectively alleviate the anxiety of hospitalised psychiatric patients who suffer from all levels of anxiety. The study recommends a practice in alleviating anxiety. Effective lower-cost interventions to reduce anxiety in psychiatric inpatient settings would be of interest to nurses and benefit patients. © 2016 John Wiley & Sons Ltd.

Shoulder impairment before breast cancer surgery.

PubMed

Flores, Ann Marie; Dwyer, Kathleen

2014-09-01

To compare pre- and post-operative shoulder active range of motion (AROM) values from female breast cancer survivors to population norm values for shoulder AROM; and to compare shoulder AROM differences pre- and post-surgery between female African American and White breast cancer survivors (BCA). This pilot study used a convenience sample and longitudinal design measuring participants 2 times (T0 = baseline, after biopsy but within 2 weeks before BCA surgery; T1 = 2 nd postoperative week). The U.S. has the largest BCA survivor population in history and yet the mortality burden remains highest among AA BCA survivors. AAs may also have greater burden of physical and functional side effects compared to whites and the general population. The data were collected from a convenience sample (n = 33; n AA = 9, n W = 24) and included data on shoulder AROM, medical chart review for pre- and co-morbid conditions, and self-reported demographics and medical history. We used t-tests to compare sample AROM means to population norms. We then compared our sample across 2 timepoints (T0 = pre-surgery; T1 = 2 weeks post-surgery) using independent samples t-tests and repeated measures analysis of variance (p < .05) to compare AA to White sub-samples AROM means. African Americans had significantly less shoulder abduction (at T0) and flexion (at T1) than whites. However, 100% had significantly reduced AROM for all movements at T0 (prior to surgery but after biopsy) when compared to population norms. The significant reduction in shoulder AROM after biopsy but before surgery points to a possible unmet need for early physical therapy intervention. Further research using randomized controlled trial design is recommended.

Method Improving Reading Comprehension In Primary Education Program Students

NASA Astrophysics Data System (ADS)

Rohana

2018-01-01

This study aims to determine the influence of reading comprehension skills of English for PGSD students through the application of SQ3R learning method. The type of this research is Pre-Experimental research because it is not yet a real experiment, there are external variables that influence the formation of a dependent variable, this is because there is no control variable and the sample is not chosen randomly. The research design is used is one-group pretest-post-test design involving one group that is an experimental group. In this design, the observation is done twice before and after the experiment. Observations made before the experiment (O1) are called pretests and the post-experimental observation (O2) is called posttest. The difference between O1 and O2 ie O2 - O1 is the effect of the treatment. The results showed that there was an improvement in reading comprehension skills of PGSD students in Class M.4.3 using SQ3R method, and better SQ3R enabling SQ3R to improve English comprehension skills.

Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching.

PubMed

Reuther, Katherine E; Larsen, Ryan; Kuhn, Pamela D; Kelly, John D; Thomas, Stephen J

2016-12-01

The natural time course for recovery of glenohumeral internal rotation (IR) loss after a throwing episode is unknown. In addition, the effect of the sleeper stretch on the time course for recovery of motion after a throwing episode has never been investigated. Therefore, the objectives of this study were to (1) to determine the natural time course for spontaneous recovery of IR after a throwing episode and (2) to evaluate the effect of the sleeper stretch on the time course for recovery of IR after a throwing episode. The study participants were 17 male high school baseball pitchers (aged 17.7 ± 0.9 years). A crossover designed was used over a 2-week period. For week 1, glenohumeral IR and external rotation (ER) were evaluated in the dominant shoulder 1 day before a throwing episode and at 2 hours, 1 day, 2 days, 3 days, 4 days, and 5 days after pitching. During week 2, participants completed a sleeper stretch protocol before measurements. The natural time course of spontaneous recovery for IR after a throwing episode was 4 days. Stretching reduced the time course of recovery for IR to 2 days. A sleeper stretch program for high school baseball pitchers can accelerate the recovery of commonly observed IR loss and also may mitigate the cumulative effects observed over the course of a season. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Circulating Hepcidin-25 Is Reduced by Endogenous Estrogen in Humans

PubMed Central

Lehtihet, Mikael; Bonde, Ylva; Beckman, Lena; Berinder, Katarina; Hoybye, Charlotte; Rudling, Mats; Sloan, John H.; Konrad, Robert J.; Angelin, Bo

2016-01-01

Objective Hepcidin reduces iron absorption by binding to the intestinal iron transporter ferroportin, thereby causing its degradation. Although short-term administration of testosterone or growth hormone (GH) has been reported to decrease circulating hepcidin levels, little is known about how hepcidin is influenced in human endocrine conditions associated with anemia. Research design and methods We used a sensitive and specific dual–monoclonal antibody sandwich immunoassay to measure hepcidin-25 in patients (a) during initiation of in vitro fertilization when endogenous estrogens were elevated vs. suppressed, (b) with GH deficiency before and after 12 months substitution treatment, (c) with hyperthyroidism before and after normalization, and (d) with hyperprolactinemia before and after six months of treatment with a dopamine agonist. Results In response to a marked stimulation of endogenous estrogen production, median hepcidin levels decreased from 4.85 to 1.43 ng/mL (p < 0.01). Hyperthyroidism, hyperprolactinemia, or GH substitution to GH-deficient patients did not influence serum hepcidin-25 levels. Conclusions In humans, gonadotropin-stimulated endogenous estrogen markedly decreases circulating hepcidin-25 levels. No clear and stable correlation between iron biomarkers and hepcidin-25 was seen before or after treatment of hyperthyroidism, hyperprolactinemia or growth hormone deficiency. PMID:26866603

Monitoring of Deformation in Ground Before and After Tunnel Excavation

NASA Astrophysics Data System (ADS)

Eren, Mehmet; Hilmi Erkoç, Muharrem

2017-04-01

As population increase in metropolitan city, we need transportation and transmission tunnel. In this context, the engineers and administors attach impotance to building and planning underground-tunnel. Moreover, we must at regular intervals monitoring to deformation in underground-tunnel for quality and safety. Firstly, a deformation monitoring network is designed as perpendicular to the tunnel main axis. Secondly, the prescribed number of deformation measurements must be made. Finally, the deformation analysis is evaluated and its results is interpreted. This study investigates how deformation in monitoring network during and after tunnel excavate change.For this purpose, a deformation monitoring network of 18 object point and 4 reference point was established. Object points networks was designed steeply to the tunnel main axis as 3 cross section. Each cross section consisted of 3 point left, 2 point right and 1 point at the flowing line. Initial conditional measurement was made before tunnel excavation. Then the deformation measurement was made 5 period (1 period measured after tunnel excavate). All data sets were adjusted according to free adjustment method. The results from the investigation considering the tunnel line, a symmetrical subsidence was observed. The following day of tunnel excavation, we were observed %68 per of the total deformation. At the end of the last period measurements, %99 per of the total deformation was detected. Keywords: Tunnel, Deformation, Subsidence, Excavation

A pilot study of eye movement desensitisation and reprocessing treatment (EMDR) for post-traumatic stress after childbirth.

PubMed

Sandström, Marianne; Wiberg, Britt; Wikman, Marianne; Willman, Anna-Klara; Högberg, Ulf

2008-03-01

to explore the possibility of using eye movement desensitisation and reprocessing (EMDR) to treat women who have experienced post-traumatic stress after childbirth. the pilot study consisted of a 'before and after' treatment design combined with follow-up measurements 1-3 years after EMDR treatment. Quantitative data from questionnaires (Traumatic Event Scale [TES]) were collected. In addition, qualitative data from individual interviews with the participants were collected as well as data from the psychotherapist's treatment notes of the EMDR treatment sessions. the north of Sweden. four women with post-traumatic stress disorder (PTSD) after childbirth (one pregnant and three non-pregnant). all participants reported reduction of post-traumatic stress after treatment. After 1-3 years, the beneficial effects of EMDR treatment remained for three of the four women. Symptoms of intrusive thoughts and avoidance seemed most sensitive for treatment. EMDR might be a useful tool in the treatment of non-pregnant women severely traumatised by childbirth; however, further research is required.

When is the best moment to apply photobiomodulation therapy (PBMT) when associated to a treadmill endurance-training program? A randomized, triple-blinded, placebo-controlled clinical trial.

PubMed

Miranda, Eduardo Foschini; Tomazoni, Shaiane Silva; de Paiva, Paulo Roberto Vicente; Pinto, Henrique Dantas; Smith, Denis; Santos, Larissa Aline; de Tarso Camillo de Carvalho, Paulo; Leal-Junior, Ernesto Cesar Pinto

2018-05-01

Photobiomodulation therapy (PBMT) employing low-level laser therapy (LLLT) and/or light emitting diode therapy (LEDT) has emerged as an electrophysical intervention that could be associated with aerobic training to enhance beneficial effects of aerobic exercise. However, the best moment to perform irradiation with PBMT in aerobic training has not been elucidated. The aim of this study was to assess the effects of PBMT applied before and/or after each training session and to evaluate outcomes of the endurance-training program associated with PBMT. Seventy-seven healthy volunteers completed the treadmill-training protocol performed for 12 weeks, with 3 sessions per week. PBMT was performed before and/or after each training session (17 sites on each lower limb, using a cluster of 12 diodes: 4 × 905 nm super-pulsed laser diodes, 4 × 875 nm infrared LEDs, and 4 × 640 nm red LEDs, dose of 30 J per site). Volunteers were randomized in four groups according to the treatment they would receive before and after each training session: PBMT before + PBMT after, PBMT before + placebo after, placebo before + PBMT after, and placebo before + placebo after. Assessments were performed before the start of the protocol and after 4, 8, and 12 weeks of training. Primary outcome was time until exhaustion; secondary outcome measures were oxygen uptake and body fat. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) significantly increased (p < 0.05) the percentage of change of time until exhaustion and oxygen uptake compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 4th, 8th, and 12th week. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) also significantly improved (p < 0.05) the percentage of change of body fat compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 8th and 12th week. PBMT applied before and after sessions of aerobic training during 12 weeks can increase the time-to-exhaustion and oxygen uptake and also decrease the body fat in healthy volunteers when compared to placebo irradiation before and after exercise sessions. Our outcomes show that PBMT applied before and after endurance-training exercise sessions lead to improvement of endurance three times faster than exercise only.

Investigating young children's learning of mass measurement

NASA Astrophysics Data System (ADS)

Cheeseman, Jill; McDonough, Andrea; Ferguson, Sarah

2014-06-01

This paper reports results of a design experiment regarding young children's concepts of mass measurement. The research built on an earlier study in which a framework of "growth points" in early mathematics learning and a related, task-based, one-to-one interview to assess children's understanding of the measurement of mass were developed. Prompted by the results and recommendations from the earlier study, five lessons were developed that offered rich learning experiences regarding concepts of mass. The 119 Year 1 and 2 children participating in the study were interviewed using the same protocol before and after the teaching period. The assessment data showed that the majority of these children moved from using nonstandard units to using standard units and instruments for measuring mass. The findings from this study challenge the traditional approach of using informal units for an extended period before the introduction of standard units.

Effects of a Crisis Intervention Team (CIT) training program upon police officers before and after Crisis Intervention Team training.

PubMed

Ellis, Horace A

2014-02-01

In communities across the United States and internationally, police officers frequently come into contact with individuals experiencing mental health crisis despite not having the skills to safely intervene. This often results in officers resorting to excessive or even deadly force. The Crisis Intervention Team (CIT) is heralded as a revolutionary and transformative intervention to correct this gap in practice. Several previous interdisciplinary national and international studies, including criminology and sociology, have examined these concepts using quantitative and qualitative methodological designs, however, no prior nursing studies have been done on this topic. The purpose of this study was to determine the effect of CIT training on police officers' knowledge, perception, and attitude toward persons with mental illness. Twenty five police officers participated. An explorative, quasi experimental, descriptive design was used to collect the data on the three major concepts. Results on knowledge about mental illness improved at p<.0125 (p<.05 after Bonferroni correction). Perception scores improved at p<.0125 (p<.05 after Bonferroni correction), and attitudes were more favorable at p<.0125 (p<.05 after Bonferroni correction). The results of this study validated the CIT program as an innovative community health program that benefits law enforcement, consumers, mental health professionals, and stakeholders. © 2013 Elsevier Inc. All rights reserved.

Normobaric oxygen worsens outcome after a moderate traumatic brain injury

PubMed Central

Talley Watts, Lora; Long, Justin Alexander; Manga, Venkata Hemanth; Huang, Shiliang; Shen, Qiang; Duong, Timothy Q

2015-01-01

Traumatic brain injury (TBI) is a multifaceted injury and a leading cause of death in children, young adults, and increasingly in Veterans. However, there are no neuroprotective agents clinically available to counteract damage or promote repair after brain trauma. This study investigated the neuroprotective effects of normobaric oxygen (NBO) after a controlled cortical impact in rats. The central hypothesis was that NBO treatment would reduce lesion volume and functional deficits compared with air-treated animals after TBI by increasing brain oxygenation thereby minimizing ischemic injury. In a randomized double-blinded design, animals received either NBO (n=8) or normal air (n=8) after TBI. Magnetic resonance imaging (MRI) was performed 0 to 3 hours, and 1, 2, 7, and 14 days after an impact to the primary forelimb somatosensory cortex. Behavioral assessments were performed before injury induction and before MRI scans on days 2, 7, and 14. Nissl staining was performed on day 14 to corroborate the lesion volume detected from MRI. Contrary to our hypothesis, we found that NBO treatment increased lesion volume in a rat model of moderate TBI and had no positive effect on behavioral measures. Our results do not promote the acute use of NBO in patients with moderate TBI. PMID:25690469

3D in vivo femoro-tibial kinematics of tri-condylar total knee arthroplasty during kneeling activities.

PubMed

Nakamura, Shinichiro; Sharma, Adrija; Kobayashi, Masahiko; Ito, Hiromu; Nakamura, Kenji; Zingde, Sumesh M; Nakamura, Takashi; Komistek, Richard D

2014-01-01

Kneeling position can serve as an important posture, providing stability and balance from a standing position to sitting on the floor or vice-versa. The purpose of the current study was to determine the kinematics during kneeling activities after subjects were implanted with a tri-condylar total knee arthroplasty. Kinematics was evaluated in 54 knees using fluoroscopy and a three-dimensional model fitting approach. The average knee flexion at before contact status, at complete contact and at maximum flexion was 98.1±9.0°, 107.2±6.7°, and 139.6±12.3°, respectively. On average, there was no gross anterior displacement from before contact status to complete contact. Only slight posterior rollback motion of both condyles from complete contact to maximum flexion was observed. Three of 39 (7.7%) knees experienced anterior movement of both condyles more than 2mm from before contact status to complete contact. Reverse rotation pattern from before contact status to complete contact and then normal rotation pattern from complete contact to maximum flexion were observed. Condylar lift-off greater than 1.0 mm was observed in 45 knees (83.3%). The presence of the ball-and-socket joint articulation provides sufficient antero-posterior stability in these designs to enable the patients to kneel safely without the incidence of any dislocation. This study suggests a safe implant design for kneeling. © 2013.

Evaluating psycho-educational interventions for informal carers of patients receiving cancer care or palliative care: strengths and limitations of different study designs.

PubMed

Schildmann, Eva K; Higginson, Irene J

2011-06-01

Despite evidence of negative psychological sequelae and unmet needs, there are few evaluated interventions for informal caregivers in cancer and palliative care. The aim of this article is to debate the strengths and limitations of randomized controlled trials (RCTs) and other designs that can be used to evaluate the effectiveness of these interventions. Psycho-educational interventions are used as example for this debate article, as a number of studies of various designs evaluating this type of intervention have been published. Systematic searching in Medline and the bibliography of a relevant systematic review identified five RCTs, one pre-test/post-test study with a control group and six one-group pre-test/post-test studies of psycho-educational interventions for caregivers. The methodological strengths and weaknesses were assessed. RCTs are seen as the gold standard, but can have important limitations in the context of carer intervention research, including biased recruitment and low generalizability, problems with blinding and attrition. Pre-test/post-test studies with a control group may be more feasible and more generalizable. Their crucial limitation is selection bias. Before-after studies are compromised by additional specific biases and therefore are the weakest of all discussed designs. After analysing the strengths and weaknesses of the mentioned study designs, this paper presents strategies to address the limitations of RCTs evaluating psycho-educational interventions for carers in cancer or palliative care. © The Author(s) 2011

76 FR 22863 - Kern and Tulare Counties Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... are to contact the Designated Federal Official, Priscilla Summers at the Western Divide Ranger... related matters to the attention of the RAC may file written statements with the RAC staff before or after...

Beliefs and emotional reactions in patients with benign paroxysmal positional vertigo: a longitudinal study.

PubMed

Pollak, Lea; Segal, Perri; Stryjer, Rafael; Stern, Hadassah Goldberg

2012-01-01

Psychologic studies in patients with benign paroxysmal positional vertigo (BPPV) are scarce, considering the high frequency of the disorder. We performed a repeated-measures design questionnaire study in a cohort of patients with BPPV before and after treatment to investigate the dynamics of the psychologic findings and possible treatment consequences. Thirty-seven consecutive patients with idiopathic BPPV participated in the study. During the first visit and 2 to 3 months after therapy, the patients completed 4 questionnaires: the Dizziness Handicap Inventory, the Illness Perception Questionnaire-Revised, the Intolerance of Uncertainty Scale, and the State-Trait Anxiety Inventory. The scores for all questioned items did not change before and after treatment except for the physical handicap scores. Correlation was found between the grade of functional and emotional impact of the disease and belief in consequences as well as anxiety levels of the patients. Moreover, uncertainty scores were in correlation with emotional impact, anxiety levels, and perceived consequences of the disease. The belief in personal control of the condition was correlated with the belief in treatment control and understanding of the disease. The main finding in this study is the lack of a significant change in beliefs and emotional reactions in patients with BPPV after treatment of their condition. Physicians dealing with BPPV should be aware that the disease is not solely a somatic condition but has a serious impact on the patient's mental state. Selected patients might benefit from anxiolytic medication. Copyright © 2012 Elsevier Inc. All rights reserved.

Individual and Contextual Variables in Municipal Officers' Workplace Learning

ERIC Educational Resources Information Center

Moraes, Valéria Vieira; Borges-Andrade, Jairo Eduardo

2015-01-01

Purpose: The purpose of this paper is to investigate workplace learning among municipal officers in the high-learning-demanding organizational context of their work practice in the first year of mandate. Design/methodology/approach: A before-and-after quasi-experimental design was used to assess the effect of time of work practice on learning work…

Effectiveness of predictive computer programs in the design of noise barriers : a before and after approach, part I, the data acquisition system.

DOT National Transportation Integrated Search

1978-01-01

A digital data acquisition system has been designed to meet the need for a long duration noise analysis capability. By sampling the DC outputs from sound level meters, it has been possible to make twenty-four hour or longer recordings, in contrast to...

Modifying Student Behavior in an Open Classroom through Changes in the Physical Design

ERIC Educational Resources Information Center

Weinstein, Carol S.

1977-01-01

Spatial distribution of activity in a second-third grade open classroom was observed before and after a change in the physical design, to test the hypothesis that minor changes in the physical setting would produce predictable, desirable changes in student behavior. In most cases the desired behavior changes were produced. (Author/MV)

Impact of an Inquiry Unit on Grade 4 Students' Science Learning

ERIC Educational Resources Information Center

Di Mauro, María Florencia; Furman, Melina

2016-01-01

This paper concerns the identification of teaching strategies that enhance the development of 4th grade students' experimental design skills at a public primary school in Argentina. Students' performance in the design of relevant experiments was evaluated before and after an eight-week intervention compared to a control group, as well as the…

2018 NASA Student Launch event, Bragg Farms, Toney, Al

NASA Image and Video Library

2018-04-10

After eight months of designing, building and testing, the middle school, high school and college and university teams launched their rockets as part of NASA Student Launch on Sunday, April 8. The rockets and their payloads are designed to fly to 1-mile in altitude before deploying recovery systems that brings them safely to the ground.

2018 NASA Student Launch event, Bragg Farms, Toney, Al

NASA Image and Video Library

2018-04-09

After eight months of designing, building and testing, the middle school, high school and college and university teams launched their rockets as part of NASA Student Launch on Sunday, April 8. The rockets and their payloads are designed to fly to 1-mile in altitude before deploying recovery systems that brings them safely to the ground.

Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

PubMed

Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

2017-09-01

An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

Control group design, contamination and drop-out in exercise oncology trials: a systematic review.

PubMed

Steins Bisschop, Charlotte N; Courneya, Kerry S; Velthuis, Miranda J; Monninkhof, Evelyn M; Jones, Lee W; Friedenreich, Christine; van der Wall, Elsken; Peeters, Petra H M; May, Anne M

2015-01-01

Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of exercise-oncology trials and explores the association with contamination and drop-out rates. Randomized controlled exercise-oncology trials from two Cochrane reviews were included. Additionally, a computer-aided search using Medline (Pubmed), Embase and CINAHL was conducted after completion date of the Cochrane reviews. Eligible studies were classified according to three control group design characteristics: the exercise instruction given to controls before start of the study (exercise allowed or not); and the intervention the control group was offered during (any (e.g., education sessions or telephone contacts) or none) or after (any (e.g., cross-over or exercise instruction) or none) the intervention period. Contamination (yes or no) and excess drop-out rates (i.e., drop-out rate of the control group minus the drop-out rate exercise group) were described according to the three design characteristics of the control group and according to the combinations of these three characteristics; so we additionally made subgroups based on combinations of type and timing of instructions received. 40 exercise-oncology trials were included based on pre-specified eligibility criteria. The lowest contamination (7.1% of studies) and low drop-out rates (excess drop-out rate -4.7±9.2) were found in control groups offered an intervention after the intervention period. When control groups were offered an intervention both during and after the intervention period, contamination (0%) and excess drop-out rates (-10.0±12.8%) were even lower. Control groups receiving an intervention during and after the study intervention period have lower contamination and drop-out rates. The present findings can be considered when designing future exercise-oncology trials.

Mental state and its psychophysical conditions in patients with acute leukaemia treated with bone marrow transplantation.

PubMed

Warchala, Anna; Wojtyna, Ewa; Krysta, Krzysztof

2015-09-01

Acute leukaemia and bone marrow transplantation (BMT) as a method of its treatment are great psychological stressors, which are responsible for anxiety and depression in the group of patients. The aim of the study was to assess the patients' mental state and its psychophysical predictors before and after BMT. The study was of a longitudinal and self-descriptive character. The questionnaires: LOT-R, AIS, Mini-Mac, CECS, RSCL and HADS were filled by 60 patients with acute leukaemia before and after BMT. There were no essential statistical differences between the severity of anxiety and depression before and after BMT but the pattern and the power of various mental state predictors changed in the course of the hospitalization. Anxiety before transplantation was greater when the psychological stress and the strategy of "anxious preoccupation" were stronger and the strategy of "fighting spirit" and the level of generalized optimism were weaker. The factors explained 51% variations of anxiety before transplantation. After BMT 77% variations of anxiety were explained, which were associated with a high level of distress at the end of the hospitalization, higher level of anxiety before transplantation, weaker strategy of "fighting spirit" before transplantation and stronger strategy of "anxious preoccupation" after BMT. Before transplantation 36% variations of depression were explained and estimated as weaker "fighting spirit" and worse "global life quality". The essential predictors of depressive symptoms after transplantation, explained by 81% variations of depression, were weaker "fighting spirit" before transplantation, stronger "anxious preoccupation" after transplantation, worse "global life quality" after transplantation and higher level of anxious and depressive symptoms on admission to hospital. The psychological and pharmacological interventions, which reduce anxiety, depression and "anxious preoccupation" as well as enhance "fighting spirit", should be introduced before BMT to improve the patients' mental state.

Elimination of Routine Contact Precautions for Endemic Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: A Retrospective Quasi-Experimental Study.

PubMed

Martin, Elise M; Russell, Dana; Rubin, Zachary; Humphries, Romney; Grogan, Tristan R; Elashoff, David; Uslan, Daniel Z

2016-11-01

OBJECTIVE To evaluate the impact of discontinuation of contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) and expansion of chlorhexidine gluconate (CHG) use on the health system. DESIGN Retrospective, nonrandomized, observational, quasi-experimental study. SETTING Two California hospitals. PARTICIPANTS Inpatients. METHODS We compared hospital-wide laboratory-identified clinical culture rates (as a marker of healthcare-associated infections) 1 year before and after routine CP for endemic MRSA and VRE were discontinued and CHG bathing was expanded to all units. Culture data from patients and cost data on material utilization were collected. Nursing time spent donning personal protective equipment was assessed and quantified using time-driven activity-based costing. RESULTS Average positive culture rates before and after discontinuing CP were 0.40 and 0.32 cultures/100 admissions for MRSA (P=.09), and 0.48 and 0.40 cultures/100 admissions for VRE (P=.14). When combining isolation gown and CHG costs, the health system saved $643,776 in 1 year. Before the change, 28.5% intensive care unit and 19% medicine/surgery beds were on CP for MRSA/VRE. On the basis of average room entries and donning time, estimated nursing time spent donning personal protective equipment for MRSA/VRE before the change was 45,277 hours/year (estimated cost, $4.6 million). CONCLUSION Discontinuing routine CP for endemic MRSA and VRE did not result in increased rates of MRSA or VRE after 1 year. With cost savings on materials, decreased healthcare worker time, and no concomitant increase in possible infections, elimination of routine CP may add substantial value to inpatient care delivery. Infect Control Hosp Epidemiol 2016;1-8.

Study on polymethylmethacrylate ring in protecting limbal stem cells during collagen cross-linking.

PubMed

Jeyalatha, Vimalin; Jambulingam, Malathi; Gupta, Nidhi; Padmanabhan, Prema; Madhavan, Hajib N

2013-01-01

The UV rays used in the collagen cross-linking (CXL) procedure seem to cause potential damage to the limbal stem cells. This study was designed to evaluate the ability of polymethylmethacrylate (PMMA) hemiannulus as an alternative to protect corneal limbal stem cells during CXL. Ten freshly enucleated human cadaveric eyeballs were subjected to the corneal CXL procedure. The cadaveric eye ball was divided into 2 sectors: A and B. Sector A was left unprotected, while sector B was covered by a PMMA shield. Limbal biopsies from both sectors before and after the procedure were analyzed. Each limbal tissue was placed on human amniotic membrane (HAM) to check the cultivability and was subjected to marker studies using reverse transcriptase PCR. Before CXL, biopsies from both sectors showed growth on HAM. After CXL, biopsies from sector A showed no growth on HAM while 2 out of the 10 from sector B covered with the PMMA ring did show growth on HAM. The putative stem-cell marker ABCG2 was negative in all the samples from sector A after CXL and was positive in 2 out of the 10 samples from sector B. Covering the limbal region with PMMA offers partial protection of the limbus from the UV rays during the CXL procedure. © 2013 S. Karger AG, Basel.

A before-after control-impact assessment to understand the potential impacts of highway construction noise and activity on an endangered songbird.

PubMed

Long, Ashley M; Colón, Melanie R; Bosman, Jessica L; Robinson, Dianne H; Pruett, Hannah L; McFarland, Tiffany M; Mathewson, Heather A; Szewczak, Joseph M; Newnam, J Cal; Morrison, Michael L

2017-01-01

Anthropogenic noise associated with highway construction and operation can have individual- and population-level consequences for wildlife (e.g., reduced densities, decreased reproductive success, behavioral changes). We used a before-after control-impact study design to examine the potential impacts of highway construction and traffic noise on endangered golden-cheeked warblers ( Setophaga chrysoparia ; hereafter warbler) in urban Texas. We mapped and monitored warbler territories before (2009-2011), during (2012-2013), and after (2014) highway construction at three study sites: a treatment site exposed to highway construction and traffic noise, a control site exposed only to traffic noise, and a second control site exposed to neither highway construction or traffic noise. We measured noise levels at varying distances from the highway at sites exposed to construction and traffic noise. We examined how highway construction and traffic noise influenced warbler territory density, territory placement, productivity, and song characteristics. In addition, we conducted a playback experiment within study sites to evaluate acute behavioral responses to highway construction noises. Noise decreased with increasing distance from the highways. However, noise did not differ between the construction and traffic noise sites or across time. Warbler territory density increased over time at all study sites, and we found no differences in warbler territory placement, productivity, behavior, or song characteristics that we can attribute to highway construction or traffic noise. As such, we found no evidence to suggest that highway construction or traffic noise had a negative effect on warblers during our study. Because human population growth will require recurring improvements to transportation infrastructure, understanding wildlife responses to anthropogenic noise associated with the construction and operation of roads is essential for effective management and recovery of prioritized species.

Operational effectiveness of blended e-learning program for nursing research ethics.

PubMed

Cho, Kap-Chul; Shin, Gisoo

2014-06-01

Since 2006, the Korean Ministry of Education, Science and Technology, and the National Research Foundation of Korea have taken the lead in developing an institutional guideline for research ethics. The purpose was to identify the effectiveness of the Good Research Practice program, developed on a fund granted by the National Research Foundation of Korea, for nurses and nursing students whose knowledge and perception of research ethics were compared before and after the implementation of the Good Research Practice program. This study was conducted to compare the levels of knowledge and perception of research ethics in the participants before and after the program was implemented. The participants included 45 nurses and 69 nursing students from hospitals, colleges of nursing, and the Korean Nurses Association, located in Seoul, Korea. This study was approved by the Institutional Research Board in Korea. Based on the Analysis, Design, Development, Implementation, and Evaluation model, the Good Research Practice program was made up of a total of 30 h of the blended learning both online and off-line. The results of this study showed that there were statistically significant differences in both knowledge and perception of research ethics in nursing students and nurses before and after the program had been implemented. The concepts of professional nursing ethics, moral issues, and bioethics were often confused with one another and not clearly defined. Therefore, the concept and scope of bioethics, moral judgment, and overall nursing ethics should be well defined and conceptualized in the future. This study suggested integrating research ethics education in the nursing curriculum as a required course of study for nursing students and as part of the in-service training program for nurses in order to improve research ethics in nursing research in Korea. © The Author(s) 2013.

Hemoglobin levels and prevalence of anemia in pregnant women assisted in primary health care services, before and after fortification of flour.

PubMed

Araújo, Claudia Regina Marchiori Antunes; Uchimura, Taqueco Teruya; Fujimori, Elizabeth; Nishida, Fernanda Shizue; Veloso, Giovanna Batista Leite; Szarfarc, Sophia Cornblutz

2013-06-01

We evaluated hemoglobin-Hb levels and prevalence of anemia in pregnant women before and after fortification of flour. It was developed a study to evaluate intervention, of the type before and after, with independent population samples. Study was conducted in primary health care services in Maringá, PR. We assessed 366 and 419 medical records, Before and After implementation of fortification. Pregnant women with Hb < 11g/dL were considered anemic. Data were submitted to multiple linear regression analysis. There was low prevalence of anemia affecting 12.3% and 9.4% pregnant women Before and After fortification (p > 0.05), but the Group After the fortification had higher Hb levels (p < 0.05). Hb levels associated with Group, gestational age, previous pregnancy number, employment and marital status (p < 0.05). Although the fortification of flour may have had role in increasing the mean hemoglobin, we need consider the contribution of other variables not investigated.

[Influence of different designs and porcelain/glaze firing on the marginal and internal fit of implant-supported zirconia crowns].

PubMed

Cuiling, Liu; Xu, Gao; Yuping, Qi; Liyuan, Yang

2016-02-01

This study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns. Three groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0. HMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05). The marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

Young children's Oral Health-Related Quality of Life and dental fear after treatment under general anaesthesia: a randomized controlled trial.

PubMed

Klaassen, Marleen A; Veerkamp, Jacobus S J; Hoogstraten, Johan

2009-06-01

During the past decade the research interest in Oral Health-Related Quality of Life (OHRQoL) has been prospering. This study was performed to test (using a randomized controlled trial design) the hypothesis that young children's OHRQoL improves after oral rehabilitation under general anaesthesia (GA). A further aim of this study was to explore whether dental fear also changes. One-hundred and four children (54 boys; mean age 4.08 yr, standard deviation = 1.09), who had been referred to a specialized clinic in paediatric dentistry, were randomly assigned, based on a Solomon four-group design, to two treatment (GA) and two control conditions. The Early Childhood Oral Health Impact Scale (ECOHIS) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) were used to assess OHRQoL and dental fear, respectively, before and after the rehabilitation procedures. A 2 x 2 analysis of variance revealed that the total ECOHIS score after GA was more positive in the GA group than in the control group. There was no effect found of the pre-test and there was also no interaction between the pre-test and treatment. In the total CFSS-DS scores no effects were found. The results of this study showed that the child's OHRQoL improved after treatment under GA. Furthermore, children need guidance in reducing dental fear after treatment under GA.

Comparative research on activation technique for GaAs photocathodes

NASA Astrophysics Data System (ADS)

Chen, Liang; Qian, Yunsheng; Chang, Benkang; Chen, Xinlong; Yang, Rui

2012-03-01

The properties of GaAs photocathodes mainly depend on the material design and activation technique. In early researches, high-low temperature two-step activation has been proved to get more quantum efficiency than high-temperature single-step activation. But the variations of surface barriers for two activation techniques have not been well studied, thus the best activation temperature, best Cs-O ratio and best activation time for two-step activation technique have not been well found. Because the surface photovoltage spectroscopy (SPS) before activation is only in connection with the body parameters for GaAs photocathode such as electron diffusion length and the spectral response current (SRC) after activation is in connection with not only body parameters but also surface barriers, thus the surface escape probability (SEP) can be well fitted through the comparative research between SPS before activation and SEP after activation. Through deduction for the tunneling process of surface barriers by Schrödinger equation, the width and height for surface barrier I and II can be well fitted through the curves of SEP. The fitting results were well proved and analyzed by quantitative analysis of angle-dependent X-ray photoelectron spectroscopy (ADXPS) which can also study the surface chemical compositions, atomic concentration percentage and layer thickness for GaAs photocathodes. This comparative research method for fitting parameters of surface barriers through SPS before activation and SRC after activation shows a better real-time in system method for the researches of activation techniques.

Effect of Instructing Care Program Through Group Discussion on the Quality of Life of the Parents of the Children Afflicted With Leukemia.

PubMed

Asadi Noughabi, Fariba; Iranpoor, Daryoush; Yousefi, Hadi; Abrakht, Hakimeh; Ghani Dehkordi, Fatemeh

2015-10-20

Children long-term involvement with cancer may have a negative impact on the quality of life their parents. Design and implementation of training programs for parents whose children have been diagnosed with leukemia, as the primary caregivers of children, will have a special significance and can contribute to better taking care of such children. The main purpose of the present study was to examine the impact of conducting group discussion, as care program training, on the quality of life parents whose children were suffering from leukemia. This quasi-experimental before-after intervention study encompassed two groups of parents (in total 41) of leukemia children. To collect data, a demographic questionnaire and the shortened version of SF-36 questionnaire were used to determine the quality of life of parents. Both groups completed the quality of life questionnaires before and two months after the intervention. Comparison of the parents' quality of life mean scores, obtained before and two months after training, showed that promotion in 6 domains of bodily pain, general health, emotional health, role limitation due to emotional problems, social functioning, and vitality were occurred. (P <0.05). Considering the important role of parents in taking care of children suffering from leukemia, introduction of care program training can be a positive step to help these parents and empower them to manage their children's problems more systematically and will ultimately lead to improved quality of life of parents.

Educating neonatal nurses in Brazil: a before-and-after study with interrupted time series analysis.

PubMed

Gilbert, Clare; Darlow, Brian; Zin, Andrea; Sivasubramaniam, Selvaraj; Shah, Shaheen; Gianini, Nicole; Beecroft, Gina; Lopes Moreira, Maria Elisabeth

2014-01-01

Preterm birth contributes significantly to infant mortality and morbidity, including blindness from retinopathy of prematurity (ROP). Access to intensive neonatal care is expanding in many countries, but care is not always optimal, one factor being that nursing is often by inadequately trained nurse assistants. The aim of this study was to evaluate whether an educational package for nurses improves a range of outcomes including survival rates and severe ROP in 5 neonatal units in Rio de Janeiro, Brazil. The study design included an uncontrolled before-and-after study in 5 units, with interrupted time series analysis. Participatory approaches were used to develop a self-administered educational package for control of pain, oxygenation, infection, nutrition, and temperature and to improve supportive care ('POINTS of Care'). Educational materials and DVD clips were developed and training skills of nurse tutors were enhanced. There were two 1-year periods of data collection before and after a 3-month period of self-administration of the education package. Overall, 74% of 401 nurses and nurse assistants were trained. A total of 679 and 563 infants were included in the pre- and post-training periods, respectively. Despite improvement in knowledge and nursing practices, such as the delivery and monitoring of oxygen, there was no change in survival (pre-training 80%, post-training 78.2%), severe ROP (1.6 vs. 2.8%), sepsis (11.3 vs. 12.3 cases per 1,000 infant days) or other outcomes. Outcomes worsened over the pre-intervention period but the change to an improvement after the intervention was not statistically significant. During the study period many trained staff left the units, but few were replaced. Future studies need to focus on barriers to implementation, team building, leadership and governance, as well as the acquisition of knowledge and skills. © 2014 S. Karger AG, Basel.

Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption.

PubMed

Frazer, Kate; Callinan, Joanne E; McHugh, Jack; van Baarsel, Susan; Clarke, Anna; Doherty, Kirsten; Kelleher, Cecily

2016-02-04

Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and the smoking behaviour of those populations they affect. Since the first version of this review in 2010, more countries have introduced national smoking legislation banning indoor smoking. To assess the effects of legislative smoking bans on (1) morbidity and mortality from exposure to secondhand smoke, and (2) smoking prevalence and tobacco consumption. We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL and reference lists of included studies. We also checked websites of various organisations. Date of most recent search; February 2015. We considered studies that reported legislative smoking bans affecting populations. The minimum standard was having an indoor smoking ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. Our search included a broad range of research designs including: randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before-and-after studies, interrupted time series as defined by the Cochrane Effective Practice and Organisation of Care Group, and uncontrolled pre- and post-ban data. One author extracted characteristics and content of the interventions, participants, outcomes and methods of the included studies and a second author checked the details. We extracted health and smoking behaviour outcomes. We did not attempt a meta-analysis due to the heterogeneity in design and content of the studies included. We evaluated the studies using qualitative narrative synthesis. There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is provided in this update, an increase of eight countries from the original review. The nature of the intervention precludes randomized controlled trials. Thirty-six studies used an interrupted time series study design, 23 studies use a controlled before-and-after design and 18 studies are before-and-after studies with no control group; six of these studies use a cohort design. Seventy-two studies reported health outcomes, including cardiovascular (44), respiratory (21), and perinatal outcomes (7). Eleven studies reported national mortality rates for smoking-related diseases. A number of the studies report multiple health outcomes. There is consistent evidence of a positive impact of national smoking bans on improving cardiovascular health outcomes, and reducing mortality for associated smoking-related illnesses. Effects on respiratory and perinatal health were less consistent. We found 24 studies evaluating the impact of national smoke-free legislation on smoking behaviour. Evidence of an impact of legislative bans on smoking prevalence and tobacco consumption is inconsistent, with some studies not detecting additional long-term change in existing trends in prevalence. Since the first version of this review was published, the current evidence provides more robust support for the previous conclusions that the introduction of a legislative smoking ban does lead to improved health outcomes through reduction in SHS for countries and their populations. The clearest evidence is observed in reduced admissions for acute coronary syndrome. There is evidence of reduced mortality from smoking-related illnesses at a national level. There is inconsistent evidence of an impact on respiratory and perinatal health outcomes, and on smoking prevalence and tobacco consumption.

Impact of the Spanish Smoking Law on Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Cohort Study

PubMed Central

Fernández, Esteve; Fu, Marcela; Pascual, José A.; López, María J.; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M.; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

Background A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. Methods and Finding We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Conclusions Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health. PMID:19165321

Effects of preoperative oral carbohydrate supplementation on postoperative metabolic stress response of patients undergoing elective abdominal surgery.

PubMed

Viganò, Jacopo; Cereda, Emanuele; Caccialanza, Riccardo; Carini, Roberta; Cameletti, Barbara; Spampinato, Marcello; Dionigi, Paolo

2012-08-01

The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. The study was designed as a controlled, prospective, cohort study including 38 patients treated with OCH (800 mL the day before surgery and 400 mL within 3 h before the induction of anesthesia) and 38 controls matched for surgical procedure. Fasting glucose, insulin, insulin resistance (HOMA-IR index), cortisol, and interleukin 6 (IL-6) were assessed before and after surgery (postoperative day (POD) 1, 2, and 3). The administration of OCH resulted in lower fasting glucose, HOMA-IR index, cortisol, and IL-6 on both POD 1 and POD 2. At multivariable regression analyses, the reduction of these parameters was independent of sex, age, body mass index, and major abdominal surgery. Particularly, models including OCH treatment explained 70, 63, and 66 % of the variance of the increase in IL-6 levels at POD 1, POD 2, and POD 3, respectively. The effect of OCH on changes in glucose, insulin resistance, and cortisol on POD 1 and POD 2 disappeared after the inclusion of IL-6 in the models. Treatment with OCH was associated with attenuation of the postoperative metabolic stress response. We hypothesize that modulation of the inflammatory response is one of the mechanisms involved.

Changes in blood flow and cellular metabolism at a myofascial trigger point with trigger point release (ischemic compression): a proof-of-principle pilot study

PubMed Central

Moraska, Albert F.; Hickner, Robert C.; Kohrt, Wendy M.; Brewer, Alan

2012-01-01

Objective To demonstrate proof-of-principle measurement for physiological change within an active myofascial trigger point (MTrP) undergoing trigger point release (ischemic compression). Design Interstitial fluid was sampled continuously at a trigger point before and after intervention. Setting A biomedical research clinic at a university hospital. Participants Two subjects from a pain clinic presenting with chronic headache pain. Interventions A single microdialysis catheter was inserted into an active MTrP of the upper trapezius to allow for continuous sampling of interstitial fluid before and after application of trigger point therapy by a massage therapist. Main Outcome Measures Procedural success, pain tolerance, feasibility of intervention during sample collection, determination of physiologically relevant values for local blood flow, as well as glucose and lactate concentrations. Results Both patients tolerated the microdialysis probe insertion into the MTrP and treatment intervention without complication. Glucose and lactate concentrations were measured in the physiological range. Following intervention, a sustained increase in lactate was noted for both subjects. Conclusions Identifying physiological constituents of MTrP’s following intervention is an important step toward understanding pathophysiology and resolution of myofascial pain. The present study forwards that aim by showing proof-of-concept for collection of interstitial fluid from an MTrP before and after intervention can be accomplished using microdialysis, thus providing methodological insight toward treatment mechanism and pain resolution. Of the biomarkers measured in this study, lactate may be the most relevant for detection and treatment of abnormalities in the MTrP. PMID:22975226

Evaluating Web accessibility at different processing phases

NASA Astrophysics Data System (ADS)

Fernandes, N.; Lopes, R.; Carriço, L.

2012-09-01

Modern Web sites use several techniques (e.g. DOM manipulation) that allow for the injection of new content into their Web pages (e.g. AJAX), as well as manipulation of the HTML DOM tree. This has the consequence that the Web pages that are presented to users (i.e. after browser processing) are different from the original structure and content that is transmitted through HTTP communication (i.e. after browser processing). This poses a series of challenges for Web accessibility evaluation, especially on automated evaluation software. This article details an experimental study designed to understand the differences posed by accessibility evaluation after Web browser processing. We implemented a Javascript-based evaluator, QualWeb, that can perform WCAG 2.0 based accessibility evaluations in the two phases of browser processing. Our study shows that, in fact, there are considerable differences between the HTML DOM trees in both phases, which have the consequence of having distinct evaluation results. We discuss the impact of these results in the light of the potential problems that these differences can pose to designers and developers that use accessibility evaluators that function before browser processing.

McStas event logger: Definition and applications

NASA Astrophysics Data System (ADS)

Bergbäck Knudsen, Erik; Bryndt Klinkby, Esben; Kjær Willendrup, Peter

2014-02-01

Functionality is added to the McStas neutron ray-tracing code, which allows individual neutron states before and after a scattering to be temporarily stored, and analysed. This logging mechanism has multiple uses, including studies of longitudinal intensity loss in neutron guides and guide coating design optimisations. Furthermore, the logging method enables the cold/thermal neutron induced gamma background along the guide to be calculated from the un-reflected neutron, using a recently developed MCNPX-McStas interface.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Demaria, N.

This paper is a review of recent progress of RD53 Collaboration. Results obtained on the study of the radiation effects on 65 nm CMOS have matured enough to define first strategies to adopt in the design of analog and digital circuits. Critical building blocks and analog very front end chains have been designed, tested before and after 5–800 Mrad. Small prototypes of 64×64 pixels with complex digital architectures have been produced, and point to address the main issues of dealing with extremely high pixel rates, while operating at very small in-time thresholds in the analog front end. Lastly, the collaborationmore » is now proceeding at full speed towards the design of a large scale prototype, called RD53A, in 65 nm CMOS technology.« less

Obstetric patients' health-related quality of life before and after intensive care.

PubMed

Pia, Seppänen; Reijo, Sund; Tero, Ala-Kokko; Mervi, Roos; Jukka, Uotila; Mika, Helminen; Tarja, Suominen

2018-03-23

Intensive care admissions during pregnancy, childbirth, and postpartum period are relatively well investigated. However, very little is known about these obstetric patients' health-related quality of life (HRQoL) before and after critical care. The objective of this study was to assess obstetric patients' HRQoL before intensive care admission (baseline) and at 6 months after discharge (follow-up) DESIGN: This was a retrospective database study. In a 5-year period, the data of all women admitted to the intensive care unit (ICU) during pregnancy, delivery, or up to 42 days postpartum were analysed. Four multidisciplinary ICUs of Finnish University hospitals participated. The HRQoL was assessed using the EuroQol-5D (EQ-5D) instrument with utility score (EQsum) and visual analogue scale (EQ-VAS). A total of 283 obstetric patients were identified from the clinical information system. Of these, 99 (35%) completed the EQ-5D questionnaires both at baseline and follow-up, and 65 of them (23%) completed EQ-VAS. The comparison of patients' EQsum scores before intensive care admission and after discharge showed that patients' HRQoL remained good (0.970 vs 0.972) (max 1.0) or increased (0.788 vs 0.982) in 80.8% of the patients. Patients reported improved overall health on the EQ-VAS at 6 months follow-up (EQ-VAS mean, 71.86 vs 88.20; p ≤ 0.001) (max 100). However, 19.2% of the patients had lower HRQoL (EQsum mean 0.987 vs 0.798) at follow-up. Following intensive care, 15% of the patients had more pain/discomfort, and 11% expressed more depression/anxiety. Multiparous patients were more likely to suffer from worsened depression/anxiety (p = 0.024). In the majority of the obstetric patients, HRQoL at 6 months follow-up remained good or had increased from baseline. However, nearly one-fifth of the patients had impaired HRQoL after discharge. Thus, intensive care management should take in to consideration follow-up program after intensive care of ICU-admitted obstetric patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units.

PubMed

Lee, Wen-Sen; Hsieh, Tai-Chin; Shiau, Justine C; Ou, Tsong-Yih; Chen, Fu-Lun; Liu, Yu-Hsin; Yen, Muh-Yong; Hsueh, Po-Ren

2017-10-01

This prospective before-after study was intended to investigate the effect of Bio-Kil on reducing environmental bacterial burden and healthcare-associated infections (HAIs) in intensive care units (ICUs) at the Municipal Wan-Fang Hospital, Taipei, Taiwan in 2014. Four rooms in the medical and surgical ICUs were investigated and designated as study rooms (n = 2) or control rooms (n = 2). Routine disinfection was performed during the pre-intervention period in both room types. Bio-Kil was applied to the fomites and surroundings of the study rooms during the intervention period. Total bacterial burden and proportion of colonization of fomites and surroundings by multidrug-resistance organisms (MDROs) were determined before and after the intervention. The demographic characteristics, underlying conditions, and clinical outcomes of patients were analyzed. After application of Bio-Kil, the bacterial burden declined in both groups, although the reduction was greater in the study rooms as compared with the control rooms (p = 0.001). During the pre-intervention period, 16 patients were admitted to control rooms and 18 patients to study rooms. After the intervention, 22 patients were admitted to control rooms and 21 patients to study rooms. The number of cases of new-onset sepsis declined in the intervention group (from 33% to 23.8%), but increased in the control group (from 25% to 40.9%); however, there was no significant difference in incidence of new-onset sepsis between the study and control rooms after intervention. Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs. Copyright © 2016. Published by Elsevier B.V.

Engineering Support of Microgravity Life Science Research: Development of an Avian Development Facility

NASA Technical Reports Server (NTRS)

Vellinger, J.; Deuser, M.; Hullinger, R.

1995-01-01

The Avian Development Facility (ADF) is designed to provide a 'window' for the study of embryogenesis in space. It allows researchers to determine and then to mitigate or nullify the forces of altered gravity upon embryos when leaving and re-entering the Earth's gravity. The ADF design will allow investigations to begin their incubation after their experiments have achieved orbit, and shut down the experiment and fix specimens before leaving orbit. In effect, the ADF makes every attempt to minimize launch and re-entry effects in order to isolate and preserve the effects of the experimental variable(s) of the space environment.

Evaluating the contributions of task expectancy in the testing and guessing benefits on recognition memory.

PubMed

Huff, Mark J; Yates, Tyler J; Balota, David A

2018-05-03

Recently, we have shown that two types of initial testing (recall of a list or guessing of critical items repeated over 12 study/test cycles) improved final recognition of related and unrelated word lists relative to restudy. These benefits were eliminated, however, when test instructions were manipulated within subjects and presented after study of each list, procedures designed to minimise expectancy of a specific type of upcoming test [Huff, Balota, & Hutchison, 2016. The costs and benefits of testing and guessing on recognition memory. Journal of Experimental Psychology: Learning, Memory, and Cognition, 42, 1559-1572. doi: 10.1037/xlm0000269 ], suggesting that testing and guessing effects may be influenced by encoding strategies specific for the type of upcoming task. We follow-up these experiments by examining test-expectancy processes in guessing and testing. Testing and guessing benefits over restudy were not found when test instructions were presented either after (Experiment 1) or before (Experiment 2) a single study/task cycle was completed, nor were benefits found when instructions were presented before study/task cycles and the task was repeated three times (Experiment 3). Testing and guessing benefits emerged only when instructions were presented before a study/task cycle and the task was repeated six times (Experiments 4A and 4B). These experiments demonstrate that initial testing and guessing can produce memory benefits in recognition, but only following substantial task repetitions which likely promote task-expectancy processes.

Sleep effects on slow-brain-potential reflections of associative learning.

PubMed

Verleger, Rolf; Ludwig, Janna; Kolev, Vasil; Yordanova, Juliana; Wagner, Ullrich

2011-03-01

Previous research has indicated that information acquired before sleep gets consolidated during sleep. This process of consolidation might be reflected after sleep in changed extent and topography of cortical activation during retrieval of information. Here, we designed an experiment to measure those changes by means of slow event-related EEG potentials (SPs). Retrieval of newly learnt verbal or spatial associations was tested both immediately after learning and two days later. In the night directly following immediate recall, participants either slept or stayed awake. In line with previous studies, SPs measured during retrieval from memory had parietal or left-frontal foci depending on whether the retrieved associations were spatial or verbal. However, contrary to our expectations, sleep-related consolidation did not further accentuate these content-specific topographic profiles. Rather, sleep modified SPs independently of the spatial or verbal type of learned association: SPs were reduced more after sleep than after waking specifically for those stimulus configurations that had been presented in the same combination at retrieval before sleep. The association-independent stimulus-specific effect might generally form a major component of sleep-related effects on memory. Copyright © 2010 Elsevier B.V. All rights reserved.

In vivo studies on insulin permeability of an immunoisolation device intended for islet transplantation using the microdialysis technique.

PubMed

Rafael, E; Wernerson, A; Arner, P; Tibell, A

1999-01-01

In this study, insulin was injected into Theracyte immunoisolation devices to analyze changes in the permeability of the device over time after implantation. The recovery of insulin was studied after subcutaneous implantation of the devices in rats, using the microdialysis technique. The area under the insulin concentration vs. time curves (AUC) after insulin injection in devices implanted 1 day previously did not differ significantly from the AUC after subcutaneous injection. At 1, 2 and 4 weeks after implantation, the recovery of insulin was significantly reduced, but at 3 months, the AUC was not significantly different from that in the control group. Histological examination showed that the number of vascular profiles within 15 microm of the device were significantly higher at 2, 4 weeks and 3 months after transplantation when compared to numbers at 1 week. The design of the device allows transplantation of cells at a chosen time point after its implantation. Delayed filling of the device would allow neovascularization of the device surface before graft implantation and we suggest that such a schedule might improve function of the encapsulated graft.

A repulsive magnetic force driven translation micromirror

NASA Astrophysics Data System (ADS)

Xue, Yuan; Zuo, Hui; He, Siyuan

2017-10-01

This paper presents a repulsive magnetic force driven micromirror with large displacement and high surface quality which well solves the limitation of the previous design, i.e. large variation in translation starting position and low repeatability, caused by the touching points between the moving film and substrate before and in operation. The new design utilizes a driving mechanism, i.e. permanent magnet ring above and electromagnet underneath the moving film, to lift the moving film from touching the substrate and generate a repulsive magnetic force (instead of attractive force in the previous design) to push the moving film up and away from the substrate for translation. Due to the touching, the previous design has to pre-oscillate for 20-30 min at 1 Hz before usage (after resting for a few hours) to reduce the starting position variation from ~15 µm to 3-4 µm. Even after the pre-oscillation, the repeatability is still low, which is 14.2% because of the touching in operation. In the design presented in this paper, the touching between the moving film and the substrate is completely eliminated before and in operation. As a result, the starting position of the translating mirror is constant each time and the repeatability is  <1%. In addition, this design does not need the residual stress gradient to curve up the moving film. The maximum displacement of 144 µm can be achieved when 140 mA current is applied on the electromagnet. As an application, the micromirror is used as the movable mirror in a Michelson interferometer to measure the wavelength of a laser beam. The result shows a measurement accuracy of 2.19% for a 532 nm laser beam.

[Morbidity in a population living close to urban waste incinerator plants in Lazio Region (Central Italy): a retrospective cohort study using a before-after design].

PubMed

Golini, Martina Nicole; Ancona, Carla; Badaloni, Chiara; Bolignano, Andrea; Bucci, Simone; Sozzi, Roberto; Davoli, Marina; Forastiere, Francesco

2014-01-01

the body of evidence on health effects of residential exposure to urban waste incinerators suggests association with reproductive outcomes and some cancers, but the overall evidence is still limited. we evaluated the impact of two incinerators on hospital admissions for respiratory and cardiovascular diseases in a cohort of people living nearby two incineration plants in Lazio Region (Central Italy) using a before-and-after design. the study area was defined as the 7-km radius around the incinerators. People who were resident in the area from 1996 to 2008 were enrolled in a retrospective longitudinal study. All addresses were geocoded. A Lagrangian dispersion model (SPRAY) for PM₁₀ (ng/m³) was used for incinerators exposure assessment. Average annual concentration of background PM₁₀ (μg/m³) was estimated on a regional basis by means of RAMS and FARM models. Both PM₁₀ exposures were estimated at the residential address. All subjects were followed for hospital admissions in the period before (1996-2002) and after (2003-2008) the activation of the plants. The association between exposure to emissions from incinerators and hospitalizations in the two periods was estimated using the multivariate Cox model (for repeated events), adjusting for age, area-level socioeconomic status, distance from industries, traffic roads and highways. An interaction term between the period of follow-up (before or after the activation of the plants) and the exposure levels was used to test the effect of the incinerators. 47,192 subjects resident in the study area were enrolled. No clear association between pollution exposure from incinerators and cause-specific morbidity of residents in highest concentration areas was found when compared to the reference group. However, an effect of PM₁₀ on respiratory diseases and chronic obstructive pulmonary disease was suggested. The effect was due to excesses of hospitalizations for the same causes among men living in highest exposure areas in respect to the reference group (hazard ratio - HR: 1.26; 95%CI 0.99-1.60, and HR: 1.86; 95%CI 1.04-3.33, respectively). There were associations between exposure to background pollution from other sources and hospitalizations for diseases of the circulatory system (HR: 1.08; 95%CI 1.03-1.13) and respiratory diseases (HR: 1.07; 95%CI 1.02-1.11) (for a unitary increment of PM₁₀, μg/m³). living in areas with high PM₁₀ levels due to incinerators was associated with increased morbidity levels for respiratory disorders among men. The study area is critical from an environmental point of view, hence an epidemiological surveillance is recommended.

Exercise Increases 24-h Fat Oxidation Only When It Is Performed Before Breakfast

PubMed Central

Iwayama, Kaito; Kurihara, Reiko; Nabekura, Yoshiharu; Kawabuchi, Ryosuke; Park, Insung; Kobayashi, Masashi; Ogata, Hitomi; Kayaba, Momoko; Satoh, Makoto; Tokuyama, Kumpei

2015-01-01

Background As part of the growing lifestyle diversity in modern society, there is wide variation in the time of day individuals choose to exercise. Recent surveys in the US and Japan have reported that on weekdays, more people exercise in the evening, with fewer individuals exercising in the morning or afternoon. Exercise performed in the post-prandial state has little effect on accumulated fat oxidation over 24 h (24-h fat oxidation) when energy intake is matched to energy expenditure (energy-balanced condition). The present study explored the possibility that exercise increases 24-h fat oxidation only when performed in a post-absorptive state, i.e. before breakfast. Methods Indirect calorimetry using a metabolic chamber was performed in 10 young, non-obese men over 24 h. Subjects remained sedentary (control) or performed 60-min exercise before breakfast (morning), after lunch (afternoon), or after dinner (evening) at 50% of VO2max. All trials were designed to be energy balanced over 24 h. Time course of energy and substrate balance relative to the start of calorimetry were estimated from the differences between input (meal consumption) and output (oxidation). Findings Fat oxidation over 24 h was increased only when exercise was performed before breakfast (control, 456 ± 61; morning, 717 ± 64; afternoon, 446 ± 57; and evening, 432 ± 44 kcal/day). Fat oxidation over 24 h was negatively correlated with the magnitude of the transient deficit in energy and carbohydrate. Interpretation Under energy-balanced conditions, 24-h fat oxidation was increased by exercise only when performed before breakfast. Transient carbohydrate deficits, i.e., glycogen depletion, observed after morning exercise may have contributed to increased 24-h fat oxidation. PMID:26844280

Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group

PubMed Central

Mogard, Olof; Alexanderson, Kristina; Karampampa, Korinna; Friberg, Emilie; Tinghög, Petter

2018-01-01

Objectives To describe how disposable income (DI) and three main components changed, and analyse whether DI development differed from working-aged people with multiple sclerosis (MS) to a reference group from 7 years before to 4 years after diagnosis in Sweden. Design Population-based cohort study, 12-year follow-up (7 years before to 4 years after diagnosis). Setting Swedish working-age population with microdata linked from two nationwide registers. Participants Residents diagnosed with MS in 2009 aged 25–59 years (n=785), and references without MS (n=7847) randomly selected with stratified matching (sex, age, education and country of birth). Primary and secondary outcome measures DI was defined as the annual after tax sum of incomes (earnings and benefits) to measure individual economic welfare. Three main components of DI were analysed as annual sums: earnings, sickness absence benefits and disability pension benefits. Results We found no differences in mean annual DI between people with and without MS by independent t-tests (p values between 0.15 and 0.96). Differences were found for all studied components of DI from diagnosis year by independent t-tests, for example, in the final study year (2013): earnings (−64 867 Swedish Krona (SEK); 95% CI−79 203 to −50 528); sickness absence benefits (13 330 SEK; 95% CI 10 042 to 16 500); and disability pension benefits (21 360 SEK; 95% CI 17 380 to 25 350). A generalised estimating equation evaluated DI trajectory development between people with and without MS to find both trajectories developed in parallel, both before (−4039 SEK; 95% CI −10 536 to 2458) and after (−781 SEK; 95% CI −6988 to 5360) diagnosis. Conclusions The key finding of parallel DI trajectory development between working-aged MS and references suggests minimal economic impact within the first 4 years of diagnosis. The Swedish welfare system was responsive to the observed reductions in earnings around MS diagnosis through balancing DI with morbidity-related benefits. Future decreases in economic welfare may be experienced as the disease progresses, although thorough investigation with future studies of modern cohorts are required. PMID:29743325

Comorbidity ascertainment from the ESRD Medical Evidence Report and Medicare claims around dialysis initiation: a comparison using US Renal Data System data.

PubMed

Krishnan, Mahesh; Weinhandl, Eric D; Jackson, Scott; Gilbertson, David T; Lacson, Eduardo

2015-11-01

The end-stage renal disease Medical Evidence Report serves as a source of comorbid condition data for risk adjustment of quality metrics. We sought to compare comorbid condition data in the Medical Evidence Report around dialysis therapy initiation with diagnosis codes in Medicare claims. Observational cohort study using US Renal Data System data. Medicare-enrolled elderly (≥66 years) patients who initiated maintenance dialysis therapy July 1 to December 31, 2007, 2008, or 2009. 12 comorbid conditions ascertained from claims during the 6 months before dialysis therapy initiation, the Medical Evidence Report, and claims during the 3 months after dialysis therapy initiation. None. Comorbid condition prevalence according to claims before dialysis therapy initiation generally exceeded prevalence according to the Medical Evidence Report. The κ statistics for comorbid condition designations other than diabetes ranged from 0.06 to 0.43. Discordance of designations was associated with age, race, sex, and end-stage renal disease Network. During 23,930 patient-years of follow-up from 4 to 12 months after dialysis therapy initiation (8,930 deaths), designations from claims during the 3 months after initiation better discriminated risk of death than designations from the Medical Evidence Report (C statistics of 0.674 vs 0.616). Between the Medical Evidence Report and claims, standardized mortality ratios changed by >10% for more than half the dialysis facilities. Neither the Medical Evidence Report nor diagnosis codes in claims constitute a gold standard of comorbid condition data; results may not apply to nonelderly patients or patients without Medicare coverage. Discordance of comorbid condition designations from the Medical Evidence Report and claims around dialysis therapy initiation was substantial and significantly associated with patient characteristics, including location. These patterns may engender bias in risk-adjusted quality metrics. In lieu of the Medical Evidence Report, claims during the 3 months after dialysis therapy initiation may constitute a useful source of comorbid condition data. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Impact of the 1994 alcohol production and sales deregulation policy on traffic crashes and fatalities in Japan.

PubMed

Desapriya, Ediriweera; Fujiwara, Takeo; Dutt, Namrata; Arason, Neil; Pike, Ian

2012-09-01

. Many studies have demonstrated a strong relationship between alcohol availability and traffic crashes involving alcohol-impaired drivers. The present analysis focuses on the evaluation of the impact of alcohol availability on the Japanese population by comparing fatal and nonfatal motor vehicle crash rates before and after implementation of the alcohol deregulation policy in 1994. Participants and method. Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRRs) in the population. To control for potential confounders, per capita alcohol consumption, unemployment rate, and vehicle miles travelled (VMT) were also added to the model. The exponents of the fitted coefficients are equivalent to the IRRs. . Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities and other traffic crashes in Japan. In the overall study results, nighttime fatalities were reduced statistically significantly by 6% since the implementation of the alcohol deregulation policy in 1994. Discussion. Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation. Further well-designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.

Intraabdominal pressure after full abdominoplasty in obese multiparous patients.

PubMed

Al-Basti, Habib B; El-Khatib, Hamdy A; Taha, Ahmed; Sattar, Hisham Abdul; Bener, Abdulbari

2004-06-01

This study measured intraabdominal pressure in morbidly obese and multiparous patients who underwent abdominoplasty with musculoaponeurotic plication. The purpose of this study was to evaluate any potential adverse effect on pulmonary function by virtue of pulmonary function tests and measurement of peak airway pressure. The study included 43 multiparous, morbidly obese women (mean body mass index, 35.8 kg/m2) with a mean age (+/- SD) of 38.6 +/- 7 years. All had full abdominoplasty and repair of the musculoaponeurotic system during the period from June of 1999 to May of 2002. Forty-three morbidly obese multiparous patients were seen over a period of 24 months. Their intraabdominal pressure was estimated by measuring the intravesical pressure before and after repair of severe diastases (divarication) of the rectus abdominis muscles with severely flaccid myofascial component before using a hydrometer connected to a Foley catheter both before and after repair. All patients had pulmonary function checked before and 2 months after the repair. The study confirmed that there are minimal changes on the intraabdominal pressure parameters compared with measurement before and after full abdominoplasty with plication of the rectus muscles, with minimal to negligible changes in the intrathoracic pressure. These changes are clinically and statistically significant (p < 0.0001). The study also recommended the safety of full abdominoplasty and repair of the musculoaponeurotic system in multiparous and morbidly obese patients. Furthermore, no statistically significant difference was found in pulmonary function parameters before and after surgery in patients with a history of bronchial asthma.

Effect of lower limb muscle fatigue induced by high-level isometric contractions on postural maintenance and postural adjustments associated with bilateral forward-reach task.

PubMed

Yiou, E; Heugas, A M; Mezaour, M; Le Bozec, S

2009-01-01

This study tested the effect of lower limb muscle fatigue induced by series of high-level isometric contractions (IC) on postural adjustments and maintenance of erect posture. Subjects (N=7) displaced a bar (grasp-bar) forward with both hands at maximal velocity towards a target ("bilateral forward-reach" task, BFR), before and after a procedure designed to induce fatigue in dorsal leg muscles. This procedure included IC at 60% of maximum. Postural joint and grasp-bar motion, along with electrical activity of postural and focal muscles were recorded. Integrated electromyographical (EMG) activity per 20 ms period ranging from 400 ms before BFR onset (t0) to 400 ms after t0 was compared before and after the fatiguing procedure. This time-window included "anticipatory", "on-line" and "corrective" postural adjustments, i.e. those postural adjustments occurring before (APAs), during (OPAs) and after (CPAs) BFR, respectively. In contrast to the literature, results showed that the fatiguing procedure had no effect on muscle excitation or timing in any of the recorded postural muscles, regardless of APA, OPA or CPA-related time-window. Therefore, the postural drive did not change with fatigue. Furthermore, the peak-to-peak motion at postural joints did not change. Postural maintenance was therefore not additionally challenged. These results are in line with the hypothesis that the effect of fatigue on postural adjustments is dependent on the adequacy between fatigued motor units (MUs) and MUs recruited during the postural adjustments. Increasing IC intensity during the fatiguing procedure might therefore not necessarily exacerbate the effect of fatigue on postural control highlighted during lower level IC.

Australian smokers' support for plain or standardised packs before and after implementation: findings from the ITC Four Country Survey.

PubMed

Swift, Elena; Borland, Ron; Cummings, K Michael; Fong, Geoffrey T; McNeill, Ann; Hammond, David; Thrasher, James F; Partos, Timea R; Yong, Hua-Hie

2015-11-01

Plain packaging (PP) for tobacco products was fully implemented in Australia on 1 December 2012 along with larger graphic health warnings. Using longitudinal data from the Australian arm of the ITC Four Country Survey, we examined attitudes to the new packs before and after implementation, predictors of attitudinal change, and the relationship between support and quitting activity. A population-based cohort study design, with some cross-sectional analyses. Surveys of Australian smokers assessed attitudes to PP at four time points prior to implementation (from 2007 to 2012) and one post-implementation wave collected (early/mid-2013). Trend analysis showed a slight rise in opposition to PP among smokers in the waves leading up to their implementation, but no change in support. Support for PP increased significantly after implementation (28.2% pre vs 49% post), such that post-PP more smokers were supportive than opposed (49% vs 34.7%). Multivariate analysis showed support either before or after implementation was predicted by belief in greater adverse health impacts of smoking, desire to quit and lower addiction. Among those not supportive before implementation, having no clear opinion about PP (versus being opposed) prior to the changes also predicted support post-implementation. Support for PP was prospectively associated with higher levels of quitting activity. Since implementation of PP along with larger warnings, support among Australian smokers has increased. Support is related to lower addiction, stronger beliefs in the negative health impacts of smoking, and higher levels of quitting activity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluation of Helping Babies Breathe Quality Improvement Cycle (HBB-QIC) on retention of neonatal resuscitation skills six months after training in Nepal.

PubMed

Kc, Ashish; Wrammert, Johan; Nelin, Viktoria; Clark, Robert B; Ewald, Uwe; Peterson, Stefan; Målqvist, Mats

2017-04-11

Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal. A time-series design was applied. The multi-faceted intervention for HBB-QIC included training, daily bag-and-mask skill checks, preparation for resuscitation before every birth, self-evaluation and peer review on neonatal resuscitation skills, and weekly review meetings. Knowledge and skills were assessed through questionnaires, skill checklists, and Objective Structured Clinical Examinations (OSCE) before implementation of the HBB-QIC, immediately after HBB training, and again at 6 months. Means were compared using paired t-tests, and associations between skill retention and HBB-QIC components were analyzed using logistic regression analysis. One hundred thirty seven health workers were enrolled in the study. Knowledge scores were higher immediately following the HBB training, 16.4 ± 1.4 compared to 12.8 ± 1.6 before (out of 17), and the knowledge was retained 6 months after the training (16.5 ± 1.1). Bag-and-mask skills improved immediately after the training and were retained 6 months after the training. The retention of bag-and-mask skills was associated with daily bag-and-mask skill checks, preparation for resuscitation before every birth, use of a self-evaluation checklist, and attendance at weekly review meetings. The implementation strategies with the highest association to skill retention were daily bag-and-mask skill checks (RR-5.1, 95% CI 1.9-13.5) and use of self-evaluation checklists after every delivery (RR-3.8, 95% CI 1.4-9.7). Health workers who practiced bag-and-mask skills, prepared for resuscitation before every birth, used self-evaluation checklists, and attended weekly review meetings were more likely to retain their neonatal resuscitation skills. Further studies are required to evaluate HBB-QIC in primary care settings, where the number of deliveries is gradually increasing. ISRCTN97846009 . Date of Registration- 15 August 2012.

Improvement of the knee center of rotation during walking after opening wedge high tibial osteotomy.

PubMed

Kim, Kyungsoo; Feng, Jun; Nha, Kyung Wook; Park, Won Man; Kim, Yoon Hyuk

2015-06-01

Accurate measurement of the center of rotation of the knee joint is indispensable for prediction of joint kinematics and kinetics in musculoskeletal models. However, no study has yet identified the knee center of rotations during several daily activities before and after high tibial osteotomy surgery, which is one surgical option for treating knee osteoarthritis. In this study, an estimation method for determining the knee joint center of rotation was developed by applying the optimal common shape technique and symmetrical axis of rotation approach techniques to motion-capture data and validated for typical activities (walking, squatting, climbing up stairs, walking down stairs) of 10 normal subjects. The locations of knee joint center of rotations for injured and contralateral knees of eight subjects with osteoarthritis, both before and after high tibial osteotomy surgery, were then calculated during walking. It was shown that high tibial osteotomy surgery improved the knee joint center of rotation since the center of rotations for the injured knee after high tibial osteotomy surgery were significantly closer to those of the normal healthy population. The difference between the injured and contralateral knees was also generally reduced after surgery, demonstrating increased symmetry. These results indicate that symmetry in both knees can be recovered in many cases after high tibial osteotomy surgery. Moreover, the recovery of center of rotation in the injured knee was prior to that of symmetry. This study has the potential to provide fundamental information that can be applied to understand abnormal kinematics in patients, diagnose knee joint disease, and design a novel implants for knee joint surgeries. © IMechE 2015.

Influence of short-term cardiac rehabilitation on oxidative stress in men after myocardial infarction depends upon smoking status.

PubMed

Mlakar, Polona; Salobir, Barbara; Cobo, Nusret; Prezelj, Marija; Terčelj, Marjeta; Sabovič, Mišo

2013-01-01

Oxidative stress is an important nonclassical risk factor for myocardial infarction (MI), and thus, it seems extremely important to recognize factors that effectively reduce it. The aim of our study was to explore possible influences of short-term cardiac rehabilitation (CR) of only 2 weeks in duration on oxidative stress in men after MI. Male patients (N = 21; aged 41-88 years, median 56 years), 6 to 8 weeks after acute MI, were included in our observational study using a pretest/posttest design. We investigated markers of oxidative stress and antioxidant enzymes before and after CR of only 2 weeks in duration and influence of smoking status on these differences. We found significant decrease in isoprostanes in urine in nonsmokers (n = 9) (P = .036) but not in smokers (n = 12) (not significant) during CR. After CR, nonsmokers had lower isoprostanes in urine (P = .039), lower non-transferrin-bound iron (P = .020), and higher erythrocyte catalase (P = .023) than smokers. Of classical risk factors, only low-density lipoprotein cholesterol was lower in nonsmokers before (P = .041) and after CR (P = .015) than in smokers. No other significant differences were seen at the beginning or at the end of CR. To our knowledge, the results of our study indicate for the first time that short-term CR of only 2 weeks in duration already has a positive effect on reduction of oxidative stress in the body. However, this positive effect is seen only in nonsmokers and not in smokers.

The Effect of Family-centered Care on Management of Blood Glucose Levels in Adolescents with Diabetes.

PubMed

Cheraghi, Fatemeh; Shamsaei, Farshid; Mortazavi, Sayyedeh Zohreh; Moghimbeigi, Abbas

2015-07-01

Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus (T1DM). This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were "Supervisory Behaviors of Caregiver" (SBC), "Management Behaviors of adolescents" (MBA) questionnaires, and the "Blood Glucose Levels Record Sheet". Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. There was a significant difference between the subjects' MBA and SBC mean scores before (110.17±26.6) and after (134.6±1.28) intervention in four domains: "blood glucose testing", "insulin therapy", "meal plan" and "physical activity" (P<0.001). There were significant differences between the mean levels of recorded blood glucose during a week before and after intervention and between the mean levels of Glycated Hemoglobin level (HbA1c) before (8.4±1.12) and three months after (7.78±1.2) it (P<0.001). Pearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention (P<0.001). Empowering adolescents with T1DM and their caregivers in home-centered care could improve diabetic adolescents' management of blood glucose levels and reduce their HbA1Clevels. Therefore, Family-centered care could provide for better regime adherence at home.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

PubMed

Llamas-Carreras, José María; Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco Javier

2012-05-01

The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Effects of kallidinogenase in patients undergoing vitrectomy for diabetic macular edema.

PubMed

Yoshizumi, Yuki; Ohara, Zaigen; Tabuchi, Hitoshi; Sumino, Hitomi; Maeda, Yukiko; Mochizuki, Hideki; Yamane, Ken; Kiuchi, Yoshiaki

2018-05-12

To evaluate the effectiveness of the combination of vitrectomy with kallidinogenase for diabetic macular edema (DME). This study was designed as a prospective, randomized, multicenter study comparing 19 eyes of 19 patients who received 150 units of kallidinogenase administered a day for 52 weeks from the day after vitrectomy (study group) with 20 eyes of 20 patients who received no kallidinogenase (control group). The main outcome measurements included logMAR visual acuity and central foveal thickness (CFT) before surgery and at 3, 6, 9, and 12 months after vitrectomy. During follow-up, 11 patients dropped out (six in the study group and five in the control group), leaving 28 eyes in 28 patients for analysis (13 in the study group and 15 in the control group). Visual acuity improved significantly at 12 months in both groups compared with before surgery. The degree of improvement did not differ significantly between the groups. At 12 months, the mean CFT decreased significantly in both groups, with no significant difference in the rate of change between the two groups. In the study group, the visual acuity and CFT significantly improved from 3 to 12 months and from 6 to 12 months, whereas these parameters did not continue to improve in the control group after 6 months (for visual acuity) or 3 months (for CFT). After vitrectomy for DME, visual acuity and CFT improved significantly in both groups, but only patients treated with kallidinogenase continued to have significant improvement throughout the study period.

Development of implant loading device for animal study about various loading protocol: a pilot study

PubMed Central

Yoon, Joon-Ho; Park, Young-Bum; Cho, Yuna; Kim, Chang-Sung; Choi, Seong-Ho; Moon, Hong-Seok; Lee, Keun-Woo

2012-01-01

PURPOSE The aims of this pilot study were to introduce implant loading devices designed for animal study and to evaluate the validity of the load transmission ability of the loading devices. MATERIALS AND METHODS Implant loading devices were specially designed and fabricated with two implant abutments and cast metal bars, and orthodontic expansion screw. In six Beagles, all premolars were extracted and two implants were placed in each side of the mandibles. The loading device was inserted two weeks after the implant placement. According to the loading protocol, the load was applied to the implants with different time and method,simulating early, progressive, and delayed loading. The implants were clinically evaluated and the loading devices were removed and replaced to the master cast, followed by stress-strain analysis. Descriptive statistics of remained strain (µε) was evaluated after repeating three cycles of the loading device activation. Statistic analysis was performed using nonparametric, independent t-test with 5% significance level and Friedman's test was also used for verification. RESULTS The loading devices were in good action. However, four implants in three Beagles showed loss of osseointegration. In stress-strain analysis, loading devices showed similar amount of increase in the remained strain after applying 1-unit load for three times. CONCLUSION Specialized design of the implant loading device was introduced. The loading device applied similar amount of loads near the implant after each 1-unit loading. However, the direction of the loads was not parallel to the long axis of the implants as predicted before the study. PMID:23236575

Educational intervention for liver transplantation candidates.

PubMed

Dal Sasso Mendes, Karina; de Castro e Silva Junior, Orlando; da Costa Ziviani, Luciana; Rossin, Fabiana Murad; Fontão Zago, Márcia Maria; Galvão, Cristina Maria

2013-02-01

The objective in this study was to analyze candidates' knowledge on the liver transplantation process before and after putting in practice an educational intervention. A quasi-experimental, one-group pretest-posttest research design was adopted. The final sample included 15 subjects. Research data were collected between January and March 2010 in three phases, which were: pretest, implementation of the educational intervention (two meetings) and posttest. The results evidenced significant cognitive gains after the intervention, with improvements in the participants' performance . The research presents evidence that putting in practice a patient education strategy can enhance candidates' knowledge on the liver transplantation process and consequently contribute to a successful treatment.

Sequential observation of infant regulated and dysregulated behavior following soothing and stimulating maternal behavior during feeding

PubMed Central

Brown, Lisa F.; Pridham, Karen A.; Brown, Roger

2014-01-01

Purpose To describe maternal behaviors occurring before infant regulated or dysregulated behavior at three times in early infancy and examine behavioral patterns over time with their prematurely born infants. Method & Design Video-recordings of 37 dyads were coded on infant regulated and dysregulated behaviors following maternal soothing and stimulating behaviors. Results At each time, infants showed more regulation after maternal soothing than after maternal stimulating. Further study is merited. Practice Implications Knowing infant regulation and dysregulation following categories of maternal behavior could help mothers anticipate infant regulatory or dysregulatory behavior in response to their own behavior and identify supportive caregiving strategies. PMID:24417766

Impact of B-Scan Averaging on Spectralis Optical Coherence Tomography Image Quality before and after Cataract Surgery

PubMed Central

Podkowinski, Dominika; Sharian Varnousfaderani, Ehsan; Simader, Christian; Bogunovic, Hrvoje; Philip, Ana-Maria; Gerendas, Bianca S.

2017-01-01

Background and Objective To determine optimal image averaging settings for Spectralis optical coherence tomography (OCT) in patients with and without cataract. Study Design/Material and Methods In a prospective study, the eyes were imaged before and after cataract surgery using seven different image averaging settings. Image quality was quantitatively evaluated using signal-to-noise ratio, distinction between retinal layer image intensity distributions, and retinal layer segmentation performance. Measures were compared pre- and postoperatively across different degrees of averaging. Results 13 eyes of 13 patients were included and 1092 layer boundaries analyzed. Preoperatively, increasing image averaging led to a logarithmic growth in all image quality measures up to 96 frames. Postoperatively, increasing averaging beyond 16 images resulted in a plateau without further benefits to image quality. Averaging 16 frames postoperatively provided comparable image quality to 96 frames preoperatively. Conclusion In patients with clear media, averaging 16 images provided optimal signal quality. A further increase in averaging was only beneficial in the eyes with senile cataract. However, prolonged acquisition time and possible loss of details have to be taken into account. PMID:28630764

The impact of self-transcendence on physical health status promotion in multiple sclerosis patients attending peer support groups.

PubMed

JadidMilani, Maryam; Ashktorab, Tahereh; AbedSaeedi, Zhila; AlaviMajd, Hamid

2015-12-01

This study aimed to investigate the effect of self-transcendence on the physical health of multiple sclerosis (MS) patients attending peer support groups. This study was a quasi-experimental before-and-after design including 33 MS patients in three groups: 10 men in the men-only group, 11 women in the women-only group, and 12 men and women in the mixed group. Participants were required to attend eight weekly sessions of 2 h each. Instruments included the physical health section of the Multiple Sclerosis Quality of Life Inventory and Reed's Self-Transcendence Scale. Peer support group attendance was found to have a significant positive effect on the physical health and self-transcendence of MS patients when comparing average scores before and after attendance. Regression analysis showed that improvement in self-transcendence predicted improvement in physical health. Results show the positive effects of peer support groups on self-transcendence and physical health in MS patients, and suggest that improvement in well-being can be gained by promoting self-transcendence and physical health. © 2015 Wiley Publishing Asia Pty Ltd.

Mitochondria-Targeted Antioxidant Mitoquinone Reduces Cisplatin-Induced Ototoxicity in Guinea Pigs.

PubMed

Tate, Alan D; Antonelli, Patrick J; Hannabass, Kyle R; Dirain, Carolyn O

2017-03-01

Objective To determine if mitoquinone (MitoQ) attenuates cisplatin-induced hearing loss in guinea pigs. Study Design Prospective and controlled animal study. Setting Academic, tertiary medical center. Subjects and Methods Guinea pigs were injected subcutaneously with either 5 mg/kg MitoQ (n = 9) or normal saline (control, n = 9) for 7 days and 1 hour before receiving a single dose of 10 mg/kg cisplatin. Auditory brainstem response thresholds were measured before MitoQ or saline administration and 3 to 4 days after cisplatin administration. Results Auditory brainstem response threshold shifts after cisplatin treatment were smaller by 28 to 47 dB in guinea pigs injected with MitoQ compared with those in the control group at all tested frequencies (4, 8, 16, and 24 kHz, P = .0002 to .04). Scanning electron microscopy of cochlear hair cells showed less outer hair cell loss and damage in the MitoQ group. Conclusion MitoQ reduced cisplatin-induced hearing loss in guinea pigs. MitoQ appears worthy of further investigation as a means of preventing cisplatin ototoxicity in humans.

What Is the Story with Narratives? How Using Narratives in Journalism Changes Health Behavior.

PubMed

Shaffer, Victoria A; Scherer, Laura D; Focella, Elizabeth S; Hinnant, Amanda; Len-Ríos, María E; Zikmund-Fisher, Brian J

2018-09-01

Health journalists frequently use narratives to bring news stories to life, with little understanding about how this influences the health behavior of readers. This study was designed to examine the effect of a New York Times health news article about a person who developed a life-threatening illness after using ibuprofen on readers' future use of ibuprofen. We recruited an Internet sample (N = 405) to participate in a longitudinal study examining ibuprofen use before, immediately following, and two weeks after reading the story. Ibuprofen use two-weeks after reading the heath news article was significantly lower than baseline use. Furthermore, intentions to use ibuprofen were also significantly reduced suggesting that the observed behavior change may persist beyond the two-week period studied. Health journalists should be cautious in their use of stories about health outcomes, particularly when those stories deviate from data about objective risks.

Breast-feeding and maternal cardiovascular function.

PubMed

Mezzacappa, E S; Kelsey, R M; Myers, M M; Katkin, E S

2001-11-01

Two studies examined the effects of breast-feeding on maternal cardiovascular function. In the first experiment, groups of breast-feeding and bottle-feeding women were compared on preejection period (PEP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) recorded for 1-min periods before and during standard laboratory stressors. Compared with bottle-feeders, breast-feeders had higher CO throughout the session, and greater decreases in CO and increases in TPR during cold pressor. In the second experiment, HR and blood pressure (BP) were compared before and after one breast-feeding and one bottle-feeding session in a within-subjects design. Both feeding methods increased BP but decreased HR, and systolic BP was higher for the breast-feeding than the bottle-feeding condition. Both studies support the notion that breast-feeding alters maternal cardiovascular function, possibly through the actions of oxytocin.

Marginal adaptation of lithium disilicate ceramic crowns cemented with three different resin cements.

PubMed

Peroz, Ingrid; Mitsas, Triantafyllos; Erdelt, Kurt; Kopsahilis, Niko

2018-04-17

The cementation process and cementation materials have an influence on the marginal adaptation of restorations. The gap could be affected by thermal and mechanical loading (TCML). The computerized x-ray microtomography (μCT) method offers the possibility of measuring the marginal gap without destruction of the restoration. The aim of this study was to evaluate the marginal gap (MG) and the absolute marginal discrepancy (AMD) before and after TCML. Thirty-nine human premolars were prepared for full ceramic crowns made of lithium disilicate. The crowns were cemented by three different resins-Panavia F 2.0, Variolink II, and Relyx Unicem. The MG and AMD were evaluated by μCT before and after TCML. Panavia F 2.0 had the lowest MG (before 118 μm-after TMCL 124 μm) and AMD (before 145 μm-after TMCL 154 μm), followed by Relyx Unicem (MG: before 164 μm-after TCML 155 μm; AMD: before 213 μm-after TMCL 209 μm) and Variolink II (MG: before 317 μm-after TMCL 320 μm; AMD: before 412 μm-after TMCL 406 μm). The differences were statistically significant before and after TCML. Rather than TCML, it appeared the resin cement was responsible for differences between the MG and AMD before and after TCML. μCT is an accurate technique for assessing cemented restorations. Panavia F 2.0 has the lowest MG and AMD before and after TCML. The resin material that features a three-step protocol (Variolink II) produced higher MG and AMG values than the Panavia or Relyx Unicem varieties with less or no intermediate steps at all.

Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction?

PubMed Central

Failla, Mathew J.; Logerstedt, David S.; Grindem, Hege; Axe, Michael J.; Risberg, May Arna; Engebretsen, Lars; Huston, Laura J.; Spindler, Kurt P.; Snyder-Mackler, Lynn

2017-01-01

Background Rehabilitation before anterior cruciate ligament (ACL) reconstruction (ACLR) is effective at improving postoperative outcomes at least in the short term. Less is known about the effects of preoperative rehabilitation on functional outcomes and return-to-sport (RTS) rates 2 years after reconstruction. Purpose/Hypothesis The purpose of this study was to compare functional outcomes 2 years after ACLR in a cohort that underwent additional preoperative rehabilitation, including progressive strengthening and neuromuscular training after impairments were resolved, compared with a nonexperimental cohort. We hypothesized that the cohort treated with extended preoperative rehabilitation would have superior functional outcomes 2 years after ACLR. Study Design Cohort study; Level of evidence, 3. Methods This study compared outcomes after an ACL rupture in an international cohort (Delaware-Oslo ACL Cohort [DOC]) treated with extended preoperative rehabilitation, including neuromuscular training, to data from the Multicenter Orthopaedic Outcomes Network (MOON) cohort, which did not undergo extended preoperative rehabilitation. Inclusion and exclusion criteria from the DOC were applied to the MOON database to extract a homogeneous sample for comparison. Patients achieved knee impairment resolution before ACLR, and postoperative rehabilitation followed each cohort's respective criterion-based protocol. Patients completed the International Knee Documentation Committee (IKDC) subjective knee form and Knee injury and Osteoarthritis Outcome Score (KOOS) at enrollment and again 2 years after ACLR. RTS rates were calculated for each cohort at 2 years. Results After adjusting for baseline IKDC and KOOS scores, the DOC patients showed significant and clinically meaningful differences in IKDC and KOOS scores 2 years after ACLR. There was a significantly higher (P < .001) percentage of DOC patients returning to preinjury sports (72%) compared with those in the MOON cohort (63%). Conclusion The cohort treated with additional preoperative rehabilitation consisting of progressive strengthening and neuromuscular training, followed by a criterion-based postoperative rehabilitation program, had greater functional outcomes and RTS rates 2 years after ACLR. Preoperative rehabilitation should be considered as an addition to the standard of care to maximize functional outcomes after ACLR. PMID:27416993

Alterations of papilla dimensions after orthodontic closure of the maxillary midline diastema: a retrospective longitudinal study.

PubMed

Jeong, Jin-Seok; Lee, Seung-Youp; Chang, Moontaek

2016-06-01

The aim of this study was to evaluate alterations of papilla dimensions after orthodontic closure of the diastema between maxillary central incisors. Sixty patients who had a visible diastema between maxillary central incisors that had been closed by orthodontic approximation were selected for this study. Various papilla dimensions were assessed on clinical photographs and study models before the orthodontic treatment and at the follow-up examination after closure of the diastema. Influences of the variables assessed before orthodontic treatment on the alterations of papilla height (PH) and papilla base thickness (PBT) were evaluated by univariate regression analysis. To analyze potential influences of the 3-dimensional papilla dimensions before orthodontic treatment on the alterations of PH and PBT, a multiple regression model was formulated including the 3-dimensional papilla dimensions as predictor variables. On average, PH decreased by 0.80 mm and PBT increased after orthodontic closure of the diastema (P<0.01). Univariate regression analysis revealed that the PH (P=0.002) and PBT (P=0.047) before orthodontic treatment influenced the alteration of PH. With respect to the alteration of PBT, the diastema width (P=0.045) and PBT (P=0.000) were found to be influential factors. PBT before the orthodontic treatment significantly influenced the alteration of PBT in the multiple regression model. PH decreased but PBT increased after orthodontic closure of the diastema. The papilla dimensions before orthodontic treatment influenced the alterations of PH and PBT after closure of the diastema. The PBT increased more when the diastema width before the orthodontic treatment was larger.

Conceptual design of an ascent-phase interceptor missile

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salguero, D E

1994-11-01

A conceptual design for an air-launched interceptor missile to defend against theater ballistic missiles is presented. The missile is designed to intercept the target while ascending, during Or just after the boost phase, before it reaches exo-atmospheric flight. The interceptor consists of a two-stage booster and a shrouded kinetic-kill vehicle. This report concentrates on the booster design required to achieve reasonable standoff ranges. The kinetic-kill vehicle and shroud (the payload) is assumed to weigh 80 lb{sub m} (36 kg) and assumed to contain guidance computers for both the kill vehicle and the booster. The interceptor missile is about 6 mmore » long, .48 m in diameter and weighs about 900 kg. Allowing 25 sec for target detection, trajectory estimation, and interceptor launch, it can intercept 90 sec after target launch from a 220 km stand-off range at an altitude of 60 km. Trade-off studies show that the interceptor performance is most sensitive to the stage mass fractions (with the first-stage mass fraction the most important), the first-stage burn time and the payload weight.« less

Sequential Responding in Accordance with Temporal Relational Cues: A Comparison of before and after

ERIC Educational Resources Information Center

Hyland, John M.; O'Hora, Denis P.; Leslie, Julian C.; Smyth, Sinead

2012-01-01

The current study investigated the relative effects of Before and After relational cues on temporal order judgments. In Experiment 1, participants (N = 20) were exposed to a 5-phase temporal relational responding task. Participants observed a sequence of 2 familiar shapes and then completed either a Before or an After statement to describe the…

Poverty Levels and Debt Indicators among Low-Income Households before and after the Great Recession

ERIC Educational Resources Information Center

Kim, Kyoung Tae; Wilmarth, Melissa J.; Henager, Robin

2017-01-01

This study analyzed the debt profile of low-income households before and after the Great Recession using the 2007, 2010, and 2013 Survey of Consumer Finances (SCF). We used Heckman selection models to investigate three debt characteristics: (a) the amount of debt, (b) debt-to-income ratio, and (c) debt delinquency. Before and after the Great…

The Effect of Aromatherapy Treatment on Fatigue and Relaxation for Mothers during the Early Puerperal Period in Japan: A Pilot Study

PubMed Central

Asazawa, Kyoko; Kato, Yoshihiro; Yamaguchi, Atsuko; Inoue, Asako

2017-01-01

ABSTRACT Background: Early in the postpartum period, mothers are often nervous and tired from the delivery, breast-feeding and caring for a new-born. The aim of this study was to evaluate the process and outcome of using aromatherapy treatments to increase relaxation and decrease fatigue for mothers during the first to the seventh day of the postpartum period. Methods: This non-randomized controlled study with a quasi-experimental one-group pretest-posttest design was used to evaluate scores in relaxation and fatigue before and after the intervention. Aromatherapy hand treatments were performed on a purposive sample of 34 postpartum mothers in Tokyo, Japan, from May to July 2016. The single treatment included a choice of one of five essential aroma oils through hand and forearm massage. Relaxation and fatigue were measured by self-administered valid and reliable questionnaires. Wilcoxon signed-rank test was conducted to analyze the data before and after the intervention. The software programs SPSS, v. 23.0 (SPSS, Tokyo), was used to analyze the data, with the significance level set at 5%. Results: Valid responses were obtained from 29 participants. A comparison of the scores before and after aroma treatment intervention indicated that the participants’ relaxation scores increased significantly (P<0.001) and fatigue scores were significantly reduced (P<0.001). The majority of participants (77.8%) were satisfied with the treatment. Conclusion: The aroma treatments significantly improved relaxation and reduced fatigue for mothers in the early puerperal period and were well received. Therefore, a larger study using a pretest-posttest random control trial is recommended. PMID:29043282

Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control.

PubMed

Romero, Carmen; Caballero, Natalia; Herrero, Montse; Ruíz, Raquel; Sadick, Neil S; Trelles, Mario A

2008-12-01

A system that combines bipolar radio frequency (RF) and intense infrared light (IR) together with mechanical massage and suction has recently been reported as being efficient for cellulite treatment. The present split study was designed to evaluate the efficacy of such a system through various treatments of cellulite located on the buttocks. Ten patients were enrolled for 12 sessions of 30 minutes each performed over one buttock, the other buttock serving as an untreated control. Sessions were conducted twice a week for a period of 12 weeks. Clinical photography and profilometry were carried out to assess textural changes before (baseline) and 2 months after the final treatment. Histopathology was performed at baseline, 2 hours after the first session, and just before the 12th session and 2 months thereafter. All patients noted improvement in the treated buttock before the final session, which was maintained at the 2-month assessment. Improved skin appearance was noticed after the first session and was maintained throughout the study. All patients were satisfied with the results and requested further treatment in order to balance the results in both buttocks. Random histological analyses suggested dermal firmness, fibre compaction and tightening of skin layers, including the subcutis, as possible reasons for the effects achieved. The authors recognize that the small number of participants limits the statistical power of the study. Treatment sessions with the combined RF, IR light and mechanical massage and suction system were complication free, produced improvements in the overall cellulite appearance and skin condition, suggesting that further treatment sessions for maintenance could sustain patient satisfaction index (SI) and lead to lasting results. Based on the good results in the limited trial population, further studies with larger patient populations are warranted.

Serum endocan levels before and after surgery on low-grade gliomas.

PubMed

Tanriverdi, Taner; Kemerdere, Rahsan; Inal, Berrin B; Yuksel, Odhan; Emre, Humeyra O; Ahmedov, Merdin; Baran, Oguz; Ates, Seda

2017-01-01

Endocan has been shown to be a marker for several cancers and may show degree of malignancy. The aim of this study is to assess serum levels of endocan before and after surgery on low-grade gliomas (LGGs). Endocan was assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits in a total of 19 patients and 12 controls. Serial serum samples were obtained before and after surgery (1 st day, 1 st week, and 1 st month of surgery). Control samples were collected from cord blood during cesarean section. The results were compared with control brain tissues. Controls showed significantly lower serum endocan levels compared to before and after surgery ( P < 0.05). There is a trend of increase in mean serum levels from before surgery and during the very early period after surgery (during first week); however, in the first month, mean serum levels became lower. Endocan, a vital molecule for angiogenesis, is highly expressed before and after surgery in LGGs, but long-term data is needed. Furthermore, future studies should include high-grade gliomas to discuss whether endocan is associated with recurrence and response to treatment.

Health Optimizing Physical Education (HOPE): A New Curriculum for School Programs--Part 1: Establishing the Need and Describing the Model

ERIC Educational Resources Information Center

Metzler, Michael W.; McKenzie, Thomas L.; van der Mars, Hans; Barrett-Williams, Shannon L.; Ellis, Rebecca

2013-01-01

Comprehensive School Physical Activity Programs (CSPAP) are designed to provide expanded opportunities for physical activity beyond regularly scheduled physical education time-including before, during, and after school, as well as at home and in the community. While CSPAPs are gaining support, currently there are no models for designing,…

Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review.

PubMed

Mann, Bikaramjit S; Barnieh, Lianne; Tang, Karen; Campbell, David J T; Clement, Fiona; Hemmelgarn, Brenda; Tonelli, Marcello; Lorenzetti, Diane; Manns, Braden J

2014-01-01

Prescription drugs are used in people with hypertension, diabetes, and cardiovascular disease to manage their illness. Patient cost sharing strategies such as copayments and deductibles are often employed to lower expenditures for prescription drug insurance plans, but the impact on health outcomes in these patients is unclear. To determine the association between drug insurance and patient cost sharing strategies on medication adherence, clinical and economic outcomes in those with chronic diseases (defined herein as diabetes, hypertension, hypercholesterolemia, coronary artery disease, and cerebrovascular disease). Studies were included if they examined various cost sharing strategies including copayments, coinsurance, fixed copayments, deductibles and maximum out-of-pocket expenditures. Value-based insurance design and reference based pricing studies were excluded. Two reviewers independently identified original intervention studies (randomized controlled trials, interrupted time series, and controlled before-after designs). MEDLINE, EMBASE, Cochrane Library, CINAHL, and relevant reference lists were searched until March 2013. Two reviewers independently assessed studies for inclusion, quality, and extracted data. Eleven studies, assessing the impact of seven policy changes, were included: 2 separate reports of one randomized controlled trial, 4 interrupted time series, and 5 controlled before-after studies. Outcomes included medication adherence, clinical events (myocardial infarction, stroke, death), quality of life, healthcare utilization, or cost. The heterogeneity among the studies precluded meta-analysis. Few studies reported the impact of cost sharing strategies on mortality, clinical and economic outcomes. The association between patient copayments and medication adherence varied across studies, ranging from no difference to significantly lower adherence, depending on the amount of the copayment. Lowering cost sharing in patients with chronic diseases may improve adherence, but the impact on clinical and economic outcomes is uncertain.

Self-administered foot reflexology for the management of chronic health conditions: a systematic review.

PubMed

Song, Hyun Jin; Choi, Sun Mi; Seo, Hyun-Ju; Lee, Heeyoung; Son, Heejeong; Lee, Sanghun

2015-02-01

To systematically review the effect of self-administered foot reflexology in patients with chronic health conditions. Electronic databases were searched for literature published from 1948 to January 2014. The databases included MEDLINE, EMBASE, the Cochrane Library, CINAHL, CNKI, J-STAGE, Koreamed, Kmbase, KISS, NDSL, KISTI, and OASIS. Key search terms were "exp/relaxation therapy," "foot," "reflexology," "zone therapy," and "self." All study designs were included. Two raters independently extracted data and assessed study quality by using the Cochrane risk of bias tool (for randomized controlled trials) and the risk of bias assessment tool for nonrandomized studies (for nonrandomized and before-and-after studies). A qualitative and descriptive analysis was performed because of the clinical diversity associated with chronic health conditions. Of the 224 records assessed, 4 trials met the inclusion criteria: 3 nonrandomized controlled trials and 1 before-and-after study without comparison. Self-administered foot reflexology might have a positive effect in type 2 diabetes, but the low quality of the included study and the lack of adequately reported clinical outcomes obscure the results. Two studies of hypertensive patients and 1 study of patients with urinary incontinence showed that self-performed foot reflexology may exert a beneficial effect on lowering blood pressure and urinary incontinence; however, given the small sample size and the lack of any description of medications and other cointerventions, there was insufficient evidence to conclusively determine whether foot reflexology had any effect. The included studies on self-administered foot reflexology in patients with type 2 diabetes, hypertension, or urinary incontinence provided insufficient evidence to determine a treatment effect. Therefore, a well-designed, large-scale, and randomized controlled trial is needed to confirm the effect of self-administered foot reflexology for chronic conditions.

Fiber type-specific muscle glycogen sparing due to carbohydrate intake before and during exercise.

PubMed

De Bock, K; Derave, W; Ramaekers, M; Richter, E A; Hespel, P

2007-01-01

The effect of carbohydrate intake before and during exercise on muscle glycogen content was investigated. According to a randomized crossover study design, eight young healthy volunteers (n = 8) participated in two experimental sessions with an interval of 3 wk. In each session subjects performed 2 h of constant-load bicycle exercise ( approximately 75% maximal oxygen uptake). On one occasion (CHO), they received carbohydrates before ( approximately 150 g) and during (1 g.kg body weight(-1).h(-1)) exercise. On the other occasion they exercised after an overnight fast (F). Fiber type-specific relative glycogen content was determined by periodic acid Schiff staining combined with immunofluorescence in needle biopsies from the vastus lateralis muscle before and immediately after exercise. Preexercise glycogen content was higher in type IIa fibers [9.1 +/- 1 x 10(-2) optical density (OD)/microm(2)] than in type I fibers (8.0 +/- 1 x 10(-2) OD/microm(2); P < 0.0001). Type IIa fiber glycogen content decreased during F from 9.6 +/- 1 x 10(-2) OD/microm(2) to 4.5 +/- 1 x 10(-2) OD/microm(2) (P = 0.001), but it did not significantly change during CHO (P = 0.29). Conversely, in type I fibers during CHO and F the exercise bout decreased glycogen content to the same degree. We conclude that the combination of carbohydrate intake both before and during moderate- to high-intensity endurance exercise results in glycogen sparing in type IIa muscle fibers.

The effects of aromatherapy on pruritus in patients undergoing hemodialysis.

PubMed

Ro, You-Ja; Ha, Hyae-Chung; Kim, Chun-Gill; Yeom, Hye-A

2002-08-01

This study was designed to investigate the effects of aromatherapy on pruritus in patients with chronic renal failure undergoing hemodialysis. The participants were 29 adult patients living in Seoul, Korea. Thirteen patients were assigned to the experimental group and received the aromatherapy massage on the arm 3 times a week for 4 weeks. Pruritus score, skin pH, stratum corneum hydration, and pruritus-related biochemical markers were measured before and after the treatment. The results showed that pruritus score was significantly decreased after aromatherapy. Skin pH showed no significant changes in either group while stratum corneum hydration increased significantly in the experimental group after aromatherapy. The results support the use aromatherapy as a useful and effective method of managing pruritus in patients undergoing hemodialysis.

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study

PubMed Central

Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

2015-01-01

Objectives To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. Setting Prelaw and postlaw design study. Participants 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. Methods We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. Primary and secondary outcome measures Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. Results Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having ‘unhealthy’ air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to ‘good’. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had ‘unhealthy’ air both before and after the law. Conclusions The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods. PMID:26185176

Abundance and Size of Gulf Shrimp in Louisiana's Coastal Estuaries following the Deepwater Horizon Oil Spill

PubMed Central

van der Ham, Joris L.; de Mutsert, Kim

2014-01-01

The Deepwater Horizon oil spill impacted Louisiana's coastal estuaries physically, chemically, and biologically. To better understand the ecological consequences of this oil spill on Louisiana estuaries, we compared the abundance and size of two Gulf shrimp species (Farfantepeneus aztecus and Litopeneus setiferus) in heavily affected and relatively unaffected estuaries, before and after the oil spill. Two datasets were used to conduct this study: data on shrimp abundance and size before the spill were available from Louisiana Department of Wildlife and Fisheries (LDWF). Data on shrimp abundance and size from after the spill were independently collected by the authors and by LDWF. Using a Before-After-Control-Impact with Paired sampling (BACIP) design with monthly samples of two selected basins, we found brown shrimp to become more abundant and the mean size of white shrimp to become smaller. Using a BACIP with data on successive shrimp year-classes of multiple basins, we found both species to become more abundant in basins that were affected by the spill, while mean shrimp size either not change after the spill, or increased in both affected and unaffected basins. We conclude that following the oil spill abundances of both species increased within affected estuaries, whereas mean size may have been unaffected. We propose two factors that may have caused these results: 1) exposure to polycyclic aromatic hydrocarbons (PAHs) may have reduced the growth rate of shrimp, resulting in a delayed movement of shrimp to offshore habitats, and an increase of within-estuary shrimp abundance, and 2) fishing closures established immediately after the spill, may have resulted in decreased fishing effort and an increase in shrimp abundance. This study accentuates the complexities in determining ecological effects of oil spills, and the need of studies on the organismal level to reveal cause-and-effect relationships of such events. PMID:25272142

Changes in Pore Water Quality After Peatland Restoration: Assessment of a Large-Scale, Replicated Before-After-Control-Impact Study in Finland

NASA Astrophysics Data System (ADS)

Menberu, Meseret Walle; Marttila, Hannu; Tahvanainen, Teemu; Kotiaho, Janne S.; Hokkanen, Reijo; Kløve, Bjørn; Ronkanen, Anna-Kaisa

2017-10-01

Drainage is known to affect peatland natural hydrology and water quality, but peatland restoration is considered to ameliorate peatland degradation. Using a replicated BACIPS (Before-After-Control-Impact Paired Series) design, we investigated 24 peatlands, all drained for forestry and subsequently restored, and 19 pristine control boreal peatlands with high temporal and spatial resolution data on hydroclimate and pore water quality. In drained conditions, total nitrogen (Ntot), total phosphorus (Ptot), and dissolved organic carbon (DOC) in pore water were several-fold higher than observed at pristine control sites, highlighting the impacts of long-term drainage on pore water quality. In general, pore water DOC and Ntot decreased after restoration measures but still remained significantly higher than at pristine control sites, indicating long time lags in restoration effects. Different peatland classes and trophic levels (vegetation gradient) responded differently to restoration, primarily due to altered hydrology and varying acidity levels. Sites that were hydrologically overrestored (inundated) showed higher Ptot, Ntot, and DOC than well-restored or insufficiently restored sites, indicating the need to optimize natural-like hydrological regimes when restoring peatlands drained for forestry. Rich fens (median pH 6.2-6.6) showed lower pore water Ptot, Ntot, and DOC than intermediate and poor peats (pH 4.0-4.6) both before and after restoration. Nutrients and DOC in pore water increased in the first year postrestoration but decreased thereafter. The most important variables related to pore water quality were trophic level, peatland class, water table level, and soil and air temperature.

Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice

PubMed Central

Ridd, Matthew J; Ferreira, Diana L Santos; Montgomery, Alan A; Salisbury, Chris; Hamilton, William

2015-01-01

Background Continuity of care may affect the diagnostic process in cancer but there is little research. Aim To estimate associations between patient–doctor continuity and time to diagnosis and referral of three common cancers. Design and setting Retrospective cohort study in general practices in England. Method This study used data from the General Practice Research Database for patients aged ≥40 years with a diagnosis of breast, colorectal, or lung cancer. Relevant cancer symptoms or signs were identified up to 12 months before diagnosis. Patient–doctor continuity (fraction-of-care index adjusted for number of consultations) was calculated up to 24 months before diagnosis. Time ratios (TRs) were estimated using accelerated failure time regression models. Results Patient–doctor continuity in the 24 months before diagnosis was associated with a slightly later diagnosis of colorectal (time ratio [TR] 1.01, 95% confidence interval [CI] =1.01 to 1.02) but not breast (TR = 1.00, 0.99 to 1.01) or lung cancer (TR = 1.00, 0.99 to 1.00). Secondary analyses suggested that for colorectal and lung cancer, continuity of doctor before the index consultation was associated with a later diagnosis but continuity after the index consultation was associated with an earlier diagnosis, with no such effects for breast cancer. For all three cancers, most of the delay to diagnosis occurred after referral. Conclusion Any effect for patient–doctor continuity appears to be small. Future studies should compare investigations, referrals, and diagnoses in patients with and without cancer who present with possible cancer symptoms or signs; and focus on ‘difficult to diagnose’ types of cancer. PMID:25918335

Impact of user fees on maternal health service utilization and related health outcomes: a systematic review.

PubMed

Dzakpasu, Susie; Powell-Jackson, Timothy; Campbell, Oona M R

2014-03-01

To assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes. Studies were identified by modifying a search strategy from a related systematic review. Primary studies of any design were included if they reported the effect of fee changes on maternal health service utilization, related health outcomes and inequalities in these outcomes. For each study, data were systematically extracted and a quality assessment conducted. Due to the heterogeneity of study methods, results were examined narratively. Twenty studies were included. Designs and analytic approaches comprised: two interrupted time series, eight repeated cross-sectional, nine before-and-after without comparison groups and one before-and-after in three groups. Overall, the quality of studies was poor. Few studies addressed potential sources of bias, such as secular trends over time, and even basic tests of statistical significance were often not reported. Consistency in the direction of effects provided some evidence of an increase in facility delivery in particular after fees were removed, as well as possible increases in the number of managed delivery complications. There was little evidence of the effect on health outcomes or inequality in accessing care and, where available, the direction of effect varied. Despite the global momentum to abolish user fees for maternal and child health services, robust evidence quantifying impact remains scant. Improved methods for evaluating and reporting on these interventions are recommended, including better descriptions of the interventions and context, looking at a range of outcome measures, and adopting robust analytical methods that allow for adjustment of underlying and seasonal trends, reporting immediate as well as longer-term (e.g. at 6 months and 1 year) effects and using comparison groups where possible.

Treatment outcomes after implementation of an adapted WHO protocol for severe sepsis and septic shock in Haiti.

PubMed

Papali, Alfred; Eoin West, T; Verceles, Avelino C; Augustin, Marc E; Nathalie Colas, L; Jean-Francois, Carl H; Patel, Devang M; Todd, Nevins W; McCurdy, Michael T

2017-10-01

The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. Using a before-and-after study design, we retrospectively enrolled 99 adult Emergency Department patients with severe sepsis from January through March 2012. After protocol implementation in January 2014, we compared outcomes to 67 patients with severe sepsis retrospectively enrolled from February to April 2014. We defined sepsis according to the WHO's Integrated Management of Adult Illness guidelines and severe sepsis as sepsis plus organ dysfunction. After protocol implementation, quantity of fluid administered increased and the physician's differential diagnoses more often included sepsis. Patients were more likely to have follow-up vital signs taken sooner, a radiograph performed, and a lactic acid tested. There were no improvements in mortality, time to fluids or antimicrobials. Use of a simplified sepsis protocol based primarily on physiologic parameters allows for substantial improvements in process measures in the care of severely septic patients in a resource-constrained setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Road transport and diet affect metabolic response to exercise in horses.

PubMed

Connysson, M; Muhonen, S; Jansson, A

2017-11-01

This study investigated the effects of transport and diet on metabolic response during a subsequent race-like test in Standardbred horses in training fed a forage-only diet and a 50:50 forage:oats diet. Six trained and raced Standardbred trotter mares were used. Two diets, 1 forage-only diet (FONLY) and 1 diet with 50% of DM intake from forage and 50% from oats (FOATS), were fed for two 29-d periods in a crossover design. At Day 21, the horses were subjected to transport for 100 km before and after they performed an exercise test (transport test [TT]). At Day 26, the horses performed a control test (CT), in which they were kept in their stall before and after the exercise test. Blood samples were collected throughout the study, and heart rate and water intake were recorded. Heart rate and plasma cortisol, glucose, and NEFA concentrations were greater for the TT than for the CT ( = 0.008, = 0.020, = 0.010, and = 0.0002, respectively) but were not affected by diet. Plasma acetate concentration was lower during the TT than during the CT ( = 0.034) and greater for the FONLY than for the FOATS ( = 0.003). There were no overall effects of the TT compared with the CT on total plasma protein concentration (TPP), but TPP was lower with the FONLY than with the FOATS ( = 0.016). There was no overall effect of the TT compared with the CT on water intake, but water intake was greater with the FONLY than the FOATS ( = 0.011). There were no overall effects of transport or diet on BW, plasma lactate, or plasma urea concentration. It was concluded that both transport and diet affect metabolic response during exercise in horses. Aerobic energy supply was most likely elevated by transportation and by the FONLY. The FONLY also decreased exercise-induced effects on extracellular fluid regulation. These results highlight the importance of experimental design in nutrition studies. If the aim is to examine how a diet affects exercise response in competition horses, transport should preferably be included in the experimental design, because horses are likely to be transported before a competition.

Prior Familiarization With Takeover Requests Affects Drivers' Takeover Performance and Automation Trust.

PubMed

Hergeth, Sebastian; Lorenz, Lutz; Krems, Josef F

2017-05-01

The objective for this study was to investigate the effects of prior familiarization with takeover requests (TORs) during conditional automated driving on drivers' initial takeover performance and automation trust. System-initiated TORs are one of the biggest concerns for conditional automated driving and have been studied extensively in the past. Most, but not all, of these studies have included training sessions to familiarize participants with TORs. This makes them hard to compare and might obscure first-failure-like effects on takeover performance and automation trust formation. A driving simulator study compared drivers' takeover performance in two takeover situations across four prior familiarization groups (no familiarization, description, experience, description and experience) and automation trust before and after experiencing the system. As hypothesized, prior familiarization with TORs had a more positive effect on takeover performance in the first than in a subsequent takeover situation. In all groups, automation trust increased after participants experienced the system. Participants who were given no prior familiarization with TORs reported highest automation trust both before and after experiencing the system. The current results extend earlier findings suggesting that prior familiarization with TORs during conditional automated driving will be most relevant for takeover performance in the first takeover situation and that it lowers drivers' automation trust. Potential applications of this research include different approaches to familiarize users with automated driving systems, better integration of earlier findings, and sophistication of experimental designs.

Mitigating Reptile Road Mortality: Fence Failures Compromise Ecopassage Effectiveness

PubMed Central

Baxter-Gilbert, James H.; Riley, Julia L.; Lesbarrères, David; Litzgus, Jacqueline D.

2015-01-01

Roadways pose serious threats to animal populations. The installation of roadway mitigation measures is becoming increasingly common, yet studies that rigorously evaluate the effectiveness of these conservation tools remain rare. A highway expansion project in Ontario, Canada included exclusion fencing and ecopassages as mitigation measures designed to offset detrimental effects to one of the most imperial groups of vertebrates, reptiles. Taking a multispecies approach, we used a Before-After-Control-Impact study design to compare reptile abundance on the highway before and after mitigation at an Impact site and a Control site from 1 May to 31 August in 2012 and 2013. During this time, radio telemetry, wildlife cameras, and an automated PIT-tag reading system were used to monitor reptile movements and use of ecopassages. Additionally, a willingness to utilize experiment was conducted to quantify turtle behavioral responses to ecopassages. We found no difference in abundance of turtles on the road between the un-mitigated and mitigated highways, and an increase in the percentage of both snakes and turtles detected dead on the road post-mitigation, suggesting that the fencing was not effective. Although ecopassages were used by reptiles, the number of crossings through ecopassages was lower than road-surface crossings. Furthermore, turtle willingness to use ecopassages was lower than that reported in previous arena studies, suggesting that effectiveness of ecopassages may be compromised when alternative crossing options are available (e.g., through holes in exclusion structures). Our rigorous evaluation of reptile roadway mitigation demonstrated that when exclusion structures fail, the effectiveness of population connectivity structures is compromised. Our project emphasizes the need to design mitigation measures with the biology and behavior of the target species in mind, to implement mitigation designs in a rigorous fashion, and quantitatively evaluate road mitigation to ensure allow for adaptive management and optimization of these increasingly important conservation tools. PMID:25806531

Mitigating reptile road mortality: fence failures compromise ecopassage effectiveness.

PubMed

Baxter-Gilbert, James H; Riley, Julia L; Lesbarrères, David; Litzgus, Jacqueline D

2015-01-01

Roadways pose serious threats to animal populations. The installation of roadway mitigation measures is becoming increasingly common, yet studies that rigorously evaluate the effectiveness of these conservation tools remain rare. A highway expansion project in Ontario, Canada included exclusion fencing and ecopassages as mitigation measures designed to offset detrimental effects to one of the most imperial groups of vertebrates, reptiles. Taking a multispecies approach, we used a Before-After-Control-Impact study design to compare reptile abundance on the highway before and after mitigation at an Impact site and a Control site from 1 May to 31 August in 2012 and 2013. During this time, radio telemetry, wildlife cameras, and an automated PIT-tag reading system were used to monitor reptile movements and use of ecopassages. Additionally, a willingness to utilize experiment was conducted to quantify turtle behavioral responses to ecopassages. We found no difference in abundance of turtles on the road between the un-mitigated and mitigated highways, and an increase in the percentage of both snakes and turtles detected dead on the road post-mitigation, suggesting that the fencing was not effective. Although ecopassages were used by reptiles, the number of crossings through ecopassages was lower than road-surface crossings. Furthermore, turtle willingness to use ecopassages was lower than that reported in previous arena studies, suggesting that effectiveness of ecopassages may be compromised when alternative crossing options are available (e.g., through holes in exclusion structures). Our rigorous evaluation of reptile roadway mitigation demonstrated that when exclusion structures fail, the effectiveness of population connectivity structures is compromised. Our project emphasizes the need to design mitigation measures with the biology and behavior of the target species in mind, to implement mitigation designs in a rigorous fashion, and quantitatively evaluate road mitigation to ensure allow for adaptive management and optimization of these increasingly important conservation tools.

A prospective study of existential issues in therapeutic horticulture for clinical depression.

PubMed

Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil Wilhelm; Kirkevold, Marit

2011-01-01

Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants' open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.