MicroRNA in Prostate Cancer Racial Disparities and Aggressiveness

DTIC Science & Technology

2017-10-01

actively followed all of the enrolled men in the cohort who did not have extensive disease at diagnosis for PSA outcomes. Mean follow-up time is currently...60 months. Follow-up of PSA test results through medical records and Caisis database were updated in August, 2017, and a linkage with Metropolitan...and from the current protocol) who did not have extensive disease at diagnosis for PSA outcomes. Mean follow-up time is currently 60 months (as of

Pediatric superficial scald burns--reassessment of our follow-up protocol.

PubMed

Egro, Francesco M; O'Neill, Jennifer K; Briard, Robert; Cubison, Tania C S; Kay, Alan R; Estela, Catalina M; Burge, Timothy S

2010-01-01

The most common pediatric burn injury is a superficial scald. The current follow-up protocol for such burns includes review of the patient at 2 weeks postinjury and then 2 months later. The authors decided to review the protocol to assess the need for this second follow-up. A retrospective study reviewed the case notes of patients younger than 16 years at the time of their injury presenting with a scald over 5% TBSA. The progress of healing and scar development up to 5 years follow-up was assessed. This study showed that scalds healing within 2 weeks following injury rarely became hypertrophic. A prospective study was performed over a 10-month period. All children who suffered a superficial partial-thickness scald injury were included. At the 2-week appointment, the need for further follow-up was predicted. The accuracy of this prediction was assessed 2 months later. This study showed that an experienced member of the burns team could reliably predict at 2-week appointment those children who could be safely discharged with no subsequent need for scar management. This study suggests that it will be safe to modify the follow-up protocol, reducing the number of clinic attendances.

Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders.

PubMed

Shelby, Grace D; Shirkey, Kezia C; Sherman, Amanda L; Beck, Joy E; Haman, Kirsten; Shears, Angela R; Horst, Sara N; Smith, Craig A; Garber, Judy; Walker, Lynn S

2013-09-01

Cross-sectional studies link functional abdominal pain (FAP) to anxiety and depression in childhood, but no prospective study has evaluated psychiatric status in adulthood or its relation to pain persistence. Pediatric patients with FAP (n = 332) and control subjects (n = 147) were tracked prospectively and evaluated for psychiatric disorders and functional gastrointestinal disorders (FGIDs) at follow-up in adolescence and young adulthood (mean age = 20.01 years). Participants were classified according to presence (FGID-POS) or absence (FGID-NEG) of FGIDs at follow-up. Lifetime and current risk of anxiety disorders was higher in FAP than controls (lifetime: 51% vs 20%; current: 30% vs 12%). Controlling for gender and age, the odds ratio was 4.9 (confidence interval = 2.83-7.43) for lifetime anxiety disorder and 3.57 (confidence interval = 2.00-6.36) for current anxiety disorder at follow-up for FAP versus controls. Lifetime risk of depressive disorder was significantly higher in FAP versus controls (40% vs. 16%); current risk did not differ. In most cases, initial onset of anxiety disorders was before pediatric FAP evaluation; onset of depressive disorders was subsequent to FAP evaluation. Within the FAP group, risk of current anxiety disorders at follow-up was significantly higher for FGID-POS versus FGID-NEG (40% vs 24%), and both were higher than controls (12%); current depressive disorders did not differ across FGID-POS, FGID-NEG, and controls. Patients with FAP carry long-term vulnerability to anxiety that begins in childhood and persists into late adolescence and early adulthood, even if abdominal pain resolves.

Variation in routine follow-up care after curative treatment for head-and-neck cancer: a population-based study in Ontario.

PubMed

Brennan, K E; Hall, S F; Owen, T E; Griffiths, R J; Peng, Y

2018-04-01

The actual practices of routine follow-up after curative treatment for head-and-neck cancer are unknown, and existing guidelines are not evidence-based. This retrospective population-based study used administrative data to describe 5 years of routine follow-up care in 3975 head-and-neck cancer patients diagnosed between 2007 and 2012 in Ontario. The mean number of visits per year declined during the follow-up period (from 7.8 to 1.9, p < 0.001). The proportion of patients receiving visits in concordance with guidelines ranged from 80% to 45% depending on the follow-up year. In at least 50% of patients, 1 head, neck, or chest imaging test was performed in the first follow-up year; that proportion subsequently declined ( p < 0.001). Factors associated with follow-up practices included comorbidity, tumour site, treatment, geographic region, and physician specialty ( p < 0.05). Given current practice variation and the absence of an evidence-based standard, the challenge in identifying a single optimal follow-up strategy might be better addressed with a harmonized approach to providing individualized follow-up care.

Long-term follow-up study of patients with refractory obsessive-compulsive disorder.

PubMed

Ross, Stephen; Fallon, Brian A; Petkova, Eva; Feinstein, Suzanne; Liebowitz, Michael R

2008-01-01

The authors prospectively followed patients with treatment-resistant obsessive-compulsive disorder (OCD). Between 1988 and 1995, 56 patients with a history of inadequate response to oral clomipramine received 14 infusions of intravenous clomipramine. The follow-up period ranged from 4 to 11 years after treatment. Of the 44 subjects interviewed at follow-up, 70.5% had current OCD and 29.5% had sub-threshold OCD. Almost half reported feeling much improved or very much improved compared to their state prior to treatment with intravenous clomipramine.

Effect of Health Literacy on Research Follow-up

PubMed Central

Leak, Cardella; Goggins, Kathryn; Schildcrout, Jonathan S.; Theobald, Cecelia; Donato, Katharine M.; Bell, Susan P.; Schnelle, John; Kripalani, Sunil

2016-01-01

Previous research has not examined the effect of health literacy on research subjects' completion of scheduled research follow-up. This article evaluates patient factors associated with incomplete research follow-up at three time points after enrollment in a large, hospital-based prospective cohort study. Predictor variables included health literacy, age, race, gender, education, employment status, difficulty paying bills, hospital diagnosis, length of stay, self-reported global health status, depression, perceived health competence, medication adherence and healthcare system distrust. In a sample of 2042 patients, multivariable models demonstrated that lower health literacy and younger age were significantly associated with a lower likelihood of completing research follow-up interviews at 2-3 days, 30 days and 90 days after hospital discharge. Additionally, patients who had less education, were currently employed, and had moderate financial stress were less likely to complete 90-day follow-up. This study is the first to demonstrate that lower health literacy is a significant predictor of incomplete research follow-up. PMID:26513035

Current state of high-risk infant follow-up care in the United States: results of a national survey of academic follow-up programs.

PubMed

Kuppala, V S; Tabangin, M; Haberman, B; Steichen, J; Yolton, K

2012-04-01

High-risk infant follow-up programs have the potential to act as multipurpose clinics by providing continuity of clinical care, education of health care trainees and facilitating outcome data research. Currently there are no nationally representative data on high-risk infant follow-up practices in the United States. The objective of this study is to collect information about the composition of high-risk infant follow-up programs associated with academic centers in the United States, with respect to their structure, function, funding resources and developmental assessment practices, and to identify the barriers to establishment of such programs. Staff neonatologists, follow-up program directors and division directors of 170 Neonatal Intensive Care Units (NICU) associated with pediatric residency programs were invited to participate in an anonymous online survey from October 2009 to January 2010. The overall response rate was 84%. Ninety three percent of the respondents have a follow-up program associated with their NICU. Birth weight, gestational age and critical illness in the NICU were the major criteria for follow-up care. Management of nutrition and neurodevelopmental assessments was the most common service provided. Over 70% have health care trainees in the clinic. About 75% of the respondents have the neurodevelopmental outcome data available. Most of the respondents reported multiple funding sources. Lack of personnel and funding were the most common causes for not having a follow-up program. High-risk infant follow-up programs associated with academic centers in the United States are functioning as multidisciplinary programs providing clinical care, trainee education and facilitating outcomes research.

Loss to follow-up in tuberculosis treatment and its relationship with patients' knowledge of the disease and other associated factors.

PubMed

Belchior, Aylana De S; Mainbourg, Evelyne Marie T; Ferreira-Gonçalves, Maria J

2016-01-01

To identify factors associated with loss to follow-up in Tuberculosis (TB) treatment, including patients' level of knowledge regarding treatment of this disease. 42 loss to follow-up cases and 84 control cases that were finishing the sixth month of their first treatment for tuberculosis were selected for this study. Primary data were gathered through interviews, while secondary data were obtained from the notification form of the disease, between December 2011 and April 2012. Factors associated with loss to follow-up were analyzed by means of a conditional logistic regression multivariate model for matched case-control groups. No significant differences were observed between loss to follow-up cases and controls regarding socioeconomic factors, lifestyle, clinical condition, treatment-related behaviors and the access of patients to sources of information on TB. In the regression multivariate analysis, significant associations with retreatment after loss to follow-up that were detected include: scarce knowledge on tuberculosis, lack of adherence to consultation during the current treatment, noncompliance with follow-up consultation deadline, smoking and HIV negative. When compared to controls, cases undergoing TB retreatment after loss to follow-up have less knowledge on the disease, which is a sign for the professionals responsible for health education of the need to invest more time and efforts in activities that help the patient understand the disease and its treatment, as well as to have higher levels of adherence. In addition, noncompliance with the follow-up consultation deadline, failure to attend consultations during the current treatment and smoking are also factors that may be influenced by poor knowledge on the disease, which leads to the treatment loss to follow-up.

A fast alignment method for breast MRI follow-up studies using automated breast segmentation and current-prior registration

NASA Astrophysics Data System (ADS)

Wang, Lei; Strehlow, Jan; Rühaak, Jan; Weiler, Florian; Diez, Yago; Gubern-Merida, Albert; Diekmann, Susanne; Laue, Hendrik; Hahn, Horst K.

2015-03-01

In breast cancer screening for high-risk women, follow-up magnetic resonance images (MRI) are acquired with a time interval ranging from several months up to a few years. Prior MRI studies may provide additional clinical value when examining the current one and thus have the potential to increase sensitivity and specificity of screening. To build a spatial correlation between suspicious findings in both current and prior studies, a reliable alignment method between follow-up studies is desirable. However, long time interval, different scanners and imaging protocols, and varying breast compression can result in a large deformation, which challenges the registration process. In this work, we present a fast and robust spatial alignment framework, which combines automated breast segmentation and current-prior registration techniques in a multi-level fashion. First, fully automatic breast segmentation is applied to extract the breast masks that are used to obtain an initial affine transform. Then, a non-rigid registration algorithm using normalized gradient fields as similarity measure together with curvature regularization is applied. A total of 29 subjects and 58 breast MR images were collected for performance assessment. To evaluate the global registration accuracy, the volume overlap and boundary surface distance metrics are calculated, resulting in an average Dice Similarity Coefficient (DSC) of 0.96 and root mean square distance (RMSD) of 1.64 mm. In addition, to measure local registration accuracy, for each subject a radiologist annotated 10 pairs of markers in the current and prior studies representing corresponding anatomical locations. The average distance error of marker pairs dropped from 67.37 mm to 10.86 mm after applying registration.

Mild cognitive impairment in Parkinson's disease is improved by transcranial direct current stimulation combined with physical therapy.

PubMed

Manenti, Rosa; Brambilla, Michela; Benussi, Alberto; Rosini, Sandra; Cobelli, Chiara; Ferrari, Clarissa; Petesi, Michela; Orizio, Italo; Padovani, Alessandro; Borroni, Barbara; Cotelli, Maria

2016-05-01

Parkinson's disease (PD) is characterized by both motor and cognitive deficits. In PD, physical exercise has been found to improve physical functioning. Recent studies demonstrated that repeated sessions of transcranial direct current stimulation led to an increased performance in cognitive and motor tasks in patients with PD. The present study investigated the effects of anodal transcranial direct current stimulation applied over the dorsolateral prefrontal cortex and combined with physical therapy in PD patients. A total of 20 patients with PD were assigned to 1 of 2 study groups: group 1, anodal transcranial direct current stimulation plus physical therapy (n = 10) or group 2, placebo transcranial direct current stimulation plus physical therapy (n = 10). The 2 weeks of treatment consisted of daily direct current stimulation application for 25 minutes during physical therapy. Long-term effects of treatment were evaluated on clinical, neuropsychological, and motor task performance at 3-month follow-up. An improvement in motor abilities and a reduction of depressive symptoms were observed in both groups after the end of treatment and at 3-month follow-up. The Parkinson's Disease Cognitive Rating Scale and verbal fluency test performances increased only in the anodal direct current stimulation group with a stable effect at follow-up. The application of anodal transcranial direct current stimulation may be a relevant tool to improve cognitive abilities in PD and might be a novel therapeutic strategy for PD patients with mild cognitive impairment. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study.

PubMed

Vijayaraghavan, Maya; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

2016-08-01

Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged 50 years or more. Little is known about the epidemiology of tobacco use among older homeless individuals. This longitudinal cohort study examines smoking behaviors and factors associated with smoking cessation among homeless individuals aged 50 years or more. We recruited a prospective cohort of 350 homeless individuals sampled from the community in Oakland, California. At 6 months follow-up, participants reported their cigarette quit attempts and 30-day abstinence. We used multivariable logistic regression to examine factors associated with making a quit attempt at follow-up, hypothesizing that heavier smokers would be less likely to make a quit attempt. Of the 272 ever-smokers, 229 (84.2%) were current smokers (quit ratio 15.8). Among current smokers at enrollment who had a follow-up interview at 6 months, 43.6% (n = 71) reported making a quit attempt during the follow-up. Of those who reported making a quit attempt, 14.3% (n = 10) reported 30-day abstinence at follow-up. Among those who had reported making a quit attempt at follow-up, 22.5% had used nicotine replacement therapy (NRT). Staying in shelters (adjusted odds ratio [AOR] = 2.5, 95% confidence interval [CI] = 1.0-5.8) was associated with higher odds of making a quit attempt at follow-up. Higher cigarette consumption was associated with lower odds of making a quit attempt (AOR = 0.9, 95% CI = 0.8-0.9). In this study of tobacco use in older homeless adults, rates of quit attempts were similar to that observed in the general population, but successful quitting was lower. The current study is among the first studies to focus specifically on tobacco use and cessation behaviors among older homeless adults. The high prevalence of smoking and the low rates of successful quitting highlight numerous opportunities to intervene to increase quitting rates among this population. Among these, increasing access to smoke-free living environments and identifying effective cessation therapies will be critical to reducing tobacco-related disease burden among older homeless adults. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Taste disorders after tonsillectomy: a long-term follow-up.

PubMed

Heiser, Clemens; Landis, Basile N; Giger, Roland; Cao Van, Helene; Guinand, Nils; Hörmann, Karl; Stuck, Boris A

2012-06-01

In a former study, taste disturbances after tonsillectomy seemed to be more frequent than expected. Eight percent of patients reported subjective taste disorders 6 months after tonsillectomy. Fifteen patients from the initial trial, who reported taste disorders after tonsillectomy, were contacted again for this long-term follow-up. A telephone interview using the same questionnaire addressing the current self-estimate of taste function was performed. At 32 ± 10 months following surgery, two (0.9%) patients still reported suffering from taste disturbance. This long-term follow-up study shows that dysgeusia following tonsillectomy occurs in approximately 1% of patients. These data should be considered when patients are informed about complications after tonsillectomy. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Six-year outcome in subjects diagnosed with attention-deficit/hyperactivity disorder as adults.

PubMed

Edvinsson, Dan; Ekselius, Lisa

2018-06-01

There are very few studies on the long-term outcome in subjects diagnosed with ADHD as adults. The objective of the present study was to assess this and relate the outcome to whether there was current medication or not and to other potential predictors of favourable outcome. A prospective clinical cohort of adults diagnosed with ADHD according to DSM-IV criteria was followed-up on an average of 6 years after first evaluation (n = 124; mean age 42 years, 51% males). ADHD symptom trajectories were assessed as well as medication, global functioning, disability, health-related quality of life, and alcohol and drug consumption at follow-up. Ninety percent of those diagnosed were initially treated pharmacologically and half of them discontinued treatment. One-third reported remission, defined as not fulfilling any ADHD subtype and a GAF-value last year ≥ 70, which was not affected by comorbidity at baseline. Current medication was not associated with remission. Subjects evaluated and first diagnosed with ADHD as adults are functionally improved at follow-up 6 years later despite a high percentage of psychiatric comorbidity at baseline. Half dropped out of medication, and there was no difference in ADHD remission between subjects with on-going medication at follow-up or subjects without medication, although current medication was related to a higher degree of self-reported global improvement.

The Effect of Career Assessments and Follow-Up Counseling on Career Decision-Making Self-Efficacy (CDMSE) among Active-Duty Coast Guard Personnel

ERIC Educational Resources Information Center

Brennan, Michael D.

2009-01-01

This study (a) examined career decision-making self-efficacy (CDMSE) differences across gender, age, military grade, level of education, previous career assessments, previous career counseling, and currently attending college, and (b) examined the effect of career assessments with follow-up counseling on CDMSE among active-duty Coast Guard…

An ontology-based approach to patient follow-up assessment for continuous and personalized chronic disease management.

PubMed

Zhang, Yi-Fan; Gou, Ling; Zhou, Tian-Shu; Lin, De-Nan; Zheng, Jing; Li, Ye; Li, Jing-Song

2017-08-01

Chronic diseases are complex and persistent clinical conditions that require close collaboration among patients and health care providers in the implementation of long-term and integrated care programs. However, current solutions focus partially on intensive interventions at hospitals rather than on continuous and personalized chronic disease management. This study aims to fill this gap by providing computerized clinical decision support during follow-up assessments of chronically ill patients at home. We proposed an ontology-based framework to integrate patient data, medical domain knowledge, and patient assessment criteria for chronic disease patient follow-up assessments. A clinical decision support system was developed to implement this framework for automatic selection and adaptation of standard assessment protocols to suit patient personal conditions. We evaluated our method in the case study of type 2 diabetic patient follow-up assessments. The proposed framework was instantiated using real data from 115,477 follow-up assessment records of 36,162 type 2 diabetic patients. Standard evaluation criteria were automatically selected and adapted to the particularities of each patient. Assessment results were generated as a general typing of patient overall condition and detailed scoring for each criterion, providing important indicators to the case manager about possible inappropriate judgments, in addition to raising patient awareness of their disease control outcomes. Using historical data as the gold standard, our system achieved a rate of accuracy of 99.93% and completeness of 95.00%. This study contributes to improving the accessibility, efficiency and quality of current patient follow-up services. It also provides a generic approach to knowledge sharing and reuse for patient-centered chronic disease management. Copyright © 2017 Elsevier Inc. All rights reserved.

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials.

PubMed

Leeson, S C; Beaver, K; Ezendam, N P M; Mačuks, R; Martin-Hirsch, P L; Miles, T; Jeppesen, M M; Jensen, P T; Zola, P

2017-03-01

After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up. The evidence base for traditional hospital based follow-up is limited. Alternative models have been reported for other cancer types but there are few evaluations of alternative approaches for gynaecological cancers. We identified five ongoing European studies; four were focused on endometrial cancer patients and one feasibility study included all gynaecological cancers. Only one study had reached the reporting stage. Alternative models included nurse-led telephone follow-up and comparisons of more intensive versus less intensive regimes. Outcomes included survival, quality of life, psychological morbidity, patient satisfaction and cost effectiveness of service. More work is needed on alternative strategies for all gynaecological cancer types. New models will be likely to include risk stratification with early discharge from secondary care for early stage disease with fast track access to specialist services for suspected cancer recurrence or other problems. Copyright © 2017 Elsevier B.V. All rights reserved.

Plantar hyperhidrosis: A review of current management.

PubMed

Singh, Sanjay; Kaur, Simranjit; Wilson, Paul

2016-11-01

To critically appraise current literature regarding the management of plantar hyperhidrosis in the form of a structured review. A literature search was conducted using various databases and search criteria. The literature reports the use of conservative, medical and surgical treatment modalities for the management of plantar hyperhidrosis. However, long-term follow-up data are rare and some treatment modalities currently available are not fully understood. There is a considerable dearth in the literature on the management of plantar hyperhidrosis. Further study in larger populations with longer follow-up times is critical to access the long-term effects of treatment. Nonetheless, iontophoresis, botulinum toxin injection and lumbar sympathectomy are promising treatment modalities for this disorder.

Mood Reactivity Rather than Cognitive Reactivity Is Predictive of Depressive Relapse: A Randomized Study with 5.5-Year Follow-Up

ERIC Educational Resources Information Center

van Rijsbergen, Gerard D.; Bockting, Claudi L. H.; Burger, Huibert; Spinhoven, Philip; Koeter, Maarten W. J.; Ruhe, Henricus G.; Hollon, Steven D.; Schene, Aart H.

2013-01-01

Objective: The current study examined whether cognitive reactivity, cognitive extremity reactivity, and mood reactivity following mood provocation predicted relapse in depression over 5.5 years. Additionally, this study was the 1st to examine whether changes in cognitive reactivity and mood reactivity following preventive cognitive therapy (PCT)…

A 7-year follow-up study on the mental health of North Korean defectors in South Korea.

PubMed

Jeon, Woo-Taek; Eom, Jin-Sup; Min, Sung Kil

2013-02-01

This study was conducted to describe the relationship of past trauma and current stress on the mental health of North Korean (NK) defectors living in South Korea 7 years after a baseline assessment. Of the 200 who participated in the initial study, 106 participated in follow-up. Previous data regarding past traumatic events experienced in North Korea and during defection, past posttraumatic stress disorder (PTSD), and their current stress levels were correlated with the participants' current mental health status including depression, anxiety, and PTSD. The rate of PTSD in the sample and the scores on the PTSD symptom scale decreased significantly from the baseline. The participants' current mental health was negatively related to previous traumatic experiences in North Korea and past symptoms of PTSD, but unrelated to previous trauma experienced during defection. In addition, although current mental health was negatively related to only current culture-related stress, it was unrelated to the level of current ordinary life stress. The results of this study suggest that PTSD symptoms decreased during the 7 years between assessments, and that current culture-related stress is the most important variable related to the mental health of NK defectors living in South Korea. Copyright © 2013 International Society for Traumatic Stress Studies.

Orthopedic surgeons' attitudes to osteoporosis investigation and management after minimal trauma fracture (MTF).

PubMed

Anderson-Wurf, Jane; McGirr, Joe; Seal, Alexa; Harding, Catherine

2017-12-01

A study of orthopedic surgeons in rural and regional Southeast Australia to determine attitudes to investigation and management of osteoporosis found they believe follow-up in regard to osteoporosis after MTF is important; responsibility for follow-up diagnosis and management lies with primary health care and current communication systems are poor. The investigation and treatment of osteoporosis after minimal trauma fracture (MTF) is regarded as sub-optimal. There is strong evidence of the benefit of identifying and treating osteoporosis after MTF, and there has been discussion of the possible role that orthopedic surgeons might play in the management of osteoporosis after MTF. The study surveyed orthopedic surgeons in rural and regional Southeast Australia to determine their attitudes to investigation and management of osteoporosis, the role health professionals should play, and the communication and co-ordination of follow-up care. A survey was developed and piloted prior to being posted to 69 orthopedic surgeons asking for their opinions about the general management of osteoporosis, and the roles and responsibilities of health professionals in dealing with osteoporosis following an MTF. Responses were received from 42 participants (60.8%) with the majority of respondents agreeing that it is important to treat osteoporosis following MTF. Less than 15% of respondents felt that it was their responsibility to initiate discussion or treatment or investigation after MTF. No respondent felt that the coordination of osteoporosis care was good and 45% stated it was poor. Communication after discharge is mostly left to the hospital (30%), while 20% stated they did not follow up at all. This study shows that many rural orthopedic surgeons believe that follow-up in regard to osteoporosis after MTF is important, that responsibility for follow-up diagnosis and management of osteoporosis lies with primary health care and the current communication systems are poor.

What sort of follow-up services would Australian breast cancer survivors prefer if we could no longer offer long-term specialist-based care? A discrete choice experiment

PubMed Central

Bessen, T; Chen, G; Street, J; Eliott, J; Karnon, J; Keefe, D; Ratcliffe, J

2014-01-01

Background: Early diagnosis and improved treatment outcomes have increased breast cancer survival rates that, in turn, have led to increased numbers of women undergoing follow-up after completion of primary treatment. The current workload growth is unsustainable for breast cancer specialists who also provide care for women newly diagnosed or with a recurrence. Appropriate and acceptable follow-up care is important; yet, currently we know little about patient preferences. The aim of this study was to explore the preferences of Australian breast cancer survivors for alternative modes of delivery of follow-up services. Methods: A self-administered questionnaire (online or paper) was developed. The questionnaire contained a discrete choice experiment (DCE) designed to explore patient preferences with respect to provider, location, frequency and method of delivery of routine follow-up care in years 3, 4 and 5 after diagnosis, as well as the perceived value of ‘drop-in' clinics providing additional support. Participants were recruited throughout Australia over a 6-month period from May to October 2012. Preference scores and choice probabilities were used to rank the top 10 most preferred follow-up scenarios for respondents. Results: A total of 836 women participated in the study, of whom 722 (86.4%) completed the DCE. In the absence of specialist follow-up, the 10 most valued surveillance scenarios all included a Breast Physician as the provider of follow-up care. The most preferred scenario is a face-to-face local breast cancer follow-up clinic held every 6 months and led by a Breast Physician, where additional clinics focused on the side effects of treatment are also provided. Conclusion: Beyond the first 2 years from diagnosis, in the absence of a specialist led follow-up, women prefer to have their routine breast cancer follow-up by a Breast Physician (or a Breast Cancer Nurse) in a dedicated local breast cancer clinic, rather than with their local General Practitioner. Drop-in clinics for the management of treatment related side effects and to provide advice to both develop and maintain good health are also highly valued by breast cancer survivors. PMID:24423927

Current Issues. 1983/84 Edition.

ERIC Educational Resources Information Center

James, Bruce

Written for students participating in the Close Up government studies program, a week-long field experience in Washington, D.C., the readings in this booklet may be incorporated into social studies units on government, political science, or current events. Following an introduction to members of the Reagan Administration and the Supreme Court and…

One Year Follow-Up to Modular Cognitive Behavioral Therapy for the Treatment of Pediatric Anxiety Disorders in an Elementary School Setting

ERIC Educational Resources Information Center

Galla, Brian M.; Wood, Jeffrey J.; Chiu, Angela W.; Langer, David A.; Jacobs, Jeffrey; Ifekwunigwe, Muriel; Larkins, Clare

2012-01-01

The current study sought to evaluate the relative long-term efficacy of a modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment…

Group and Individual Treatment of Obsessive-Compulsive Disorder Using Cognitive Therapy and Exposure Plus Response Prevention: A 2-Year Follow-Up of Two Randomized Trials

ERIC Educational Resources Information Center

Whittal, Maureen L.; Robichaud, Melisa; Thordarson, Dana S.; McLean, Peter D.

2008-01-01

Relatively little is known about the long-term durability of group treatments for obsessive-compulsive disorder (OCD) and contemporary cognitive treatments. The current study investigated the 2-year follow-up results for participants who completed randomized trials of group or individual treatment and received either cognitive therapy (CT) or…

Association between an individual housing-based socioeconomic index and inconsistent self-reporting of health conditions: a prospective cohort study in the Mayo Clinic Biobank.

PubMed

Ryu, Euijung; Olson, Janet E; Juhn, Young J; Hathcock, Matthew A; Wi, Chung-Il; Cerhan, James R; Yost, Kathleen J; Takahashi, Paul Y

2018-05-14

Using surveys to collect self-reported information on health and disease is commonly used in clinical practice and epidemiological research. However, the inconsistency of self-reported information collected longitudinally in repeated surveys is not well investigated. We aimed to investigate whether a socioeconomic status based on current housing characteristics, HOUsing-based SocioEconomic Status (HOUSES) index linking current address information to real estate property data, is associated with inconsistent self-reporting. We performed a prospective cohort study using the Mayo Clinic Biobank (MCB) participants who resided in Olmsted County, Minnesota, USA, at the time of enrolment between 2009 and 2013, and were invited for a 4-year follow-up survey (n=11 717). Using repeated survey data collected at the baseline and 4 years later, the primary outcome was the inconsistency in survey results when reporting prevalent diseases, defined by reporting to have 'ever' been diagnosed with a given disease in the baseline survey but reported 'never' in the follow-up survey. Secondary outcome was the response rate for the 4-year follow-up survey. Among the MCB participants invited for the 4-year follow-up survey, 8508/11 717 (73%) responded to the survey. Forty-three per cent had at least one inconsistent self-reported disease. Lower HOUSES was associated with higher inconsistency rates, and the association remained significant after pertinent characteristics such as age and perceived general health (OR=1.46; 95% CI 1.17 to 1.84 for the lowest compared with the highest HOUSES decile). HOUSES was also associated with lower response rate for the follow-up survey (56% vs 77% for the lowest vs the highest HOUSES decile). This study demonstrates the importance of using the HOUSES index that reflects current SES when using self-reporting through repeated surveys, as the HOUSES index at baseline survey was inversely associated with inconsistent self-report and the response rate for the follow-up survey. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study.

PubMed

Rickelt, Judith; Viechtbauer, Wolfgang; Lieverse, Ritsaert; Overbeek, Thea; van Balkom, Anton J; van Oppen, Patricia; van den Heuvel, Odile A; Marcelis, Machteld; Eikelenboom, Merijn; Tibi, Lee; Schruers, Koen Rj

2016-10-01

Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD. Copyright © 2016 Elsevier B.V. All rights reserved.

Feasibility, Acceptability and Preliminary Efficacy of an Online Peer-to-Peer Social Support ART Adherence Intervention

PubMed Central

Horvath, Keith J.; Oakes, J. Michael; Rosser, B.R. Simon; Danilenko, Gene; Vezina, Heather; Amico, K. Rivet; Williams, Mark L.; Simoni, Jane

2013-01-01

This study describes the results of an online social support intervention, called “Thrive With Me” (TWM), to improve antiretroviral therapy (ART) adherence. HIV-positive gay or bisexually-identified men self-reporting imperfect ART adherence in the past month were randomized to receive usual care (n=57) or the eight-week TWM intervention (n=67). Self-reported ART outcome measures (0–100% in the past month) were collected at baseline, post-intervention, and 1-month follow-up. Follow-up assessment completion rate was 90%. Participants rated (1–7 scale) the intervention high in information and system quality and overall satisfaction (Means≥5.0). The intervention showed modest effects for the overall sample. However, among current drug-using participants, the TWM (v. Control) group reported significantly higher overall ART adherence (90.1% v. 57.5% at follow-up; difference=31.1, p=.02) and ART taken correctly with food (81.6% v. 55.7% at follow-up; difference=47.9, p=.01). The TWM intervention appeared feasible to implement, acceptable to users, and demonstrated greatest benefits for current drug users. PMID:23553347

Growth, metabolic markers, and cognition in 8-year old children born prematurely, follow-up of a randomized controlled trial with essential fatty acids.

PubMed

Henriksen, Christine; Almaas, Astrid N; Westerberg, Ane C; Drevon, Christian A; Iversen, Per O; Nakstad, Britt

2016-09-01

The study is a follow-up of a randomized, double-blinded, placebo-controlled trial of supplementation with docosahexaenoic acid (DHA) and arachidonic acid (AA) to 129 very low birth weight (VLBW; birth weight <1500 g) infants fed human milk. The main hypothesis was that supplementation would affect growth, metabolic markers, and cognitive function. The secondary aim was to describe predictors of metabolic markers and cognitive status at follow-up. Ninety-eight children met for 8-year follow-up with anthropometric measures, blood biomarkers, and cognitive testing. The intervention group had significantly lower insulin-like growth factor-1 (IGF-1) at 8 years, whereas no differences in growth or intelligence quotient (IQ) were found. For the total cohort, weight gain during first year of life was neither associated with BMI, metabolic markers, nor IQ at follow-up. Blood DHA at 8 years was positively associated with IQ. The study is the first long-term follow-up of a randomized controlled trial with essential fatty acids investigating growth, metabolic factors, and IQ. IGF-1 levels were significantly lower in the intervention group at 8 years. First-year growth was not associated with BMI, metabolic markers, or IQ at follow-up. Current DHA status was a significant predictor of higher IQ at follow-up. • Preterm children have increased risk of lower intelligence quotient (IQ), reduced growth, and abnormal metabolic status. • Early intake of docosahexaenoic acid (DHA) and arachidonic acid (AA), as well as early growth pattern, may influence both IQ and metabolic status. What is New: • Early intervention with DHA and AA led to reduced insulin-like growth factor-1 in blood at 8 years of age. • Weight gain during first year of life was neither associated with impaired metabolic markers nor improved IQ at follow-up. • Current DHA status was a significant predictor of higher IQ at 8 years, also when maternal education and birth weight were included in the model.

The Impact of Exercise, Cognitive Activities, and Socialization on Cognitive Function: Results From the National Long-Term Care Survey

PubMed Central

Jedrziewski, M. Kathryn; Ewbank, Douglas C.; Wang, Haidong; Trojanowski, John Q.

2014-01-01

Currently, there are no effective treatments for Alzheimer’s disease and related disorders and age continues to be a robust risk factor. Thus, population aging in the United States may have catastrophic results if interventions are not found and implemented. This study examines possible associations between cognitive impairment and exercise, cognitive activities, and socialization. Cognitive activities, socialization, and exercise were assessed at baseline, and cognitive function was measured at baseline, 5-year, and 10-year follow-up. Controlling for baseline cognitive function, age, sex, education, diabetes, and hypertension, linear regression was performed. Engagement in cognitive activities was inversely associated with the onset of cognitive impairment at 5-year follow-up but was no longer significant at 10-year follow-up. Exercise was associated with a lower risk of cognitive impairment at 10-year follow-up but was not significant at 5-year follow-up. Associations with socialization were not statistically significant at either follow-up. PMID:24408752

Follow-up of Temporary Implantable Nitinol Device (TIND) Implantation for the Treatment of BPH: a Systematic Review.

PubMed

Bertolo, Riccardo; Fiori, Cristian; Amparore, Daniele; Porpiglia, Francesco

2018-04-26

The purpose of the present systematic review is to offer a narrative synthesis of the available literature regarding the role of the temporary implantable nitinol device (TIND) (Medi-Tate®; Medi-Tate Ltd., Or Akiva, Israel) for the treatment of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), specifically focusing on the follow-up data. Current available evidences are limited in this topic. Sample size of patients available for analysis is small. Moreover, the duration of follow-up period is intermediate and longer follow-up is required. At the available 3 years follow-up, the TIND implantation is safe, effective, and well tolerated. The extended follow-up of the first and only available cohort of patients who underwent TIND for LUTS related to BPH corroborated previous literature findings. Further studies are required in order to assess the durability of TIND outcomes over a longer follow-up, to better define the indications of this approach, and to demonstrate the advantages of second-generation device over the first.

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

PubMed Central

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

2014-01-01

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

CHARACTERIZATION OF ENDEMIC DISEASE: HEALTH EFFECTS ASSOCIATED WITH DIFFERENCES IN SOURCE WATER QUALITY AND TREATMENT

EPA Science Inventory

A study in Canada by Payment et al. found that up to 35% of gastrointestinal illness in a community served by surface water was associated with drinking water that met current drinking water standards. A similar follow-up study by the same investigators tended to repeat the resul...

Efficacy of transcranial direct-current stimulation in women with provoked vestibulodynia.

PubMed

Morin, Annie; Léonard, Guillaume; Gougeon, Véronique; Cyr, Marie-Pierre; Waddell, Guy; Bureau, Yves-André; Girard, Isabelle; Morin, Mélanie

2017-06-01

Provoked vestibulodynia is a highly prevalent condition characterized by acute recurrent pain located at the vaginal entrance in response to pressure application or attempted vaginal penetration. Despite a wide variety of treatments offered to women with provoked vestibulodynia, a high proportion of women are refractory to conventional treatment. Transcranial direct-current stimulation is a noninvasive brain stimulation technique that has been shown effective for improving various chronic pain conditions. Growing evidence suggests that the central nervous system could play a key role in provoked vestibulodynia. Targeting the central nervous system could therefore be a promising treatment for women with provoked vestibulodynia. The purpose of this study was to evaluate and compare the efficacy of active and sham transcranial direct-current stimulation in reducing pain intensity during intercourse in patients with provoked vestibulodynia. We conducted a triple-blind, parallel-group, randomized controlled trial. Women aged 17-45 years diagnosed with provoked vestibulodynia by a gynecologist using a validated protocol were randomized to 10 sessions of either active transcranial direct-current stimulation (intensity = 2 mA) or 10 sessions of sham transcranial direct-current stimulation, over a 2-week period. Both active and sham transcranial direct-current stimulation were applied for 20 minutes, with the anode positioned over the primary motor cortex, and the cathode over the contralateral supraorbital area. Outcome measures were collected at baseline, 2 weeks after treatment, and at 3-month follow-up by an evaluator blinded to group assignment. The primary objective was to assess pain intensity during intercourse, using a numerical rating scale. Secondary outcomes focused on sexual function and distress, vestibular sensitivity, psychological distress, treatment satisfaction, and patient impression of change. Statistical analyses were conducted on the intention-to-treat basis, and treatment effects were evaluated using a mixed linear model for repeated measures. A total of 40 patients were randomly assigned to receive either active (n = 20) or sham (n = 20) transcranial direct-current stimulation treatments from November 2014 through February 2016. Baseline characteristics were similar between the active and sham transcranial direct-current stimulation groups. In full compliance with the study protocol, every participant followed all courses of the study treatment, including assessments at 2-week and 3-month follow-up. Pain during sexual intercourse was not significantly different between active and sham treatment groups 2 weeks after treatment (P = .84) and at follow-up (P = .09). Mean baseline and 2-week assessment pain intensity were, respectively, 6.8 (95% confidence interval, 5.9-7.7) and 5.6 (95% confidence interval, 4.7-6.5) for active transcranial direct-current stimulation (P = .03) vs 7.5 (95% confidence interval, 6.6-8.4) and 5.7 (95% confidence interval, 4.8-6.6) for sham transcranial direct-current stimulation (P = .001). Nonsignificant differences between the 2 groups were also found in their sexual function and distress after treatment (P > .20) and at follow-up (P > .10). Overall, at 2-week assessment 68% assigned to active transcranial direct-current stimulation reported being very much, much, or slightly improved compared to 65% assigned to sham transcranial direct-current stimulation (P = .82), and still comparable at follow-up: 42% vs 65%, respectively (P = .15). Findings suggest that active transcranial direct-current stimulation is not more effective than sham transcranial direct-current stimulation for reducing pain in women with provoked vestibulodynia. Likewise, no significant effects were found on sexual function, vestibular sensitivity, or psychological distress. Copyright © 2017 Elsevier Inc. All rights reserved.

Workplace bullying and common mental disorders: a follow-up study.

PubMed

Lahelma, Eero; Lallukka, Tea; Laaksonen, Mikko; Saastamoinen, Peppiina; Rahkonen, Ossi

2012-06-01

Workplace bullying has been associated with mental health, but longitudinal studies confirming the association are lacking. This study examined the associations of workplace bullying with subsequent common mental disorders 5-7 years later, taking account of baseline common mental disorders and several covariates. Baseline questionnaire survey data were collected in 2000-2002 among municipal employees, aged 40-60 years (n=8960; 80% women; response rate 67%). Follow-up data were collected in 2007 (response rate 83%). The final data amounted to 6830 respondents. Workplace bullying was measured at baseline using an instructed question about being bullied currently, previously or never. Common mental disorders were measured at baseline and at follow-up using the 12-item version of the General Health Questionnaire. Those scoring 3-12 were classified as having common mental disorders. Covariates included bullying in childhood, occupational and employment position, work stress, obesity and limiting longstanding illness. Logistic regression analysis was used. After adjusting for age, being currently bullied at baseline was associated with common mental disorders at follow-up among women (OR 2.34, CI 1.81 to 3.02) and men (OR 3.64, CI 2.13 to 6.24). The association for the previously bullied was weaker. Adjusting for baseline common mental disorders, the association attenuated but remained. Adjusting for further covariates did not substantially alter the studied association. CONCLUSION The study confirms that workplace bullying is likely to contribute to subsequent common mental disorders. Measures against bullying are needed at workplaces to prevent mental disorders.

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: A Follow-Up Study.

PubMed

Alabdulqader, Noof A; Shareef, Sameera Q; Ali, Jassim A; Yousef, Mohammad M; Al-Abbadi, Mousa A

2015-01-01

This is a follow-up study to our previous analysis of thyroid aspirates utilizing the Bethesda System for Reporting Thyroid Cytology (BSRTC). The same study design was utilized for 2 years comparing 2 periods. A total of 251 thyroid aspirates from 218 patients were reviewed and deemed comparable to the previous cohort. The variance and consequently the number of interpretations dropped from 26 to 11 with a statistically significant 58% reduction and more consistency. Our unsatisfactory rate dropped from 22 to 10% (reduction of 55%). The risk of malignancy in this follow-up study showed a similar trend: an increase in risk with each step up in the BSRTC categories starting from the 'nondiagnostic' and up to 'malignant'. Few of our benign cases ended up with resection. We noticed sensitivity to the word 'follicular' in this benign category; therefore we propose a modification of the current BSRTC system by omitting the word 'follicular' from the benign category. We strongly believe that this modification harbors no serious damage to the intentions of BSRTC. This follow-up study has shown that the previous awareness campaign about the implementation has worked and can be considered a valid performance improvement program. © 2015 S. Karger AG, Basel.

Cost Analysis of Following Up Incomplete Low-Risk Fetal Anatomy Ultrasounds.

PubMed

O'Brien, Karen; Shainker, Scott A; Modest, Anna M; Spiel, Melissa H; Resetkova, Nina; Shah, Neel; Hacker, Michele R

2017-03-01

To examine the clinical utility and cost of follow-up ultrasounds performed as a result of suboptimal views at the time of initial second-trimester ultrasound in a cohort of low-risk pregnant women. We conducted a retrospective cohort study of women at low risk for fetal structural anomalies who had second-trimester ultrasounds at 16 to less than 24 weeks of gestation from 2011 to 2013. We determined the probability of women having follow-up ultrasounds as a result of suboptimal views at the time of the initial second-trimester ultrasound, and calculated the probability of detecting an anomaly on follow-up ultrasound. These probabilities were used to estimate the national cost of our current ultrasound practice, and the cost to identify one fetal anomaly on follow-up ultrasound. During the study period, 1,752 women met inclusion criteria. Four fetuses (0.23% [95% CI 0.06-0.58]) were found to have anomalies at the initial ultrasound. Because of suboptimal views, 205 women (11.7%) returned for a follow-up ultrasound, and one (0.49% [95% CI 0.01-2.7]) anomaly was detected. Two women (0.11%) still had suboptimal views and returned for an additional follow-up ultrasound, with no anomalies detected. When the incidence of incomplete ultrasounds was applied to a similar low-risk national cohort, the annual cost of these follow-up scans was estimated at $85,457,160. In our cohort, the cost to detect an anomaly on follow-up ultrasound was approximately $55,000. The clinical yield of performing follow-up ultrasounds because of suboptimal views on low-risk second-trimester ultrasounds is low. Since so few fetal abnormalities were identified on follow-up scans, this added cost and patient burden may not be warranted. © 2016 Wiley Periodicals, Inc.

Effects of Medical Interventions on Gender Dysphoria and Body Image: A Follow-Up Study.

PubMed

van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; De Cuypere, Griet; Richter-Appelt, Hertha; Kreukels, Baudewijntje P C

2017-09-01

The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre)treatment factors on posttreatment outcomes. Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort). At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction. Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up.

Reconsidering the prognosis of major depressive disorder across diagnostic boundaries: full recovery is the exception rather than the rule.

PubMed

Verduijn, Judith; Verhoeven, Josine E; Milaneschi, Yuri; Schoevers, Robert A; van Hemert, Albert M; Beekman, Aartjan T F; Penninx, Brenda W J H

2017-12-12

Major depressive disorder (MDD) is often handled as an episodic and isolated disorder, resulting in an optimistic view about its prognosis. Herein, we test the idea that the prognosis of MDD changes if we vary the perspective in terms of (1) a longer time frame and (2) a broader diagnostic conceptualisation including dysthymia, (hypo)mania and anxiety disorders as relevant outcomes. Patients with current MDD at baseline (n = 903) and available 2-, 4-, and/or 6-year follow-up assessments were selected from the Netherlands Study of Depression and Anxiety, a psychiatric cohort study. Combining psychiatric DSM-IV-based diagnoses and life-chart data, patient course trajectories were classified as (1) recovered (no diagnoses at 2-year follow-up or thereafter), (2) recurrent without chronic episodes, (3) recurrent with chronic episodes or (4) consistently chronic since baseline. A chronic episode was defined as having a current diagnosis at the follow-up assessment and consistent symptoms over 2 years. Proportions of course trajectories were provided moving from a short, narrow perspective (2-year follow-up, considering only MDD diagnosis) to a long, broad perspective (6-year follow-up, including MDD, dysthymia, (hypo)mania and anxiety diagnoses). With the short, narrow perspective, the recovery rate was 58% and 21% had a chronic episode. However, in the long, broad perspective the recovery rate was reduced to 17%, while 55% of the patients experienced chronic episodes. Results from a long and rigorous follow-up in a large cohort suggests that most MDD patients have an unfavourable prognosis. Longer follow-up and broader diagnostic conceptualisation show that the majority of patients have a disabling and chronic disorder. Conceptualising and handling MDD as a narrowly defined and episodic disorder may underestimate the prognosis of the majority of depressed patients and, consequently, the type of care that is appropriate.

Loss to specialist follow-up in congenital heart disease; out of sight, out of mind

PubMed Central

Wray, Jo; Frigiola, Alessandra; Bull, Catherine

2013-01-01

Objective To evaluate the scale and clinical importance of loss to follow-up of past patients with serious congenital heart disease, using a common malformation as an example. To better understand the antecedents of loss to specialist follow-up and patients’ attitudes to returning. Design Cohort study using NHS number functionality. Content and thematic analysis of telephone interviews of subset contacted after loss to follow-up. Patients, intervention and setting Longitudinal follow-up of complete consecutive list of all 1085 UK patients with repair of tetralogy of Fallot from single institution 1964–2009. Main outcome measures Survival, freedom from late pulmonary valve replacement, loss to specialist follow-up, shortfall in late surgical revisions related to loss to follow-up. Patients’ narrative about loss to follow-up. Results 216 (24%) of patients known to be currently alive appear not to be registered with specialist clinics; some are seen in general cardiology clinics. Their median age is 32 years and median duration of loss to follow-up is 22 years; most had been lost before Adult Congenital services had been consolidated in their present form. 48% of the late deaths to date have occurred in patients not under specialist follow-up. None of those lost to specialist follow-up has had secondary pulmonary valve replacement while 188 patients under specialist care have. Patients lost to specialist follow-up who were contacted by telephone had no knowledge of its availability. Conclusions Loss to specialist follow-up, typically originating many years ago, impacts patient management. PMID:23257171

Aging and low back pain among exercise participants: a follow-up study with psychological adaptation factors.

PubMed

Wilks, Scott E; Kadivar, Zahra; Guillory, Stephen A; Isaza, Jorge

2009-01-01

This study is a follow-up to a study previously published in this journal that reported the moderating function of exercise exertion amid the relationship between age and low back pain (LBP) among consistent exercise participants. The current study analyzed factors of psychological adaptation as potential mediators within the age--LBP relationship. Measures of psychological adaptation included psychological vulnerability, avoidant coping, resilient coping, and perceived resilience. The sample reported slightly moderate psychological vulnerability; a moderate extent of avoidant coping and resilient coping; and high resilience. Age inversely correlated with psychological vulnerability and avoidance coping. LBP correlated inversely with avoidant coping. Avoidant coping positively mediated (enhanced) age's effect on LBP. Results from this follow-up analysis highlight the importance of understanding and testing psychological factors in models with age and a physical health outcome.

CHARACTERIZATION OF ENDEMIC DISEASE: HEALTH EFFECTS ASSOCIATED WITH DIFFERENCES IN SOURCE WATER QUALITY AND TREATMENT PROCESS

EPA Science Inventory

A study in Canada by Payment et al. found that up to 35% of gastrointestinal illness in a community served by surface water was associated with drinking water that met current drinking water standards. A similar follow-up study by the same investigators tended to repeat the resul...

Multiple socioeconomic determinants of weight gain: the Helsinki Health Study.

PubMed

Loman, Tina; Lallukka, Tea; Laaksonen, Mikko; Rahkonen, Ossi; Lahelma, Eero

2013-03-22

Socioeconomic differences in weight gain have been found, but several socioeconomic determinants have not been simultaneously studied using a longitudinal design. The aim of this study was to examine multiple socioeconomic determinants of weight gain. Mail surveys were conducted in 2000-2002 among 40 to 60-year old employees of the City of Helsinki, Finland (n = 8,960, response rate 67%). A follow-up survey was conducted among the baseline respondents in 2007 with a mean follow-up of 5 to 7 years (n = 7,332, response rate 83%). The outcome measure was weight gain of 5 kg or more over the follow-up. Socioeconomic position was measured by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Multivariable logistic regression models were fitted adjusting simultaneously for all covariates in the final model. Of women 27% and of men 24% gained 5 kg or more in weight over the follow-up. Among women, after adjusting for age, baseline weight and all socioeconomic determinants, those with basic (OR 1.40 95% CI 1.11-1.76) or intermediate education (OR 1.43 95% CI 1.08-1.90), renters (OR 1.18 95% CI 1.03-1.36) and those with occasional (OR 1.19 95% CI 1.03-1.38) or frequent (OR 1.50 95% CI 1.26-1.79) economic difficulties had increased risk of weight gain. Among men, after full adjustment, having current frequent economic difficulties (OR 1.70 95% CI 1.15-2.49) remained associated with weight gain. Current economic difficulties among both women and men, and among women low education and renting, were associated with weight gain. Prevention of weight gain among ageing people would benefit from focusing in particular on those with economic difficulties.

Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

ERIC Educational Resources Information Center

Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.; Trentacosta, Christopher J.

2013-01-01

In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or…

The Stability of Comorbid Psychiatric Disorders: A 7 Year Follow Up of Children with Pervasive Developmental Disorder--Not Otherwise Specified

ERIC Educational Resources Information Center

Verheij, C.; Louwerse, A.; van der Ende, J.; Eussen, M. L. J. M.; Van Gool, A. R.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

2015-01-01

The current study was a 7-year follow-up of 74 6-12 year old children with Pervasive Developmental Disorder-Not Otherwise Specified. We examined the rates and 7 year stability of comorbid psychiatric diagnoses as ascertained with the Diagnostic Interview Schedule for Children: Parent version at ages 6-12 and again at ages 12-20. Also, we examined…

Review of 1953-2003 ORAU Follow-Up Studies on Science Education Programs: Impacts on Participants' Education and Careers

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

Oak Ridge Associated Universities

2006-06-01

Through sponsorship of science education programs for undergraduates and graduates, such as research participation programs and fellowships, the Department of Energy (DOE) encouraged the development of adequate numbers of qualified science and engineering (S&E) personnel to meet its current and future research and development (R&D) needs. This retrospective study summarizes impacts of selected programs on these participants. The summary data are from follow-up studies conducted from 1953 through 2003 by Oak Ridge Associated Universities and its predecessor, the Oak Ridge Institute for Nuclear Studies (ORINS).

The Mediating Role of Autonomy and Relatedness on Maternal and Child Outcomes.

PubMed

Guo, Xiamei; Slesnick, Natasha

2018-02-01

The current study examined the mediating role of both mother and child interactive behaviors, which granted or undermined autonomy and relatedness, on the bidirectional and longitudinal association between maternal depressive symptoms and child internalizing behaviors, as well as the association between maternal substance use and child externalizing behaviors. Child's sex and mother's drug of choice were explored as potential moderators of the mediation relationship. Data were collected from 183 dyads including treatment-seeking substance using mothers and their children (95 males, aged between 8 and 16 years old). Structural equation modeling analysis showed girls' internalizing and externalizing behaviors at the 3-month follow-up were negatively associated with the same behaviors at the 12-month follow-up through increased relatedness undermining behaviors from their mothers at the 6-month follow-up. Among mothers with opioids as their drug of choice (DOC), children's externalizing behaviors at the 3-month follow-up were positively associated with mothers' substance use at the 12-month follow-up through the elevated levels of mothers' relatedness undermining behaviors at the 6-month follow-up. Among mothers with alcohol as their DOC, maternal depressive symptoms at the 3-month follow-up were positively related to children's internalizing behaviors at the 12-month follow-up through reduced relatedness undermining behaviors exhibited by mothers at the 6-month follow-up. To our knowledge, this is one of the first studies to attempt to unravel these longitudinal and bidirectional influences as well as the moderated mediation pathways among families with a substance using mothers.

Hydrophobic Interaction Chromatography for Bottom-Up Proteomics Analysis of Single Proteins and Protein Complexes.

PubMed

Rackiewicz, Michal; Große-Hovest, Ludger; Alpert, Andrew J; Zarei, Mostafa; Dengjel, Jörn

2017-06-02

Hydrophobic interaction chromatography (HIC) is a robust standard analytical method to purify proteins while preserving their biological activity. It is widely used to study post-translational modifications of proteins and drug-protein interactions. In the current manuscript we employed HIC to separate proteins, followed by bottom-up LC-MS/MS experiments. We used this approach to fractionate antibody species followed by comprehensive peptide mapping as well as to study protein complexes in human cells. HIC-reversed-phase chromatography (RPC)-mass spectrometry (MS) is a powerful alternative to fractionate proteins for bottom-up proteomics experiments making use of their distinct hydrophobic properties.

Inattentiveness, parental smoking and adolescent smoking initiation.

PubMed

Barman, Satu K; Pulkkinen, Lea; Kaprio, Jaakko; Rose, Richard J

2004-08-01

To examine how adolescents' inattentive behaviour, together with parental smoking patterns, predicts smoking initiation by age 14. DESIGN, SETTINGS: A prospective, longitudinal study: baseline at ages 11-12, follow-up at age 14. A population-based sample of Finnish twins, born 1983-1987, with parents and classroom teachers as additional informants. Two groups were formed, allocating the co-twins of each family into separate groups: the study sample and a replication sample. Twin individuals (n = 4552), aged 11-12 at baseline and 14 (average 14.04 years) at follow-up. At baseline, inattentiveness was assessed with the Multidimensional Peer Nomination Inventory (MPNI, Teacher Form) and parental smoking with individual questionnaires completed by each twins' parents; at the age 14 follow-up, adolescent smoking was assessed with a self-report questionnaire. At age 14, 57% reported never having smoked, 34% had experimented with cigarettes and 9% were current smokers. Inattentiveness and parental smoking additively predicted both experimental and current smoking in adolescence. The effects were independent of each other. The risk related to inattentiveness itself is high, but in combination with the effects of parental smoking, the probability of current smoking can rise as high as 38%, compared with 5% without these two risk factors. For prevention purposes, parental commitment to non-smoking should be emphasized.

THE EFFECT OF GAMBLING ACTIVITIES ON HAPPINESS LEVELS OF NURSING HOME RESIDENTS

PubMed Central

Dixon, Mark R; Nastally, Becky L; Waterman, Amber

2010-01-01

The current study evaluated the effect of participating in simulated gambling activities on happiness levels of 3 nursing home residents. A 4-component analysis was used to measure objective responses associated with happiness during baseline, varying durations of engagement in simulated gambling activities, and 2 follow-up periods. Results indicated that all residents exhibited a higher percentage of happiness levels while engaged in simulated gambling activities compared with baseline. Follow-up assessment took place 10 min and 30 min following the intervention; no lasting effects were observed. PMID:21358915

Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

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

Abbott, B. P.

This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

DOE PAGES

Abbott, B. P.

2016-07-20

This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing.

PubMed

North, Carol S; Pfefferbaum, Betty; Tivis, Laura; Kawasaki, Aya; Reddy, Chandrashekar; Spitznagel, Edward L

2004-01-01

The course of posttraumatic stress disorder (PTSD) in populations directly exposed to terrorist attacks is of major importance in the post-9/11 era. Because no systematic diagnostic studies of the most highly exposed individuals of the 9/11 terrorist attacks have yet been done, the Oklahoma City bombing remains a unique opportunity to examine PTSD over time in high-exposure terrorist victims. This study assessed 137 survivors in the direct path of the explosion at approximately 6 and 17 months postdisaster, using the Diagnostic Interview Schedule. Combined index and follow-up data yielded a higher (41%) incidence of PTSD than detected at index (32%) or follow-up (31%). All PTSD was chronic (89% unremitted at 17 months) with no delayed-onset cases. The avoidance and numbing symptom group C, unlike groups B and D alone, was pivotal to current PTSD status and was associated with indicators of functioning at index and follow-up. The findings at index were sustainable. This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning.

Smoking Status and Incidence of Cancer After Myocardial Infarction: A Follow-Up Study of over 20 Years.

PubMed

Lotan, Katrin; Goldbourt, Uri; Gerber, Yariv

2017-09-01

We evaluated long-term incidence of cancer after myocardial infarction among current, former, and never smokers, and assessed whether reducing cigarette consumption is associated with decreased cancer risk. Consecutive patients aged ≤65 years discharged from 8 hospitals in central Israel after first myocardial infarction in 1992-1993 were followed for cancer and death. Extensive data including smoking habits were obtained at the index hospitalization and 4 time points during follow-up. Survival methods were applied to assess the hazard ratios (HRs) for cancer associated with smoking categories. Included in the study were 1486 cancer-free participants (mean age, 54 years; 81% men), among whom 787 were current smokers at baseline (average daily cigarette consumption = 29). Smokers were younger than nonsmokers and more likely to be male and of lower socioeconomic status. Over a median follow-up of 21.4 years, 273 (18.4%) patients developed cancer. Baseline smoking was associated with a ∼40% excess adjusted risk of cancer; ∼25% after accounting for death as a competing event. Considering changes in smoking during follow-up, the excess risk was confined to persistent smokers (adjusted HR 1.75; 95% confidence interval [CI], 1.22-2.50), whereas post- (HR 1.14; 95% CI, 0.80-1.62) and pre-myocardial infarction quitters (HR 1.02; 95% CI, 0.71-1.47) were comparable with never smokers. Among persistent smokers, each reduction of 10 cigarettes relative to pre-myocardial infarction consumption was associated with a ∼10% reduced adjusted risk. Among young survivors of first myocardial infarction followed-up longitudinally, smoking cessation is associated with lower risk of cancer. Reducing consumption among smokers may also be beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

Seropersistence of TBE virus antibodies 10 years after first booster vaccination and response to a second booster vaccination with FSME-IMMUN 0.5mL in adults.

PubMed

Konior, R; Brzostek, J; Poellabauer, E M; Jiang, Q; Harper, L; Erber, W

2017-06-16

Tick-borne encephalitis (TBE) is a viral disease that can have a severe acute clinical course and considerable long-term morbidity. As there is no causal treatment currently available for TBE, vaccination is the only way to combat the disease in endemic areas. The studies presented here were conducted to obtain prospective long-term TBE serum antibody persistence data of subjects up to 10years after the first booster with FSME-IMMUN. This report presents the results of 2 follow-up studies in the same study population of 315 healthy adults. Blood was drawn to assess the seropersistence of TBE virus antibodies yearly, from 2-5 and 7-10years after the first booster vaccination with FSME-IMMUN administered during a previous study. The timing of the second booster vaccination was dependent on the level of serum TBE antibodies observed during yearly follow-up serology observations. The current follow up showed that adult recipients were 84.9% seropositive 10years after a 3 dose primary series and the first booster vaccination of FSME-IMMUN. Seropositivity rates were even higher (88.6%) in subjects below 50years of age. ClinicalTrials.gov Identifier: NCT00503529. ClinicalTrials.gov Identifier: NCT01582698. Copyright © 2017. Published by Elsevier Ltd.

Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers.

PubMed

Pompe, E; Bartstra, J; Verhaar, H J; de Koning, H J; van der Aalst, C M; Oudkerk, M; Vliegenthart, R; Lammers, J-W J; de Jong, P A; Mohamed Hoesein, F A A

2017-04-01

Cigarette smoking negatively affects bone quality and increases fracture risk. Little is known on the effect of smoking cessation and computed tomography (CT)-derived bone mineral density (BMD) decline in the spine. We evaluated the association of current and former smoking with BMD decline after 3-year follow-up. Male current and former smokers participating in a lung cancer screening trial who underwent baseline and 3-year follow-up CT were included. BMD was measured by manual placement of a region of interest in the first lumbar vertebra and expressed in Hounsfield Unit (HU). Multiple linear regression analysis was used to evaluate the association between pack years smoked and smoking status with BMD decline. 408 participants were included with median (25th-75th percentile) age of 59.4 (55.9-63.5) years. At the start of the study, 197 (48.3%) participants were current smokers and 211 (51.7%) were former smokers and had a similar amount of pack years. Current smokers had quit smoking for 6 (4-8) years prior to inclusion. There was no difference in BMD between current and former smokers at baseline (109±34 HU vs. 108±32 HU, p=0.96). At 3-year follow-up, current smokers had a mean BMD decline of -3±13 HU (p=0.001), while BMD in former smokers did not change as compared to baseline (1±13 HU, p=0.34). After adjustment for BMD at baseline and body mass index, current smoking was independently associated with BMD decline (-3.8 HU, p=0.003). Age, pack years, and the presence of a fracture at baseline did not associate with BMD decline. Current smokers showed a more rapid BMD decline over a 3-year period compared to former smokers. This information might be important to identify subjects at risk for osteoporosis and emphasizes the importance of smoking cessation in light of BMD decline. Copyright © 2017 Elsevier B.V. All rights reserved.

Tesamorelin Therapy to Enhance Axonal Regeneration, Minimize Muscle Atrophy and Improve Functional Outcomes Following Peripheral Nerve Injury and Repair

DTIC Science & Technology

2017-10-01

Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We are currently completing the set-up phase for this study . We have hired and trained all...Hospital and University of Maryland Medical Center/Shock Trauma). The final step with regards to study set up prior to beginning recruitment will be...to receive HRPO approval. 15. SUBJECT TERMS IRB, FDA IND exemption, HRPO, study set-up phase 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF

Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature.

PubMed

Meregaglia, Michela; Cairns, John

2015-01-01

The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

A Prospective Cohort Study of Outpatient Interdisciplinary Rehabilitation of Chronic Headache Patients.

PubMed

Krause, Steven J; Stillman, Mark J; Tepper, Deborah E; Zajac, Deborah

2017-03-01

To evaluate the efficacy of an intensive outpatient program designed to improve functioning and reduce psychological impairment in chronic headache patients. Chronic headaches, occurring 15 or more days per month, for three or more months, may arise from multiple International Classification of Headache Disorders diagnoses: Chronic Migraine, Chronic Tension Type Headache, New Daily Persistent Headache, Chronic Post Traumatic Headaches, and Medication Overuse Headache. Several interdisciplinary programs that treat patients with chronic headaches have reported decreases in headache frequency. This study sought to evaluate the effect of a 3 week interdisciplinary treatment program for patients with chronic headache disorders on headache severity, functional status, and psychological impairment. Subjects were 379 patients admitted to an outpatient chronic headache treatment program. Assessments of headache severity, psychological status, and functional impairment were completed by 371 (97.8%) of these at the time of admission. At discharge, 340 subjects (89.7%) provided assessment data, and 152 (40.1%) provided data at 1-year follow-up. Subjects' mean ratings on a 0-10 scale for their headache pain in the prior week declined, and these improvements were maintained at follow-up. (Estimated marginal means on a 0-10 scale for Average pain: admission 6.1, discharge 3.5, follow-up 3.3; for Least pain: admission 3.2; discharge 1.5; follow-up 1.3; for Worst pain: admission 8.2; discharge 6.4; follow-up 5.7), and similar results were found for current pain (admission 4.7; discharge 2.8; follow-up 2.4): Measures of functional impairment also improved following treatment, and these gains were maintained at 12 month follow up (Estimated marginal mean Headache Impact Test-6 score: admission 66.1, discharge 55.4, follow-up 51.9; Estimated marginal mean Pain Disability Index score: admission 36.2, discharge 14.1, follow-up 11.6). As measured by the Depression, Anxiety and Stress Scale, anxiety and reactivity to stress decreased following treatment, and remained improved at follow-up (Estimated marginal mean score for Anxiety: admission 8.7, discharge 5.2, follow-up 4.4; Estimated marginal mean score for stress: admission 14.9, discharge 7.2, follow-up 7.6). Depression decreased with treatment, but while 1-year follow-up depression scores remained significantly lower than at admission, they were also significantly higher than at discharge (Estimated marginal means: admission 13.3, discharge 4.1, follow-up 6.6). The study supports the efficacy of the treatment model. Limitations of the study and suggestions for future research are also discussed. © 2017 American Headache Society.

The long-term impact of post traumatic stress disorder on recovery from heroin dependence.

PubMed

Mills, Katherine L; Marel, Christina; Darke, Shane; Ross, Joanne; Slade, Tim; Teesson, Maree

2018-06-01

The high prevalence of post traumatic stress disorder (PTSD) among people with heroin dependence and its impact on short term outcomes has been well established. The impact of PTSD on long-term recovery is, however, unknown. This paper examines the impact of current and lifetime PTSD on long-term recovery from heroin dependence among participants who took part in the 11-year follow-up of the Australian Treatment Outcome Study (ATOS), a prospective naturalistic longitudinal study of 615 people with heroin dependence recruited from Sydney, Australia, in 2001-2002. Seventy-one percent of the cohort (n = 431) were re-interviewed 11-years post study entry. Outcomes examined included heroin and other drug use, dependence, general physical and mental health, depression, PTSD, employment, and the incidence of trauma exposure, overdose, imprisonment, and attempted suicide over the 11- year follow-up. Despite having a poorer profile at baseline, individuals with current PTSD or a history of PTSD at baseline demonstrated similar levels of improvement to those without a history of PTSD in all outcome domains across the 11-year follow-up, PTSD was associated with consistently higher levels of major depression, and attempted suicide, subsequent trauma exposure, and poorer occupational functioning across the 11-year follow-up. These findings highlight the importance of interventions aimed at occupational rehabilitation, reducing the likelihood of retraumatisation, and addressing PTSD and associated comorbidities among people with heroin dependence. Copyright © 2018 Elsevier Inc. All rights reserved.

Five year follow-up after a first booster vaccination against tick-borne encephalitis following different primary vaccination schedules demonstrates long-term antibody persistence and safety.

PubMed

Beran, Jiří; Xie, Fang; Zent, Olaf

2014-07-23

Long-term vaccination programs are recommended for individuals living in regions endemic for tick-borne encephalitis (TBE). Current recommendations suggest a first booster vaccine be administered 3 years after a conventional regimen or 12-18 months after a rapid regimen. However, the research supporting subsequent booster intervals is limited. The aim of this study was thus to evaluate the long-term persistence of TBE antibodies in adults and adolescents after a first booster dose with Encepur(®). A total of 323 subjects aged 15 years and over, who had received one of four different primary TBE vaccination series in a parent study, participated in this follow-up Phase IV trial. Immunogenicity and safety were assessed for up to five years after a first booster dose, which was administered three years after completion of the primary series. One subset of subjects was excluded from the booster vaccination since they had already received their booster prior to enrollment. For comparison, immune responses were still recorded for these subjects on Day 0 and on an annual basis until Year 5, but safety information was not collected. Following a booster vaccination, high antibody titers were recorded in all groups throughout the study. Neutralization test (NT) titers of ≥ 10 were noted in at least 94% of subjects at every time point post-booster (on Day 21 and through Years 1-5). These results demonstrated that a first booster vaccination following any primary immunization schedule results in high and long-lasting (>5 years) immune responses. These data lend support to the current belief that subsequent TBE booster intervals could be extended from the current recommendation. NCT00387634. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of Medical Interventions on Gender Dysphoria and Body Image: A Follow-Up Study

PubMed Central

van de Grift, Tim C.; Elaut, Els; Cerwenka, Susanne C.; Cohen-Kettenis, Peggy T.; De Cuypere, Griet; Richter-Appelt, Hertha; Kreukels, Baudewijntje P.C.

2017-01-01

ABSTRACT Objective The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre)treatment factors on posttreatment outcomes. Methods Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort). Results At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction. Conclusions Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up. PMID:28319558

Hypnotherapy for persistent genital arousal disorder: a case study.

PubMed

Elkins, Gary R; Ramsey, Derek; Yu, Yimin

2014-01-01

Persistent genital arousal disorder (PGAD) is characterized by intrusive sexual arousal that is unresolvable via sexual activity and persists for an extended period of time. PGAD's etiology is unknown, and it has no established treatments. This case study reports on a 71-year-old female patient diagnosed with PGAD who received 9 sessions of hypnotherapy. The following measures were administered at baseline and follow-up: Hospital Anxiety and Depression Scale, Center for Epidemiologic Studies Depression Scale, Pittsburgh Sleep Quality Index, and visual analogue measurements of quality of life, intensity of symptoms, and marital interference. At follow-up, there were significant improvements in all measures. Given the currently limited alternatives for treatment, this case study suggests that hypnotherapy may be beneficial for some patients with PGAD.

Newborn follow-up after discharge from a tertiary care hospital in the Western Cape region of South Africa: a prospective observational cohort study.

PubMed

Milambo, Jean Paul Muambangu; Cho, KaWing; Okwundu, Charles; Olowoyeye, Abiola; Ndayisaba, Leonidas; Chand, Sanjay; Corden, Mark H

2018-01-01

Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section. Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment. We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up. Mother-newborn dyads at Tygerberg Hospital in Cape Town, South Africa were enrolled from November 2014 to April 2015. Demographic data were obtained via questionnaire and medical records. Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit, and if not, the barriers to follow-up. Factors associated with follow-up were analyzed using logistic regression. Of 972 newborns, 794 (82%) were seen at a clinic for a follow-up visit within one week of discharge. Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up. The follow-up rate did not differ based on hospital length of stay. Main reported barriers to follow-up included maternal illness, lack of money for transportation, and mother felt follow-up was unnecessary because newborn was healthy. Nearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge, in keeping with local practice guidelines. Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.

Investigation of the effect of conservative interventions in thumb carpometacarpal osteoarthritis: systematic review and meta-analysis.

PubMed

Bertozzi, Lucia; Valdes, Kristin; Vanti, Carla; Negrini, Stefano; Pillastrini, Paolo; Villafañe, Jorge Hugo

2015-01-01

The purpose of this study was to conduct a current review of randomized controlled trials regarding the effect of conservative interventions on pain and function in people with thumb carpometacarpal (CMC) osteoarthritis (OA), perform a meta-analysis of the findings and summarize current knowledge. Data were obtained from MEDLINE, CINAHL, Embase, PEDro and CENTRAL databases from their inception to May 2014. Reference lists of relevant literature reviews were also searched. All published randomized trials without restrictions to time of publication or language were considered for inclusion. Study subjects were symptomatic adults with thumb CMC OA. Two reviewers independently selected studies, conducted quality assessment and extracted results. Data were pooled in a meta-analysis, when possible, using a random-effects model. Quality of the body evidence was assessed using GRADE approach. Sixteen RCTs involving 1145 participants met the inclusion criteria. Twelve were of high quality (PEDro score > 6). We found moderate quality evidence that manual therapy and therapeutic exercise combined with manual therapy improve pain in thumb CMC OA at short- and intermediate-term follow-up, and from low to moderate quality evidences that magneto therapy improves pain and function at short-term follow-up. Orthoses (splints) were found to improve function at long-term follow-up and pinch strength at short-term follow-up. Finally, we found from very low to low-quality evidence that other conservative interventions provide no significant improvement in pain and in function at short- and long-term follow-up. Some of the commonly performed conservative interventions performed in therapy have evidence to support their use to improve hand function and decrease hand pain. Additional research is required to determine the efficacy of other therapeutic interventions that are performed with patients with thumb CMC OA. Manual therapy and exercise are an effective means of improving pain and function at short-term follow-up by patients with thumb CMC OA. Magneto therapy, manual therapy, manual therapy and exercise and Orthoses (splints) were found to have clinically significant results. Very few of the included studies showed a clinically significant effect size in favor of treatment.

A comprehensive postpartum follow-up health care program for women with history of preeclampsia: protocol for a mixed methods research.

PubMed

Kamravamanesh, Mastaneh; Kohan, Shahnaz; Rezavand, Negin; Farajzadegan, Ziba

2018-05-18

Long-term postpartum follow-up is of great importance since women with preeclampsia history are at high risk of upcoming health complications. However, postpartum follow-up rates are poor. According to evidences, preeclampsia is not just a transient health problem; rather it causes short term and long term complications, which affect women's life for years after delivery. Although it seems the problem is solved by the end of pregnancy, the follow-up of subjects should not be stopped after delivery. Postpartum is the best possible time to provide necessary care to these women who are at the risk of future complications. Due to importance of well-designed follow-up plan for women suffering preeclampsia, this study will carry out to provide a postpartum follow-up health care program for subjected women. This study is a qualitative-quantitative mixed sequencing exploratory study that consists of three consecutive phases. In this study, following a qualitative approach, the researcher will explain the needs and strategies related to promoting the health of women with preeclampsia history in the postpartum period. By entering the second phase, the researcher will design a comprehensive follow-up health care program in the postpartum period in which, in addition to using the qualitative study results, related papers and texts will be also used. The proposed program is designed by a panel of experts based on prioritization guidelines. Finally, after passing different stages of program finalizing, its effectiveness on the lifestyle of women with preeclampsia history will be investigated in a semi-experimental study in the third phase of the study. It is expected conducting a mixed method study to design and execute an interventional program to follow up women with preeclampsia history improve their health status and well-being, while reducing their health care costs through prevention in various levels within the current structure of health care services. If this program is effective, it could be included in the postpartum health care guidelines. IRCT20170927036445N2 Registered 10 March 2018.

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

PubMed

Gillespie, Paddy; O'Shea, Eamon; O'Hara, Mary Clare; Dinneen, Sean F

2014-06-14

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

Growth rate and malignant potential of small gallbladder polyps--systematic review of evidence.

PubMed

Wiles, Rebecca; Varadpande, Mandar; Muly, Sudha; Webb, Jolanta

2014-08-01

The overall aim of this systematic review was to determine whether ultrasound (US) follow up for gallbladder polyps (GBPs) measuring less than 10 mms is necessary. A search was performed in MEDLINE and EMBASE between January 1976 and January 2012 using keywords: gallbladder, polyps, neoplasm, cancer, tumour, carcinoma, malignant, adenoma. Included were studies involving adult patients, examined with transabdominal US at least twice. The outcomes of included studies were gallbladder polyp growth as demonstrated on US over time, followed where available by histological examination of cholecystectomy specimens. Ten studies met the inclusion criteria for the review. Altogether 1958 subjects with mean age between 41.5 and 59 years were followed up with US. The percentage of GBPs which showed growth over the follow up period ranged from 1% to 23%. 43 neoplastic polyps were found in total irrespective of size, 20 of which were malignant and at least 7 of those were >10 mms. At least 7 malignancies were present in polyps <10 mms but it was unknown if they had undergone growth on follow up. Level II-2 and below evidence on rate of growth of small GBPs <10 mms exists in the literature. It indicates that growth does occur in a significant minority of small GBPs, but it is slow. Due to deficient reporting and small numbers of cases, the correlation between growth of GBP and development of malignancy cannot be established using currently available evidence. Malignancy can be present in polyps <10 mms although it is significantly more frequent in polyps >10 mms. Cholecystectomy for symptomatic GBPs irrespective of their size, alongside the current practice for removal of gall bladders containing asymptomatic polyps >10 mms, is proposed. No evidence based US follow up schedule can be recommended at present for asymptomatic polyps <10 mms, and in its absence an intuitive follow up with US is likely to continue. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Associations Between Initial Water Pipe Tobacco Smoking and Snus Use and Subsequent Cigarette Smoking Results From a Longitudinal Study of US Adolescents and Young Adults

PubMed Central

Soneji, Samir; Sargent, James D.; Tanski, Susanne E.; Primack, Brian A.

2015-01-01

IMPORTANCE Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. OBJECTIVE To assess whether prior water pipe tobacco smoking and snus use among never smokers are risk factors for subsequent cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS We conducted a 2-wave national longitudinal study in the United States among 2541 individuals aged 15 to 23 years old. At baseline (October 25, 2010, through June 11, 2011), we ascertained whether respondents had smoked cigarettes, smoked water pipe tobacco, or used snus. At the 2-year follow-up (October 27, 2012, through March 31, 2013), we determined whether baseline non–cigarette smokers had subsequently tried cigarette smoking, were current (past 30 days) cigarette smokers, or were high-intensity cigarette smokers. We fit multivariable logistic regression models among baseline non–cigarette smokers to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with subsequent cigarette smoking initiation and current cigarette smoking, accounting for established sociodemographic and behavioral risk factors. We fit similarly specified multivariable ordinal logistic regression models to assess whether baseline water pipe tobacco smoking and baseline snus use were associated with high-intensity cigarette smoking at follow-up. EXPOSURES Water pipe tobacco smoking and the use of snus at baseline. MAIN OUTCOMES AND MEASURES Among baseline non–cigarette smokers, cigarette smoking initiation, current (past 30 days) cigarette smoking at follow-up, and the intensity of cigarette smoking at follow-up. RESULTS Among 1596 respondents, 1048 had never smoked cigarettes at baseline, of whom 71 had smoked water pipe tobacco and 20 had used snus at baseline. At follow-up, accounting for behavioral and sociodemographic risk factors, baseline water pipe tobacco smoking and snus use were independently associated with cigarette smoking initiation (adjusted odds ratios: 2.56; 95% CI, 1.46-4.47 and 3.73; 95% CI, 1.43-9.76, respectively), current cigarette smoking (adjusted odds ratios: 2.48; 95% CI, 1.01-6.06 and 6.19; 95% CI, 1.86-20.56, respectively), and higher intensity of cigarette smoking (adjusted proportional odds ratios: 2.55; 95% CI, 1.48-4.38 and 4.45; 95% CI, 1.75-11.27, respectively). CONCLUSIONS AND RELEVANCE Water pipe tobacco smoking and the use of snus independently predicted the onset of cigarette smoking and current cigarette smoking at follow-up. Comprehensive Food and Drug Administration regulation of these tobacco products may limit their appeal to youth and curb the onset of cigarette smoking. PMID:25485959

SUPPLEMENT: “LOCALIZATION AND BROADBAND FOLLOW-UP OF THE GRAVITATIONAL-WAVE TRANSIENT GW150914” (2016, ApJL, 826, L13)

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

Abbott, B. P.; Abbott, R.; Abernathy, M. R.

This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

Supplement: “Localization and Broadband Follow-up of the Gravitational-wave Transient GW150914” (2016, ApJL, 826, L13)

NASA Astrophysics Data System (ADS)

Abbott, B. P.; Abbott, R.; Abbott, T. D.; Abernathy, M. R.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V. B.; Affeldt, C.; Agathos, M.; Agatsuma, K.; Aggarwal, N.; Aguiar, O. D.; Aiello, L.; Ain, A.; Ajith, P.; Allen, B.; Allocca, A.; Altin, P. A.; Anderson, S. B.; Anderson, W. G.; Arai, K.; Araya, M. C.; Arceneaux, C. C.; Areeda, J. S.; Arnaud, N.; Arun, K. G.; Ascenzi, S.; Ashton, G.; Ast, M.; Aston, S. M.; Astone, P.; Aufmuth, P.; Aulbert, C.; Babak, S.; Bacon, P.; Bader, M. K. M.; Baker, P. T.; Baldaccini, F.; Ballardin, G.; Ballmer, S. W.; Barayoga, J. C.; Barclay, S. E.; Barish, B. C.; Barker, D.; Barone, F.; Barr, B.; Barsotti, L.; Barsuglia, M.; Barta, D.; Barthelmy, S.; Bartlett, J.; Bartos, I.; Bassiri, R.; Basti, A.; Batch, J. C.; Baune, C.; Bavigadda, V.; Bazzan, M.; Behnke, B.; Bejger, M.; Bell, A. S.; Bell, C. J.; Berger, B. K.; Bergman, J.; Bergmann, G.; Berry, C. P. L.; Bersanetti, D.; Bertolini, A.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Birch, J.; Birney, R.; Biscans, S.; Bisht, A.; Bitossi, M.; Biwer, C.; Bizouard, M. A.; Blackburn, J. K.; Blair, C. D.; Blair, D. G.; Blair, R. M.; Bloemen, S.; Bock, O.; Bodiya, T. P.; Boer, M.; Bogaert, G.; Bogan, C.; Bohe, A.; Bojtos, P.; Bond, C.; Bondu, F.; Bonnand, R.; Boom, B. A.; Bork, R.; Boschi, V.; Bose, S.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Brady, P. R.; Braginsky, V. B.; Branchesi, M.; Brau, J. E.; Briant, T.; Brillet, A.; Brinkmann, M.; Brisson, V.; Brockill, P.; Brooks, A. F.; Brown, D. A.; Brown, D. D.; Brown, N. M.; Buchanan, C. C.; Buikema, A.; Bulik, T.; Bulten, H. J.; Buonanno, A.; Buskulic, D.; Buy, C.; Byer, R. L.; Cadonati, L.; Cagnoli, G.; Cahillane, C.; Bustillo, J. C.; Callister, T.; Calloni, E.; Camp, J. B.; Cannon, K. C.; Cao, J.; Capano, C. D.; Capocasa, E.; Carbognani, F.; Caride, S.; Diaz, J. C.; Casentini, C.; Caudill, S.; Cavagliá, M.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cepeda, C. B.; Baiardi, L. C.; Cerretani, G.; Cesarini, E.; Chakraborty, R.; Chalermsongsak, T.; Chamberlin, S. J.; Chan, M.; Chao, S.; Charlton, P.; Chassande-Mottin, E.; Chen, H. Y.; Chen, Y.; Cheng, C.; Chincarini, A.; Chiummo, A.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chua, S.; Chung, S.; Ciani, G.; Clara, F.; Clark, J. A.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Collette, C. G.; Cominsky, L.; Constancio, M., Jr.; Conte, A.; Conti, L.; Cook, D.; Corbitt, T. R.; Cornish, N.; Corsi, A.; Cortese, S.; Costa, C. A.; Coughlin, M. W.; Coughlin, S. B.; Coulon, J.-P.; Countryman, S. T.; Couvares, P.; Cowan, E. E.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Craig, K.; Creighton, J. D. E.; Cripe, J.; Crowder, S. G.; Cumming, A.; Cunningham, L.; Cuoco, E.; Dal Canton, T.; Danilishin, S. L.; D'Antonio, S.; Danzmann, K.; Darman, N. S.; Dattilo, V.; Dave, I.; Daveloza, H. P.; Davier, M.; Davies, G. S.; Daw, E. J.; Day, R.; DeBra, D.; Debreczeni, G.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Denker, T.; Dent, T.; Dereli, H.; Dergachev, V.; DeRosa, R. T.; De Rosa, R.; DeSalvo, R.; Dhurandhar, S.; Díaz, M. C.; Di Fiore, L.; Di Giovanni, M.; Di Lieto, A.; Di Pace, S.; Di Palma, I.; Di Virgilio, A.; Dojcinoski, G.; Dolique, V.; Donovan, F.; Dooley, K. L.; Doravari, S.; Douglas, R.; Downes, T. P.; Drago, M.; Drever, R. W. P.; Driggers, J. C.; Du, Z.; Ducrot, M.; Dwyer, S. E.; Edo, T. B.; Edwards, M. C.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J.; Eikenberry, S. S.; Engels, W.; Essick, R. C.; Etzel, T.; Evans, M.; Evans, T. M.; Everett, R.; Factourovich, M.; Fafone, V.; Fair, H.; Fairhurst, S.; Fan, X.; Fang, Q.; Farinon, S.; Farr, B.; Farr, W. M.; Favata, M.; Fays, M.; Fehrmann, H.; Fejer, M. M.; Ferrante, I.; Ferreira, E. C.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Fiorucci, D.; Fisher, R. P.; Flaminio, R.; Fletcher, M.; Fournier, J.-D.; Franco, S.; Frasca, S.; Frasconi, F.; Frei, Z.; Freise, A.; Frey, R.; Frey, V.; Fricke, T. T.; Fritschel, P.; Frolov, V. V.; Fulda, P.; Fyffe, M.; Gabbard, H. A. G.; Gair, J. R.; Gammaitoni, L.; Gaonkar, S. G.; Garufi, F.; Gatto, A.; Gaur, G.; Gehrels, N.; Gemme, G.; Gendre, B.; Genin, E.; Gennai, A.; George, J.; Gergely, L.; Germain, V.; Ghosh, A.; Ghosh, S.; Giaime, J. A.; Giardina, K. D.; Giazotto, A.; Gill, K.; Glaefke, A.; Goetz, E.; Goetz, R.; Gondan, L.; González, G.; Castro, J. M. G.; Gopakumar, A.; Gordon, N. A.; Gorodetsky, M. L.; Gossan, S. E.; Gosselin, M.; Gouaty, R.; Graef, C.; Graff, P. B.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greco, G.; Green, A. C.; Groot, P.; Grote, H.; Grunewald, S.; Guidi, G. M.; Guo, X.; Gupta, A.; Gupta, M. K.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Hacker, J. J.; Hall, B. R.; Hall, E. D.; Hammond, G.; Haney, M.; Hanke, M. M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hanson, J.; Hardwick, T.; Haris, K.; Harms, J.; Harry, G. M.; Harry, I. W.; Hart, M. J.; Hartman, M. T.; Haster, C.-J.; Haughian, K.; Heidmann, A.; Heintze, M. C.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Hennig, J.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hoak, D.; Hodge, K. A.; Hofman, D.; Hollitt, S. E.; Holt, K.; Holz, D. E.; Hopkins, P.; Hosken, D. J.; Hough, J.; Houston, E. A.; Howell, E. J.; Hu, Y. M.; Huang, S.; Huerta, E. A.; Huet, D.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh-Dinh, T.; Idrisy, A.; Indik, N.; Ingram, D. R.; Inta, R.; Isa, H. N.; Isac, J.-M.; Isi, M.; Islas, G.; Isogai, T.; Iyer, B. R.; Izumi, K.; Jacqmin, T.; Jang, H.; Jani, K.; Jaranowski, P.; Jawahar, S.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; Kalaghatgi, C. V.; Kalogera, V.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Karki, S.; Kasprzack, M.; Katsavounidis, E.; Katzman, W.; Kaufer, S.; Kaur, T.; Kawabe, K.; Kawazoe, F.; Kéfélian, F.; Kehl, M. S.; Keitel, D.; Kelley, D. B.; Kells, W.; Kennedy, R.; Key, J. S.; Khalaidovski, A.; Khalili, F. Y.; Khan, I.; Khan, S.; Khan, Z.; Khazanov, E. A.; Kijbunchoo, N.; Kim, C.; Kim, J.; Kim, K.; Kim, N.; Kim, N.; Kim, Y.-M.; King, E. J.; King, P. J.; Kinzel, D. L.; Kissel, J. S.; Kleybolte, L.; Klimenko, S.; Koehlenbeck, S. M.; Kokeyama, K.; Koley, S.; Kondrashov, V.; Kontos, A.; Korobko, M.; Korth, W. Z.; Kowalska, I.; Kozak, D. B.; Kringel, V.; Królak, A.; Krueger, C.; Kuehn, G.; Kumar, P.; Kuo, L.; Kutynia, A.; Lackey, B. D.; Landry, M.; Lange, J.; Lantz, B.; Lasky, P. D.; Lazzarini, A.; Lazzaro, C.; Leaci, P.; Leavey, S.; Lebigot, E. O.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Lee, K.; Lenon, A.; Leonardi, M.; Leong, J. R.; Leroy, N.; Letendre, N.; Levin, Y.; Levine, B. M.; Li, T. G. F.; Libson, A.; Littenberg, T. B.; Lockerbie, N. A.; Logue, J.; Lombardi, A. L.; Lord, J. E.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J. D.; Lück, H.; Lundgren, A. P.; Luo, J.; Lynch, R.; Ma, Y.; MacDonald, T.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña-Sandoval, F.; Magee, R. M.; Mageswaran, M.; Majorana, E.; Maksimovic, I.; Malvezzi, V.; Man, N.; Mandel, I.; Mandic, V.; Mangano, V.; Mansell, G. L.; Manske, M.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markosyan, A. S.; Maros, E.; Martelli, F.; Martellini, L.; Martin, I. W.; Martin, R. M.; Martynov, D. V.; Marx, J. N.; Mason, K.; Masserot, A.; Massinger, T. J.; Masso-Reid, M.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; Mazzolo, G.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McGuire, S. C.; McIntyre, G.; McIver, J.; McManus, D. J.; McWilliams, S. T.; Meacher, D.; Meadors, G. D.; Meidam, J.; Melatos, A.; Mendell, G.; Mendoza-Gandara, D.; Mercer, R. A.; Merilh, E.; Merzougui, M.; Meshkov, S.; Messenger, C.; Messick, C.; Meyers, P. M.; Mezzani, F.; Miao, H.; Michel, C.; Middleton, H.; Mikhailov, E. E.; Milano, L.; Miller, J.; Millhouse, M.; Minenkov, Y.; Ming, J.; Mirshekari, S.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moggi, A.; Mohan, M.; Mohapatra, S. R. P.; Montani, M.; Moore, B. C.; Moore, C. J.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mossavi, K.; Mours, B.; Mow-Lowry, C. M.; Mueller, C. L.; Mueller, G.; Muir, A. W.; Mukherjee, A.; Mukherjee, D.; Mukherjee, S.; Mukund, N.; Mullavey, A.; Munch, J.; Murphy, D. J.; Murray, P. G.; Mytidis, A.; Nardecchia, I.; Naticchioni, L.; Nayak, R. K.; Necula, V.; Nedkova, K.; Nelemans, G.; Neri, M.; Neunzert, A.; Newton, G.; Nguyen, T. T.; Nielsen, A. B.; Nissanke, S.; Nitz, A.; Nocera, F.; Nolting, D.; Normandin, M. E. N.; Nuttall, L. K.; Oberling, J.; Ochsner, E.; O'Dell, J.; Oelker, E.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Oliver, M.; Oppermann, P.; Oram, R. J.; O'Reilly, B.; O'Shaughnessy, R.; Ottaway, D. J.; Ottens, R. S.; Overmier, H.; Owen, B. J.; Pai, A.; Pai, S. A.; Palamos, J. R.; Palashov, O.; Palliyaguru, N.; Palomba, C.; Pal-Singh, A.; Pan, H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Paoletti, F.; Paoli, A.; Papa, M. A.; Paris, H. R.; Parker, W.; Pascucci, D.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patricelli, B.; Patrick, Z.; Pearlstone, B. L.; Pedraza, M.; Pedurand, R.; Pekowsky, L.; Pele, A.; Penn, S.; Perreca, A.; Phelps, M.; Piccinni, O.; Pichot, M.; Piergiovanni, F.; Pierro, V.; Pillant, G.; Pinard, L.; Pinto, I. M.; Pitkin, M.; Poggiani, R.; Popolizio, P.; Post, A.; Powell, J.; Prasad, J.; Predoi, V.; Premachandra, S. S.; Prestegard, T.; Price, L. R.; Prijatelj, M.; Principe, M.; Privitera, S.; Prodi, G. A.; Prokhorov, L.; Puncken, O.; Punturo, M.; Puppo, P.; Pürrer, M.; Qi, H.; Qin, J.; Quetschke, V.; Quintero, E. A.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rakhmanov, M.; Rapagnani, P.; Raymond, V.; Razzano, M.; Re, V.; Read, J.; Reed, C. M.; Regimbau, T.; Rei, L.; Reid, S.; Reitze, D. H.; Rew, H.; Reyes, S. D.; Ricci, F.; Riles, K.; Robertson, N. A.; Robie, R.; Robinet, F.; Rocchi, A.; Rolland, L.; Rollins, J. G.; Roma, V. J.; Romano, R.; Romanov, G.; Romie, J. H.; Rosińska, D.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Salconi, L.; Saleem, M.; Salemi, F.; Samajdar, A.; Sammut, L.; Sanchez, E. J.; Sandberg, V.; Sandeen, B.; Sanders, J. R.; Sassolas, B.; Sathyaprakash, B. S.; Saulson, P. R.; Sauter, O.; Savage, R. L.; Sawadsky, A.; Schale, P.; Schilling, R.; Schmidt, J.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schönbeck, A.; Schreiber, E.; Schuette, D.; Schutz, B. F.; Scott, J.; Scott, S. M.; Sellers, D.; Sentenac, D.; Sequino, V.; Sergeev, A.; Serna, G.; Setyawati, Y.; Sevigny, A.; Shaddock, D. A.; Shah, S.; Shahriar, M. S.; Shaltev, M.; Shao, Z.; Shapiro, B.; Shawhan, P.; Sheperd, A.; Shoemaker, D. H.; Shoemaker, D. M.; Siellez, K.; Siemens, X.; Sigg, D.; Silva, A. D.; Simakov, D.; Singer, A.; Singh, A.; Singh, R.; Singhal, A.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, J. R.; Smith, N. D.; Smith, R. J. E.; Son, E. J.; Sorazu, B.; Sorrentino, F.; Souradeep, T.; Srivastava, A. K.; Staley, A.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stephens, B. C.; Stone, R.; Strain, K. A.; Straniero, N.; Stratta, G.; Strauss, N. A.; Strigin, S.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sun, L.; Sutton, P. J.; Swinkels, B. L.; Szczepańczyk, M. J.; Tacca, M.; Talukder, D.; Tanner, D. B.; Tápai, M.; Tarabrin, S. P.; Taracchini, A.; Taylor, R.; Theeg, T.; Thirugnanasambandam, M. P.; Thomas, E. G.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thorne, K. S.; Thrane, E.; Tiwari, S.; Tiwari, V.; Tokmakov, K. V.; Tomlinson, C.; Tonelli, M.; Torres, C. V.; Torrie, C. I.; Töyrä, D.; Travasso, F.; Traylor, G.; Trifirò, D.; Tringali, M. C.; Trozzo, L.; Tse, M.; Turconi, M.; Tuyenbayev, D.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; Van Den Broeck, C.; Vander-Hyde, D. C.; van der Schaaf, L.; van Heijningen, J. V.; van Veggel, A. A.; Vardaro, M.; Vass, S.; Vasúth, M.; Vaulin, R.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinciguerra, S.; Vine, D. J.; Vinet, J.-Y.; Vitale, S.; Vo, T.; Vocca, H.; Vorvick, C.; Voss, D.; Vousden, W. D.; Vyatchanin, S. P.; Wade, A. R.; Wade, L. E.; Wade, M.; Walker, M.; Wallace, L.; Walsh, S.; Wang, G.; Wang, H.; Wang, M.; Wang, X.; Wang, Y.; Ward, R. L.; Warner, J.; Was, M.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Welborn, T.; Wen, L.; Wessels, P.; Westphal, T.; Wette, K.; Whelan, J. T.; White, D. J.; Whiting, B. F.; Williams, R. D.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M. H.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Worden, J.; Wright, J. L.; Wu, G.; Yablon, J.; Yam, W.; Yamamoto, H.; Yancey, C. C.; Yap, M. J.; Yu, H.; Yvert, M.; Zadrożny, A.; Zangrando, L.; Zanolin, M.; Zendri, J.-P.; Zevin, M.; Zhang, F.; Zhang, L.; Zhang, M.; Zhang, Y.; Zhao, C.; Zhou, M.; Zhou, Z.; Zhu, X. J.; Zucker, M. E.; Zuraw, S. E.; Zweizig, J.; LIGO Scientific Collaboration; Virgo Collaboration; Allison, J.; Bannister, K.; Bell, M. E.; Chatterjee, S.; Chippendale, A. P.; Edwards, P. G.; Harvey-Smith, L.; Heywood, Ian; Hotan, A.; Indermuehle, B.; Marvil, J.; McConnell, D.; Murphy, T.; Popping, A.; Reynolds, J.; Sault, R. J.; Voronkov, M. A.; Whiting, M. T.; Australian Square Kilometer Array Pathfinder (ASKAP Collaboration); Castro-Tirado, A. J.; Cunniffe, R.; Jelínek, M.; Tello, J. C.; Oates, S. R.; Hu, Y.-D.; Kubánek, P.; Guziy, S.; Castellón, A.; García-Cerezo, A.; Muñoz, V. F.; Pérez del Pulgar, C.; Castillo-Carrión, S.; Castro Cerón, J. M.; Hudec, R.; Caballero-García, M. D.; Páta, P.; Vitek, S.; Adame, J. A.; Konig, S.; Rendón, F.; Mateo Sanguino, T. de J.; Fernández-Muñoz, R.; Yock, P. C.; Rattenbury, N.; Allen, W. H.; Querel, R.; Jeong, S.; Park, I. H.; Bai, J.; Cui, Ch.; Fan, Y.; Wang, Ch.; Hiriart, D.; Lee, W. H.; Claret, A.; Sánchez-Ramírez, R.; Pandey, S. B.; Mediavilla, T.; Sabau-Graziati, L.; BOOTES Collaboration; Abbott, T. M. C.; Abdalla, F. B.; Allam, S.; Annis, J.; Armstrong, R.; Benoit-Lévy, A.; Berger, E.; Bernstein, R. A.; Bertin, E.; Brout, D.; Buckley-Geer, E.; Burke, D. L.; Capozzi, D.; Carretero, J.; Castander, F. J.; Chornock, R.; Cowperthwaite, P. S.; Crocce, M.; Cunha, C. E.; D'Andrea, C. B.; da Costa, L. N.; Desai, S.; Diehl, H. T.; Dietrich, J. P.; Doctor, Z.; Drlica-Wagner, A.; Drout, M. R.; Eifler, T. F.; Estrada, J.; Evrard, A. E.; Fernandez, E.; Finley, D. A.; Flaugher, B.; Foley, R. J.; Fong, W.-F.; Fosalba, P.; Fox, D. B.; Frieman, J.; Fryer, C. L.; Gaztanaga, E.; Gerdes, D. W.; Goldstein, D. A.; Gruen, D.; Gruendl, R. A.; Gutierrez, G.; Herner, K.; Honscheid, K.; James, D. J.; Johnson, M. D.; Johnson, M. W. G.; Karliner, I.; Kasen, D.; Kent, S.; Kessler, R.; Kim, A. G.; Carrasco Kind, M.; Kuehn, K.; Kuropatkin, N.; Lahav, O.; Li, T. S.; Lima, M.; Lin, H.; Maia, M. A. G.; Margutti, R.; Marriner, J.; Martini, P.; Matheson, T.; Melchior, P.; Metzger, B. D.; Miller, C. J.; Miquel, R.; Neilsen, E.; Nichol, R. C.; Nord, B.; Nugent, P.; Ogando, R.; Petravick, D.; Plazas, A. A.; Quataert, E.; Roe, N.; Romer, A. K.; Roodman, A.; Rosell, A. C.; Rykoff, E. S.; Sako, M.; Sanchez, E.; Scarpine, V.; Schindler, R.; Schubnell, M.; Scolnic, D.; Sevilla-Noarbe, I.; Sheldon, E.; Smith, N.; Smith, R. C.; Soares-Santos, M.; Sobreira, F.; Stebbins, A.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Thaler, J.; Thomas, D.; Thomas, R. C.; Tucker, D. L.; Vikram, V.; Walker, A. R.; Wechsler, R. H.; Wester, W.; Yanny, B.; Zhang, Y.; Zuntz, J.; Dark Energy Survey Collaboration; Dark Energy Camera GW-EM Collaboration; Connaughton, V.; Burns, E.; Goldstein, A.; Briggs, M. S.; Zhang, B.-B.; Hui, C. M.; Jenke, P.; Wilson-Hodge, C. A.; Bhat, P. N.; Bissaldi, E.; Cleveland, W.; Fitzpatrick, G.; Giles, M. M.; Gibby, M. H.; Greiner, J.; von Kienlin, A.; Kippen, R. M.; McBreen, S.; Mailyan, B.; Meegan, C. A.; Paciesas, W. S.; Preece, R. D.; Roberts, O.; Sparke, L.; Stanbro, M.; Toelge, K.; Veres, P.; Yu, H.-F.; Blackburn, L.; Fermi GBM Collaboration; Ackermann, M.; Ajello, M.; Albert, A.; Anderson, B.; Atwood, W. B.; Axelsson, M.; Baldini, L.; Barbiellini, G.; Bastieri, D.; Bellazzini, R.; Bissaldi, E.; Blandford, R. D.; Bloom, E. D.; Bonino, R.; Bottacini, E.; Brandt, T. J.; Bruel, P.; Buson, S.; Caliandro, G. A.; Cameron, R. A.; Caragiulo, M.; Caraveo, P. A.; Cavazzuti, E.; Charles, E.; Chekhtman, A.; Chiang, J.; Chiaro, G.; Ciprini, S.; Cohen-Tanugi, J.; Cominsky, L. R.; Costanza, F.; Cuoco, A.; D'Ammando, F.; de Palma, F.; Desiante, R.; Digel, S. W.; Di Lalla, N.; Di Mauro, M.; Di Venere, L.; Domínguez, A.; Drell, P. S.; Dubois, R.; Favuzzi, C.; Ferrara, E. C.; Franckowiak, A.; Fukazawa, Y.; Funk, S.; Fusco, P.; Gargano, F.; Gasparrini, D.; Giglietto, N.; Giommi, P.; Giordano, F.; Giroletti, M.; Glanzman, T.; Godfrey, G.; Gomez-Vargas, G. A.; Green, D.; Grenier, I. A.; Grove, J. E.; Guiriec, S.; Hadasch, D.; Harding, A. K.; Hays, E.; Hewitt, J. W.; Hill, A. B.; Horan, D.; Jogler, T.; Jóhannesson, G.; Johnson, A. S.; Kensei, S.; Kocevski, D.; Kuss, M.; La Mura, G.; Larsson, S.; Latronico, L.; Li, J.; Li, L.; Longo, F.; Loparco, F.; Lovellette, M. N.; Lubrano, P.; Magill, J.; Maldera, S.; Manfreda, A.; Marelli, M.; Mayer, M.; Mazziotta, M. N.; McEnery, J. E.; Meyer, M.; Michelson, P. F.; Mirabal, N.; Mizuno, T.; Moiseev, A. A.; Monzani, M. E.; Moretti, E.; Morselli, A.; Moskalenko, I. V.; Negro, M.; Nuss, E.; Ohsugi, T.; Omodei, N.; Orienti, M.; Orlando, E.; Ormes, J. F.; Paneque, D.; Perkins, J. S.; Pesce-Rollins, M.; Piron, F.; Pivato, G.; Porter, T. A.; Racusin, J. L.; Rainò, S.; Rando, R.; Razzaque, S.; Reimer, A.; Reimer, O.; Salvetti, D.; Saz Parkinson, P. M.; Sgrò, C.; Simone, D.; Siskind, E. J.; Spada, F.; Spandre, G.; Spinelli, P.; Suson, D. J.; Tajima, H.; Thayer, J. B.; Thompson, D. J.; Tibaldo, L.; Torres, D. F.; Troja, E.; Uchiyama, Y.; Venters, T. M.; Vianello, G.; Wood, K. S.; Wood, M.; Zhu, S.; Zimmer, S.; Fermi LAT Collaboration; Brocato, E.; Cappellaro, E.; Covino, S.; Grado, A.; Nicastro, L.; Palazzi, E.; Pian, E.; Amati, L.; Antonelli, L. A.; Capaccioli, M.; D'Avanzo, P.; D'Elia, V.; Getman, F.; Giuffrida, G.; Iannicola, G.; Limatola, L.; Lisi, M.; Marinoni, S.; Marrese, P.; Melandri, A.; Piranomonte, S.; Possenti, A.; Pulone, L.; Rossi, A.; Stamerra, A.; Stella, L.; Testa, V.; Tomasella, L.; Yang, S.; GRAvitational Wave Inaf TeAm (GRAWITA); Bazzano, A.; Bozzo, E.; Brandt, S.; Courvoisier, T. J.-L.; Ferrigno, C.; Hanlon, L.; Kuulkers, E.; Laurent, P.; Mereghetti, S.; Roques, J. P.; Savchenko, V.; Ubertini, P.; INTEGRAL Collaboration; Kasliwal, M. M.; Singer, L. P.; Cao, Y.; Duggan, G.; Kulkarni, S. R.; Bhalerao, V.; Miller, A. A.; Barlow, T.; Bellm, E.; Manulis, I.; Rana, J.; Laher, R.; Masci, F.; Surace, J.; Rebbapragada, U.; Cook, D.; Van Sistine, A.; Sesar, B.; Perley, D.; Ferreti, R.; Prince, T.; Kendrick, R.; Horesh, A.; Intermediate Palomar Transient Factory (iPTF Collaboration); Hurley, K.; Golenetskii, S. V.; Aptekar, R. L.; Frederiks, D. D.; Svinkin, D. S.; Rau, A.; von Kienlin, A.; Zhang, X.; Smith, D. M.; Cline, T.; Krimm, H.; InterPlanetary Network; Abe, F.; Doi, M.; Fujisawa, K.; Kawabata, K. S.; Morokuma, T.; Motohara, K.; Tanaka, M.; Ohta, K.; Yanagisawa, K.; Yoshida, M.; J-GEM Collaboration; Baltay, C.; Rabinowitz, D.; Ellman, N.; Rostami, S.; La Silla-QUEST Survey; Bersier, D. F.; Bode, M. F.; Collins, C. A.; Copperwheat, C. M.; Darnley, M. J.; Galloway, D. K.; Gomboc, A.; Kobayashi, S.; Mazzali, P.; Mundell, C. G.; Piascik, A. S.; Pollacco, Don; Steele, I. A.; Ulaczyk, K.; Liverpool Telescope Collaboration; Broderick, J. W.; Fender, R. P.; Jonker, P. G.; Rowlinson, A.; Stappers, B. W.; Wijers, R. A. M. J.; Low Frequency Array (LOFAR Collaboration); Lipunov, V.; Gorbovskoy, E.; Tyurina, N.; Kornilov, V.; Balanutsa, P.; Kuznetsov, A.; Buckley, D.; Rebolo, R.; Serra-Ricart, M.; Israelian, G.; Budnev, N. M.; Gress, O.; Ivanov, K.; Poleshuk, V.; Tlatov, A.; Yurkov, V.; MASTER Collaboration; Kawai, N.; Serino, M.; Negoro, H.; Nakahira, S.; Mihara, T.; Tomida, H.; Ueno, S.; Tsunemi, H.; Matsuoka, M.; MAXI Collaboration; Croft, S.; Feng, L.; Franzen, T. M. O.; Gaensler, B. M.; Johnston-Hollitt, M.; Kaplan, D. L.; Morales, M. F.; Tingay, S. J.; Wayth, R. B.; Williams, A.; Murchison Wide-field Array (MWA Collaboration); Smartt, S. J.; Chambers, K. C.; Smith, K. W.; Huber, M. E.; Young, D. R.; Wright, D. E.; Schultz, A.; Denneau, L.; Flewelling, H.; Magnier, E. A.; Primak, N.; Rest, A.; Sherstyuk, A.; Stalder, B.; Stubbs, C. W.; Tonry, J.; Waters, C.; Willman, M.; Pan-STARRS Collaboration; Olivares E., F.; Campbell, H.; Kotak, R.; Sollerman, J.; Smith, M.; Dennefeld, M.; Anderson, J. P.; Botticella, M. T.; Chen, T.-W.; Della Valle, M.; Elias-Rosa, N.; Fraser, M.; Inserra, C.; Kankare, E.; Kupfer, T.; Harmanen, J.; Galbany, L.; Le Guillou, L.; Lyman, J. D.; Maguire, K.; Mitra, A.; Nicholl, M.; Razza, A.; Terreran, G.; Valenti, S.; Gal-Yam, A.; PESSTO Collaboration; Ćwiek, A.; Ćwiok, M.; Mankiewicz, L.; Opiela, R.; Zaremba, M.; Żarnecki, A. F.; Pi of Sky Collaboration; Onken, C. A.; Scalzo, R. A.; Schmidt, B. P.; Wolf, C.; Yuan, F.; SkyMapper Collaboration; Evans, P. A.; Kennea, J. A.; Burrows, D. N.; Campana, S.; Cenko, S. B.; Giommi, P.; Marshall, F. E.; Nousek, J.; O'Brien, P.; Osborne, J. P.; Palmer, D.; Perri, M.; Siegel, M.; Tagliaferri, G.; Swift Collaboration; Klotz, A.; Turpin, D.; Laugier, R.; TAROT Collaboration; Zadko Collaboration; Algerian National Observatory, Algerian Collaboration; C2PU Collaboration; Beroiz, M.; Peñuela, T.; Macri, L. M.; Oelkers, R. J.; Lambas, D. G.; Vrech, R.; Cabral, J.; Colazo, C.; Dominguez, M.; Sanchez, B.; Gurovich, S.; Lares, M.; Marshall, J. L.; DePoy, D. L.; Padilla, N.; Pereyra, N. A.; Benacquista, M.; TOROS Collaboration; Tanvir, N. R.; Wiersema, K.; Levan, A. J.; Steeghs, D.; Hjorth, J.; Fynbo, J. P. U.; Malesani, D.; Milvang-Jensen, B.; Watson, D.; Irwin, M.; Fernandez, C. G.; McMahon, R. G.; Banerji, M.; Gonzalez-Solares, E.; Schulze, S.; Postigo, A. de U.; Thoene, C. C.; Cano, Z.; Rosswog, S.; VISTA Collaboration

2016-07-01

This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

Improving Attachments of Remotely-Deployed Dorsal Fin-Mounted Tags: Tissue Structure, Hydrodynamics, In Situ Performance, and Tagged-Animal Follow-Up

DTIC Science & Technology

2013-09-30

in situ performance of our current attachment devices and then design and test improved retention systems 4. Conduct follow-up studies of tagged... retention system operates when first implanted, we do not fully understand the mechanics in a living fin. Therefore, we will use non-invasive imaging of...carcass tissue to determine how the retention elements behave in situ. These results, along with those from the analysis of dorsal fin histology

Computer Programming in the UK Undergraduate Mathematics Curriculum

ERIC Educational Resources Information Center

Sangwin, Christopher J.; O'Toole, Claire

2017-01-01

This paper reports a study which investigated the extent to which undergraduate mathematics students in the United Kingdom are currently taught to programme a computer as a core part of their mathematics degree programme. We undertook an online survey, with significant follow-up correspondence, to gather data on current curricula and received…

The US Department of Defense Millennium Cohort Study: career span and beyond longitudinal follow-up.

PubMed

Smith, Tyler C

2009-10-01

To describe current and future career-span health research in the US Department of Defense Millennium Cohort Study. Collaborating with all military service branches and the Department of Veterans Affairs, the Millennium Cohort Study launched in 2001, before September 11 and the start of deployments in Afghanistan and Iraq, to conduct coordinated strategic research to determine any effects of military occupational and deployment-related exposures, on long-term health. More than 150,000 consenting members represent demographic, occupational, military, and health characteristics of the US military. More than 70% of the first two panels have submitted follow-up questionnaires and >50% have deployed since 2001. Prospective cohort data have identified subgroups of military populations at higher risk or more resilient to decrements in mental and physical health. Continued career span and beyond follow-up will answer long-term health questions related to military service.

Value of a short-term imaging follow-up after a benign result in a one-stop breast unit: Is it still useful?

PubMed

Daroles, Johanna; Borget, Isabelle; Suciu, Voichita; Mazouni, Chafika; Delaloge, Suzette; Balleyguier, Corinne

2017-11-01

A short-term radiologic follow-up after a benign breast biopsy or fine needle aspiration (FNA) is recommended in many guidelines. However, the current trend is to reduce imaging investigations, radiation dose and costs. The objectives of this study were to evaluate the cancer detection rate at short-term follow-up and to estimate its cost. We retrospectively assessed all consecutive patients referred to our 'one-stop' breast unit between 2004 and 2012, with a benign histological or cytological result and at least one short-term follow-up within 3-12 months after the initial diagnosis. We evaluated the number of cancers detected, as well as the mean cost to detect each cancer and per patient. About 1366 patients were eligible for this study. Ten patients were diagnosed with cancers (0.73%) at short-term follow-up; six of 10 were low-grade tumours or ductal carcinoma in situ. The cost for detecting one cancer was 19,043€, with mean cost per patient of 139€. The cancer detection rate at short-term follow-up after benign biopsy or FNA was low and was similar to that of most national screening programs. The cost of cancer detection appeared high, considering that most cancers were indolent. This suggests that radiologic follow-up could reasonably be carried out at a later point in time. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do patterns of change during treatment for panic disorder predict future panic symptoms?

PubMed Central

Steinman, Shari A.; Hunter, Michael D.; Teachman, Bethany A.

2012-01-01

Background and Objectives Cognitive-behavioral therapies are currently the gold standard for panic disorder treatment, with well-documented treatment response. However, following interventions, some individuals continue to improve, while others experience a return of symptoms. The field lacks reliable ways to predict follow-up symptomology. In the current study, a cluster analysis with a repeated measures design was conducted to examine change patterns over 12 weeks of cognitive behavioral group therapy for panic disorder. The central aim of the study was to evaluate if change patterns predict level of panic symptom severity at a six month follow-up in this sample. Methods Individuals with panic disorder (N = 36) completed a measure of panic symptoms (Panic Disorder Severity Scale) at the outset of every therapy session and at a six month follow-up. Results Results revealed three patterns of change in this specific trial, which significantly predicted level of panic symptoms six months post-treatment, beyond initial or final level of panic symptoms, and beyond total symptom change. Limitations Given the relatively small, lab-based sample, replications in other settings and samples will be important. Conclusions Overall, results provide initial evidence that change patterns are meaningful predictors of panic symptom severity well after the final session of treatment. PMID:23187115

Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices.

PubMed

Fridman, Liraz; Scolnik, Michal; Macpherson, Alison; Rothman, Linda; Guttmann, Astrid; Grool, Anne M; Rodriguez Duque, Daniel; Zemek, Roger L

2018-01-01

To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study.

PubMed

van Kampen, V; Hoffmeyer, F; Deckert, A; Kendzia, B; Casjens, S; Neumann, H D; Buxtrup, M; Willer, E; Felten, C; Schöneich, R; Brüning, T; Raulf, M; Bünger, J

2016-12-01

To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study. 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/.

Treatment Options for Gastrointestinal Carcinoid Tumors

MedlinePlus

... have any of these signs or symptoms. Imaging studies and tests that examine the blood and urine are used ... or after starting their cancer treatment. Follow-up tests may be needed. ... is a research study meant to help improve current treatments or obtain ...

Stages of Gastrointestinal Carcinoid Tumors

MedlinePlus

... have any of these signs or symptoms. Imaging studies and tests that examine the blood and urine are used ... or after starting their cancer treatment. Follow-up tests may be needed. ... is a research study meant to help improve current treatments or obtain ...

Treatment Option Overview (Gastrointestinal Carcinoid Tumors)

MedlinePlus

... have any of these signs or symptoms. Imaging studies and tests that examine the blood and urine are used ... or after starting their cancer treatment. Follow-up tests may be needed. ... is a research study meant to help improve current treatments or obtain ...

Current status of neonatal follow-up in Canada

PubMed Central

Synnes, Anne R; Lefebvre, Francine; Cake, Heather A

2006-01-01

Follow-up programs in Canada collect audit and outcome research data, and provide clinical and preventive health care to extremely premature survivors and other new survivors of neonatal intensive care. Results of a 2001 to 2002 survey of Canadian follow-up programs showed a tremendous variation in the patient populations seen, the timing of visits and the evaluations performed. A description of the new Quebec consortium of follow-up programs is provided and possible future directions are discussed. PMID:19030287

Online follow-up after total hip replacement: a first case

PubMed Central

Dexter, Caroline; Bradley, Benjamin; Williams, Daniel H

2013-01-01

With the current challenging financial climate in the NHS there is an increasing drive to reduce the number of postoperative follow-up appointments. We report on a patient who has successfully used a new online platform, www.myclinicaloutcomes.co.uk, to record condition-specific and generic wellbeing scores following total hip replacement. This case highlights the potential for remote follow-up of routine postoperative patients. PMID:23396931

Assessment of follow-up, and the completeness and accuracy of cancer case ascertainment in three areas of India

PubMed Central

Mathew, Aleyamma; Daniel, Carrie R.; Ferrucci, Leah M.; Seth, Tulika; Devesa, Susan S.; George, Preethi S.; Shetty, Hemali; Devasenapathy, Niveditha; Yurgalevitch, Susan; Rastogi, Tanuja; Prabhakaran, Dorairaj; Gupta, Prakash C.; Chatterjee, Nilanjan; Sinha, Rashmi

2012-01-01

Background A prospective study of diet and cancer has not been conducted in India; consequently, little is known regarding follow-up rates or the completeness and accuracy of cancer case ascertainment. Methods We assessed follow-up in the India Health Study (IHS; 4,671 participants aged 35–69 residing in New Delhi, Mumbai, or Trivandrum). We evaluated the impact of medical care access and relocation, re-contacted the IHS participants to estimate follow-up rates, and conducted separate studies of cancer cases to evaluate registry coverage (604 cases in Trivandrum) and the accuracy of self- and proxy-reporting (1600 cases in New Delhi and Trivandrum). Results Over 97% of people reported seeing a doctor and 85% had lived in their current residence for over six years. The 2-year follow-up rate was 91% for Trivandrum and 53% for New Delhi. No cancer cases were missed among public institutions participating in the surveillance program in Trivandrum during 2003–04; but there are likely to be unmatched cases (ranging from 5 to13% of total cases) from private hospitals in the Trivandrum registry, as there are no mandatory reporting requirements. Vital status was obtained for 36% of cancer cases in New Delhi as compared to 78% in Trivandrum after a period of 4 years. Conclusions A prospective cohort study of cancer may be feasible in some centers in India with active follow-up to supplement registry data. Inclusion of cancers diagnosed at private institutions, unique identifiers for individuals, and computerized medical information would likely improve cancer registries. PMID:21621499

Analysis of the potential for point-of-care test to enable individualised treatment of infections caused by antimicrobial-resistant and susceptible strains of Neisseria gonorrhoeae: a modelling study.

PubMed

Turner, Katy Me; Christensen, Hannah; Adams, Elisabeth J; McAdams, David; Fifer, Helen; McDonnell, Anthony; Woodford, Neil

2017-06-14

To create a mathematical model to investigate the treatment impact and economic implications of introducing an antimicrobial resistance point-of-care test (AMR POCT) for gonorrhoea as a way of extending the life of current last-line treatments. Modelling study. England. Patients accessing sexual health services. Incremental impact of introducing a hypothetical AMR POCT that could detect susceptibility to previous first-line antibiotics, for example, ciprofloxacin or penicillin, so that patients are given more tailored treatment, compared with the current situation where all patients are given therapy with ceftriaxone and azithromycin. The hypothetical intervention was assessed using a mathematical model developed in Excel. The model included initial and follow-up attendances, loss to follow-up, use of standard or tailored treatment, time taken to treatment and the costs of testing and treatment. Number of doses of ceftriaxone saved, mean time to most appropriate treatment, mean number of visits per (infected) patient, number of patients lost to follow-up and total cost of testing. In the current situation, an estimated 33 431 ceftriaxone treatments are administered annually and 792 gonococcal infections remain untreated due to loss to follow-up. The use of an AMR POCT for ciprofloxacin could reduce these ceftriaxone treatments by 66%, and for an AMR POCT for penicillin by 79%. The mean time for patients receiving an antibiotic treatment is reduced by 2 days in scenarios including POCT and no positive patients remain untreated through eliminating loss to follow-up. Such POCTs are estimated to add £34 million to testing costs, but this does not take into account reductions in costs of repeat attendances and the reuse of older, cheaper antimicrobials. The introduction of AMR POCT could allow clinicians to discern between the majority of gonorrhoea-positive patients with strains that could be treated with older, previously abandoned first-line treatments, and those requiring our current last-line dual therapy. Such tests could extend the useful life of dual ceftriaxone and azithromycin therapy, thus pushing back the time when gonorrhoea may become untreatable. © 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.

Analysis of the potential for point-of-care test to enable individualised treatment of infections caused by antimicrobial-resistant and susceptible strains of Neisseria gonorrhoeae: a modelling study

PubMed Central

Christensen, Hannah; Adams, Elisabeth J; McAdams, David; Fifer, Helen; McDonnell, Anthony; Woodford, Neil

2017-01-01

Objective To create a mathematical model to investigate the treatment impact and economic implications of introducing an antimicrobial resistance point-of-care test (AMR POCT) for gonorrhoea as a way of extending the life of current last-line treatments. Design Modelling study. Setting England. Population Patients accessing sexual health services. Interventions Incremental impact of introducing a hypothetical AMR POCT that could detect susceptibility to previous first-line antibiotics, for example, ciprofloxacin or penicillin, so that patients are given more tailored treatment, compared with the current situation where all patients are given therapy with ceftriaxone and azithromycin. The hypothetical intervention was assessed using a mathematical model developed in Excel. The model included initial and follow-up attendances, loss to follow-up, use of standard or tailored treatment, time taken to treatment and the costs of testing and treatment. Main outcome measures Number of doses of ceftriaxone saved, mean time to most appropriate treatment, mean number of visits per (infected) patient, number of patients lost to follow-up and total cost of testing. Results In the current situation, an estimated 33 431 ceftriaxone treatments are administered annually and 792 gonococcal infections remain untreated due to loss to follow-up. The use of an AMR POCT for ciprofloxacin could reduce these ceftriaxone treatments by 66%, and for an AMR POCT for penicillin by 79%. The mean time for patients receiving an antibiotic treatment is reduced by 2 days in scenarios including POCT and no positive patients remain untreated through eliminating loss to follow-up. Such POCTs are estimated to add £34 million to testing costs, but this does not take into account reductions in costs of repeat attendances and the reuse of older, cheaper antimicrobials. Conclusions The introduction of AMR POCT could allow clinicians to discern between the majority of gonorrhoea-positive patients with strains that could be treated with older, previously abandoned first-line treatments, and those requiring our current last-line dual therapy. Such tests could extend the useful life of dual ceftriaxone and azithromycin therapy, thus pushing back the time when gonorrhoea may become untreatable. PMID:28615273

Durability of Effects of Group Counseling with Institutionalized Delinquent Females

ERIC Educational Resources Information Center

Redfering, David L.

1973-01-01

The current study is a one-year follow-up of an earlier report that group counseling with institutionalized delinquent females resulted in significant gains in the connotative meanings of several concepts. (Author)

Report on Catholic School Leadership: Ten Years Later

ERIC Educational Resources Information Center

Schuttloffel, Merylann J.

2014-01-01

The current follow-up study to data first presented in 2003 and published in "Report on the Future of Catholic School Leadership," provides the comparisons, analysis, commentary, and some reflections and recommendations on the study implications; useful to individual schools and diocesan leaders.

Long-Term Follow-Up of Contemporary Treatment in Early-Stage Hodgkin Lymphoma: Updated Analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 Trials.

PubMed

Sasse, Stephanie; Bröckelmann, Paul J; Goergen, Helen; Plütschow, Annette; Müller, Horst; Kreissl, Stefanie; Buerkle, Carolin; Borchmann, Sven; Fuchs, Michael; Borchmann, Peter; Diehl, Volker; Engert, Andreas

2017-06-20

Purpose Combined-modality treatment is widely considered the standard of care in early-stage Hodgkin lymphoma (HL), and treatment intensity has been reduced over the last years. Long-term follow-up is important to judge both efficacy and safety of the different therapies used. Patients and Methods We analyzed updated follow-up data on 4,276 patients treated within the German Hodgkin Study Group trials HD7 and HD10 for early-stage favorable HL and HD8 and HD11 for early-stage unfavorable HL between 1993 and 2003. Results In HD7 (N = 627; median follow-up, 120 months), combined-modality treatment was superior to extended-field radiotherapy (RT), with 15-year progression-free survival (PFS) of 73% versus 52% (hazard ratio [HR], 0.5; 95% CI, 0.3 to 0.6; P < .001), without differences in overall survival (OS). In HD10 (N = 1,190; median follow-up, 98 months), noninferiority of two cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) plus 20 Gy involved-field (IF)-RT to more intensive four cycles of ABVD plus 30 Gy IF-RT was confirmed with 10-year PFS of 87% each (HR, 1.0; 95%, 0.6 to 1.5) and OS of 94% each (HR, 0.9; 95% CI, 0.5 to 1.6), respectively. In both trials, no differences in second neoplasias were observed. In HD8 (N = 1,064; median follow-up, 153 months), noninferiority of involved-field RT to extended-field RT regarding PFS was confirmed (HR, 1.0; 95% CI, 0.8 to 1.2). In HD11 (N = 1,395; median follow-up, 106 months), superiority of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone at baseline over ABVD was not observed. After BEACOPP baseline , 20 Gy IF-RT was noninferior to 30 Gy (10-year PFS, 84% v 84%; HR, 1.0; 95% CI, 0.7 to 1.5). In contrast, PFS was inferior in ABVD-treated patients receiving 20 Gy instead of 30 Gy IF-RT (10-year PFS, 76% v 84%; HR, 1.5; 95% CI, 1.0 to 2.1). No differences in OS or second neoplasias were observed in in both trials. Conclusion Long-term follow-up data of the four randomized trials largely support the current risk-adapted therapeutic strategies in early-stage HL. Nevertheless, continued follow-up is necessary to assess the long-term safety of currently applied therapeutic strategies.

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

PubMed Central

2014-01-01

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

Accumulation and dissipation of positive charges induced on a PMMA build-up cap of an ionisation chamber by (60)Co gamma-ray irradiation.

PubMed

Morishita, Y; Takata, N

2013-07-01

The signal current from an ionisation chamber with a PMMA build-up cap decreases with irradiation time due to electric fields produced by positive charges induced on the cap. In the present study, it was confirmed that the signal current decreases faster for irradiation using narrower (60)Co gamma-ray beams. This is because the number of secondary electrons that are emitted from surrounding materials and penetrate the build-up cap is smaller in a narrower gamma-ray beam, so that fewer positive charges are neutralised. The ionisation chamber was first subjected to continuous gamma-ray irradiation for 24 h, following which it was irradiated with shorter periodic gamma-ray bursts while measuring the current signal. This allowed the coefficients of positive charge accumulation and dissipation to be determined. It was found that the dissipation coefficient has a large constant value during gamma-ray irradiation and decreases asymptotically to a small value after irradiation is stopped. From the coefficients, the minimum signal current was calculated, which is the value when accumulation and dissipation balance each other under continuous irradiation. The time required for the signal current to recover following irradiation was also calculated.

Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care: A SEER-Medicare Analysis.

PubMed

Neuman, Heather B; Schumacher, Jessica R; Schneider, David F; Winslow, Emily R; Busch, Rebecca A; Tucholka, Jennifer L; Smith, Maureen A; Greenberg, Caprice C

2017-03-01

The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. Stages 1-3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care. Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year). Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers' responsibilities during follow-up care could lead to improved efficiency and quality of care.

Follow-up of Cross-section of 1965-1966 High School Seniors. 1970-1971 Technical Progress Report, September 1, 1970 through August 31, 1971.

ERIC Educational Resources Information Center

Columbia Univ., New York, NY. Bureau of Applied Social Research.

During Fall 1970 the questionnaire for the Winter 1970-1971, or fourth follow-up, of the 1965-1966 current population survey (CPS) of high school seniors was completed by the Columbia researchers and Census Bureau personnel jointly. The field phase of the follow-up was conducted by Census in Winter 1970-1971, followed by data processing by Census.…

A cluster randomised controlled trial evaluating the effectiveness of eHealth-supported patient recruitment in primary care research: the TRANSFoRm study protocol.

PubMed

Mastellos, Nikolaos; Andreasson, Anna; Huckvale, Kit; Larsen, Mark; Curcin, Vasa; Car, Josip; Agreus, Lars; Delaney, Brendan

2015-02-03

Opportunistic recruitment is a highly laborious and time-consuming process that is currently performed manually, increasing the workload of already busy practitioners and resulting in many studies failing to achieve their recruitment targets. The Translational Medicine and Patient Safety in Europe (TRANSFoRm) platform enables automated recruitment, data collection and follow-up of patients, potentially improving the efficiency, time and costs of clinical research. This study aims to assess the effectiveness of TRANSFoRm in improving patient recruitment and follow-up in primary care trials. This multi-centre, parallel-arm cluster randomised controlled trial will compare TRANSFoRm-supported with standard opportunistic recruitment. Participants will be general practitioners and patients with gastro-oesophageal reflux disease from 40 primary care centres in five European countries. Randomisation will take place at the care centre level. The intervention arm will use the TRANSFoRm tools for recruitment, baseline data collection and follow-up. The control arm will use web-based case report forms and paper self-completed questionnaires. The primary outcome will be the proportion of eligible patients successfully recruited at the end of the 16-week recruitment period. Secondary outcomes will include the proportion of recruited patients with complete baseline and follow-up data and the proportion of participants withdrawn or lost to follow-up. The study will also include an economic evaluation and measures of technology acceptance and user experience. The study should shed light on the use of eHealth to improve the effectiveness of recruitment and follow-up in primary care research and provide an evidence base for future eHealth-supported recruitment initiatives. Reporting of results is expected in October 2015. EudraCT: 2014-001314-25.

Trajectories of BMI change impact glucose and insulin metabolism.

PubMed

Walsh, E I; Shaw, J; Cherbuin, N

2018-03-01

The aim of this study was to examine, in a community setting, whether trajectory of weight change over twelve years is associated with glucose and insulin metabolism at twelve years. Participants were 532 community-living middle-aged and elderly adults from the Personality and Total Health (PATH) Through Life study. They spanned the full weight range (underweight/normal/overweight/obese). Latent class analysis and multivariate generalised linear models were used to investigate the association of Body Mass Index (BMI, kg/m 2 ) trajectory over twelve years with plasma insulin (μlU/ml), plasma glucose (mmol/L), and HOMA2 insulin resistance and beta cell function at follow-up. All models were adjusted for age, gender, hypertension, pre-clinical diabetes status (normal fasting glucose or impaired fasting glucose) and physical activity. Four weight trajectories were extracted; constant normal (mean baseline BMI = 25; follow-up BMI = 25), constant high (mean baseline BMI = 36; follow-up BMI = 37), increase (mean baseline BMI = 26; follow-up BMI = 32) and decrease (mean baseline BMI = 34; follow-up BMI = 28). At any given current BMI, individuals in the constant high and increase trajectories had significantly higher plasma insulin, greater insulin resistance, and higher beta cell function than those in the constant normal trajectory. Individuals in the decrease trajectory did not differ from the constant normal trajectory. Current BMI significantly interacted with preceding BMI trajectory in its association with plasma insulin, insulin resistance, and beta cell function. The trajectory of preceding weight has an independent effect on blood glucose metabolism beyond body weight measured at any given point in time. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

The relation of early experienced negative life events and current itch. A longitudinal study among adolescents in Oslo, Norway.

PubMed

Lien, Lars; Halvorsen, Jon Anders; Haavet, Ole Rikard; Dalgard, Florence

2012-03-01

Negative life events have impact on mental health and skin diseases among adults. Itch is a common, disabling skin symptom. The aim was to describe negative life events associated with current itch and to analyze the impact of number of negative life events on symptoms of itch, controlling for possible confounders. This school-based longitudinal survey was conducted among 15 and 18 years old high-school students in Oslo, Norway. From a baseline cohort of 3811 students, 2489 (65%) participants were followed-up after three years later. They completed questionnaires at baseline and follow-up. Current itch was measured with a validated instrument asking for symptoms on a four point Likert scale at follow-up. More girls than boys reported itch. There were no gender differences in number of negative life events. Death among close relative/friend was the most common negative life event among boys and girls. All negative life experiences before 15 years of age were statistically significantly associated with itch, but after 15 years only half of the negative life events were associated with itch. The bivariate association between number of negative life events and itch was statistically significant, and only when adjusting for mental distress at baseline there was a considerable drop in the Odds Ratio. There is a clear association between number of negative life events at baseline and itch at follow-up three years later among adolescents. It is therefore important to discuss possible adverse experiences with adolescents presenting with severe symptoms of itch. Copyright © 2011 Elsevier Inc. All rights reserved.

Neuropsychological and socio-occupational functioning in young psychiatric outpatients: a longitudinal investigation.

PubMed

Lee, Rico S C; Hermens, Daniel F; Redoblado-Hodge, M Antoinette; Naismith, Sharon L; Porter, Melanie A; Kaur, Manreena; White, Django; Scott, Elizabeth M; Hickie, Ian B

2013-01-01

Clinical symptoms and neuropsychological deficits are longitudinally associated with functional outcome in chronic psychiatric cohorts. The current study extended these findings to young and early-course psychiatric outpatients, with the aim of identifying cognitive markers that predict later socio-occupational functioning. At baseline, 183 young psychiatric outpatients were assessed. Ninety-three returned for follow-up (M = 21.6 years old; SD = 4.5) with an average re-assessment interval of 21.6 months (SD = 7.0), and primary diagnoses of major depressive disorder (n = 34), bipolar disorder (n = 29), or psychosis (n = 30). The primary outcome measure was cross-validated with various other functional measures and structural equation modelling was used to map out the interrelationships between predictors and later functional outcome. Good socio-occupational functioning at follow-up was associated with better quality of life, less disability, current employment and being in a romantic relationship. The final structural equation model explained 47.5% of the variability in functional outcome at follow-up, with baseline neuropsychological functioning (a composite of memory, working memory and attentional switching) the best independent predictor of later functional outcome. Notably, depressive and negative symptoms were only associated with functioning cross-sectionally. Diagnosis at follow-up was not associated with functional outcome. Neuropsychological functioning was the single best predictor of later socio-occupational outcome among young psychiatric outpatients. Therefore, framing psychiatric disorders along a neuropsychological continuum is likely to be more useful in predicting functional trajectory than traditional symptom-based classification systems. The current findings also have implications for early intervention utilising cognitive remediation approaches.

Monitoring progress in population health: trends in premature death rates.

PubMed

Remington, Patrick L; Catlin, Bridget B; Kindig, David A

2013-12-26

Trends in population health outcomes can be monitored to evaluate the performance of population health systems at the national, state, and local levels. The objective of this study was to compare and contrast 4 measures for assessing progress in population health improvement by using age-adjusted premature death rates as a summary measure of the overall health outcomes in the United States and in all 50 states. To evaluate the performance of statewide population health systems during the past 20 years, we used 4 measures of age-adjusted premature (<75 years of age) death rates: current rates (2009), baseline trends (1990s), follow-up trends (2000s), and changes in trends from baseline to the follow-up periods (ie, "bending the curve"). Current premature death rates varied by approximately twofold, with the lowest rate in Minnesota (268 deaths per 100,000) and the highest rate in Mississippi (482 deaths per 100,000). Rates improved the most in New York during the baseline period (-3.05% per year) and in New Jersey during the follow-up period (-2.87% per year), whereas Oklahoma ranked last in trends during both periods (-0.30%/y, baseline; +0.18%/y, follow-up). Trends improved the most in Connecticut, bending the curve downward by -1.03%; trends worsened the most in New Mexico, bending the curve upward by 1.21%. Current premature death rates, recent trends, and changes in trends vary by state in the United States. Policy makers can use these measures to evaluate the long-term population health impact of broad health care, behavioral, social, and economic investments in population health.

Growth and development after oesophageal atresia surgery: Need for long-term multidisciplinary follow-up.

PubMed

IJsselstijn, Hanneke; Gischler, Saskia J; Toussaint, Leontien; Spoel, Marjolein; Zijp, Monique H M van der Cammen-van; Tibboel, Dick

2016-06-01

Survival rates in oesophageal atresia patients have reached over 90%. In long-term follow-up studies the focus has shifted from purely surgical or gastrointestinal evaluation to a multidisciplinary approach. We reviewed the literature on the long-term morbidity of these patients and discuss mainly issues of physical growth and neurodevelopment. We conclude that growth problems - both stunting and wasting - are frequently seen, but that sufficient longitudinal data are lacking. Therefore, it is unclear whether catch-up growth into adolescence and adulthood occurs. Data on determinants of growth retardation are also lacking in current literature. Studies on neurodevelopment beyond preschool age are scarce but oesophageal atresia patients seem at risk for academic problems and motor function delay. Many factors contribute to the susceptibility to growth and development problems and we propose a multidisciplinary follow-up schedule into adulthood future care which may help improve quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ability of the rhTSH stimulation test to predict relapse in patients with differentiated thyroid carcinoma, after long-term follow-up

PubMed Central

MARCELINO, MAFALDA; LOPES, ANA FILIPA; MADUREIRA, DEOLINDA; FERREIRA, TERESA C.; LIMBERT, EDWARD; LEITE, VALERIANO

2015-01-01

The analysis of serum thyroglobulin (Tg) following thyroid-stimulating hormone (TSH) stimulation (sTg) has been recommended in the follow-up of differentiated thyroid carcinoma (DTC) patients, however, its routine use remains controversial. The aim of the current study was to evaluate the accuracy of sTg testing following recombinant human (rh) TSH stimulation in DTC patients, with a follow-up of 12.4 years. Retrospective studies were conducted of 125 DTC patients, who underwent rhTSH stimulation testing between 1999 and 2002. The exclusion criteria were: Patients with anti-Tg antibodies, Tg levels >1 ng/ml under TSH suppression and the absence of radioactive iodine (RAI) ablation therapy following surgery. In total, 49 patients were included in the study and all had been previously treated with total or near total thyroidectomy (with or without central neck dissection) and RAI, postoperatively. The Tg functional sensitivity was 1.0 ng/ml. The follow-up for patients was performed annually. During the median follow-up of 12.4 years after the rhTSH stimulation test, nine patients exhibited recurrence (18.4%). Of the nine patients, six exhibited sTg levels >2 ng/ml (positive result) and three exhibited levels <2 ng/ml (negative result). Relapse occurred at a mean of 5.9 years following the rhTSH stimulation test. The positive predictive value and negative predictive value (NPV) of positive sTg were 50 and 91.9%, respectively, with a sensitivity of 66.6% and a specificity of 85.0%. The rhTSH-stimulated Tg levels have a high NPV, allowing the identification of the patients who are free of the tumour. These results are consistent with the previously published data; however, to the best of our knowledge, this is the study with the longest follow-up duration after rhTSH stimulation. PMID:25663898

An observational study on outcome of hemispherotomy in children with refractory epilepsy.

PubMed

Panigrahi, Manas; Krishnan, Shyam Sundar; Vooturi, Sudhindra; Vadapalli, Rammohan; Somayajula, Shanmukhi; Jayalakshmi, Sita

2016-12-01

The current study aimed to evaluate the clinical characteristics and outcome of hemispherotomy in children with refractory hemispherical epilepsy. Retrospective analysis of data in twenty one children aged ≤12 years who underwent hemispherotomy and had at least two years post surgery follow-up was performed. Sixteen children underwent Delalande's vertical para-sagittal hemispherotomy (VPH), while lateral peri-insular functional hemispherotomy was performed in the rest. The average age of onset for epilepsy in the study population was 2.9 ± 2.4 years; the average duration of epilepsy was 4.0 ± 2.9 years. The mean age at surgery of the study population was 6.8 ± 2.8 years. Six (28.5%) children were girls. Gliosis due to presumed childhood infarct was most common etiology, observed in 13 (62.0%) of the children, followed by Rasmussen's encephalitis in six (28.5%). There was no significant difference between the surgery groups for the reported acute post operative seizures (APOS) (20.0% vs. 25.0%; p = 1.000). At last follow up 90.5% patients were seizure free; there was no difference between the groups for seizure freedom (60.0% vs. 87.5%; p = 0.228). When analyzed for outcome between the etiologies, seizure freedom was similar for gliosis due to infarct (76.9%), Rassmussens encephalitis (83.3%) and malformations of cortical development (MCD) (100.0%). Moreover, improved quality of life in epilepsy (QOLIE) scores was observed in 80.0% of the lateral peri-insular functional hemispherotomy group and 87.5% children in VPH group at the last follow-up. Gliosis due to presumed childhood infarct was the leading cause of medically refractory epilepsy caused by hemispheric lesions in the current study. Encouragingly, hemispherotomy offers seizure freedom (in 90.5% patients) and improvement in QOLIE scores at two years follow up. Copyright © 2015 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Treatment Options for Childhood Extracranial Germ Cell Tumors

MedlinePlus

... menstrual periods . In females, unusual vaginal bleeding. Imaging studies and blood tests are used to detect (find) and diagnose childhood ... or after starting their cancer treatment. Follow-up tests may be needed. ... trial is a research study meant to help improve current treatments or obtain ...

Stages of Childhood Extracranial Germ Cell Tumors

MedlinePlus

... menstrual periods . In females, unusual vaginal bleeding. Imaging studies and blood tests are used to detect (find) and diagnose childhood ... or after starting their cancer treatment. Follow-up tests may be needed. ... trial is a research study meant to help improve current treatments or obtain ...

Childhood Central Nervous System Germ Cell Tumors Treatment

MedlinePlus

... very tired. Having problems with school work. Imaging studies and tests are used to detect (find) and diagnose childhood ... or after starting their cancer treatment. Follow-up tests may be needed. ... trial is a research study meant to help improve current treatments or obtain ...

Follow up of injected polyurethane slab jacking.

DOT National Transportation Integrated Search

2003-08-01

GLENN JACKSON BRIDGE FOLLOW-UP REPORT The elevation monitoring in the report entitled Injected Polyurethane Slab Jacking (Soltesz 2000) is continued in this current report. The elevations of the concrete slabs are being monitored to see if polyuretha...

61. The World-Wide Inaccessible Web, Part 2: Internet Routes

ERIC Educational Resources Information Center

Baggaley, Jon; Batpurev, Batchuluun; Klaas, Jim

2007-01-01

In the previous report in this series, Web browser loading times were measured in 12 Asian countries, and were found to be up to four times slower than commonly prescribed as acceptable. Failure of webpages to load at all was frequent. The current follow-up study compares these loading times with the complexity of the Internet routes linking the…

Current Warm-Up Practices and Contemporary Issues Faced by Elite Swimming Coaches.

PubMed

McGowan, Courtney J; Pyne, David B; Raglin, John S; Thompson, Kevin G; Rattray, Ben

2016-12-01

McGowan, CJ, Pyne, DB, Raglin, JS, Thompson, KG, and Rattray, B. Current warm-up practices and contemporary issues faced by elite swimming coaches. J Strength Cond Res 30(12): 3471-3480, 2016-A better understanding of current swimming warm-up strategies is needed to improve their effectiveness. The purpose of this study was to describe current precompetition warm-up practices and identify contemporary issues faced by elite swimming coaches during competition. Forty-six state-international level swimming coaches provided information through a questionnaire on their prescription of volume, intensity, and recovery within their pool and dryland-based competition warm-ups, and challenges faced during the final stages of event preparation. Coaches identified four key objectives of the precompetition warm-up: physiological (elevate body temperature and increase muscle activation), kinesthetic (tactile preparation, increase "feel" of the water), tactical (race-pace rehearsal), and mental (improve focus, reduce anxiety). Pool warm-up volume ranged from ∼1300 to 2100 m, beginning with 400-1000 m of continuous, low-intensity (∼50-70% of perceived maximal exertion) swimming, followed by 200-600 m of stroke drills and 1-2 sets (100-400 m in length) of increasing intensity (∼60-90%) swimming, concluding with 3-4 race or near race-pace efforts (25-100 m; ∼90-100%) and 100-400 m easy swimming. Dryland-based warm-up exercises, involving stretch cords and skipping, were also commonly prescribed. Coaches preferred swimmers complete their warm-up 20-30 minutes before race start. Lengthy marshalling periods (15-20+ minutes) and the time required to don racing suits (>10 minutes) were identified as complicating issues. Coaches believed that the pool warm-up affords athletes the opportunity to gain a tactile feel for the water and surrounding pool environment. The combination of dryland-based activation exercises followed by pool-based warm-up routines seems to be the preferred approach taken by elite swimming coaches preparing their athletes for competition.

Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study.

PubMed

Choi, Stephanie K Y; Boyle, Eleanor; Cairney, John; Collins, Evan J; Gardner, Sandra; Bacon, Jean; Rourke, Sean B

2016-01-01

Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals. We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes. Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline) was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses. Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario's HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression) and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and demonstrate the need for long-term support and routine management of depression, particularly for individuals at high risk.

Antipsychotic medication and remission of psychotic symptoms 10years after a first-episode psychosis.

PubMed

Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten; Austin, Stephen F; Albert, Nikolai; Secher, Rikke Gry; Thorup, Anne Amalie Elgaard; Mors, Ole; Nordentoft, Merete

2017-04-01

Several national guidelines recommend continuous use of antipsychotic medication after a psychotic episode in order to minimize the risk of relapse. However some studies have identified a subgroup of patients who obtain remission of psychotic symptoms while not being on antipsychotic medication for a period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up. The study was a cohort study including 496 patients diagnosed with schizophrenia spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication. 61% of the patients from the original cohort attended the 10-year follow up and 30% of these had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This outcome was associated with female gender, high GAF-F score, participation in the labour market and absence of substance abuse. Our results describe a subgroup of patients who obtained remission while not being on antipsychotic medication at the 10-year follow-up. The finding calls for further investigation on a more individualized approach to long-term treatment with antipsychotic medication. Copyright © 2016 Elsevier B.V. All rights reserved.

Change in lean body mass is a major determinant of change in areal bone mineral density of the proximal femur: a 12-year observational study.

PubMed

Liu-Ambrose, T; Kravetsky, L; Bailey, D; Sherar, L; Mundt, C; Baxter-Jones, A; Khan, K M; McKay, H A

2006-09-01

Our objective was to assess the contribution of lean body mass (LBM) and fat body mass (FBM) to areal bone mineral density (aBMD) in women during the years surrounding menopause. We used a 12-year observational design. Participants included 75 Caucasian women who were premenopausal, 53 of whom were available for follow-up. There were two measurement periods: baseline and 12-year follow-up. At both measurement periods, bone mineral content and aBMD of the proximal femur, posterior-anterior lumbar spine, and total body was assessed using dual-energy X-ray absorptiometry (DXA). LBM and FBM were derived from the total-body scans. General health, including current menopausal status, hormone replace therapy use, medication use, and physical activity, was assessed by questionnaires. At the end of the study, 44% of the women were postmenopausal. After controlling for baseline aBMD, current menopausal status, and current hormone replacement therapy, we found that change in LBM was independently associated with change in aBMD of the proximal femur (P = 0.001). The cross-sectional analyses also indicated that LBM was a significant determinant of aBMD of all three DXA-scanned sites at both baseline and follow-up. These novel longitudinal data highlight the important contribution of LBM to the maintenance of proximal femur bone mass at a key time in women's life span, the years surrounding menopause.

Predictors of short- and long-term avoidance in completers of inpatient group interventions for agoraphobia.

PubMed

Hoffart, Asle; Øktedalen, Tuva; Svanøe, Karol; Hedley, Liv M; Sexton, Harold

2015-08-01

Little is currently known about predictors of follow-up outcome of psychological treatment of agoraphobia. In this study, we wished to examine predictors of short- and long-term avoidance after inpatient group interventions for agoraphobia. Ninety-six (68%) of 141 agoraphobic patients (74% women) who had completed treatment in two open and one randomized controlled trial (RCT) were followed up 13 to 21 years after start of treatment. Major depression at pre-treatment predicted less short-term (up to one year after end of treatment) improvement in agoraphobic avoidance. Working and being married/cohabiting at pre-treatment predicted greater long-term (across one-year, two-year, and 13-21 years follow-up) improvement. In contrast, the duration of agoraphobia, amount of Axis I and II co-morbidity, being diagnosed with avoidant, dependent, and obsessive-compulsive personality disorder, and the use of antidepressants and benzodiazepines the month before intake to treatment, were unrelated to short-term as well as long-term outcome. As many as 31.9% of the included patients did not attend long-term follow-up and the power of the study was limited. The long time period between the two and 13-21 year follow-ups is a limitation, in which it is difficult to assess what actually happened. Although all the patients received some form of CBT, there was variability among the treatments. The only short-term predictor identified represented a clinical feature, whereas the long-term predictors represented features of the patients' life situation. The limited power of the study precludes the inference that non-significant predictors are unrelated to follow-up outcome. Copyright © 2015 Elsevier B.V. All rights reserved.

The cost of long-term follow-up of high-risk infants for research studies.

PubMed

Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

2015-10-01

Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Employment outcomes in people with bipolar disorder: a systematic review.

PubMed

Marwaha, S; Durrani, A; Singh, S

2013-09-01

Employment outcome in bipolar disorder is an under investigated, but important area. The aim of this study was to identify the long-term employment outcomes of people with bipolar disorder. A systematic review using the Medline, PsychInfo and Web of Science databases. Of 1962 abstracts retrieved, 151 full text papers were read. Data were extracted from 25 papers representing a sample of 4892 people with bipolar disorder and a mean length of follow-up of 4.9 years. Seventeen studies had follow-up periods of up to 4 years and eight follow-up of 5-15 years. Most studies with samples of people with established bipolar disorder suggest approximately 40-60% of people are in employment. Studies using work functioning measures mirrored this result. Bipolar disorder appears to lead to workplace underperformance and 40-50% of people may suffer a slide in their occupational status over time. Employment levels in early bipolar disorder were higher than in more established illness. Bipolar disorder damages employment outcome in the longer term, but up to 60% of people may be in employment. Whilst further studies are necessary, the current evidence provides support for extending the early intervention paradigm to bipolar disorder. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort.

PubMed

Junker, Asbjørn; Bjørngaard, Johan Håkon; Bjerkeset, Ottar

2017-01-01

Self-harm is associated with increased suicide risk, and constitutes a major challenge in adolescent mental healthcare. In the current study, we examined the association between different aspects of adolescent health and risk of later self-harm requiring hospital admission. We linked baseline information from 13 to 19 year old participants (n = 8965) in the Norwegian Young-HUNT 1 study to patient records of self-harm hospitalisation during 15 years of follow-up. We used Cox regression to estimate risk factor hazard ratios (HR). Eighty-nine persons (71% female) were admitted to hospital because of self-harm. Intoxication/self-poisoning was the most frequent method (81%). Both mental (anxiety/depression, loneliness, being bullied) and somatic (epilepsy, migraine) health issues were associated with up to fourfold increased risk of self-harm-related hospital admission. Several health issues during adolescence markedly increased the risk of later self-harm hospitalisation. Current findings should be incorporated in the strive to reduce self-harming and attempted suicides among young people.

Plans for Follow-Up Observations of Kepler Planet Candidates

NASA Astrophysics Data System (ADS)

Gautier, Thomas N., III

2009-05-01

Ground based follow-up observations of transiting planet candidates identified by Kepler are pursued to identify false positives and to search for non-transiting planets in the systems of true transiting planets. I will describe the observational protocols developed by the Kepler team and the web based infrastructure we are using to support the observations. The current state of the Kepler follow-up observations will be reported.

Recall of E-cigarette Advertisements and Adolescent E-cigarette Use.

PubMed

Nicksic, Nicole E; Harrell, Melissa B; Pérez, Adriana; Pasch, Keryn E; Perry, Cheryl L

2017-04-01

We examined the impact of e-cigarette advertising on e-cigarette use behaviors among youth over time. At baseline, 3907 students participated in a youth tobacco surveillance study from 2014-2015 and 2488 students completed a 6-month follow-up. Weighted logistic regression models investigated the recall of e-cigarette advertisements (TV/radio/billboards/retail/Internet) as a risk factor for e-cigarette perceived harm, use, and susceptibility. The odds of ever e-cigarette use was 3 times higher (AOR=2.99; 95% CI, 1.50-5.97) at 6-month follow-up among e-cigarette never-users who recalled e-cigarette advertisements in retail stores at baseline, compared to those who did not. Likewise, the odds of current e-cigarette use and susceptibility to e-cigarette use at 6-month follow-up were 2.03 (95% CI, 1.11-3.72) and 1.77 (95% CI, 1.20-2.61), respectively. Additionally, recall of e-cigarette advertisements on the Internet at baseline was significantly related to current use (AOR=2.17; 95% CI, 1.05-4.48) and susceptibility to use e-cigarettes (AOR=1.72;95% CI, 1.15-2.58) at 6-month follow-up. Recall of e-cigarette advertisements at point-of-sale and on the Internet was significantly associated with adolescent e-cigarette susceptibility and use, which supports the need to minimize adolescent exposure to these advertisements.

Relationship status predicts lower restrictive eating pathology for bisexual and gay men across 10-year follow-up.

PubMed

Brown, Tiffany A; Keel, Pamela K

2015-09-01

Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. BG (n = 51) and heterosexual (n = 522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. © 2015 Wiley Periodicals, Inc.

Relationship Status Predicts Lower Restrictive Eating Pathology for Bisexual and Gay Men across 10-year Follow-up

PubMed Central

Brown, Tiffany A.; Keel, Pamela K.

2015-01-01

Objective Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. Method BG (n=51) and heterosexual (n=522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. Results For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Discussion Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. PMID:26172055

Transcranial Direct Current Stimulation Does Not Improve Language Outcome in Subacute Poststroke Aphasia.

PubMed

Spielmann, Kerstin; van de Sandt-Koenderman, W Mieke E; Heijenbrok-Kal, Majanka H; Ribbers, Gerard M

2018-04-01

The aim of the present study is to investigate the effect of transcranial direct current stimulation on word-finding treatment outcome in subacute poststroke aphasia. In this multi-center, double-blind, randomized controlled trial with 6-month follow-up, we included 58 patients with subacute aphasia (<3 months poststroke), who were enrolled in a stroke rehabilitation program. Patients participated in 2 separate intervention weeks. Each intervention week included 5 daily sessions of 45-minute word-finding therapy combined with either anodal transcranial direct current stimulation (1 mA, 20 minutes; experimental group) or sham transcranial direct current stimulation (control group) over the left inferior frontal gyrus. The primary outcome measure was the Boston Naming Test. Secondary outcome measures included naming performance for trained/untrained picture items and verbal communication. Both the experimental (n=26) and the control group (n=32) improved on the Boston Naming Test over the intervention period and 6-month follow-up; however, there were no significant differences between groups. Also for the secondary outcome measures, no significant differences were found. The results of the present study do not support an effect of transcranial direct current stimulation as an adjuvant treatment in subacute poststroke aphasia. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp. Unique identifier: NTR4364. © 2018 American Heart Association, Inc.

A prospective study of the impact of opening a casino on gambling behaviours: 2- and 4-year follow-ups.

PubMed

Jacques, Christian; Ladouceur, Robert

2006-10-01

It is widely believed that the rate of pathological gambling is related to the accessibility and availability of gambling activities. Few empirical studies have yet been conducted to evaluate this hypothesis. Using a longitudinal prospective design, the current study evaluates the impact of a casino in Canada's Hull, Quebec region. A random sample of respondents from Hull (experimental group) and from Quebec City (comparison group) completed the South Oaks Gambling Screen (SOGS) and gambling- related questions before the opening of the Hull Casino (pretest), 1 year after the opening (posttest), and on follow-up at Years 2 and 4. Although, 1 year after the opening of the casino, we did observe an increase in playing casino games and in the maximum amount of money lost in 1 day's gambling, this trend was not maintained over time (2- and 4-year follow-ups). In the Hull cohort, the rate of at-risk and probable pathological gamblers and the number of criteria on the SOGS did not increase at the 2- and 4-year follow-ups. The residents' reluctance to open a local casino was generally stable over time following the casino's opening. The discussion raises different explanatory factors and focuses on the context of the Regional Exposure Model as a potentially more applicable measure of studying the expansion of gambling.

Bone mineral density and markers of bone turnover and inflammation in diabetes patients with or without a Charcot foot: An 8.5-year prospective case-control study.

PubMed

Jansen, Rasmus Bo; Christensen, Tomas Møller; Bülow, Jens; Rørdam, Lene; Holstein, Per E; Jørgensen, Niklas Rye; Svendsen, Ole Lander

2018-02-01

Charcot foot is a rare but severe complication to diabetes and peripheral neuropathy. It is still unclear if an acute Charcot foot has long-term effects on the bone metabolism. To investigate this, we conducted a follow-up study to examine if a previously acute Charcot foot has any long-term effects on bone mineral density (BMD) or local or systemic bone metabolism. An 8.5-year follow-up case-control study of 44 individuals with diabetes mellitus, 24 of whom also had acute or chronic Charcot foot at the baseline visit in 2005-2007, who were followed up in 2015 with DXA scans and blood samples. 21 of the 44 baseline participants participated in the follow-up. There were no difference in the change in total hip BMD from baseline to follow-up in either the Charcot or the control group (p = 0.402 and 0.517), and no increased risk of osteoporosis in the previous Charcot feet either. From baseline to follow-up, there was a significant difference in the change in levels of fsRANK-L in the Charcot group, but not in the control group (p = 0.002 and 0.232, respectively). At follow-up, there were no differences in fsRANK-L between the groups. The fsRANK-L/OPG ratio also significantly decreased from baseline to follow-up in the Charcot group (3.4 versus 0.5) (p = 0.009), but not in the control group (1.3 versus 1.1) (p = 0.302). We found that diabetes patients with an acute Charcot foot have an elevated fsRANK-L/OPG ratio, and that the level decreased from baseline to follow-up to be comparable to the level in diabetes patients without previous or current Charcot foot. We found no permanent effect of an acute Charcot foot on hip or foot BMD. Copyright © 2017 Elsevier Inc. All rights reserved.

A multi-dimensional approach to insight and its evolution in first-episode psychosis: a 1-year outcome naturalistic study.

PubMed

Capdevielle, Delphine; Norton, Joanna; Jaussent, Isabelle; Prud'homme, Cindy; Raffard, Stéphane; Gelly, Françoise; Boulenger, Jean-Philippe; Ritchie, Karen

2013-12-30

The aim of the study was to describe the evolution of the different dimensions of insight at 1 year and its associations with psychopathology and symptomatic remission. Participants included 55 patients hospitalized for a first psychosis episode and followed up at 6 and 12 months after discharge. Measures included the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale (PANSS). Six dimensions of insight were evaluated, for current episode at hospital discharge and at 6 and 12 month FUs and past episode (at 6 and 12 month follow-ups). Our results show that concerning the current episode, only awareness of the social consequences and of the positive symptoms significantly improved during follow-up. Insight into the past episode improved for awareness of having a mental disorder, the social consequences and the positive symptoms of mental illness. Cross-sectional associations between insight and PANSS show weak to moderate, albeit significant, associations. Most of the dimensions of insight are positively and significantly associated with remission. Our findings suggest that the main underlying dimensions of insight evolve differently over time, which could suggest different inherent processes. This could be useful for developing psychotherapeutic programmes acting upon the different aspects of insight. © 2013 Elsevier Ireland Ltd. All rights reserved.

Low emotion-oriented coping and informal help-seeking behaviour as major predictive factors for improvement in major depression at 5-year follow-up in the adult community.

PubMed

Rodgers, S; Vandeleur, C L; Strippoli, M-P F; Castelao, E; Tesic, A; Glaus, J; Lasserre, A M; Müller, M; Rössler, W; Ajdacic-Gross, V; Preisig, M

2017-09-01

Given the broad range of biopsychosocial difficulties resulting from major depressive disorder (MDD), reliable evidence for predictors of improved mental health is essential, particularly from unbiased prospective community samples. Consequently, a broad spectrum of potential clinical and non-clinical predictors of improved mental health, defined as an absence of current major depressive episode (MDE) at follow-up, were examined over a 5-year period in an adult community sample. The longitudinal population-based PsyCoLaus study from the city of Lausanne, Switzerland, was used. Subjects having a lifetime MDD with a current MDE at baseline assessment were selected, resulting in a subsample of 210 subjects. Logistic regressions were applied to the data. Coping styles were the most important predictive factors in the present study. More specifically, low emotion-oriented coping and informal help-seeking behaviour at baseline were associated with the absence of an MDD diagnosis at follow-up. Surprisingly, neither formal help-seeking behaviour, nor psychopharmacological treatment, nor childhood adversities, nor depression subtypes turned out to be relevant predictors in the current study. The paramount role of coping styles as predictors of improvement in depression found in the present study might be a valuable target for resource-oriented therapeutic models. On the one hand, the positive impact of low emotion-oriented coping highlights the utility of clinical interventions interrupting excessive mental ruminations during MDE. On the other hand, the importance of informal social networks raises questions regarding how to enlarge the personal network of affected subjects and on how to best support informal caregivers.

A comparison of current practice patterns of US dermatologists versus published guidelines for the biopsy, initial management, and follow up of patients with primary cutaneous melanoma.

PubMed

Farberg, Aaron S; Rigel, Darrell S

2016-12-01

Guidelines exist for the management of cutaneous malignant melanoma, but their adoption, prevalence, and impact have not yet been determined. To determine current melanoma clinical management practices of US dermatologists and the variance from guidelines that might exist. A cross-sectional e-mail survey study assessing preferred biopsy methods for lesions suspicious for melanoma, margins used for excision, and recommended follow-up intervals were sent to 6177 US dermatologists (540 responding). The representative nature of the responding subset was verified by comparing their demographics to that from the American Academy of Dermatology (AAD) membership. Management varied from published guidelines. Shave biopsy (35%) was the most commonly used method followed by narrow excisional biopsy (31%), saucerization/scoop shave (12%), punch (11%), and wide excision (3%). Excisional margins narrower than recommended were noted and follow-up intervals varied. There were significant management differences noted for dermatologists by practice setting and by years in practice. The impact of patient history, lesion anatomic site, and size of lesion were not assessed. Recall and nonresponder sampling bias may exist. Variations in dermatologists' approaches to melanoma management and variance from current guidelines suggest that a knowledge gap may exist representing an educational opportunity. However, emerging data may also justify deviations from existing guidelines, suggesting a reassessment of the guidelines may be indicated. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Ten Years down the Road: Predictors of Driving Cessation

ERIC Educational Resources Information Center

Edwards, Jerri D.; Bart, Edward; O'Connor, Melissa L.; Cissell, Gayla

2010-01-01

Purpose: Recent prospective studies have found that cognition is a more salient predictor of driving cessation than physical performance or demographic factors among community-dwelling older adults. However, these studies have been limited to 5 years of follow-up. The current study used data from the Maryland Older Drivers Project to examine…

Six-week follow-up after HIV-1 exposure: a position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy.

PubMed

Gaines, Hans; Albert, Jan; Axelsson, Maria; Berglund, Torsten; Gisslén, Magnus; Sönnerborg, Anders; Blaxhult, Anders; Bogdanovic, Gordana; Brytting, Maria; Carlander, Christina; Flamholc, Leo; Follin, Per; Haggar, Axana; Hagstam, Per; Johansson, Marcus; Navér, Lars; Persson Blom, Jenny; Samuelson, Agneta; Ström, Helena; Sundqvist, Martin; Svedhem Johansson, Veronica; Tegmark Wisell, Karin; Tegnell, Anders; Thorstensson, Rigmor

2016-02-01

In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.

New Faculty Members' Emotions: A Mixed-Method Study

ERIC Educational Resources Information Center

Stupnisky, Robert H.; Pekrun, Reinhard; Lichtenfeld, Stephanie

2016-01-01

The current study developed when new faculty members spontaneously reported discrete emotions during focus groups exploring the factors affecting their success. Qualitative analysis using the framework of Pekrun's control-value theory of emotions revealed 18 different emotions with varying frequencies. A follow-up survey of 79 new faculty members…

Survey and Analysis of Alternative Education Programs II

ERIC Educational Resources Information Center

Hosley, Nathaniel S.; Hosley, Jessica; Thein, Myint

2009-01-01

This research is a follow up to a similar study published by the Center for Rural Pennsylvania in 2003 in which researchers examined alternative education policies and practices among Pennsylvania school districts. The current study extended the previous research to include information on the perceptions of administrators and teachers on the…

The Hawthorne Effect: a randomised, controlled trial

PubMed Central

McCarney, Rob; Warner, James; Iliffe, Steve; van Haselen, Robbert; Griffin, Mark; Fisher, Peter

2007-01-01

Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation) or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months). Our primary outcomes were cognitive functioning (ADAS-Cog) and participant and carer-rated quality of life (QOL-AD). Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT), with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group), and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group). There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048 PMID:17608932

A New Era of Submillimeter GRB Afterglow Follow-Ups with the Greenland Telescope

NASA Astrophysics Data System (ADS)

Urata, Yuji; Huang, Kuiyun; Asada, Keiichi; Hirashita, Hiroyuki; Inoue, Makoto; Ho, Paul T. P.

A planned rapid submillimeter (submm) Gamma Ray Burst (GRBs) follow-up observations conducted using the Greenland Telescope (GLT) is presented. The GLT is a 12-m submm telescope to be located at the top of the Greenland ice sheet, where the high-altitude and dry weather porvides excellent conditions for observations at submm wavelengths. With its combination of wavelength window and rapid responding system, the GLT will explore new insights on GRBs. Summarizing the current achievements of submm GRB follow-ups, we identify the following three scientific goals regarding GRBs: (1) systematic detection of bright submm emissions originating from reverse shock (RS) in the early afterglow phase, (2) characterization of forward shock and RS emissions by capturing their peak flux and frequencies and performing continuous monitoring, and (3) detections of GRBs as a result of the explosion of first-generation stars result of GRBs at a high redshift through systematic rapid follow ups. The light curves and spectra calculated by available theoretical models clearly show that the GLT could play a crucial role in these studies.

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

PubMed Central

Semple, John L; Coyte, Peter C

2014-01-01

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

Determining triglyceride reductions needed for clinical impact in severe hypertriglyceridemia.

PubMed

Christian, Jennifer B; Arondekar, Bhakti; Buysman, Erin K; Jacobson, Terry A; Snipes, Rose G; Horwitz, Ralph I

2014-01-01

Patients with severe hypertriglyceridemia have an increased risk of cardiovascular disease and pancreatitis. Target triglyceride levels associated with clinical benefit for patients with severe hypertriglyceridemia are not currently known. This study evaluates the association between lower follow-up triglyceride levels and incidence of clinical events for patients with severe hypertriglyceridemia. By using claims data from 2 large US healthcare databases, we conducted a retrospective cohort study and identified 41,210 adults with severe hypertriglyceridemia (triglycerides ≥ 500 mg/dL) between June 2001 and September 2010. The date of the first severe hypertriglyceridemia laboratory result was the index date. Patients were categorized into 1 of 5 triglyceride ranges (<200 mg/dL, 200-299 mg/dL, 300-399 mg/dL, 400-499 mg/dL, and ≥ 500 mg/dL) based on a follow-up triglyceride level assessed 6 to 24 weeks after initial triglyceride levels were measured. Adjusted Cox regression models were developed to evaluate the impact of follow-up triglyceride levels on rates of pancreatitis episodes and cardiovascular events. The mean age of patients was 50 years, 72% were male, and the mean follow-up was 825 days. Patients with severe hypertriglyceridemia with follow-up triglyceride levels <200 mg/dL experienced a lower rate of pancreatitis episodes (adjusted incidence rate ratio, 0.45; 95% confidence interval, 0.34-0.60) and cardiovascular events (adjusted incidence rate ratio, 0.71; 95% confidence interval, 0.64-0.78) with some clinical benefit in adults with severe hypertriglyceridemia with follow-up triglyceride levels 200 to 299 mg/dL and 300 to 399 mg/dL (P < .001 for trend). We observed the greatest impact on clinical events among patients with severe hypertriglyceridemia with the lowest follow-up triglyceride levels. Copyright © 2014 Elsevier Inc. All rights reserved.

Back posture education in elementary schoolchildren: a 2-year follow-up study.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2007-06-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age 13.2 +/- 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential.

Back posture education in elementary schoolchildren: a 2-year follow-up study

PubMed Central

Geldhof, Elisabeth; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-01-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13–14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential. PMID:17013655

Monitoring Progress in Population Health: Trends in Premature Death Rates

PubMed Central

Catlin, Bridget B.; Kindig, David A.

2013-01-01

Introduction Trends in population health outcomes can be monitored to evaluate the performance of population health systems at the national, state, and local levels. The objective of this study was to compare and contrast 4 measures for assessing progress in population health improvement by using age-adjusted premature death rates as a summary measure of the overall health outcomes in the United States and in all 50 states. Methods To evaluate the performance of statewide population health systems during the past 20 years, we used 4 measures of age-adjusted premature (<75 years of age) death rates: current rates (2009), baseline trends (1990s), follow-up trends (2000s), and changes in trends from baseline to the follow-up periods (ie, “bending the curve”). Results Current premature death rates varied by approximately twofold, with the lowest rate in Minnesota (268 deaths per 100,000) and the highest rate in Mississippi (482 deaths per 100,000). Rates improved the most in New York during the baseline period (−3.05% per year) and in New Jersey during the follow-up period (−2.87% per year), whereas Oklahoma ranked last in trends during both periods (−0.30%/y, baseline; +0.18%/y, follow-up). Trends improved the most in Connecticut, bending the curve downward by −1.03%; trends worsened the most in New Mexico, bending the curve upward by 1.21%. Discussion Current premature death rates, recent trends, and changes in trends vary by state in the United States. Policy makers can use these measures to evaluate the long-term population health impact of broad health care, behavioral, social, and economic investments in population health. PMID:24370109

Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial

PubMed Central

2013-01-01

Background Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. Method/Design This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker’s quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the health service packages. Intention-to-treat analysis will be followed. Factors influencing smoking cessation will be analyzed by the structure equation model. Discussion This multicomponent intervention, accessible at primary healthcare clinics, and focusing on the individual as well as the family and social environment, is unique and expected to work effectively. Trial registration Current Controlled Trials ISRCTN89315117 PMID:24308874

Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial.

PubMed

Aung, Myo Nyein; Yuasa, Motoyuki; Lorga, Thaworn; Moolphate, Saiyud; Fukuda, Hiroshi; Kitajima, Tsutomu; Yokokawa, Hirohide; Minematsu, Kazuo; Tanimura, Susumu; Hiratsuka, Yoshimune; Ono, Koichi; Naunboonruang, Prissana; Thinuan, Payom; Kawai, Sachio; Suya, Yaoyanee; Chumvicharana, Somboon; Marui, Eiji

2013-12-05

Smoking cessation is a high-priority intervention to prevent CVD events and deaths in developing countries. While several interventions to stop smoking have been proved successful, the question of how to increase their effectiveness and practicality in developing countries remains. In this study, a newly devised evidence-based smoking cessation service package will be compared with the existing service in a randomized controlled trial within the community setting of Thailand. This randomized control trial will recruit 440 current smokers at CVD risk because of being diabetic and/or hypertensive. Informed, consented participants will be randomly allocated into the new service-package arm and the routine service arm. The study will take place in the non-communicable disease clinics of the Maetha District Hospital, Lampang, northern Thailand. The new smoking-cessation service-package comprises (1) regular patient motivation and coaching from the same primary care nurse over a 3-month period; (2) monthly application of piCO + smokerlyzer to sustain motivation of smoker's quitting attempt and provide positive feedback over a 3-month period; (3) assistance by an assigned family member; (4) nicotine replacement chewing gum to relieve withdrawal symptoms. This new service will be compared with the traditional routine service comprising the 5A approach in a 1-year follow-up. Participants who consent to participate in the study but refuse to attempt quitting smoking will be allocated to the non-randomized arm, where they will be just followed up and monitored. Primary outcome of the study is smoking cessation rate at 1-year follow-up proven by breath analysis measuring carbomonoxide in parts per million in expired air. Secondary outcomes are smoking cessation rate at the 6-month follow-up, blood pressure and heart rate, CVD risk according to the Framingham general cardiovascular risk score, CVD events and deaths at the 12-month follow-up, and the cost-effectiveness of the health service packages. Intention-to-treat analysis will be followed. Factors influencing smoking cessation will be analyzed by the structure equation model. This multicomponent intervention, accessible at primary healthcare clinics, and focusing on the individual as well as the family and social environment, is unique and expected to work effectively. Current Controlled Trials ISRCTN89315117.

Disparities in abnormal mammogram follow-up time for Asian women compared with non-Hispanic white women and between Asian ethnic groups.

PubMed

Nguyen, Kim H; Pasick, Rena J; Stewart, Susan L; Kerlikowske, Karla; Karliner, Leah S

2017-09-15

Delays in abnormal mammogram follow-up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow-up between non-Hispanic white (NHW) and Asian women. The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI-RADS) abnormal result of category 0 or 3-plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan-Meier estimation for the median number of days to follow-up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow-up at 30 days, 60 days, and 90 days and no follow-up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow-up with adjusted Cox proportional hazards models. Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow-up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow-up at 30 days was lower for Asians versus NHWs (57% vs 77%; P<.0001), and these disparities persisted at 60 days and 90 days for all Asian ethnic groups except Japanese. Asian women had a reduced hazard of follow-up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69-0.72). Asian women also had a higher rate of receiving no follow-up compared with NHW women (15% vs 10%; P<.001); among Asian ethnic groups, Filipinas were found to have the highest percentage of women with no follow-up (18.1%). Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

A Study of Current Trends and Issues for Graphics Education: Results from a Five-Year Follow-Up Survey

ERIC Educational Resources Information Center

Clark, Aaron C.; Scales, Alice Y.

2006-01-01

During the 1998-1999 academic year, a survey was conducted to look at current trends and issues in the profession of graphics education (Clark & Scales, 1999). The survey solicited information from the membership of the Engineering Design Graphics Division of the American Society for Engineering Education related to their view of future areas of…

Long-term outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study.

PubMed

Weiss, Roger D; Potter, Jennifer Sharpe; Griffin, Margaret L; Provost, Scott E; Fitzmaurice, Garrett M; McDermott, Katherine A; Srisarajivakul, Emily N; Dodd, Dorian R; Dreifuss, Jessica A; McHugh, R Kathryn; Carroll, Kathleen M

2015-05-01

Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS). POATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences. At Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use. Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prevalence and prognosis of schizophrenia in Jinuo people in China: a prospective 30-year follow-up study.

PubMed

Yang, JianZhong; Kang, ChuanYuan; Zeng, Yong; Li, JianHua; Li, PeiKai; Wan, WenPeng; Zhao, XuDong; Guo, WanJun; Xu, XiuFeng; Yang, XiaoBin; Li, QiuYuan; Liu, XiaoYan; Pauline, Sung-Chan

2014-08-01

There are few studies investigating the influence of the development on mental health of minorities in China. To follow up the prevalence, natural course and prognosis of schizophrenia in Jinuo people, the last group to be recognized as a 'national minority' in China, every 10 years since 1979. From 1979 to 2009, 15%-19% of Jinuo residents were evaluated by random cluster sampling and followed up every 10 years using the Chinese version of the Composite International Diagnostic Interview (CIDI) as the screening tool and the International Classification of Diseases (ICD) as diagnostic criteria tool. There were no significant differences for the lifetime prevalence and current prevalence of schizophrenia across the three decades. Neither were there any significant differences for the prognosis of schizophrenia; however, at least half the patients had deteriorated or had residual symptoms in the follow-up. PANSS symptoms were significantly different according to different illness duration. During the three decades, there was no increasing trend for schizophrenia prevalence in Jinuo society; however, the prognosis of schizophrenia was not optimistic. In the natural, untreated status, schizophrenia patients with an illness duration of more than 20 years had more serious symptoms. © The Author(s) 2013.

Adolescents' protection motivation and smoking behaviour.

PubMed

Thrul, Johannes; Stemmler, Mark; Bühler, Anneke; Kuntsche, Emmanuel

2013-08-01

The protection motivation theory (PMT) is a well-known theory of behaviour change. This study tested the applicability of the sub-constructs of threat and coping appraisal in predicting adolescents' smoking-related behavioural intentions and smoking behaviour longitudinally. Adolescents (N = 494) aged 11-16 years and not currently smoking at baseline participated in the study. Predictive validity of PMT constructs was tested in a path analysis model. Self-efficacy significantly predicted behavioural intention at baseline, which significantly predicted behavioural intention at follow-up, which in turn predicted smoking behaviour at follow-up. The effect of self-efficacy on behavioural intention at follow-up was mediated by behavioural intention at baseline and the effect of self-efficacy on smoking behaviour was mediated by behavioural intention at baseline and follow-up. In conclusion, we found support for one part of the PMT, namely for the predictive validity of the coping appraisal construct self-efficacy in predicting adolescents' smoking-related behavioural intention and smoking behaviour. These results fail to support the appropriateness of the PMT's construct threat appraisal in longitudinally predicting adolescents' smoking as well as the applicability of communicating fear and negative information as preventive interventions for this target group.

Do Changes in the Production Process Affect the Outcome of Ceramic Liners: A 3-Year Follow-Up Study.

PubMed

Schmidt-Braekling, Tom; Renner, Lisa; Mintz, Douglas N; Waldstein, Wenzel; Endo, Yoshimi; Boettner, Friedrich

2017-04-01

In 2011, the current liner was withdrawn from the market because of the potential risk for liner fracture secondary to increased pressures used to assemble the metal locking ring. The present study provides a short-term follow-up of patients with this implant. We retrospectively evaluated 63 consecutive hips in 53 patients operated by a single surgeon using a recalled ceramic-on-ceramic bearing. There were 30 women and 23 men with an average age of 50.6 years (range 20.3-63.5 years). The mean follow-up was 36.8 months. Six hips in 6 patients were revised (9.5%) because of a liner-fracture during the follow-up period. All liner fractures were identified on computer tomography imaging. Nine patients had self-reported episodes of squeaking (14.3%). All 6 patients that underwent revision surgery for liner fracture described squeaking before revision. There were no revisions for other causes. Two of the revised patients had a subsequent dislocation (33%). The recalled ceramic liner lots have an increased liner fracture rate. Patients with mechanical symptoms or squeaking should undergo computer tomography to rule out liner facture. Copyright © 2016 Elsevier Inc. All rights reserved.

Vocational outcome 6-15 years after a traumatic brain injury.

PubMed

Lexell, J; Wihlney, A-K; Jacobsson, L J

2016-01-01

To describe vocational outcome 6-15 years after a traumatic brain injury (TBI) among individuals who were productive by working or studying at the time of their TBI and determine the associations with variables related to the time of injury and at follow-up. Thirty-four individuals with a mild TBI and 45 with a moderate-to-severe TBI were assessed on average 10 years post-injury. Logistic regression was used to determine the association between their current vocational situation and variables related to the time of injury (gender, age, injury severity and educational level) and at follow-up (time since injury, marital status and overall disability). A total of 67% were productive at follow-up. Age at injury, injury severity and the degree of disability at follow-up were strongly associated with being productive. Younger individuals with milder TBI and less severe disability were significantly more likely to be fully productive. No significant associations were found between productivity and gender, education, time since injury or marital status. This study indicates that return to productivity in a long-term perspective after a TBI is possible, in particular when the individual is young, has sustained a mild TBI and has a milder form of overall disability.

Low rates of recurrence after successful treatment of multidrug-resistant tuberculosis in Tomsk, Russia.

PubMed

Gelmanova, I Y; Ahmad Khan, F; Becerra, M C; Zemlyanaya, N A; Unakova, I A; Andreev, Y G; Berezina, V I; Pavlova, V E; Shin, S; Yedilbayev, A B; Krasnov, V A; Keshavjee, S

2015-04-01

Tomsk, Russia, where multidrug-resistant tuberculosis (MDR-TB) is prevalent. To report rates of recurrence following successful treatment of MDR-TB in a program providing individualized treatment regimens designed according to the current global standard of care. A retrospective cohort study of 408 adults successfully treated for pulmonary MDR-TB from 10 September 2000 to 1 November 2004, and followed for up to 6 years post-treatment. We used Poisson regression with generalized estimating equations to assess whether recurrence rates changed significantly with time. We analyzed 399 (97.5%) patients with at least one follow-up visit (15 850 person-months of observation [PMO]). Baseline resistance to second-line drugs was common (65.2%); 398 patients (99.7%) were human immunodeficiency virus (HIV) negative. In the first year of post-treatment follow-up, there were six episodes of recurrence (1.4/1000 PMO, 95%CI 0.5-3.0). After the first post-treatment year, there were 21 episodes of recurrence (1.8/1000 PMO, 95%CI 1.1-2.8). The rate did not change significantly with time. Individualized regimens designed according to the current global standard of care achieved low rates of MDR-TB recurrence among non-HIV-infected persons treated in a programmatic setting.

Rumination prospectively predicts executive functioning impairments in adolescents.

PubMed

Connolly, Samantha L; Wagner, Clara A; Shapero, Benjamin G; Pendergast, Laura L; Abramson, Lyn Y; Alloy, Lauren B

2014-03-01

The current study tested the resource allocation hypothesis, examining whether baseline rumination or depressive symptom levels prospectively predicted deficits in executive functioning in an adolescent sample. The alternative to this hypothesis was also evaluated by testing whether lower initial levels of executive functioning predicted increases in rumination or depressive symptoms at follow-up. A community sample of 200 adolescents (ages 12-13) completed measures of depressive symptoms, rumination, and executive functioning at baseline and at a follow-up session approximately 15 months later. Adolescents with higher levels of baseline rumination displayed decreases in selective attention and attentional switching at follow-up. Rumination did not predict changes in working memory or sustained and divided attention. Depressive symptoms were not found to predict significant changes in executive functioning scores at follow-up. Baseline executive functioning was not associated with change in rumination or depression over time. Findings partially support the resource allocation hypothesis that engaging in ruminative thoughts consumes cognitive resources that would otherwise be allocated towards difficult tests of executive functioning. Support was not found for the alternative hypothesis that lower levels of initial executive functioning would predict increased rumination or depressive symptoms at follow-up. Our study is the first to find support for the resource allocation hypothesis using a longitudinal design and an adolescent sample. Findings highlight the potentially detrimental effects of rumination on executive functioning during early adolescence. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rumination prospectively predicts executive functioning impairments in adolescents

PubMed Central

Connolly, Samantha L.; Wagner, Clara A.; Shapero, Benjamin G.; Pendergast, Laura L.; Abramson, Lyn Y.; Alloy, Lauren B.

2014-01-01

Background and objectives The current study tested the resource allocation hypothesis, examining whether baseline rumination or depressive symptom levels prospectively predicted deficits in executive functioning in an adolescent sample. The alternative to this hypothesis was also evaluated by testing whether lower initial levels of executive functioning predicted increases in rumination or depressive symptoms at follow-up. Methods A community sample of 200 adolescents (ages 12–13) completed measures of depressive symptoms, rumination, and executive functioning at baseline and at a follow-up session approximately 15 months later. Results Adolescents with higher levels of baseline rumination displayed decreases in selective attention and attentional switching at follow-up. Rumination did not predict changes in working memory or sustained and divided attention. Depressive symptoms were not found to predict significant changes in executive functioning scores at follow-up. Baseline executive functioning was not associated with change in rumination or depression over time. Conclusions Findings partially support the resource allocation hypothesis that engaging in ruminative thoughts consumes cognitive resources that would otherwise be allocated towards difficult tests of executive functioning. Support was not found for the alternative hypothesis that lower levels of initial executive functioning would predict increased rumination or depressive symptoms at follow-up. Our study is the first to find support for the resource allocation hypothesis using a longitudinal design and an adolescent sample. Findings highlight the potentially detrimental effects of rumination on executive functioning during early adolescence. PMID:23978629

Drink refusal training as part of a combined behavioral intervention: Effectiveness and mechanisms of change

PubMed Central

Witkiewitz, Katie; Donovan, Dennis M.; Hartzler, Bryan

2012-01-01

Objective Many trials have demonstrated the effectiveness of cognitive behavioral interventions for alcohol dependence, yet few studies have examined why particular treatments are effective. This study was designed to evaluate whether drink refusal training was an effective component of a combined behavioral intervention (CBI) and whether change in self-efficacy was a mechanism of change following drink refusal training for individuals with alcohol dependence. Method The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. The goal of the current study was to examine whether a drink refusal skills training module, administered as part of a 16-week CBI (n=776; 31% female, 23% non-White, average age=44) predicted changes in drinking frequency and self-efficacy during and following the CBI, and whether changes in self-efficacy following drink refusal training predicted changes in drinking frequency up to one year following treatment. Results Participants (n=302) who received drink refusal skills training had significantly fewer drinking days during treatment (d=0.50) and up to one year following treatment (d=0.23). In addition the effect of the drink refusal skills training module on drinking outcomes following treatment was significantly mediated by changes in self-efficacy, even after controlling for changes in drinking outcomes during treatment (proportion mediated = 0.47). Conclusions Drink refusal training is an effective component of CBI and some of the effectiveness may be attributed to changes in client self-efficacy. PMID:22289131

Transcranial Alternating Current Stimulation: A Potential Risk for Genetic Generalized Epilepsy Patients (Study Case)

PubMed Central

San-Juan, Daniel; Sarmiento, Carlos Ignacio; Hernandez-Ruiz, Axel; Elizondo-Zepeda, Ernesto; Santos-Vázquez, Gabriel; Reyes-Acevedo, Gerardo; Zúñiga-Gazcón, Héctor; Zamora-Jarquín, Carol Marina

2016-01-01

Transcranial alternating current stimulation (tACS) is a re-emergent neuromodulation technique that consists in the external application of oscillating electrical currents that induces changes in cortical excitability. We present the case of a 16-year-old female with pharmaco-resistant juvenile myoclonic epilepsy to 3 antiepileptic’s drugs characterized by 4 myoclonic and 20 absence seizures monthly. She received tACS at 1 mA at 3 Hz pulse train during 60 min over Fp1–Fp2 (10–20 EEG international system position) during 4 consecutive days using an Endeavor™ IOM Systems device® (Natus Medical Incorporated, Middleton, WI, USA). At the 1-month follow-up, she reported a 75% increase in seizures frequency (only myoclonic and tonic–clonic events) and developed a 24-h myoclonic status epilepticus that resolved with oral clonazepam and intravenous valproate. At the 2-month follow-up, the patient reported a 15-day seizure-free period. PMID:27965623

Practices, attitudes and perceptions toward road safety in yerevan, republic of armenia.

PubMed

Chekijian, Sharon Anoush; Truzyan, Nune

2012-01-01

: To determine knowledge and attitudes regarding traffic safety devices, measures, and legislation in the general population in Yerevan, Republic of Armenia. : We conducted a baseline random digit dial fixed line telephone verbal survey of Yerevan households in April 2009 with a follow-up survey in May 2010. Survey domains included restraint use, motor vehicle crash experiences, and attitudes regarding traffic safety. : In the initial survey, of 2137 numbers dialed, 436 persons were reached and 390 (90%) agreed to participate. Of survey respondents, 90% percent of household cars had seatbelts, while 47% had airbags. Twenty-four percent always or usually wore a seatbelt when driving, 21% wore a belt as a passenger. 39% were unaware of child restraints. Of the 61% who were aware of child restraints, only 32% had ever used one. A follow-up survey was conducted one year later after enforcement efforts were increased. In the follow-up survey, 81% percent always or usually wore a seatbelt when driving, and 69% wore a belt as a passenger. There was no significant increase of awareness or use of child restraints in the follow-up survey. : Although cars in Yerevan have seat belts, the majority of drivers and passengers prior to the intervention did not use them. Knowledge and use of child restraints was poor. The follow-up survey conducted after an enforcement campaign was underway in Yerevan showed that improved enforcement greatly increased awareness and compliance with current legislation. This study provides vital baseline information for the formulation of future policy. It also highlights the need for a multi-dimensional road traffic safety initiative through public educational campaigns, enforcement of current laws, and development of novel prevention policies and regulations.

Changes in T-lymphocyte distribution associated with ingestion of aldicarb-contaminated drinking water: a follow-up study.

PubMed

Mirkin, I R; Anderson, H A; Hanrahan, L; Hong, R; Golubjatnikov, R; Belluck, D

1990-02-01

The carbamate pesticide, aldicarb, is the most commonly found man-made groundwater contaminant in Wisconsin. A 1985 study linked ingestion of aldicarb-contaminated drinking water with altered T-cell distributions, specifically an increase in the mean number of CD8+ (T8) T cells. To further evaluate this finding, a follow-up study was done in 1987. Of the 50 Portage County, Wisconsin, women who participated in the first study, 45 participated in the follow-up: 18 formerly exposed and 27 formerly unexposed. In our follow-up study, only 5 women were found to be currently exposed to aldicarb. This group of 5 women, compared to 39 unexposed women who had peripheral blood specimens taken, had an increased percentage of lymphocytes and an increased number of CD2+ T cells, due to an increased number of total CD8+ T cells. Although the number of exposed persons was small, the increases in percentage lymphocytes and absolute numbers of CD2+ and CD8+ T cells were consistent with a dose-response relationship. No identified drinking water contaminant other than aldicarb could explain these findings. These results support earlier evidence linking aldicarb exposure and lymphocyte distribution changes. Although adverse clinical effects have not been documented, the widespread use of this chemical and consequent potential for widespread exposure indicate a clear need for further research on this issue.

Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence.

PubMed

Mellgren, Anders; Wexner, Steven D; Coller, John A; Devroede, Ghislain; Lerew, Darin R; Madoff, Robert D; Hull, Tracy

2011-09-01

Sacral nerve stimulation is effective in the treatment of urinary incontinence and is currently under Food and Drug Administration review in the United States for fecal incontinence. Previous reports have focused primarily on short-term results of sacral nerve stimulation for fecal incontinence. The present study reports the long-term effectiveness and safety of sacral nerve stimulation for fecal incontinence in a large prospective multicenter study. Patients with fecal incontinent episodes more than twice per week were offered participation in this multicentered prospective trial. Patients showing ≥ 50% improvement during test stimulation were offered chronic implantation of the InterStim Therapy system (Medtronic; Minneapolis, MN). The aims of the current report were to provide 3-year follow-up data on patients from that study who underwent sacral nerve stimulation and were monitored under the rigors of an Food and Drug Administration-approved investigational protocol. One hundred thirty-three patients underwent test stimulation with a 90% success rate, of whom 120 (110 females) with a mean age of 60.5 years and a mean duration of fecal incontinence of 7 years received chronic implantation. Mean length of follow-up was 3.1 (range, 0.2-6.1) years, with 83 patients completing all or part of the 3-year follow-up assessment. At 3 years follow-up, 86% of patients (P < .0001) reported ≥ 50% reduction in the number of incontinent episodes per week compared with baseline and the number of incontinent episodes per week decreased from a mean of 9.4 at baseline to 1.7. Perfect continence was achieved in 40% of subjects. The therapy also improved the fecal incontinence severity index. Sacral nerve stimulation had a positive impact on the quality of life, as evidenced by significant improvements in all 4 scales of the Fecal Incontinence Quality of Life instrument at 12, 24, and 36 months of follow-up. The most common device- or therapy-related adverse events through the mean 36 months of follow-up included implant site pain (28%), paresthesia (15%), change in the sensation of stimulation (12%), and infection (10%). There were no reported unanticipated adverse device effects associated with sacral nerve stimulation therapy. Sacral nerve stimulation using InterStim Therapy is a safe and effective treatment for patients with fecal incontinence. These data support long-term safety and effectiveness to 36 months.

Provider management of equivocal cervical cancer screening results among underserved women, 2009–2011: follow-up of atypical squamous cells of undetermined significance

PubMed Central

Watson, Meg; Benard, Vicki; Lin, Lavinia; Rockwell, Tanner; Royalty, Janet

2015-01-01

Purpose Reflex human papillomavirus (HPV) testing is the preferred triage option for most women diagnosed with atypical squamous cells of undetermined significance (ASC-US). This study was conducted to describe follow-up results of women with ASC-US Pap test results in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), focusing on HPV test use. Methods We examined the follow-up of 45,049 women in the NBCCEDP with ASC-US Pap tests during 2009–2011. Data on demographic characteristics, diagnostic procedures, and clinical outcomes were analyzed. Results NBCCEDP providers diagnosed 45,049 women (4.5 % of all Pap tests) with an ASC-US result. Of those, 28,271 (62.8 %) were followed with an HPV test, 3,883 (8.6 %) with a repeat Pap test, 6,592 (14.6 %) with colposcopy, and 6,303 were lost to follow-up (14.0 %). Women aged 40 and older were followed more often with an HPV test. White, black, and Asian/Pacific Islander women were followed more often with an HPV test after an ASC-US Pap compared to Hispanic and American Indian/Alaska Native (AI/AN) women. Among women with a positive HPV test on follow-up, almost 90 % continued with colposcopy as recommended. AI/AN women had the highest rates of HPV positivity (55.2 %) and of no follow-up (25.0 %). Conclusion This is the first analysis describing follow-up of ASC-US Pap test results in the NBCCEDP, providing a window into current management of ASC-US results. Findings raise concerns about persistent disparities among AI/AN women. During 2009–2011, nearly two-thirds of women with an ASC-US Pap test result were followed with an HPV reflex test. PMID:25794897

Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review.

PubMed

Lagares-Franco, Carolina; Almenara-Barrios, José; O'Ferrall-González, Cristina; Castellvi-Obiols, Pere; Gabilondo, Andrea; Blasco-Cubedo, María Jesús; Miranda-Mendizábal, Andrea; Parés-Badell, Oleguer; Piqueras, José Antonio; Roca, Miquel; Rodríguez-Jiménez, Tíscar; Rodríguez-Marín, Jesús; Soto-Sanz, Victoria; Vilagut-Saiz, Gemma; Alonso, Jordi

2017-12-12

A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Pollinosis and all-cause mortality among middle-aged and elderly Japanese: a population-based cohort study.

PubMed

Konishi, S; Ng, C F S; Stickley, A; Watanabe, C

2016-08-01

Having an allergic disease may have health implications beyond those more commonly associated with allergy given that previous epidemiological studies have suggested that both atopy and allergy are linked to mortality. More viable immune functioning among the elderly, as indicated by the presence of an allergic disease, might therefore be associated with differences in all-cause mortality. Using data from a Japanese cohort, this study examined whether having pollinosis (a form of allergic rhinitis) in a follow-up survey could predict all-cause and cause-specific mortality. Data came from the Komo-Ise cohort, which at its 1993 baseline recruited residents aged 40-69 years from two areas in Gunma prefecture, Japan. The current study used information on pollinosis that was obtained from the follow-up survey in 2000. Mortality and migration data were obtained throughout the follow-up period up to December 2008. Proportional hazard models were used to examine the relation between pollinosis and mortality. At the 2000 follow-up survey, 12% (1088 of 8796) of respondents reported that they had pollinosis symptoms in the past 12 months. During the 76 186 person-years of follow-up, 748 died from all causes. Among these, there were 37 external, 208 cardiovascular, 74 respiratory, and 329 neoplasm deaths. After adjusting for potential confounders, pollinosis was associated with significantly lower all-cause [hazard ratio 0.57 (95% confidence interval = 0.38-0.87)] and neoplasms mortality [hazard ratio 0.48 (95% confidence interval = 0.26-0.92)]. Having an allergic disease (pollinosis) at an older age may be indicative of more viable immune functioning and be protective against certain causes of death. Further research is needed to determine the possible mechanisms underlying the association between pollinosis and mortality. © 2015 John Wiley & Sons Ltd.

Perimetric progression using the Visual Field Index and the Advanced Glaucoma Intervention Study score and its clinical correlations.

PubMed

Gros-Otero, Juan; Castejón, Miguel; Paz-Moreno, Javier; Mikropoulos, Dimitrios; Teus, Miguel

2015-01-01

To evaluate the association between clinical parameters and the diagnosis of progression using VFI (Visual Field Index) and AGIS (Advanced Glaucoma Intervention Study) score in primary open angle glaucoma. Retrospective study of 517 visual fields of 78 eyes with primary open angle glaucoma analyzed with VFI and AGIS score. Clinical data registered included: age, sphere, pachimetry, basal intraocular pressure (IOP), and IOP during the follow up. Only the AGIS score diagnosis of progression was associated with the clinical parameters registered. Among the analyzed data, the mean IOP during follow up (p = 0.0005) and IOP at the third month of follow up (p = 0.004) were statistically associated with progression using the AGIS criteria. The diagnosis of perimetric progression using the AGIS score in the current study was closer to the real functional progression than the diagnosis using the VFI, as the former was associated with known risk factors for progression in glaucoma. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

The entanglement between relapse and posttreatment criminal justice involvement.

PubMed

Kopak, Albert M; Haugh, Stephanie; Hoffmann, Norman G

2016-09-01

Research has established a connection between substance use and criminal activity, but much less is known about the association between posttreatment relapse and related contact with the criminal justice system. The current study was designed to elucidate this relationship by examining the long-term effects of relapse on arrest. The study also investigated the probability of relapse into substance use as it followed an arrest. Data from 5,822 adults who participated in the Comprehensive Assessment and Treatment Outcome Research (CATOR) system were analyzed. This prospective longitudinal research design included 0-6, 6-12, 12-18, and 18-24 month follow-up data. A series of logistic regression analyses indicated that relapse was associated with posttreatment arrest within the observed follow-up period, but did not significantly influence the likelihood of arrest in future follow-up periods. In comparison, posttreatment arrest in the 6-12 month follow-up period had lasting effects for relapse to substance use in the 12-18 and 18-24 month periods. Arrest in the 0-6 month posttreatment period was also associated with increased risk for relapse in the 18-24 month period. Given the evidence that demonstrated within follow-up period associations between relapse and arrest, relapse prevention is critical to preventing contact with the criminal justice system. In addition, the lasting impact of an arrest must be mitigated to maintain posttreatment recovery from substance use for adults who come into contact with the criminal justice system.

The Effect of a Leisure Time Physical Activity Intervention Delivered via a Workplace: 15-Month Follow-Up Study

PubMed Central

Skogstad, Marit; Lunde, Lars-Kristian; Ulvestad, Bente; Aass, Hans Christian D.; Clemm, Thomas; Mamen, Asgeir

2018-01-01

In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA) facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates if improvements in cardiovascular risk status are sustainable, and elucidates differences according to educational level. One hundred and twenty one employees (43 women) were examined before and after the 8-week PA-initiative and 94 at the 15-month follow-up. PA-levels, blood pressure, resting heart rate, lipids, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and selected markers of inflammation were registered at baseline, immediately after the 8-week PA-initiative, and 15 months after baseline. At the end of follow-up (15-month), PA-levels—increased during the 8-week intervention—had returned to baseline values. None of the five improvements in cardiovascular markers (total cholesterol, low density lipoprotein (LDL), P-selectin, CD40Ligand (CD40L) and Monocyte chemoattractant protein-1 (MCP-1)) seen at the 8-week follow-up were sustained. At the 15-month follow-up as compared to baseline HbA1c, CRP (log) and interleukin-6 (IL-6) were reduced by 0.06 mmol/L (95% CI −0.11,−0.01), 0.25 mg/L (95% CI −0.46,−0.04) and 0.39 pg/mL (95% CI −0.75, −0.04), respectively. At baseline, there were differences in cardiovascular risk factors comparing men with low versus high levels of education. No differences in changes in outcomes between these groups of men were found during follow-up. In this study highly educated men generally have lower levels of cardiovascular risk factors, but the effect of PA on such markers in this group do not differ from the effects seen in less educated men. PMID:29401699

Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder.

PubMed

Krebs, Georgina; de la Cruz, Lorena Fernández; Monzani, Benedetta; Bowyer, Laura; Anson, Martin; Cadman, Jacinda; Heyman, Isobel; Turner, Cynthia; Veale, David; Mataix-Cols, David

2017-07-01

Emerging evidence suggests that cognitive-behavioral therapy (CBT) is an efficacious treatment for adolescent body dysmorphic disorder (BDD) in the short term, but longer-term outcomes remain unknown. The current study aimed to follow up a group of adolescents who had originally participated in a randomized controlled trial of CBT for BDD to determine whether treatment gains were maintained. Twenty-six adolescents (mean age = 16.2, SD = 1.6) with a primary diagnosis of BDD received a course of developmentally tailored CBT and were followed up over 12 months. Participants were assessed at baseline, midtreatment, posttreatment, 2-, 6-, and 12-month follow-up. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD. Secondary outcomes included measures of insight, depression, quality of life, and global functioning. BDD symptoms decreased significantly from pre- to posttreatment and remained stable over the 12-month follow-up. At this time point, 50% of participants were classified as responders and 23% as remitters. Participants remained significantly improved on all secondary outcomes at 12-month follow-up. Neither baseline insight nor baseline depression predicted long-term outcomes. The positive effects of CBT appear to be durable up to 12-month follow-up. However, the majority of patients remained symptomatic and vulnerable to a range of risks at 12-month follow-up, indicating that longer-term monitoring is advisable in this population. Future research should focus on enhancing the efficacy of CBT in order to improve long-term outcomes. Copyright © 2017. Published by Elsevier Ltd.

Current Condition of Michigan Curriculum Materials Centers and Collections in Academic Institutions

ERIC Educational Resources Information Center

Kohrman, Rita

2015-01-01

A 2005 sabbatical study revealed 24 unique curriculum materials centers or collections (CMCs) in Michigan colleges or universities. The focus of the study was to investigate the number, characteristics, and quality of these centers and collections supporting education faculty and students. A follow up 2014 study asked how or if the Michigan…

Follow-Up Study of Former Students of the Executive Secretarial Program. Volume XVI, No. 2.

ERIC Educational Resources Information Center

Jirak, Mary Ann; Lucas, John A.

A study was conducted at Illinois' William Rainey Harper College (WRHC) to assess the current employment experiences of students who had been enrolled in the college's Executive Secretarial Program. The study population consisted of all 232 students who completed SEC-237 (Secretarial Seminar and Internship) between fall 1976 and spring 1986, and…

Inconsistent Self-Report of Delinquency by Adolescents and Young Adults with ADHD

ERIC Educational Resources Information Center

Sibley, Margaret H.; Pelham, William E.; Molina, Brooke S. G.; Waschbusch, Daniel A.; Gnagy, Elizabeth M.; Babinski, Dara E.; Biswas, Aparajita

2010-01-01

The purpose of the current study was to test the ability of adolescents and young adults with childhood ADHD to reliably self-report delinquency history. Data were examined from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of children diagnosed with ADHD between 1987 and 1996. Self-report of lifetime delinquency history was…

Toward Improving Research in Social Studies Education. SSEC Monograph Series.

ERIC Educational Resources Information Center

Fraenkel, Jack R.; Wallen, Norman E.

Social studies research has been criticized for sampling bias, inappropriate methodologies, incorrect or inappropriate use of statistics, weak or ill-defined treatments, and lack of replication and/or longitudinal follow-up. In an effort to ascertain whether past criticisms were true of current research as well, a review was conducted of 118…

Parental Alcohol-Specific Rules and Alcohol Use from Early Adolescence to Young Adulthood

ERIC Educational Resources Information Center

Mares, Suzanne H. W.; Lichtwarck-Aschoff, Anna; Burk, William J.; van der Vorst, Haske; Engels, Rutger C. M. E.

2012-01-01

Background: Several studies stress the importance of alcohol-specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow-up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study…

The Association of Sitting Time With Sarcopenia Status and Physical Performance at Baseline and 18-Month Follow-Up in the Residential Aged Care Setting.

PubMed

Reid, Natasha; Keogh, Justin W; Swinton, Paul; Gardiner, Paul A; Henwood, Timothy R

2018-06-18

This study investigated the association of sitting time with sarcopenia and physical performance in residential aged care residents at baseline and 18-month follow-up. Measures included the International Physical Activity Questionnaire (sitting time), European Working Group definition of sarcopenia, and the short physical performance battery (physical performance). Logistic regression and linear regression analyses were used to investigate associations. For each hour of sitting, the unadjusted odds ratio of sarcopenia was 1.16 (95% confidence interval [0.98, 1.37]). Linear regression showed that each hour of sitting was significantly associated with a 0.2-unit lower score for performance. Associations of baseline sitting with follow-up sarcopenia status and performance were nonsignificant. Cross-sectionally, increased sitting time in residential aged care may be detrimentally associated with sarcopenia and physical performance. Based on current reablement models of care, future studies should investigate if reducing sedentary time improves performance among adults in end of life care.

Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort.

PubMed

Mirabelli, Maria C; Preisser, John S; Loehr, Laura R; Agarwal, Sunil K; Barr, R Graham; Couper, David J; Hankinson, John L; Hyun, Noorie; Folsom, Aaron R; London, Stephanie J

2016-04-01

Interpretation of longitudinal information about lung function decline from middle to older age has been limited by loss to follow-up that may be correlated with baseline lung function or the rate of decline. We conducted these analyses to estimate age-related decline in lung function across groups of race, sex, and smoking status while accounting for dropout from the Atherosclerosis Risk in Communities Study. We analyzed data from 13,896 black and white participants, aged 45-64 years at the 1987-1989 baseline clinical examination. Using spirometry data collected at baseline and two follow-up visits, we estimated annual population-averaged mean changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by race, sex, and smoking status using inverse-probability-weighted independence estimating equations conditioning-on-being-alive. Estimated rates of FEV1 decline estimated using inverse-probability-weighted independence estimating equations conditioning on being alive were higher among white than black participants at age 45 years (e.g., male never smokers: black: -29.5 ml/year; white: -51.9 ml/year), but higher among black than white participants by age 75 (black: -51.2 ml/year; white: -26). Observed differences by race were more pronounced among men than among women. By smoking status, FEV1 declines were larger among current than former or never smokers at age 45 across all categories of race and sex. By age 60, FEV1 decline was larger among former and never than current smokers. Estimated annual declines generated using unweighted generalized estimating equations were smaller for current smokers at younger ages in all four groups of race and sex compared with results from weighted analyses that accounted for attrition. Using methods accounting for dropout from an approximately 25-year health study, estimated rates of lung function decline varied by age, race, sex, and smoking status, with largest declines observed among current smokers at younger ages. Published by Elsevier Ltd.

Factor Structure and Stability of Smoking-Related Health Beliefs in the National Lung Screening Trial

PubMed Central

Koblitz, Amber R.; Persoskie, Alexander; Ferrer, Rebecca A.; Klein, William M. P.; Dwyer, Laura A.; Park, Elyse R.

2016-01-01

Introduction: Absolute and comparative risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy are important theoretical determinants of tobacco use, but no measures have been validated to ensure the discriminant validity as well as test-retest reliability of these measures in the tobacco context. The purpose of the current study is to examine the reliability and factor structure of a measure assessing smoking-related health cognitions and emotions in a national sample of current and former heavy smokers in the National Lung Screening Trial. Methods: A sub-study of the National Lung Screening Trial assessed current and former smokers’ (age 55–74; N = 4379) self-reported health cognitions and emotions at trial enrollment and at 12-month follow-up. Items were derived from the Health Belief Model and Self-Regulation Model. Results: An exploratory factor analysis of baseline responses revealed a five-factor structure for former smokers (risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy) and a six-factor structure for current smokers, such that absolute risk and comparative risk perceptions emerged as separate factors. A confirmatory factor analysis of 12-month follow-up responses revealed a good fit for the five latent constructs for former smokers and six latent constructs for current smokers. Longitudinal stability of these constructs was also demonstrated. Conclusions: This is the first study to examine tobacco-related health cognition and emotional constructs over time in current and former heavy smokers undergoing lung screening. This study found that the theoretical constructs were stable across time and that the factor structure differed based on smoking status (current vs. former). PMID:25964503

Recall of E-cigarette Advertisements and Adolescent E-cigarette Use

PubMed Central

Nicksic, Nicole E.; Harrell, Melissa B.; Pérez, Adriana; Pasch, Keryn E.; Perry, Cheryl L.

2017-01-01

Objective We examined the impact of e-cigarette advertising on e-cigarette use behaviors among youth over time. Methods At baseline, 3907 students participated in a youth tobacco surveillance study from 2014–2015 and 2488 students completed a 6-month follow-up. Weighted logistic regression models investigated the recall of e-cigarette advertisements (TV/radio/billboards/retail/Internet) as a risk factor for e-cigarette perceived harm, use, and susceptibility. Results The odds of ever e-cigarette use was 3 times higher (AOR=2.99; 95% CI, 1.50–5.97) at 6-month follow-up among e-cigarette never-users who recalled e-cigarette advertisements in retail stores at baseline, compared to those who did not. Likewise, the odds of current e-cigarette use and susceptibility to e-cigarette use at 6-month follow-up were 2.03 (95% CI, 1.11–3.72) and 1.77 (95% CI, 1.20–2.61), respectively. Additionally, recall of e-cigarette advertisements on the Internet at baseline was significantly related to current use (AOR=2.17; 95% CI, 1.05–4.48) and susceptibility to use e-cigarettes (AOR=1.72;95% CI, 1.15–2.58) at 6-month follow-up. Conclusions Recall of e-cigarette advertisements at point-of-sale and on the Internet was significantly associated with adolescent e-cigarette susceptibility and use, which supports the need to minimize adolescent exposure to these advertisements. PMID:29104901

High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head.

PubMed

Xie, Kai; Mao, Yuanqing; Qu, Xinhua; Dai, Kerong; Jia, Qingwei; Zhu, Zhenan; Yan, Mengning

2018-02-02

Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I-III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study. The visual analog pain scale (VAS), Harris hip score, radiography, and magnetic resonance imaging were used to estimate treatment results. The progression of ONFH was evaluated by imaging examination and clinical outcomes. The results were classified as clinical success (no progression of hip symptoms) and imaging success (no progression of stage or substage on radiography and MRI). The mean follow-up duration was 130.6 months (range, 121 to 138 months). The mean VAS decreased from 3.8 before ESWT to 2.2 points at the 10-year follow-up (p < 0.001). The mean Harris hip score improved from 77.4 before ESWT to 86.9 points at the 10-year follow-up. The clinical success rates were 87.5% in ARCO stage I patients, 71.4% in ARCO stage II patients, and 75.0% in ARCO stage III patients. Imaging success was observed in all stage I hips, 64.3% of stage II hips, and 12.5% of stage III hips. Seventeen hips showed progression of the ARCO stage/substage on imaging examination. Eight hips showed femoral head collapse at the 10-year follow-up. Four hips in ARCO stage III and one hip in ARCO stage II were treated with total hip arthroplasty during the follow-up. Three were performed 1 year after ESWT, one at 2 years, and one at 5 years. The results of the current study indicated that ESWT is an effective treatment method for nontraumatic ONFH, resulting in pain relief and function restoration, especially for patients with ARCO stage I-II ONFH.

Panic disorder and subthreshold panic in the light of comorbidity: a follow-up study.

PubMed

Oral, Elif; Aydin, Nazan; Gulec, Mustafa; Oral, Meltem

2012-10-01

Especially in the presence of agoraphobia and comorbid conditions, panic disorder causes significant impairment in life quality. Although there are several studies about epidemiology and clinical features, subthreshold symptoms and courses of comorbidity have not been studied sufficiently in panic disorder. The current study assessed the courses of panic disorder and subthreshold panic symptoms in consideration of the major and subthreshold comorbid conditions. Patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-diagnosed panic disorder were assessed using the panic disorder follow-up questionnaire, Panic and Agoraphobia Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders was used to determine comorbidity, and all participants were received to 1-year follow-up. Comorbidity assessment showed that the threshold comorbidity decreased, while the subthreshold comorbidity increased at 1-year follow-up. Panic disorder symptom severity was decreased, but subthreshold panic symptoms continued to be present within the course of the illness. Presence of agoraphobia and duration of disease were significantly related with higher Panic and Agoraphobia Scale scores in the second assessment, and these relationships were independent from the treatment process. Even if the comorbidity and the severity of panic decrease with treatment, subthreshold panic and comorbid symptoms may still resist in panic disorder. Copyright © 2012 Elsevier Inc. All rights reserved.

Positive exercise test and obstructive spirometry in young male conscripts associated with persistent asthma 20 years later.

PubMed

Lindström, Irmeli; Suojalehto, Hille; Lindholm, Harri; Pallasaho, Paula; Luukkonen, Ritva; Karjalainen, Jouko; Lauerma, Antti; Karjalainen, Antti

2012-12-01

Asthma often begins in childhood or early adulthood and is a common disease among conscripts. The identification of long-term predictive factors for persistent asthma may lead to improved treatment opportunities and better disease control. Our aim was to study the prognostic factors of the severity of asthma among 40-year-old male conscripts whose asthma began in youth. We studied 119 conscripts who were referred to the Central Military Hospital during 1987-1990 due to asthma and who attended a follow-up visit approximately 20 years later. Asthma severity was evaluated during military service according to the medical records, and 20 years later during a follow-up visit using Global Initiative for Asthma guidelines. We used the results of lung function and allergy tests at baseline as predictors of current persistent asthma. Compared with baseline, asthma was less severe at follow-up: 11.8% of subjects were in remission, 42.0% had intermittent asthma, 10.9% had mild persistent asthma, and 35.3% had moderate/severe persistent asthma (p < .001). In multivariate models, a positive exercise test at baseline yielded an odds ratio (OR) of 3.2 (95% CI 1.0-9.8, p = .046), a decreased FEV1/FVC % predicted an OR of 4.0 (95% CI 1.7-9.3, p = .002), and a decreased FEF50% % predicted an OR of 2.8 (95% CI 1.3-6.4, p = .012) for current persistent asthma. About half of the men had persistent asthma at the 20-year follow-up. Positive exercise tests and obstructive spirometry results were related to the persistence of asthma and may be useful long-term prognostic factors for asthma severity.

Acute effects of a loaded warm-up protocol on change of direction speed in professional badminton players.

PubMed

Maloney, Sean J; Turner, Anthony N; Miller, Stuart

2014-10-01

It has previously been shown that a loaded warm-up may improve power performances. We examined the acute effects of loaded dynamic warm-up on change of direction speed (CODS), which had not been previously investigated. Eight elite badminton players participated in three sessions during which they performed vertical countermovement jump and CODS tests before and after undertaking the dynamic warm-up. The three warm-up conditions involved wearing a weighted vest (a) equivalent to 5% body mass, (b) equivalent to 10% body mass, and (c) a control where a weighted vest was not worn. Vertical jump and CODS performances were then tested at 15 seconds and 2, 4, and 6 minutes post warm-up. Vertical jump and CODS significantly improved following all warm-up conditions (P < .05). Post warm-up vertical jump performance was not different between conditions (P = .430). Post warm-up CODS was significantly faster following the 5% (P = .02) and 10% (P < .001) loaded conditions compared with the control condition. In addition, peak CODS test performances, independent of recovery time, were faster than the control condition following the 10% loaded condition (P = .012). In conclusion, the current study demonstrates that a loaded warm-up augmented CODS, but not vertical jump performance, in elite badminton players.

Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa - a qualitative study.

PubMed

Muhwava, Lorrein Shamiso; Murphy, Katherine; Zarowsky, Christina; Levitt, Naomi

2018-05-10

Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders' perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant's first year of life. Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa's two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided.

Long-term results of heart valve replacement with the Edwards Duromedics bileaflet prosthesis: a prospective ten-year clinical follow-up.

PubMed

Podesser, B K; Khuenl-Brady, G; Eigenbauer, E; Roedler, S; Schmiedberger, A; Wolner, E; Moritz, A

1998-05-01

The Edwards Duromedics valve (Baxter Healthcare Corp., Edwards Division, Santa Ana, Calif.) was designed with a self-irrigating hinge mechanism to reduce thromboembolic complications. After good initial clinical results, distribution was suspended in 1988 after reports of valve fracture after 20,000 valves had been implanted. The manufacturer conducted extensive studies to improve the Edwards Duromedics and reintroduced a modified version, which is available as Edwards Tekna. The purpose of the study was the evaluation of long-term results of the original Edwards Duromedics that might be important for the current version, the Edwards Tekna valve. A prospective clinical 10-year follow-up was performed of 508 patients who underwent valve replacement with the Edwards Duromedics valve in the aortic (n = 268), mitral (n = 183), and aortic and mitral (n = 56) position. The perioperative mortality rate was 6.9%; follow-up was 98% complete, comprising 3648 patient-years for a mean follow-up of 86 months (range: 33 to 144 months). The actuarial freedom from complications at the 10-year follow-up and the incidence rate (percent per patient-year) were as follows: late mortality rate, 69.2% +/- 2.4% (3.5% per patient-year); thromboembolism, 90.7% +/- 1.6% (0.96% per patient-year); anticoagulation-related hemorrhage, 87.7% +/- 1.7% (1.34% per patient-year); prosthetic valve endocarditis, 96.7% +/- 0.09% (0.38% per patient-year); valve-related mortality rate, 89.3% +/- 1.6% (1.21% per patient-year); valve failure, 86.2% +/- 1.85% (1.54% per patient-year); and valve-related morbidity and mortality rate, 71.1% +/- 2.3% (3.2% per patient-year). Three leaflet escapes were observed (one lethal, two successful reoperations; 99.1% +/- 0.05% freedom, 0.08% per patient-year). All patients functionally improved (86% in New York Heart Association classes I and II), and incidence of anemia was insignificant. These results confirm that the Edwards Duromedics valve shows excellent performance concerning thromboembolism, hemolysis, and functional improvement and will serve as a reference for the last version, the Edwards Tekna valve, where comparable long-term data are currently not available.

The use of a computed tomographic application for mobile devices in the diagnosis of oral and maxillofacial surgery.

PubMed

Aoki, Eduardo Massaharu; Cortes, Arthur Rodriguez Gonzalez; Arita, Emiko Saito

2015-01-01

The aim of the current technical report was to introduce a computed tomographic (CT) application for mobile devices as a diagnostic tool for analyzing CT images. An iPad and an iPhone (Apple, Cuppertino, CA) were used to navigate through multiplanar reconstructions of cone beam CT scans, using an application derived from the OsiriX CT software. Tools and advantages of this method were recorded. In addition, images rendered in the iPad were manipulated during dental implant placement and grafting procedures to follow up and confirm the implant digital planning in real time. The study population consisted of 10 patients. In all cases, it was possible to use image manipulation tools, such as changing contrast and brightness, zooming, rotating, panning, performing both linear and area measurements, and analyzing gray-scale values of a region of interest. Furthermore, it was possible to use the OsiriX application in the dental clinic where the study was conducted, to follow-up the analyzed implant placement and grafting procedures at the chairside. The current findings suggest that technological and practical methods to visualize radiographic images are invaluable resources to improve training, teaching, networking, and the performance of real-time follow-up of oral and maxillofacial surgical procedures. This article discusses the advantages and disadvantages of introducing this new technology in the clinical routine.

Sentinel surveillance of soil-transmitted helminthiasis in preschool-aged and school-aged children in selected local government units in the Philippines: follow-up assessment.

PubMed

Belizario, Vicente Y; Totañes, Francis Isidore G; de Leon, Winifreda U; Ciro, Raezelle Nadine T; Lumampao, Yvonne F

2015-03-01

This study was a follow-up to the baseline nationwide survey of soil-transmitted helminth (STH) infections in preschool-aged children in the Philippines and in school-aged children in selected sentinel sites to assess the Integrated Helminth Control Program of the Department of Health. The objective of the study was to describe the current prevalence and intensity of STH infections in preschool-aged and school-aged children in 6 sentinel provinces and to compare these data with baseline findings. A cross-sectional study design was used to determine the prevalence and intensity of STH infections. Parasitological assessment involved the examination of stool samples by the Kato-Katz method. Although parasitological parameters in the 2 age groups at follow-up showed significant reductions from the baseline, these parameters remained high despite 3 years of mass drug administration (MDA). Efforts toward achieving high MDA coverage rates, provision of clean water, environmental sanitation, and promotion of hygiene practices must be prioritized. © 2013 APJPH.

The patellofemoral pain syndrome in recruits undergoing military training: a prospective 2-year follow-up study.

PubMed

Dorotka, Ronald; Jimenez-Boj, Esther; Kypta, Alexander; Kollar, Bruno

2003-04-01

Patellofemoral pain syndrome is a frequent phenomenon among recruits undergoing military training. The causes, however, are largely unknown, which makes it difficult for medical staff and military personnel to deal with the problem. A prospective 2-year follow-up study was performed in 58 recruits with patellofemoral pain that had started prior to or during basic military training. Anthropometric data and patient history were recorded, and a clinical examination of the knee joint was performed according to established criteria at the time of inclusion into the study. At follow-up investigation, a questionnaire concerning the patient's current physical status and his assessment of his former military seniors were filled out. A large number of patients were engaged in jobs or sports that burdened the knee; previous injuries were also very common. The majority of our patients adhered to the recommended period of reduced activity. However, retrospectively the patients did not feel military personnel had understood them. Less activity appears to have been the main factor that reduced symptoms and complaints.

Fertility drugs and the risk of breast cancer: a meta-analysis and review.

PubMed

Zreik, Tony G; Mazloom, Ali; Chen, Yanli; Vannucci, Marina; Pinnix, Chelsea C; Fulton, Stephanie; Hadziahmetovic, Mersiha; Asmar, Nadia; Munkarah, Adnan R; Ayoub, Chakib M; Shihadeh, Ferial; Berjawi, Ghina; Hannoun, Antoine; Zalloua, Pierre; Wogan, Christine; Dabaja, Bouthaina

2010-11-01

The risk of breast cancer has been associated with reproductive history. The purpose of this study was to determine the relationship between fertility drugs used in assisted reproductive procedures and the risk of breast cancer. We performed a literature search using the MEDLINE, the COCHRANE Library, and Scopus to identify studies linking breast cancer to fertility drugs. We excluded case series, case reports, and review articles from our analysis. The study populations included women who were treated for infertility with clomiphene, gonadotropins, gonadotropin-releasing hormones, or other unspecified fertility agents. We extracted information on study design, sample size, type of fertility drugs and number of treatment cycles, breast cancer incidence, and follow-up time from these studies. Eight case-control studies and fifteen cohort studies were included in the quantitative analyses. The Newcastle-Ottawa Quality Assessment Scales were used. Two investigators independently extracted study methods, sources of bias, and outcomes. We found that the risk of breast cancer was not significantly associated with fertility drug treatment. The follow-up periods were short in some of the studies analyzed in our study; however, we proceeded to test the trend in risk estimates across different durations of follow-up and found a trend for association using the nonparametric test; this was interpreted with caution in view of the lack of adjustment with other confounding factors. The current published data do not suggest higher risk of breast cancer in women who receive fertility treatment, but the lack of long-term follow up and the inherent weaknesses in some of the published studies have to be cautiously taken into account.

Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study

PubMed Central

Choi, Stephanie K. Y.; Boyle, Eleanor; Cairney, John; Collins, Evan J.; Gardner, Sandra; Bacon, Jean; Rourke, Sean B.

2016-01-01

Introduction Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals. Methods We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes. Results Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline) was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses. Conclusions Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario’s HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression) and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and demonstrate the need for long-term support and routine management of depression, particularly for individuals at high risk. PMID:27802346

A multistage chronobiologic intervention for the treatment of depression: a pilot study.

PubMed

Moscovici, Lucian; Kotler, Moshe

2009-08-01

Most antidepressant medications in current use have several disadvantages: a delayed therapeutic effect, side effects, stigmatization and concerns about safety for the developing fetus during pregnancy. Several chronobiologic techniques which are free of these disadvantages were proposed as an alternative. The current article reports the design and the initial outcome results of a new chronobiologic multistage intervention (CMI) that is comprised of the following techniques: (i) partial sleep deprivation during the second half of the night (wake therapy--WT), (ii) medium (green) wavelength light in combination with dawn simulation (DS), (iii) bright light therapy (BLT), and (iv) sleep phase advance (SPA). The study was conducted as a set of 12 single-case designs with moderate-to-severe depressive volunteering patients. Depression, anxiety and tension measurements were taken on a daily basis beginning with a baseline measurement (T0), followed by a set of four consecutive morning measurements during the therapeutic intervention (T1-T4),and with a final measurement carried out at the end of 4 weeks of follow-up (T5). A clinically significant rapid improvement of the depressive symptoms was demonstrated and maintained for at least 4 weeks after the end of the intervention. No dropouts or compliance difficulties were observed. Patient satisfaction was high, and other than having to sleep for four nights at the Research and Development Unit, participants were not inconvenienced by the nature of the therapeutic design. Sleepiness in the late afternoon hours was reported by several of the participants, but did not reach a level that interfered with their ability to function. Levels of tension did not show a consistent improvement along the intervention procedure and were not maintained in follow-up. There was some unexpected improvement in the level of anxiety that persisted at follow-up. This latter finding requires further validation by additional studies. These initial findings showed the procedure to be effective and well tolerated. It affords many advantages, such as the achievement of a rapid response, no extinction of the therapeutic effect after 4 weeks of follow-up, safety, high patient compliance and cost effectiveness. These encouraging results warrant validation in further randomized controlled clinical trials.

He Asked Me What!?--Using Shared Online Accounts as Training Tools for Distance Learning Librarians

ERIC Educational Resources Information Center

Robinson, Kelly; Casey, Anne Marie; Citro, Kathleen

2017-01-01

This study explores the idea of creating a knowledge base from shared online accounts to use in training librarians who perform distance reference services. Through a survey, follow-up interviews and a case study, the investigators explored current and potential use of shared online accounts as training tools. This study revealed that the…

Battered Women's Perceptions of Risk Versus Risk Factors and Instruments in Predicting Repeat Reassault

ERIC Educational Resources Information Center

Heckert, D. Alex; Gondolf, Edward W.

2004-01-01

This study partially replicates and expands on a previous study that showed women's perceptions of risk to be a strong predictor of reassault among batterers. The current study employed a larger and multisite sample, a longer follow-up period of 15 months, and multiple outcomes including "repeated reassault" (n = 499). According to the multinomial…

Should the diagnostic and therapeutic protocols for adrenal incidentalomas be changed?

PubMed

Mateo-Gavira, Isabel; Vilchez-López, Francisco Javier; Larrán-Escandón, Laura; Ojeda-Schuldt, María Belén; Tinoco, Cristina López; Aguilar-Diosdado, Manuel

2015-01-01

The prevalence of adrenal incidentalomas is increasing with the aging of the population and the use of high resolution imaging technics. Current protocols propose a comprehensive monitoring of their functional and morphological state, but with no conclusive clinical evidence that endorses it. Retrospective study of 96 patients diagnosed with adrenal incidentaloma between 2008 and 2012. We evaluated clinical, functional and imaging at baseline and during follow-up. Initially, 9 cases were surgically removed: 4 due to hyperfunction (2 Cushing syndromes and 2 pheochromocytomas) and 5 due to size larger than 4cm. During follow-up one case of pheochromocytoma was diagnosed and another grew more than 1cm, needing surgery. In 98.86% of nonfunctional and benign lesions, there was no functional and/or morphological changes in the final evaluation. The results of our study challenge the validity of current diagnostic-therapeutic protocols of incidentalomas, which should be reassessed in prospective studies taking into account efficiency characteristics. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies

PubMed Central

Dahlberg, K; Odencrants, S; Hagberg, L

2016-01-01

Introduction Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life. Methods and analysis This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery. The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A–C) at 1 and 2 weeks and (D) at 1 and 4 months. Trial registration number NCT02492191; Pre-results. PMID:26769788

RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies.

PubMed

Nilsson, U; Jaensson, M; Dahlberg, K; Odencrants, S; Grönlund, Å; Hagberg, L; Eriksson, M

2016-01-13

Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life. This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery.The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A-C) at 1 and 2 weeks and (D) at 1 and 4 months. NCT02492191; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Papillary thyroid cancer: time course of recurrences during postsurgery surveillance.

PubMed

Durante, Cosimo; Montesano, Teresa; Torlontano, Massimo; Attard, Marco; Monzani, Fabio; Tumino, Salvatore; Costante, Giuseppe; Meringolo, Domenico; Bruno, Rocco; Trulli, Fabiana; Massa, Michela; Maniglia, Adele; D'Apollo, Rosaria; Giacomelli, Laura; Ronga, Giuseppe; Filetti, Sebastiano

2013-02-01

The current use of life-long follow-up in patients with papillary thyroid cancer (PTC) is based largely on the study of individuals diagnosed and treated in the latter half of the 20th century when recurrence rates were approximately 20% and relapses detected up to 20-30 years after surgery. Since then, however, diagnosis, treatment, and postoperative monitoring of PTC patients have evolved significantly. The objective of the study was to identify times to PTC recurrence and rates by which these relapses occurred in a more recent patient cohort. We retrospectively analyzed follow-up data for 1020 PTC patients consecutively diagnosed in 1990-2008 in 8 Italian hospital centers for thyroid disease. Patients underwent thyroidectomy, with or without radioiodine ablation of residual thyroid tissue and were followed up with periodic serum thyroglobulin assays and neck sonography. At the initial posttreatment (≤ 12 months) examination, 948 patients had no structural/functional evidence of disease. During follow-up (5.1-20.4 years; median 10.4 years), recurrence (cervical lymph nodes, thyroid bed) was diagnosed in 13 (1.4%) of these patients. All relapses occurred 8 or fewer years after treatment (10 within the first 5 years, 6 within the first 3 years). Recurrence was unrelated to the use/omission of postoperative radioiodine ablation. In PTC patients whose initial treatment produces disease remission (no structural evidence of disease), recurrent disease is rare, and it usually occurs during the early postoperative period. The picture of recurrence timing during the follow-up provides a foundation for the design of more cost-effective surveillance protocols for PTC patients.

Current reclamation practices after oil and gas development do not speed up succession or plant community recovery in big sagebrush ecosystems in Wyoming

USDA-ARS?s Scientific Manuscript database

Reclamation is an application of treatment(s) following disturbance to promote succession and accelerate the return of target conditions. Previous studies have framed reclamation in the context of succession by studying its effectiveness in re-establishing late-successional plant communities. Re-est...

The Effects of Tulsa's CAP Head Start Program on Middle-School Academic Outcomes and Progress

ERIC Educational Resources Information Center

Phillips, Deborah; Gormley, William; Anderson, Sara

2016-01-01

This study presents evidence pertinent to current debates about the lasting impacts of early childhood educational interventions and, specifically, Head Start. A group of students who were first studied to examine the immediate impacts of the Tulsa, Oklahoma, Community Action Project (CAP) Head Start program were followed-up in middle school,…

Colleges and Schools: Partners for Iowa's Education.

ERIC Educational Resources Information Center

Dreier, William H.

The normal school began in Iowa in 1849, developed early partnerships with local districts, and evolved into the current situation of 29 teacher education institutions (TEIs). By 1980, 42.5% of Iowa's population was rural; a 1981-1982 study showed 37.5% of Iowa's students were in rural districts. A follow-up placement study of the University of…

Examining Mental Health Differences among Transfer University Students Seeking Counseling Services

ERIC Educational Resources Information Center

Daltry, Rachel; Mehr, Kristin E.

2016-01-01

This brief report was designed as a follow-up to a study that found that compared to nontransfer students that presented to the counseling center, transfer students who presented to the counseling center endorsed higher levels of symptoms of depression and social anxiety, as well as more academic and family problems. The current study investigated…

Manpower and Employment in American Astronomy.

ERIC Educational Resources Information Center

Berendzen, Richard

The study indicates that jobs in astronomy have become severely limited in the last few years, with a near balance between supply and demand of astronomers. The following issues are assessed in this study: the current supply of astronomers in the United States, and its change as a function of time; the background and make-up of astronomers in the…

Intraosseous lipoma: retrospective analysis of 29 patients.

PubMed

Radl, Roman; Leithner, Andreas; Machacek, Felix; Cetin, Erdal; Koehler, Wolfgang; Koppany, Bodo; Dominkus, Martin; Windhager, Reinhard

2004-12-01

We reviewed 29 patients with intraosseous lipoma treated between 1985 and 2002. Mean patient age was 48 (20-75) years. According to Milgram's classification, ten cases were classified as stage I, 14 as stage II, and three as stage III. All patients were initially treated by curettage. In 11 cases an additional phenolization was performed. The average follow-up was 32 (6-208) months. At the last follow-up, none had any clinical or radiological signs of recurrence. The adequate treatment of a symptomatic intraosseous lipoma is curettage and bone grafting. In the current study, phenolization showed no added benefit. An asymptomatic intraosseous lipoma without impending pathological fracture can be treated conservatively.

Challenges and strategies for cohort retention and data collection in an indigenous population: Australian Aboriginal Birth Cohort.

PubMed

Lawrance, Megan; Sayers, Susan M; Singh, Gurmeet R

2014-02-26

Longitudinal prospective birth cohort studies are pivotal to identifying fundamental causes and determinants of disease and health over the life course. There is limited information about the challenges, retention, and collection strategies in the study of Indigenous populations. The aim is to describe the follow-up rates of an Australian Aboriginal Birth Cohort study and how they were achieved. Participants were 686 babies enrolled between January 1987 and March 1990, born to a mother recorded in the Delivery Suite Register of the Royal Darwin Hospital (RDH) as a self-identified Aboriginal. The majority of the participants (70%) resided in Northern Territory within rural, remote and very remote Aboriginal communities that maintain traditional connections to their land and culture. The Aboriginal communities are within a sparsely populated (0.2 people/ km2) area of approximately 900,000 km² (347 sq miles), with poor communication and transport infrastructures. Follow-ups collecting biomedical and lifestyle data directly from participants in over 40 locations were conducted at 11.4 years (Wave-2) and 18.2 years (Wave-3), with Wave-4 follow-up currently underway. Follow-ups at 11 and 18 years of age successfully examined 86% and 72% of living participants respectively. Strategies addressing logistic, cultural and ethical challenges are documented. Satisfactory follow-up rates of a prospective longitudinal Indigenous birth cohort with traditional characteristics are possible while maintaining scientific rigor in a challenging setting. Approaches included flexibility, respect, and transparent communication along with the adoption of culturally sensitive behaviours. This work should inform and assist researchers undertaking or planning similar studies in Indigenous and developing populations.

Radiation risks in lung cancer screening programs: a comparison with nuclear industry workers and atomic bomb survivors.

PubMed

McCunney, Robert J; Li, Jessica

2014-03-01

The National Lung Cancer Screening Trial (NLST) demonstrated that screening with low-dose CT (LDCT) scan reduced lung cancer and overall mortality by 20% and 7%, respectively. The LDCT scanning involves an approximate 2-mSv dose, whereas full-chest CT scanning, the major diagnostic study used to follow up nodules, may involve a dose of 8 mSv. Radiation associated with CT scanning and other diagnostic studies to follow up nodules may present an independent risk of lung cancer. On the basis of the NLST, we estimated the incidence and prevalence of nodules detected in screening programs. We followed the Fleischner guidelines for follow-up of nodules to assess cumulative radiation exposure over 20- and 30-year periods. We then evaluated nuclear worker cohort studies and atomic bomb survivor studies to assess the risk of lung cancer from radiation associated with long-term lung cancer screening programs. The findings indicate that a 55-year-old lung screening participant may experience a cumulative radiation exposure of up to 280 mSv over a 20-year period and 420 mSv over 30 years. These exposures exceed those of nuclear workers and atomic bomb survivors. This assessment suggests that long-term (20-30 years) LDCT screening programs are associated with nontrivial cumulative radiation doses. Current lung cancer screening protocols, if conducted over 20- to 30-year periods, can independently increase the risk of lung cancer beyond cigarette smoking as a result of cumulative radiation exposure. Radiation exposures from LDCT screening and follow-up diagnostic procedures exceed lifetime radiation exposures among nuclear power workers and atomic bomb survivors.

Cancer risk after resection of polypoid dysplasia in patients with longstanding ulcerative colitis: a meta-analysis.

PubMed

Wanders, Linda K; Dekker, Evelien; Pullens, Bo; Bassett, Paul; Travis, Simon P L; East, James E

2014-05-01

American and European guidelines propose complete endoscopic resection of polypoid dysplasia (adenomas or adenoma-like masses) in patients with longstanding colitis, with close endoscopic follow-up. The incidence of cancer after detection of flat low-grade dysplasia or dysplasia-associated lesion or mass is estimated at 14 cases/1000 years of patient follow-up. However, the risk for polypoid dysplasia has not been determined with precision. We investigated the risk of cancer after endoscopic resection of polypoid dysplasia in patients with ulcerative colitis. MEDLINE, EMBASE, PubMed, and the Cochrane library were searched for studies of patients with colitis and resected polypoid dysplasia, with reports of colonoscopic follow-up and data on cancers detected. Outcomes from included articles were pooled to provide a single combined estimate of outcomes by using Poisson regression. Of 425 articles retrieved, we analyzed data from 10 studies, comprising 376 patients with colitis and polypoid dysplasia with a combined 1704 years of follow-up. A mean of 2.8 colonoscopies were performed for each patient after the index procedure (range, 0-15 colonoscopies). The pooled incidence of cancer was 5.3 cases (95% confidence interval, 2.7-10.1 cases)/1000 years of patient follow-up. There was no evidence of heterogeneity or publication bias. The pooled rate of any dysplasia was 65 cases (95% confidence interval, 54-78 cases)/1000 patient years. Patients with colitis have a low risk of colorectal cancer after resection of polypoid dysplasia; these findings support the current strategy of resection and surveillance. However, these patients have a 10-fold greater risk of developing any dysplasia than colorectal cancer and should undergo close endoscopic follow-up. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

How do Residents of Recovery Houses Experience Confrontation between Entry and 12-Month Follow-Up?

PubMed Central

Polcin, Douglas L.; Galloway, Gantt P.; Bond, Jason; Korcha, Rachael; Greenfield, Thomas K.

2010-01-01

The role of confrontation in recovery has been vigorously debated. Proponents suggest that confrontation can help break down denial and increase motivation. Critics point to counseling studies showing confrontation harms the therapeutic alliance and increases resistance. Frequently missing in these debates is an operational definition of confrontation that can be reliably measured. The Alcohol and Drug Confrontation Scale (ADCS) is a new 72-item measure that defines confrontation as “warnings about potential harm” that might result from substance use. Previous psychometric work using a sample of residents of recovery homes at intake (N=323) indicated the ADCS had acceptable reliability and validity. Confrontation from different sources (e.g., family, friends and professionals) was generally experienced as supportive and helpful. The goals of the current study were twofold: 1) to see if the psychometric properties of the ADCS were maintained at 6 and 12 month follow up, and 2) to see if experiences and perceptions of confrontation changed over time. Despite minor variations in the factor structure between baseline and follow up, the ADCS generally maintained good reliability and validity. At follow up, the amount of confrontation participants received declined, but it continued to be generally experienced as supportive and helpful. PMID:20464806

A Follow up: Developing Growing Need for Soft-Skills in IT Professionals

ERIC Educational Resources Information Center

Swanson, Dewey A.; Phillips, Julie

2004-01-01

In this paper we follow up "Developing Growing Need for Soft-Skills in IT Professionals," a paper from the 2003 ASCUE Conference. In that paper we examined the need for "soft-skills" by information technology professionals. In the current economic climate, IT outsourcing is becoming increasingly popular. Our Columbus, Indiana…

Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic

PubMed Central

Wielders, Cornelia C. H.; van Loenhout, Joris A. F.; Morroy, Gabriëlla; Rietveld, Ariene; Notermans, Daan W.; Wever, Peter C.; Renders, Nicole H. M.; Leenders, Alexander C. A. P.; van der Hoek, Wim; Schneeberger, Peter M.

2015-01-01

Background Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007–2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever. Methods A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever. Results Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6%) were included in the analysis. At any time during the four-year follow-up period, 58 (4.5%) patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ≥1:1,024 to as serologic criterion for chronic Q-fever). Fifty-two (89.7%) of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months. Conclusions A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ≥1:512, as they showed the highest risk to progress to chronic Q-fever. PMID:26161658

Social ecological predictors of the transition to overweight in youth: results from the Teens Eating for Energy and Nutrition at Schools (TEENS) study.

PubMed

Klein, Elizabeth G; Lytle, Leslie A; Chen, Vincent

2008-07-01

To explore the social ecological predictors of the transition to overweight in youth, as shown in results from the Teens Eating for Energy and Nutrition at Schools study. Longitudinal data from a school-based intervention trial. Adolescents who were involved in the Teens Eating for Energy and Nutrition at Schools intervention study who reported a healthful weight at baseline in 1998 (n=1,728). Transition to overweight status (body mass index > or =85th percentile) at follow-up in eighth grade. Generalized linear mixed model regression. Factors in the social, environmental, individual, and behavioral domains had significant unadjusted relationships with a transition to overweight status. In the multivariate analysis, adolescents who perceived themselves to be overweight at baseline were 2.3 times more likely to be overweight at follow-up compared to those with a normal weight self-perception. Compared to nondieters, current dieters were 2.6 times more likely to be overweight at follow-up, and boys were nearly three times more likely to transition to overweight status at follow-up compared with girls. Individual factors, primarily related to a self-perception of being overweight, were the strongest predictors of transitioning to overweight as adolescents progressed from seventh through eighth grade. A better understanding of the relationship between weight concern and transition to overweight is needed.

Longitudinal study of accelerated long-term forgetting in children with genetic generalized epilepsy: Evidence of ongoing deficits.

PubMed

Grayson-Collins, Jasmin; Gascoigne, Michael B; Barton, Belinda; Webster, Richard; Gill, Deepak; Lah, Suncica

2017-09-15

Accelerated long-term forgetting (ALF) is a recently described memory disorder characterised by adequate recall after short, but not long delays. Currently, the prevailing conceptualisation of ALF is of a seizure related phenomenon. The main aim of this study was to assess whether ALF subsides as epilepsy severity and seizures abate in children with genetic generalized epilepsy (GGE). Eighteen children with GGE were compared over time to 29 healthy controls on a range of cognitive measures. The primary outcome was a modified version of the California Verbal Learning Test for Children with a long delay (seven day) recall component. At approximately two years follow up, ALF was apparent, although epilepsy severity subsided and seizures resolved in many children. This result contrasts with the dominant conceptualisation of ALF being a seizure related phenomenon. Moreover, at follow-up, worse recall at the long delay was related to greater epilepsy severity at baseline and earlier age of seizure onset, but not to being seizure free at follow-up. While at follow-up worse recall at the long delay related to the worse baseline recall at the long delay, this recall did not relate to scores obtained on standardised memory tests at baseline. Our study suggests that ALF may not be seizure related and identifies factors associated with risk of ALF in children with GGE. Copyright © 2017 Elsevier Ltd. All rights reserved.

Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population

PubMed Central

Perkett, Mackenzie; Robson, Shannon M.; Kripalu, Varsha; Wysota, Christina; McGarry, Charlotte; Weddle, David; Papas, Mia A.

2017-01-01

Food assistance recipients are at higher risk for poor cardiovascular health given their propensity to poor dietary intake and tobacco use. This study sought to evaluate the cardiovascular health status, and determine the impact of a low-intensity smoking cessation education intervention that connected mobile food pantry participants to state quit-smoking resources. A pre-post design with a 6-week follow-up was used to evaluate the impact of a 10–12 min smoking cessation education session implemented in five food pantries in Delaware. Baseline cardiovascular health, smoking behaviors and food security status were assessed. Smoking cessation knowledge, intention to quit and use of the state quit line were also assessed at follow-up. Of the 144 participants 72.3% reported having hypertension, 34.3% had diabetes, 13.9% had had a stroke. 50.0% were current smokers. The low-intensity intervention significantly increased smoking cessation knowledge but not intention to quit at follow-up. Seven percent of current smokers reported calling the quit line. Current tobacco use was five times more likely in food insecure versus food secure adults (OR 4.98; p=0.006), even after adjustment for demographic factors. Systems based approaches to address tobacco use and cardiovascular health in low-income populations are needed. The extent to which smoking cessation could reduce food insecurity and risk for cardiovascular disease in this population warrants investigation. PMID:27837357

Quality of Life Outcomes after Primary Treatment for Clinically Localised Prostate Cancer: A Systematic Review.

PubMed

Lardas, Michael; Liew, Matthew; van den Bergh, Roderick C; De Santis, Maria; Bellmunt, Joaquim; Van den Broeck, Thomas; Cornford, Philip; Cumberbatch, Marcus G; Fossati, Nicola; Gross, Tobias; Henry, Ann M; Bolla, Michel; Briers, Erik; Joniau, Steven; Lam, Thomas B; Mason, Malcolm D; Mottet, Nicolas; van der Poel, Henk G; Rouvière, Olivier; Schoots, Ivo G; Wiegel, Thomas; Willemse, Peter-Paul M; Yuan, Cathy Yuhong; Bourke, Liam

2017-12-01

Current evidence-based management for clinically localised prostate cancer includes active surveillance, surgery, external beam radiotherapy (EBRT) and brachytherapy. The impact of these treatment modalities on quality of life (QoL) is uncertain. To systematically review comparative studies investigating disease-specific QoL outcomes as assessed by validated cancer-specific patient-reported outcome measures with at least 1 yr of follow-up after primary treatment for clinically localised prostate cancer. MEDLINE, EMBASE, AMED, PsycINFO, and Cochrane Library were searched to identify relevant studies. Studies were critically appraised for the risk of bias. A narrative synthesis was undertaken. Of 11486 articles identified, 18 studies were eligible for inclusion, including three randomised controlled trials (RCTs; follow-up range: 60-72 mo) and 15 nonrandomised comparative studies (follow-up range: 12-180 mo) recruiting a total of 13604 patients. Two RCTs recruited small cohorts and only one was judged to have a low risk of bias. The quality of evidence from observational studies was low to moderate. For a follow-up of up to 6 yr, active surveillance was found to have the lowest impact on cancer-specific QoL, surgery had a negative impact on urinary and sexual function when compared with active surveillance and EBRT, and EBRT had a negative impact on bowel function when compared with active surveillance and surgery. Data from one small RCT reported that brachytherapy has a negative impact on urinary function 1 yr post-treatment, but no significant urinary toxicity was reported at 5 yr. This is the first systematic review comparing the impact of different primary treatments on cancer-specific QoL for men with clinically localised prostate cancer, using validated cancer-specific patient-reported outcome measures only. There is robust evidence that choice of primary treatment for localised prostate cancer has distinct impacts on patients' QoL. This should be discussed in detail with patients during pretreatment counselling. Our review of the current evidence suggests that for a period of up to 6 yr after treatment, men with localised prostate cancer who were managed with active surveillance reported high levels of quality of life (QoL). Men treated with surgery reported mainly urinary and sexual problems, while those treated with external beam radiotherapy reported mainly bowel problems. Men eligible for brachytherapy reported urinary problems up to a year after therapy, but then their QoL returned gradually to as it was before treatment. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Universal Versus Conditional Third Day Follow-Up Visit for Children With Nonsevere Unclassified Fever at the Community Level in Ethiopia: Protocol for a Cluster Randomized Noninferiority Trial.

PubMed

Källander, Karin; Alfven, Tobias; Workineh, Ayalkibet Abebe; Hailemariam, Abreham; Petzold, Max; Getachew, Dawit; Barat, Lawrence; Steinhardt, Laura C; Gutman, Julie R

2018-04-12

Under the World Health Organization's integrated community case management strategy, febrile children seen by community health workers (on day 1) without a diagnosable illness and without danger signs are advised to return on day 3, regardless of symptom resolution. This advice might be unnecessary and place additional time and cost burdens on caregivers and community health workers. However, the safety of not following up with respect to children with unclassified fever is unknown. The objective of this study is to establish the safety of conditional follow-up of nonsevere unclassified fever, that is, nonsevere illness with fever, no malaria, pneumonia, diarrhea, or danger signs, compared with universal follow-up on day 3, through a 2-arm cluster randomized controlled noninferiority trial. The study is being conducted in 3 districts in southwest Ethiopia. A total of 25 health facilities are randomized to one of the 2 intervention arms; all 144 health posts and 284 community health workers are included. All enrolled children are followed-up after 1 week (on day 8) for re-assessment. If still sick on day 8, additional follow-up takes place after 2 weeks (day 15) and 1 month (day 29). To demonstrate that there is no significant increase in the percentage of children deteriorating clinically, the sample size needed for a noninferiority margin of 4%, a power of 80%, an alpha of 5%, and a design effect of 3 is 4284 children with unclassified fever. Main outcome is treatment failure on day 8, defined as death, hospitalization, one or more danger signs, or persistent fever. The project was funded in 2015 and enrollment was completed 2016. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2018. This study addresses the question as to whether there is any benefit in recommending universal follow-up among children seen for nonsevere unclassified fever, or whether parents can be counseled to return in the event of persistent fever, using a cluster randomized controlled trial design embedded in a national program. Outcomes will be relevant for policy makers and are important for the evaluation of current and future World Health Organization guidelines for the management of children with fever. ClinicalTrials.gov NCT02926625; https://clinicaltrials.gov/ct2/show/NCT02926625 (Archived by WebCite at http://www.webcitation.org/6xrQWn50t). ©Karin Källander, Tobias Alfven, Ayalkibet Abebe Workineh, Abreham Hailemariam,, Max Petzold, Dawit Getachew, Lawrence Barat, Laura C Steinhardt, Julie R Gutman. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.04.2018.

Suicidality, self-harm and psychotic-like symptoms in a general adolescent psychiatric sample.

PubMed

Lindgren, Maija; Manninen, Marko; Kalska, Hely; Mustonen, Ulla; Laajasalo, Taina; Moilanen, Kari; Huttunen, Matti O; Cannon, Tyrone D; Suvisaari, Jaana; Therman, Sebastian

2017-04-01

We investigated the associations between clinical high-risk for psychosis (CHR), psychotic-like symptoms and suicidality among adolescent psychiatric patients. The sample consisted of 54 CHR and 107 non-CHR psychiatric patients aged 15-18 in Helsinki, Finland, who were assessed at the beginning of their psychiatric treatment with the Structured Interview for Prodromal Syndromes (SIPS). Current suicidality was measured with the Beck Depression Inventory (item 9), while lifetime suicidality was evaluated from all available data, including patient files. The participants were followed for 2.8-8.9 years via the national hospital discharge register, with the follow-up outcome being intentional self-harm. Data on suicides were also gathered from the Causes of Death statistics. Only 30.5% of the adolescents had no suicidal ideation at the beginning of their treatment. CHR risk state and SIPS-assessed delusions, suspiciousness, and hallucinations were associated with higher current suicidality. Of the 154 adolescents with register follow-up, there were five (3.2%) with intentional self-harm resulting in hospital treatment, all female. CHR status was not associated with self-harm. Current suicidality, familial risk of psychosis, and SIPS decreased expression of emotions were associated with self-harm during follow-up. In a Cox regression analysis model among girls, only decreased expression of emotions remained a significant predictor of intentional self-harm. Baseline suicidality measures were not associated with transitions to psychosis. CHR status was associated with higher current suicidality but did not predict follow-up intentional self-harm in treatment-seeking adolescents. Decreased expression of emotions may indicate higher risk of intentional self-harm in adolescent treatment-seeking girls. © 2015 Wiley Publishing Asia Pty Ltd.

Teacher Turnover in Charter Schools. Research Brief

ERIC Educational Resources Information Center

Stuit, David; Smith, Thomas M.

2010-01-01

The current study aimed to contribute to a deeper understanding of the organizational conditions of charter schools by examining teacher turnover. Using data from the National Center for Education Statistics (NCES) 2003-04 Schools and Staffing Survey (SASS) and the Teacher Follow-Up Survey (TFS), researchers from the National Center on School…

National and Scottish Vocational Qualifications: Early Indications of Employers' Take-up and Use.

ERIC Educational Resources Information Center

Callender, C.; And Others

A study examined British employers' adoption of National Vocational Qualifications and Scottish Vocational Qualifications (NVQ/SVQs) and the occupational standards underpinning them. Data regarding current/projected use of the NVQ/SVQs and their perceived costs, benefits, and difficulties of implementation were collected from the following:…

Follow-up of early stage melanoma: specialist clinician perspectives on the functions of follow-up and implications for extending follow-up intervals.

PubMed

Rychetnik, Lucie; McCaffery, Kirsten; Morton, Rachael L; Thompson, John F; Menzies, Scott W; Irwig, Les

2013-04-01

There is limited evidence on the relative effectiveness of different follow-up schedules for patients with AJCC stage I or II melanoma, but less frequent follow-up than is currently recommended has been proposed. To describe melanoma clinicians' perspectives on the functions of follow-up, factors that influence follow-up intervals, and important considerations for extending intervals. Qualitative interviews with 16 clinicians (surgical oncologists, dermatologists, melanoma unit physicians) who conduct follow-up at two of Australia's largest specialist centers. Follow-up is conducted for early detection of recurrences or new primary melanomas, to manage patient anxiety, support patient self-care, and as part of shared care. Recommended intervals are based on guidelines but account for each patient's clinical risk profile, level of anxiety, patient education requirements, capacity to engage in skin self-examination, and how the clinician prefers to manage any suspicious lesions. To revise guidelines and implement change it is important to understand the rationale underpinning existing practice. Extended follow-up intervals for early stage melanoma are more likely to be adopted after the first year when patients are less anxious and sufficiently prepared to conduct self-examination. Clinicians may retain existing schedules for highly anxious patients or those unable to examine themselves. Copyright © 2012 Wiley Periodicals, Inc.

Self-Reported Periodontitis and Incident Type 2 Diabetes among Male Workers from a 5-Year Follow-Up to MY Health Up Study

PubMed Central

Miyawaki, Atsushi; Toyokawa, Satoshi; Inoue, Kazuo; Miyoshi, Yuji; Kobayashi, Yasuki

2016-01-01

Aims The purpose of this study was to examine whether periodontitis is associated with incident type 2 diabetes in a Japanese male worker cohort. Methods The study participants were Japanese men, aged 36–55 years, without diabetes. Data were extracted from the MY Health Up study, consisting of self-administered questionnaire surveys at baseline and following annual health examinations for an insurance company in Japan. The oral health status of the participants was classified by two self-reported indicators: (1) gingival hemorrhage and (2) tooth loosening. Type 2 diabetes incidence was determined by self-reporting or blood test data. Modified Poisson regression approach was used to estimate the relative risks and the 95% confidence intervals of incident diabetes with periodontitis. Covariates included age, body mass index, family history of diabetes, hypertension, current smoking habits, alcohol use, dyslipidemia, and exercise habits. Results Of the 2895 candidates identified at baseline in 2004, 2469 men were eligible for follow-up analysis, 133 of whom were diagnosed with diabetes during the 5-year follow-up period. Tooth loosening was associated with incident diabetes [adjusted relative risk = 1.73, 95% confidence interval = 1.14–2.64] after adjusting for other confounding factors. Gingival hemorrhage displayed a similar trend but was not significantly associated with incident diabetes [adjusted relative risk = 1.32, 95% confidence interval = 0.95–1.85]. Conclusions Tooth loosening is an independent predictor of incident type 2 diabetes in Japanese men. PMID:27115749

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

ERIC Educational Resources Information Center

Baugh, Ronald C.

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

Baseline grey matter volume of non-transitioned "ultra high risk" for psychosis individuals with and without attenuated psychotic symptoms at long-term follow-up.

PubMed

Cropley, Vanessa L; Lin, Ashleigh; Nelson, Barnaby; Reniers, Renate L E P; Yung, Alison R; Bartholomeusz, Cali F; Klauser, Paul; Velakoulis, Dennis; McGorry, Patrick; Wood, Stephen J; Pantelis, Christos

2016-06-01

Two thirds of individuals identified as ultra-high risk (UHR) for psychosis do not transition to psychosis over the medium to long-term (non-transition; UHR-NT). Nevertheless, many of these individuals have persistent attenuated psychotic symptoms (APS). The current study examined whether there were differences in baseline grey matter volume (i.e. at initial identification as UHR) in UHR-NT individuals whom had APS compared to those without APS (No-APS) at medium to long-term follow-up. Participants were help-seeking individuals who were identified as being at UHR for psychosis between 2 and 12years previously (mean=7.5). The sample consisted of 109 participants who underwent a Magnetic Resonance Imaging scan at baseline and who had not been observed to develop a psychotic disorder over the follow-up period (UHR-NT). Using voxel-based morphometry, baseline grey matter volume (GMV) was compared between participants with (N=30) and without (N=79) APS at follow-up. At baseline, the APS and No-APS groups were clinically indistinguishable. At follow-up, the APS group had significantly worse symptoms and impaired functioning. Individuals with APS had reduced baseline GMV in frontal, temporal, posterior and cingulate regions compared to those without APS at follow-up. Reduced GMV was associated with more severe positive, negative and depressive symptoms and lower global functioning in the combined UHR-NT cohort. These associations were independent of later APS outcome. This study found that differences in regional GMV are discernible at an early stage of UHR and may be specific to individuals who have APS and psychopathology at follow-up. Our findings suggest that lower GMV at baseline may confer neurobiological risk for later APS and/or increased psychopathology while the absence of these structural abnormalities might be protective. Copyright © 2015 Elsevier B.V. All rights reserved.

Current CD4 cell count and the short-term risk of AIDS and death before the availability of effective antiretroviral therapy in HIV-infected children and adults.

PubMed

Dunn, David; Woodburn, Patrick; Duong, Trinh; Peto, Julian; Phillips, Andrew; Gibb, Di; Porter, Kholoud

2008-02-01

Currently, there are no comparable estimates of the short-term risk of disease progression in the absence of effective antiretroviral therapy for human immunodeficiency virus (HIV)-infected adults and children. A joint analysis of 2 large studies of children with vertically acquired HIV infection (the HIV Paediatric Prognostic Markers Collaborative Study) and adults with seroconversion (the CASCADE [Concerted Action on Sero-Conversion to AIDS and Death in Europe] collaboration) was conducted. Follow-up was censored at the end of 1995, before the introduction of combination antiretroviral therapy. The incidence rates of death and AIDS or death (AIDS/death) were estimated on the basis of age and current CD4 cell count. A total of 1260 deaths (over 20,500 person-years of follow-up) and 1894 initial AIDS events (over 17,200 person-years of follow-up) were observed among 6741 patients (3244 children [i.e., patients < or =15 years of age] and 3497 adults). Young children (age, <5 years) experienced high morbidity and mortality rates. After adjustment for the CD4 cell count, the effect of age on disease progression was not significant among older children, whereas the risk increased markedly in association with increasing age among adults. Death rates were similar among older children and adults aged approximately 20 years, as were the rates of progression to AIDS/death when cases of serious recurrent bacterial infection, which has a more restrictive case definition in adults, were excluded. Similar CD4 cell count criteria for initiation of antiretroviral therapy can be applied to adults and children > or = 5 years of age.

Depression as a modifiable factor to decrease the risk of dementia

PubMed Central

Almeida, O P; Hankey, G J; Yeap, B B; Golledge, J; Flicker, L

2017-01-01

Depression is an accepted risk factor for dementia, but it is unclear if this relationship is causal. This study investigated whether dementia associated with depression decreases with antidepressant use and is independent of the time between exposure to depression and the onset of dementia. We completed a 14-year longitudinal study of 4922 cognitively healthy men aged 71–89 years, and collected information about history of past depression, current depression and severity of depressive symptoms. Other measures included use of antidepressants, age, education, smoking and history of diabetes, hypertension, coronary heart disease, and stroke. The onset of dementia and death during follow-up was ascertained via the Western Australian Data Linkage System. A total of 682 men had past (n=388) or current (n=294) depression. During 8.9 years follow-up, 903 (18.3%) developed dementia and 1884 (38.3%) died free of dementia. The sub-hazard ratios (SHRs) of dementia for men with past and current depression were 1.3 (95% confidence interval (CI)=1.0, 1.6) and 1.5 (95% CI=1.2, 2.0). The use of antidepressants did not decrease this risk. Compared to men with no symptoms, the SHRs of dementia associated with questionable, mild-to-moderate and severe depressive symptoms were 1.2 (95% CI=1.0, 1.4), 1.7 (95% CI=1.4, 2.2) and 2.1 (95% CI=1.4, 3.2), respectively. The association between depression and dementia was only apparent during the initial 5 years of follow-up. Older men with history of depression are at increased risk of developing dementia, but depression is more likely to be a marker of incipient dementia than a truly modifiable risk factor. PMID:28463236

Calcium plus vitamin D supplementation and lung cancer incidence among postmenopausal women in the Women's Health Initiative.

PubMed

Tao, Meng-Hua; Dai, Qi; Chen, Shande; Freudenheim, Jo L; Rohan, Thomas; Wakelee, Heather; Datta, Mridul; Wactawski-Wende, Jean

2017-08-01

Magnesium and calcium are antagonistic in many physiologic processes. However, few studies have investigated the associations of supplemental calcium with lung cancer risk taking this antagonism into account. We evaluated the effect of calcium and vitamin D supplementation on lung cancer incidence and explored whether the ratio of baseline calcium to magnesium (Ca:Mg) intake modifies the association in the Women's Health Initiative (WHI) calcium plus vitamin D supplementation (CaD) trial. The intervention phase of the WHI CaD was a double-blinded, randomized, placebo-controlled trial in 36,382 postmenopausal women aged 50-79 years, recruited at 40U.S. centers. Post-intervention follow-up continued among 29,862 (86%) of the surviving participants. Risk of lung cancer in association with CaD supplementation was evaluated using proportional hazard regression models. After 11 years' cumulative follow-up, there were 207 lung cancers (incidence 0.11% per year) in the supplement arm and 241 (0.12%) in the placebo arm (hazard ratio (HR) for the intervention, 0.91; 95% confidence interval (CI), 0.71-1.17). Subgroup analyses suggested that the HR for lung cancer varied by baseline Ca:Mg intake ratio among women who were current smokers at enrollment (p=0.04 for interaction). Over the entire follow-up period, calcium and vitamin D supplementation did not reduce lung cancer incidence among postmenopausal women. In exploratory analyses, an interaction was found for the baseline Ca:Mg intake ratio on lung cancer among current smokers at the trial entry. This findings need to be further studied for the role of calcium with magnesium in lung carcinogenesis in current smokers. Copyright © 2017 Elsevier B.V. All rights reserved.

The 2009 U.N. Durban Review Conference: Follow-Up to the 2001 U.N. World Conference Against Racism

DTIC Science & Technology

2008-11-20

Order Code RL34754 The 2009 U.N. Durban Review Conference: Follow-Up to the 2001 U.N. World Conference Against Racism November 20, 2008 Luisa...information if it does not display a currently valid OMB control number. 1. REPORT DATE 20 NOV 2008 2. REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00...2008 4. TITLE AND SUBTITLE The 2009 U.N. Durban Review Conference: Follow-Up to the 2001 U.N. World Conference Against Racism 5a. CONTRACT NUMBER

PTSD onset and course following the World Trade Center disaster: findings and implications for future research.

PubMed

Boscarino, Joseph A; Adams, Richard E

2009-10-01

We sought to identify common risk factors associated with posttraumatic stress disorder (PTSD) onset and course, including delayed, persistent, and remitted PTSD following a major traumatic exposure. Based on a prospective study of New York City adults following the World Trade Center disaster (WTCD), we conducted baseline interviews with 2,368 persons one year after this event and then at follow-up 1 year later to evaluate changes in current PTSD status based on DSM-IV criteria. Baseline analysis suggested that current PTSD, defined as present if this occurred in the past 12 months, was associated with females, younger adults, those with lower self-esteem, lower social support, higher WTCD exposure, more lifetime traumatic events, and those with a history of pre-WTCD depression. At follow-up, current PTSD was associated with Latinos, non-native born persons, those with lower self-esteem, more negative life events, more lifetime traumatic events, and those with mixed handedness. Classifying respondents at follow-up into resilient (no PTSD time 1 or 2), remitted (PTSD time 1, not 2), delayed (no PTSD time 1, but PTSD time 2), and persistent (PTSD both time 1 and 2) PTSD, revealed the following: compared to resilient cases, remitted ones were more likely to be female, have more negative life events, have greater lifetime traumatic events, and have pre-WTCD depression. Delayed cases were more likely to be Latino, be non-native born, have lower self-esteem, have more negative life events, have greater lifetime traumas, and have mixed handedness. Persistent cases had a similar profile as delayed, but were the only cases associated with greater WTCD exposures. They were also likely to have had a pre-WTCD depression diagnosis. Examination of WTCD-related PTSD at follow-up, more specifically, revealed a similar risk profile, except that handedness was no longer significant and WTCD exposure was now significant for both remitted and persistent cases. PTSD onset and course is complex and appears to be related to trauma exposure, individual predispositions, and external factors not directly related to the original traumatic event. This diagnostic classification may benefit from additional conceptualization and research as this relates to changes in PTSD status over time.

The choice of optimal antireflux procedure after laparoscopic cardiomyotomy: two decades of clinical experience in one center

PubMed Central

Kiudelis, Mindaugas; Sakalys, Egidijus; Jonaitis, Laimas; Mickevicius, Antanas; Endzinas, Zilvinas

2017-01-01

Introduction Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated. Aim To compare the long-term rates of dysphagia, reflux symptoms and patient satisfaction with current postoperative condition between two fundoplication groups in achalasia treatment. Material and methods Our retrospective study included 97 consecutive patients with achalasia: 37 patients underwent laparoscopic posterior Toupet (270°) fundoplication followed by Heller myotomy (group I); 60 patients underwent laparoscopic anterior partial Dor fundoplication followed by Heller myotomy (group II). Long-term follow-up results included evaluation of dysphagia symptoms, intensity of heartburn and patient satisfaction with current condition. Results Patients in these two groups did not differ according to age, weight, height, postoperative stay or follow-up period. Laparoscopic myotomy with posterior Toupet fundoplication was effective in 89% of patients, while laparoscopic myotomy with anterior Dor was effective in 93% of patients (p > 0.05). 11% of patients after posterior Toupet fundoplication had clinically significant heartburn vs. 35% of patients after anterior Dor fundoplication (p < 0.05). Overall patient satisfaction with current condition was 88%, with no significant difference between the groups. Conclusions According to our study results, the two laparoscopic techniques were similarly effective in reducing achalasia symptoms, but postoperative clinical manifestation of heartburn is significantly more frequent after anterior Dor fundoplication (35% vs. 11%). The majority of patients (88%) were satisfied with operation outcomes. PMID:29062443

The Economic Impact of Texas A&M University-Corpus Christi on the Corpus Christi Metropolitan Statistical Areas: 1998 Update.

ERIC Educational Resources Information Center

Texas A and M Univ., Corpus Christi.

A study was conducted to examine the socioeconomic impact of Texas A&M University-Corpus Christi (TAMU-CC) on the surrounding community. This study was a follow-up to a previous examination of the economic relationship between the university and the community. The current study examined the short-term measurable economic impact of university…

[Confronting the practice of surgery on differentiated thyroid cancer with current guidelines in Germany. A multicenter trial].

PubMed

Schwab, R; Wieler, H; Birtel, S; Ostwald-Lenz, E; Kaiser, K P; Becker, H P

2005-01-01

For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected? Is there a difference concerning the surgical radicalism and the outcome? Does the perioperative morbidity increase with the higher radicalism of the procedure? Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following rodioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas < 1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas < 1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the so-called papillary microcarcinomas (old term) has to be respected within the current guidelines.

Current Sickle Cell Screening Program for Newborns in New York City, 1979-1980.

ERIC Educational Resources Information Center

Grover, Ranjeet; And Others

1983-01-01

Screening tests indicated that 141 out of 106,565 infants examined in New York City during 1979-80, had various forms of sickle cell anemia. Follow-up of 131 patients confirmed the original diagnoses, suggesting that the New York City Follow-up Program for Sickle Cell Screening of newborns was successful. (Author/MJL)

Does film smoking promote youth smoking in middle-income countries?: A longitudinal study among Mexican adolescents

PubMed Central

Thrasher, James F.; Sargent, James D.; Huang, Liling; Arillo-Santillán, Edna; Dorantes-Alonso, Ana; Pérez-Hernández, Rosaura

2013-01-01

Objective To determine whether exposure to smoking imagery in films predicts smoking onset among never-smoking Mexican adolescents. Methods The analytic sample was comprised of 11- to 14-year old secondary school students who reported never having tried smoking at baseline, 83% (1741/2093) of whom were successfully followed up after one year. Exposure to 42 popular films that contained smoking was assessed at baseline, whereas smoking behavior and risk factors were assessed at baseline and follow up. Logistic regression was used to estimate bivariate and adjusted relative risks of trying smoking and current smoking at follow up. Results At follow up, 36% reported having tried smoking and 8% reported having smoked in the previous month. Students who were successfully followed up were exposed to an average of 43.8 minutes of smoking in the films they reported viewing at baseline. Adjusted relative risks (ARRs) indicated that students in the two highest levels of exposure to film smoking were more than twice as likely to have smoked in the previous 30 days at follow up (ARR3v1=2.44, 95%CI 1.31, 4.55; ARR4v1=2.23, 95% CI 1.19, 4.17). The adjusted relative risk of having tried smoking by follow up reached statistical significance only when comparing the 3rd highest to the lowest exposure group (ARR3v1=1.54, 95%CI 1.01, 2.64). Having a parent or best friend who smoked at baseline were the only other variables that independently predicted both outcomes. Conclusions Exposure to movie smoking is a risk factor for smoking onset among Mexican youth. PMID:19959694

Intramyocardial bone marrow mononuclear cell transplantation in ischemic heart failure: Long-term follow-up.

PubMed

Lehtinen, Miia; Pätilä, Tommi; Kankuri, Esko; Lauerma, Kirsi; Sinisalo, Juha; Laine, Mika; Kupari, Markku; Vento, Antti; Harjula, Ari

2015-07-01

Long-term results regarding treatment of chronic ischemic heart failure with bone marrow mononuclear cells (BMMCs) have been few. We received encouraging results at the 1-year follow-up of patients treated with combined coronary artery bypass grafting (CABG) and BMMCs, so we decided to extend the follow-up. The study patients had received injections of BMMCs or vehicle into the myocardial infarction border area during CABG in a randomized and double-blind manner. We could contact 36 of the 39 patients recruited for the original study. Pre-operatively and after an extended follow-up period, we performed magnetic resonance imaging, measured pro-B-type amino-terminal natriuretic peptide, reviewed patient records from the follow-up period, and determined current quality of life with the Medical Outcomes Study Short-Form 36 (SF-36) Health Survey. The median follow-up time was 60.7 months (interquartile range [IQR], 45.1-72.6 months). No statistically significant difference was detected in change of pro-B-type amino-terminal natriuretic peptide values or in quality of life between groups. The median change in left ventricular ejection fraction was 4.9% (IQR, -2.1% to 12.3%) for controls and 3.9% (IQR, -5.2% to 10.2%) for the BMMC group (p = 0.647). Wall thickening in injected segments increased by a median of 17% (IQR, -5% to 30%) for controls and 15% (IQR, -12% to 19%) for BMMC patients (p = 0.434). Scar size in injected segments increased by a median of 2% (IQR, -7% to 19%) for controls but diminished for BMMC patients, with a median change of -17% (IQR, -30% to -6%; p = 0.011). In the treatment of chronic ischemic heart failure, combining intramyocardial BMMC therapy with CABG fails to affect cardiac function but can sustainably reduce scar size, even in the long-term. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Adult Outcomes, Reported Self-Aptitude, and Perceived Training: A Follow-Up Study of Individuals with Visual Impairment

ERIC Educational Resources Information Center

Lawson, Holly Michelle

2010-01-01

The purpose of this study was to examine factors that relate to successful adult outcomes for 28 individuals with visual impairment ages 23-30. The primary dependent variable was current employment. Independent living and completion of postsecondary educational program were secondary, related outcome measures. A secondary goal of this research was…

Project Word-Back: Exploratory Follow-Up Study on Deaf-Blind (Rubella) Children in California.

ERIC Educational Resources Information Center

Scheffelin, Edward J.

Project Word-Back, an exploratory followup study of 21 young deaf-blind (Rubella) children (6 to 9 years old), was conducted to establish a tentative reference source of information, obtain teacher estimates on selected aspects of the current functioning level of a sample of children, and provide basic data from which hypotheses may be formulated…

The Depiction of Native Americans in Recent (1991-1998) Secondary American History Textbooks.

ERIC Educational Resources Information Center

Sanchez, Antonio R.

As a follow-up to studies by R. Costo and J. Henry (1970) and J. Loewen (1995), this study examined 12 current secondary level U.S. history textbooks to evaluate their accuracy in depicting Native Americans. The criteria embodied an authenticity guideline based upon the "Five Great Values" (generosity and sharing, respect for elders and…

Motor Development in Children at Risk of Autism: A Follow-Up Study of Infant Siblings

ERIC Educational Resources Information Center

Leonard, Hayley C.; Bedford, Rachael; Charman, Tony; Elsabbagh, Mayada; Johnson, Mark H.; Hill, Elisabeth L.

2014-01-01

Recently, evidence of poor or atypical motor skills in autism spectrum disorder has led some to argue that motor impairment is a core feature of the condition. The current study uses a longitudinal prospective design to assess the development of motor skills of 20 children at increased risk of developing autism spectrum disorder, who were…

Four-Year Follow-up of Cognitive Behavioral Therapy in Persons at Ultra-High Risk for Developing Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial.

PubMed

Ising, Helga K; Kraan, Tamar C; Rietdijk, Judith; Dragt, Sara; Klaassen, Rianne M C; Boonstra, Nynke; Nieman, Dorien H; Willebrands-Mendrik, Monique; van den Berg, David P G; Linszen, Don H; Wunderink, Lex; Veling, Wim; Smit, Filip; van der Gaag, Mark

2016-09-01

Previously, we demonstrated that cognitive behavior therapy for ultra-high risk (called CBTuhr) halved the incidence of psychosis over an 18-month period. Follow-up data from the same study are used to evaluate the longer-term effects at 4 years post-baseline. The Dutch Early Detection and Intervention Evaluation study was a randomized controlled trial of 196 UHR patients comparing CBTuhr with treatment-as-usual (TAU) for comorbid disorders with TAU only. Of the original 196 patients, 113 consented to a 4-year follow-up (57.7%; CBTuhr = 56 vs TAU = 57). Over the study period, psychosis incidence, remission from UHR status, and the effects of transition to psychosis were evaluated. The number of participants in the CBTuhr group making the transition to psychosis increased from 10 at 18-month follow-up to 12 at 4-year follow-up whereas it did not change in the TAU group (n = 22); this still represents a clinically important (incidence rate ratio [IRR] = 12/22 = 0.55) and significant effect (F(1,5) = 8.09, P = .03), favoring CBTuhr. The odds ratio of CBTuhr compared to TAU was 0.44 (95% CI: 0.24-0.82) and the number needed to treat was 8. Moreover, significantly more patients remitted from their UHR status in the CBTuhr group (76.3%) compared with the TAU group (58.7%) [t(120) = 2.08, P = .04]. Importantly, transition to psychosis was associated with more severe psychopathology and social functioning at 4-year follow-up. CBTuhr to prevent a first episode of psychosis in persons at UHR of developing psychosis is still effective at 4-year follow-up. Our data also show that individuals meeting the formal criteria of a psychotic disorder have worse functional and social outcomes compared with non-transitioned cases. The trial is registered at Current Controlled Trials as trial number ISRCTN21353122 (http://controlled-trials.com/ISRCTN21353122/gaag). © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

PubMed

King, Daniel L; Delfabbro, Paul H

2014-10-01

Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD. © 2014 Wiley Periodicals, Inc.

Cell assisted lipotransfer in breast augmentation and reconstruction: A systematic review of safety, efficacy, use of patient reported outcomes and study quality.

PubMed

Arshad, Zeeshaan; Karmen, Lindsey; Choudhary, Rajan; Smith, James A; Branford, Olivier A; Brindley, David A; Pettitt, David; Davies, Benjamin M

2016-12-01

Cell assisted lipotransfer serves as a novel technique for both breast reconstruction and breast augmentation. This systematic review assesses the efficacy, safety and use of patient reported outcome measures in studies involving cell assisted lipotransfer. We also carry out an objective assessment of study quality focussing on recruitment, follow-up and provide an up-to-date clinical trial landscaping analysis. Key electronic databases were searched according to PRISMA guidelines and pre-defined inclusion and exclusion criteria. Two independent reviewers examined the retrieved publications and performed data extraction. 3980 publications were identified. Following screening, 11 studies were included for full review, representing a total of 336 patients with a follow-up time ranging from six to 42 months. A degree of variation was noted in graft retention and reported satisfaction levels, although there were only three comparative studies with conflicting results. Complications occurred at a rate of 37%. Additionally, there was a paucity of objective outcomes assessments (e.g. 3D assessment modalities or validated patient reported outcome measures) in the selected studies. Cell assisted lipotransfer is a surgical technique that is currently employed sparingly within the plastic & reconstructive surgery community. Presently, further technical and outcome standardization is required, in addition to rigorous randomized controlled trials and supporting long-term follow-up data to better determine procedural safety and efficacy. Routine use of more objective outcome measures, particularly 3D assessments and validated patient reported outcome measures, will also help facilitate wider clinical adoption and establish procedural utility.

Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in the Democratic Republic of the Congo: A cluster-randomized, community-based non-inferiority trial.

PubMed

Mullany, Luke C; van Boetzelaer, Elburg W; Gutman, Julie R; Steinhardt, Laura C; Ngoy, Pascal; Barbera Lainez, Yolanda; Wittcoff, Alison; Harvey, Steven A; Ho, Lara S

2018-04-01

The World Health Organization's integrated community case management (iCCM) guidelines recommend that all children presenting with uncomplicated fever and no danger signs return for follow-up on day 3 following the initial consultation on day 1. Such fevers often resolve rapidly, however, and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aimed to determine if a conditional follow-up visit was non-inferior to a universal follow-up visit for these children. We conducted a cluster-randomized, community-based non-inferiority trial among children 2-59 months old presenting to community health workers (CHWs) with non-severe unclassified fever in Tanganyika Province, Democratic Republic of the Congo. Clusters (n = 28) of CHWs were randomized to advise caregivers to either (1) return for a follow-up visit on day 3 following the initial consultation on day 1, regardless of illness resolution (as per current WHO guidelines; universal follow-up group) or (2) return for a follow-up visit on day 3 only if illness continued (conditional follow-up group). Children in both arms were assessed again at day 8, and classified as a clinical failure if fever (caregiver-reported), malaria, diarrhea, pneumonia, or decline of health status (development of danger signs, hospitalization, or death) was noted (failure definition 1). Alternative failure definitions were examined, whereby caregiver-reported fever was first restricted to caregiver-reported fever of at least 3 days (failure definition 2) and then replaced with fever measured via axillary temperature (failure definition 3). Study participants, providers, and investigators were not masked. Among 4,434 enrolled children, 4,141 (93.4%) met the per-protocol definition of receipt of the arm-specific advice from the CHW and a timely day 8 assessment (universal follow-up group: 2,210; conditional follow-up group: 1,931). Failure was similar (difference: -0.7%) in the conditional follow-up group (n = 188, 9.7%) compared to the universal follow-up group (n = 230, 10.4%); however, the upper bound of a 1-sided 95% confidence interval around this difference (-∞, 5.1%) exceeded the prespecified non-inferiority margin of 4.0% (non-inferiority p = 0.089). When caregiver-reported fever was restricted to fevers lasting ≥3 days, failure in the conditional follow-up group (n = 159, 8.2%) was similar to that in the universal follow-up group (n = 200, 9.1%) (difference: -0.8%; 95% CI: -∞, 4.1%; p = 0.053). If caregiver-reported fever was replaced by axillary temperature measurement in the definition of failure, failure in the conditional follow-up group (n = 113, 5.9%) was non-inferior to that in the universal follow-up group (n = 160, 7.2%) (difference: -1.4%; 95% CI: -∞, 2.5%; p = 0.012). In post hoc analysis, when the definition of failure was limited to malaria, diarrhea, pneumonia, development of danger signs, hospitalization, or death, failure in the conditional follow-up group (n = 108, 5.6%) was similar to that in the universal follow-up group (n = 147, 6.7%), and within the non-inferiority margin (95% CI: -∞, 2.9%; p = 0.017). Limitations include initial underestimation of the proportion of clinical failures as well as substantial variance in cluster-specific failure rates, reducing the precision of our estimates. In addition, heightened security concerns slowed recruitment in the final months of the study. We found that advising caregivers to return only if children worsened or remained ill on day 3 resulted in similar rates of caregiver-reported fever and other clinical outcomes on day 8, compared to advising all caregivers to return on day 3. Policy-makers could consider revising guidelines for management of uncomplicated fever within the iCCM framework. ClinicalTrials.gov NCT02595827.

Chronic exposure to adverse psychosocial work factors and high psychological distress among white-collar workers: A 5-year prospective study.

PubMed

Ndjaboue, Ruth; Brisson, Chantal; Talbot, Denis; Vézina, Michel

2017-03-01

Prospective studies which evaluated whether the effects of chronic exposure to psychosocial work factors on mental health persisted over time are scarce. For the first time, this study evaluated: 1) the effect of chronic exposure to effort-reward imbalance over 5years on the prevalence of high psychological distress among men and women, and 2) the persistence of this effect over time. Overall, 1747 white-collar workers from three public organizations participated in a prospective study. Psychological distress and effort-reward imbalance were measured using validated questionnaires at baseline, and at 3- and 5-year follow-ups. Prevalence ratios (PRs) of high psychological distress were estimated using log-binomial regression according to baseline and repeated exposure. Compared to unexposed workers, those with repeated exposure to effort-reward imbalance had a higher prevalence of high psychological distress. Workers exposed only at some time-points also had a higher prevalence. The deleterious effect of repeated exposure observed at the 3-year follow-up persisted at the 5-year follow-up among women (PR=2.48 95% confidence interval (CI) 1.97-3.11) and men (PR=1.91 95% CI 1.20-3.04). These effects were greater than those found using a single baseline measurement. The current study supported a deleterious effect of repeated exposure to effort-reward imbalance on psychological distress, and a lack of adaptation to these effects over time among men and women. Since psychological distress may later lead to severe mental problems, current results highlight the need to consider exposure to these adverse work factors in primary and secondary preventions aimed at reducing mental health problems at work. Copyright © 2017 Elsevier Inc. All rights reserved.

Mediation of a Preventive Intervention’s Six-Year Effects on Health Risk Behaviors

PubMed Central

Soper, Ana C.; Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.

2010-01-01

Using data from a 6-year longitudinal follow-up sample of 240 youth who participated in a randomized experimental trial of a preventive intervention for divorced families with children ages 9 -12, the current study tested mechanisms by which the intervention reduced substance use and risky sexual behavior in mid to late adolescence (15–19 years old). Mechanisms tested included parental monitoring, adaptive coping, and negative errors. Parental monitoring at 6-year follow-up mediated program effects to reduce alcohol and marijuana use, polydrug use, and other drug use for those with high pre-test risk for maladjustment. In the condition that included a program for mothers only, increases in youth adaptive coping at 6-year follow-up mediated program effects on risky sexual behavior for those with high pre-test risk for maladjustment. Contrary to expectation, program participation increased negative errors and decreased adaptive coping among low risk youth in some of the analyses. Ways in which this study furthers our understanding of pathways through which evidence-based preventive interventions affect health risk behaviors are discussed. PMID:20565156

HIGH-EFFICIENCY AUTONOMOUS LASER ADAPTIVE OPTICS

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

Baranec, Christoph; Riddle, Reed; Tendulkar, Shriharsh

2014-07-20

As new large-scale astronomical surveys greatly increase the number of objects targeted and discoveries made, the requirement for efficient follow-up observations is crucial. Adaptive optics imaging, which compensates for the image-blurring effects of Earth's turbulent atmosphere, is essential for these surveys, but the scarcity, complexity and high demand of current systems limit their availability for following up large numbers of targets. To address this need, we have engineered and implemented Robo-AO, a fully autonomous laser adaptive optics and imaging system that routinely images over 200 objects per night with an acuity 10 times sharper at visible wavelengths than typically possible frommore » the ground. By greatly improving the angular resolution, sensitivity, and efficiency of 1-3 m class telescopes, we have eliminated a major obstacle in the follow-up of the discoveries from current and future large astronomical surveys.« less

Contemporary Trends in the Management and Outcomes of Patients With Familial Hypercholesterolemia in Canada: A Prospective Observational Study.

PubMed

Brunham, Liam R; Cermakova, Lubomira; Lee, Terry; Priecelova, Ida; Alloul, Karine; de Chantal, Marilyn; Francis, Gordon A; Frohlich, Jiri

2017-03-01

Heterozygous familial hypercholesterolemia (HeFH) is one of the most common genetic diseases in the world and an important cause of premature cardiovascular (CV) disease. The purpose of this study was to characterize the clinical features, current treatment patterns, and CV outcomes of patients with HeFH in British Columbia, Canada. We conducted a longitudinal observational study of patients with HeFH attending a specialized lipid clinic. We collected data on lipid levels, medication use, and CV events at baseline and last follow-up. We recruited 339 patients with clinically diagnosed HeFH, with a total of 3700 person-years of follow-up. The mean low-density lipoprotein cholesterol (LDL-C) level was 5.9 mmol/L at baseline and 3.7 mmol/L at last follow-up. Use of lipid-lowering therapy (LLT) increased from 35.7% at baseline to 84.7% at last follow-up. A ≥ 50% reduction in LDL-C level was achieved in 34.5% of patients, and an LDL-C level ≤ 2 mmol/L was seen in 8.3%. The overall CV event rate in this cohort was 33.5/1000 person-years. Among patients who had a CV event during follow-up, 59% experienced a recurrent event within 5 years. These data contribute to our understanding of contemporary trends in the management of patients with HeFH in Canada. Despite a majority of patients receiving LLT, few patients reached high-risk lipid targets. These data highlight important opportunities to improve the care of patients with HeFH. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study

PubMed Central

Hudson, Jennifer L.; Keers, Robert; Roberts, Susanna; Coleman, Jonathan R.I.; Breen, Gerome; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Hartman, Catharina; Heiervang, Einar R.; Hötzel, Katrin; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J.; Marin, Carla E.; McKinnon, Anna; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike; Rapee, Ronald M.; Schneider, Silvia; Schneider, Sophie C.; Silverman, Wendy K.; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Lester, Kathryn J.; Eley, Thalia C.

2015-01-01

Objective The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic, and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child’s gender, type of anxiety disorder, initial severity and comorbidity, and parents’ psychopathology would significantly predict outcome. Method A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models. Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these time points. Results Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly predicted response (although not remission) at follow-up. Conclusion SoAD, nonanxiety comorbidity, and parental psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes. PMID:26004660

Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study.

PubMed

Hudson, Jennifer L; Keers, Robert; Roberts, Susanna; Coleman, Jonathan R I; Breen, Gerome; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Hartman, Catharina; Heiervang, Einar R; Hötzel, Katrin; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J; Marin, Carla E; McKinnon, Anna; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike; Rapee, Ronald M; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Lester, Kathryn J; Eley, Thalia C

2015-06-01

The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic, and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child's gender, type of anxiety disorder, initial severity and comorbidity, and parents' psychopathology would significantly predict outcome. A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models. Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these time points. Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly predicted response (although not remission) at follow-up. SoAD, nonanxiety comorbidity, and parental psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Stemless shoulder arthroplasty: current status.

PubMed

Churchill, R Sean

2014-09-01

Since the original Neer humeral replacement in the 1950s, the standard primary anatomic total shoulder arthroplasty design has slowly evolved. Most recently, the humeral stem has become progressively shorter to help combat stem-related complications. Currently, there are several companies who have developed and marketed a stemless humeral arthroplasty component. Manufacturers' data for 5 stemless shoulder arthroplasty components currently on the market were analyzed and reviewed. A literature review of short-term results for stemless shoulder arthroplasty was completed. Of the stemless shoulder arthroplasty systems available on the market, 3 are currently undergoing clinical trials in the United States. The Tornier Simpliciti (Tornier, Edina, MN, USA) clinical trial began in 2011. The study with 2-year minimum follow-up results is scheduled for completion in November 2014. The Arthrex Eclipse (Arthrex, Naples, FL, USA) clinical trial was started in January 2013. The tentative study completion date is 2017. The Biomet Nano (Biomet, Warsaw, IN, USA) clinical trial began in October 2013 and also has a tentative completion date of 2017. No other clinical trial is currently under way in the United States. Early results for stemless shoulder arthroplasty indicate clinical results similar to standard stemmed shoulder arthroplasty. Radiographic analysis indicates implant stability without migration or subsidence at 2- to 3-year minimum follow-up.. Several stemless shoulder arthroplasty implants are available outside the United States. Early clinical and radiographic results are promising, but well-designed clinical studies and midterm results are lacking. Three clinical trials are currently under way in the United States with initial availability for use anticipated in 2015. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Predictors of Persistent Axial Neck Pain After Cervical Laminoplasty.

PubMed

Kimura, Atsushi; Shiraishi, Yasuyuki; Inoue, Hirokazu; Endo, Teruaki; Takeshita, Katsushi

2018-01-01

Retrospective analysis of prospective data. The aim of this study was to reveal baseline predictors of persistent postlaminoplasty neck pain. Axial neck pain is one of the most common complications after cervical laminoplasty; however, baseline predictors of persistent postlaminoplasty neck pain are unclear. We analyzed data from 156 patients who completed a 2-year follow-up after double-door laminoplasty for degenerative cervical myelopathy. Patients rated the average intensity of axial neck pain in the last month using an 11-point numerical rating scale preoperatively and at the 2-year follow-up. The dependent variable was the presence of moderate-to-severe neck pain (numerical rating scale ≥4) at the 2-year follow-up. The independent variables included patient characteristics, baseline radiological parameters, surgical variables, baseline axial neck pain intensity, and baseline functions, which were measured by the Japanese Orthopaedic Association score and the Short Form-36 survey (SF-36). Logistic regression analysis was performed to identify independent predictors of moderate-to-severe neck pain after laminoplasty. At the 2-year follow-up, 51 patients (32%) had moderate-to-severe neck pain, and 106 patients (68%) had no or mild pain. Univariate analysis revealed that the ratio of cervical anterolisthesis, ratio of current smoking, baseline neck pain intensity, and baseline SF-36 Mental Component Summary differed significantly between the groups. Multivariate logistic regression analysis showed that independent predictors of moderate-to-severe neck pain at the 2-year follow-up include the presence of anterolisthesis, current smoking, moderate-to-severe baseline neck pain, and lower SF-36 Mental Component Summary. The presence of anterolisthesis and moderate-to-severe baseline neck pain were also associated with significantly poorer physical function after surgery. The presence of anterolisthesis was associated not only with the highest odds ratio of persistent neck pain but also with significantly poorer functional outcomes. Indications for cervical laminoplasty should be carefully determined in patients with cervical anterolisthesis. 4.

Frequency and characteristics associated with exposure to tobacco direct mail marketing and its prospective effect on smoking behaviors among young adults from the US Midwest.

PubMed

Choi, Kelvin; Forster, Jean L

2014-11-01

We examined the exposure to tobacco direct mail marketing and its effect on subsequent smoking behaviors in a US Midwest regional cohort of young adults. Data were collected from 2622 young adults (mean age = 24 years) in 2010 to 2011 (baseline) and 2011 to 2012 (follow-up). We collected information on demographics, tobacco use, and exposure to tobacco direct mail materials in the previous 6 months at baseline. Smoking behaviors were reassessed at follow-up. We investigated the characteristics associated with receiving these materials at baseline, and the associations between receiving cigarette coupons in the mail at baseline and smoking behaviors at follow-up. Thirteen percent of participants reported receiving tobacco direct mail materials in the previous 6 months. Receipt of these materials was associated with age, education, and tobacco use (P < .05). Among those who received these materials, 77% and 56% reported receiving coupons for cigarettes and other tobacco products, respectively. Among baseline nonsmokers and ex-smokers, receiving coupons was associated with becoming current smokers at follow-up (P < .05). Among baseline current smokers, receiving coupons was associated with lower likelihood of smoking cessation at follow-up (P < .05). Tobacco direct mail marketing promoted and sustained smoking behaviors among US Midwest young adults. Regulating this marketing strategy might reduce the prevalence of smoking in this population.

Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in Ethiopia: A cluster-randomised non-inferiority trial.

PubMed

Källander, Karin; Alfvén, Tobias; Funk, Tjede; Abebe, Ayalkibet; Hailemariam, Abreham; Getachew, Dawit; Petzold, Max; Steinhardt, Laura C; Gutman, Julie R

2018-04-01

With declining malaria prevalence and improved use of malaria diagnostic tests, an increasing proportion of children seen by community health workers (CHWs) have unclassified fever. Current community management guidelines by WHO advise that children seen with non-severe unclassified fever (on day 1) should return to CHWs on day 3 for reassessment. We compared the safety of conditional follow-up reassessment only in cases where symptoms do not resolve with universal follow-up on day 3. We undertook a 2-arm cluster-randomised controlled non-inferiority trial among children aged 2-59 months presenting with fever and without malaria, pneumonia, diarrhoea, or danger signs to 284 CHWs affiliated with 25 health centres (clusters) in Southern Nations, Nationalities, and Peoples' Region, Ethiopia. The primary outcome was treatment failure (persistent fever, development of danger signs, hospital admission, death, malaria, pneumonia, or diarrhoea) at 1 week (day 8) of follow-up. Non-inferiority was defined as a 4% or smaller difference in the proportion of treatment failures with conditional follow-up compared to universal follow-up. Secondary outcomes included the percentage of children brought for reassessment, antimicrobial prescription, and severe adverse events (hospitalisations and deaths) after 4 weeks (day 29). From December 1, 2015, to November 30, 2016, we enrolled 4,595 children, of whom 3,946 (1,953 universal follow-up arm; 1,993 conditional follow-up arm) adhered to the CHW's follow-up advice and also completed a day 8 study visit within ±1 days. Overall, 2.7% had treatment failure on day 8: 0.8% (16/1,993) in the conditional follow-up arm and 4.6% (90/1,953) in the universal follow-up arm (risk difference of treatment failure -3.81%, 95% CI -∞, 0.65%), meeting the prespecified criterion for non-inferiority. There were no deaths recorded by day 29. In the universal follow-up arm, 94.6% of caregivers reported returning for reassessment on day 3, in contrast to 7.5% in the conditional follow-up arm (risk ratio 22.0, 95% CI 17.9, 27.2, p < 0.001). Few children sought care from another provider after their initial visit to the CHW: 3.0% (59/1,993) in the conditional follow-up arm and 1.1% (22/1,953) in the universal follow-up arm, on average 3.2 and 3.4 days later, respectively, with no significant difference between arms (risk difference 1.79%, 95% CI -1.23%, 4.82%, p = 0.244). The mean travel time to another provider was 2.2 hours (95% CI 0.01, 5.3) in the conditional follow-up arm and 2.6 hours (95% CI 0.02, 4.5) in the universal follow-up arm (p = 0.82); the mean cost for seeking care after visiting the CHW was 26.5 birr (95% CI 7.8, 45.2) and 22.8 birr (95% CI 15.6, 30.0), respectively (p = 0.69). Though this study was an important step to evaluate the safety of conditional follow-up, the high adherence seen may have resulted from knowledge of the 1-week follow-up visit and may therefore not transfer to routine practice; hence, in an implementation setting it is crucial that CHWs are well trained in counselling skills to advise caregivers on when to come back for follow-up. Conditional follow-up of children with non-severe unclassified fever in a low malaria endemic setting in Ethiopia was non-inferior to universal follow-up through day 8. Allowing CHWs to advise caregivers to bring children back only in case of continued symptoms might be a more efficient use of resources in similar settings. www.clinicaltrials.gov, identifier NCT02926625.

Reductions in Hard Drug Use Among Homeless Youth Receiving a Strength-Based Outreach Intervention: Comparing the Long-Term Effects of Shelter Linkage Versus Drop-in Center Linkage.

PubMed

Guo, Xiamei; Slesnick, Natasha

2017-06-07

The current study sought to test hard drug use outcomes for youth receiving a strengths-based outreach and advocacy intervention that linked youth to either a shelter or a drop-in center. Homeless youth (14-24 years old) were engaged by research assistants (RAs) at soup kitchens, parks, libraries, and other locations that homeless youth were known to frequent. Youth were randomly assigned to receive six months of advocacy that focused on linking youth to a drop-in center (n = 40) or to a crisis shelter (n = 39). Follow-up assessments were conducted at 3, 6, and 9 months post-baseline. Hard drug use over time was the main outcome. Intervention condition and service connection were used as predictors for the baseline level and the slope of change in hard drug use over time. Data analysis was conducted with Bernoulli Hierarchical Generalized Linear Modeling in HLM7. The current study found that those who were in the drop-in linkage condition exhibited a greater reduction in their odds of using hard drugs during the follow-up points than their counterparts in the shelter linkage condition. And finally, those who utilized services more often during the follow-ups were those who exhibited less hard drug use at baseline and less reduction in their odds of using hard drugs. This study suggests that drop-in centers, which are often characterized by low-demand programming and few behavioral restrictions, are effective for addressing hard drug use among homeless youth.

Examining overgeneral autobiographical memory as a risk factor for adolescent depression.

PubMed

Rawal, Adhip; Rice, Frances

2012-05-01

Identifying risk factors for adolescent depression is an important research aim. Overgeneral autobiographical memory (OGM) is a feature of adolescent depression and a candidate cognitive risk factor for future depression. However, no study has ascertained whether OGM predicts the onset of adolescent depressive disorder. OGM was investigated as a predictor of depressive disorder and symptoms in a longitudinal study of high-risk adolescents. In addition, cross-sectional associations between OGM and current depression and OGM differences between depressed adolescents with different clinical outcomes were examined over time. A 1-year longitudinal study of adolescents at familial risk for depression (n = 277, 10-18 years old) was conducted. Autobiographical memory was assessed at baseline. Clinical interviews assessed diagnostic status at baseline and follow-up. Currently depressed adolescents showed an OGM bias compared with adolescents with no disorder and those with anxiety or externalizing disorders. OGM to negative cues predicted the onset of depressive disorder and depressive symptoms at follow-up in adolescents free from depressive disorder at baseline. This effect was independent of the contribution of age, IQ, and baseline depressive symptoms. OGM did not predict onset of anxiety or externalizing disorders. Adolescents with depressive disorder at both assessments were not more overgeneral than adolescents who recovered from depressive disorder over the follow-up period. OGM to negative cues predicted the onset of depressive disorder (but not other disorders) and depressive symptoms over time in adolescents at familial risk for depression. Results are consistent with OGM as a risk factor for depression. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Economic difficulties and subsequent sleep problems: Evidence from British and Finnish occupational cohorts

PubMed Central

Lallukka, Tea; Ferrie, Jane E.; Kivimäki, Mika; Shipley, Martin J.; Rahkonen, Ossi; Lahelma, Eero

2012-01-01

Background Social determinants of sleep may prove to be as important as health status. In this study we examined the extent to which persistent and changing economic difficulties are associated with sleep problems in two prospective occupational cohorts. Methods We used data from Finnish (baseline 2000–2002; follow-up 2007; n = 6328) and British (baseline 1997–1999; follow-up 2003–2004; n = 5002) public sector employees. Economic difficulties, sleep problems, and a variety of covariates were assessed at baseline and follow-up. Results Prevalence of frequent sleep problems at follow-up was 27% and 20% among women and men in the Finnish cohort, and 34% and 27% in the British cohort, respectively. Odds for sleep problems were higher among those with persistent economic difficulties (frequent economic difficulties at baseline and follow-up) compared to those with no difficulties. This association remained after multiple adjustments, including parental and current socioeconomic position, in the Finnish (OR 1.72, 95% CI 1.35–2.18) cohort. Increases in economic difficulties were similarly associated with sleep problems in the Finnish and the British cohort. Conclusion Evidence from two occupational cohorts suggests strong associations between economic difficulty and poor sleep. Awareness of this association will help health care professionals identify and prevent sleep problems. PMID:22445231

Canadian oncology nurse work environments: part II.

PubMed

Bakker, Debra; Conlon, Michael; Fitch, Margaret; Green, Esther; Butler, Lorna; Olson, Karin; Cummings, Greta

2012-03-01

In the aftermath of healthcare restructuring, it is important to pay attention to nurses' perceptions of workplace and professional practice factors that attract nurses and influence their retention. Continuing constraints on cancer care systems make the issue of health human resources an ongoing priority. This paper presents the findings of a follow-up study of a cohort of Canadian oncology nurses that aimed to compare nurses' perceptions of their work environment, job satisfaction and retention over a two-year period. Participants of the follow-up survey represented 65% (397/615) of the initial cohort. Many similar perceptions about the work environment were found over two years; however, at follow-up a larger proportion of nurses reported an absence of enough RNs to provide quality care and a lack of support for innovative ideas. With respect to career status, only 6% (25/397) of the follow-up sample had left oncology nursing. However, the proportion of nurses declaring an intention to leave their current job increased from 6.4% (39/615) on the initial survey to 26% (102/397) on the follow-up survey. Findings suggest that decision-makers need to use both the growing body of workplace knowledge and the input from staff nurses to implement changes that positively influence nurse recruitment and retention. Future research should focus on the implementation and evaluation of strategies that address workplace issues such as nurse staffing adequacy, leadership and organizational commitment.

Expert system verification and validation study. Delivery 1: Survey and interview questions

NASA Technical Reports Server (NTRS)

1990-01-01

The NASA funded questionnaire is presented to help define the state-of-the-practice in the formal evaluation of Expert Systems on current NASA and industry applications. The answers to this questionnaire, together with follow-up interviews, will provide realistic answers to the following questions: (1) How much evaluation is being performed; (2) What evaluation techniques are in use; and (3) What, if any, are the unique issues in evaluating Expert Systems.

A transdiagnostic study of education, employment, and training outcomes in young people with mental illness.

PubMed

Lee, R S C; Hermens, D F; Scott, J; O'Dea, B; Glozier, N; Scott, E M; Hickie, I B

2017-09-01

Optimizing functional recovery in young individuals with severe mental illness constitutes a major healthcare priority. The current study sought to quantify the cognitive and clinical factors underpinning academic and vocational engagement in a transdiagnostic and prospective youth mental health cohort. The primary outcome measure was 'not in education, employment or training' ('NEET') status. A clinical sample of psychiatric out-patients aged 15-25 years (n = 163) was assessed at two time points, on average, 24 months apart. Functional status, and clinical and neuropsychological data were collected. Bayesian structural equation modelling was used to confirm the factor structure of predictors and cross-lagged effects at follow-up. Individually, NEET status, cognitive dysfunction and negative symptoms at baseline were predictive of NEET status at follow-up (p < 0.05). Baseline cognitive functioning was the only predictor of follow-up NEET status in the multivariate Bayesian model, while controlling for baseline NEET status. For every 1 s.d. deficit in cognition, the probability of being disengaged at follow-up increased by 40% (95% credible interval 19-58%). Baseline NEET status predicted poorer negative symptoms at follow-up (β = 0.24, 95% credible interval 0.04-0.43). Disengagement with education, employment or training (i.e. being NEET) was reported in about one in four members of this cohort. The initial level of cognitive functioning was the strongest determinant of future NEET status, whereas being academically or vocationally engaged had an impact on future negative symptomatology. If replicated, these findings support the need to develop early interventions that target cognitive phenotypes transdiagnostically.

A 5-Year Prospective Follow-Up Study of Lipid-Rich Adrenal Incidentalomas: No Tumor Growth or Development of Hormonal Hypersecretion

PubMed Central

Raade, Merja; Hämäläinen, Esa; Sane, Timo

2015-01-01

Background Current guidelines for follow-up of adrenal incidentalomas are extensive and hampered by lack of follow-up studies. We tested the hypothesis that small lipid-rich adrenal incidentalomas, initially characterized by tumor size <40 mm and <10 Hounsfield units (HUs) on unenhanced computed tomography (CT) may not demonstrate excessive growth/hormonal hypersecretion on follow-up. Methods Sixty-nine incidentalomas in 56 patients were restudied with unenhanced CT and screening for hypercortisolism (dexamethasone suppression test [DST], plasma adrenocorticotropic hormone) and pheochromocytoma (24-hour urinary metanephrines and normetanephrines) 5 years later. Primary hyperaldosteronism was excluded at base-line. Results Tumor (n=69) size was similar before and after 5 years follow-up (19±6 mm vs. 20±7 mm). Mean tumor growth was 1±2 mm. Largest increase in tumor size was 8 mm, this tumor was surgically removed and histopathology confirmed cortical adenoma. DST was normal in 54 patients and two patients (3.6%) were still characterized by subclinical hypercortisolism. Initial tumor size was >20 mm for the patient with largest tumor growth and those with subclinical hypercortisolism. All patients had normal 24-hour urinary metanephrines and normetanephrines. Low attenuation (<10 HU) was demonstrated in 97% of 67 masses re-evaluated with unenhanced CT. Conclusion None of the patients developed clinically relevant tumor growth or new subclinical hypercortisolism. Biochemical screening for pheochromocytoma in incidentalomas demonstrating <10 HU on unenhanced CT is not needed. For such incidentalomas <40 mm, it seems sufficient to perform control CT and screen for hypercortisolism after 5 years. PMID:26354488

A 5-Year Prospective Follow-Up Study of Lipid-Rich Adrenal Incidentalomas: No Tumor Growth or Development of Hormonal Hypersecretion.

PubMed

Schalin-Jäntti, Camilla; Raade, Merja; Hämäläinen, Esa; Sane, Timo

2015-12-01

Current guidelines for follow-up of adrenal incidentalomas are extensive and hampered by lack of follow-up studies. We tested the hypothesis that small lipid-rich adrenal incidentalomas, initially characterized by tumor size <40 mm and <10 Hounsfield units (HUs) on unenhanced computed tomography (CT) may not demonstrate excessive growth/hormonal hypersecretion on follow-up. Sixty-nine incidentalomas in 56 patients were restudied with unenhanced CT and screening for hypercortisolism (dexamethasone suppression test [DST], plasma adrenocorticotropic hormone) and pheochromocytoma (24-hour urinary metanephrines and normetanephrines) 5 years later. Primary hyperaldosteronism was excluded at base-line. Tumor (n=69) size was similar before and after 5 years follow-up (19±6 mm vs. 20±7 mm). Mean tumor growth was 1±2 mm. Largest increase in tumor size was 8 mm, this tumor was surgically removed and histopathology confirmed cortical adenoma. DST was normal in 54 patients and two patients (3.6%) were still characterized by subclinical hypercortisolism. Initial tumor size was >20 mm for the patient with largest tumor growth and those with subclinical hypercortisolism. All patients had normal 24-hour urinary metanephrines and normetanephrines. Low attenuation (<10 HU) was demonstrated in 97% of 67 masses re-evaluated with unenhanced CT. None of the patients developed clinically relevant tumor growth or new subclinical hypercortisolism. Biochemical screening for pheochromocytoma in incidentalomas demonstrating <10 HU on unenhanced CT is not needed. For such incidentalomas <40 mm, it seems sufficient to perform control CT and screen for hypercortisolism after 5 years.

Early Exposure to Movie Smoking Predicts Established Smoking by Older Teens and Young Adults

PubMed Central

Dalton, Madeline A.; Beach, Michael L.; Adachi-Mejia, Anna M.; Longacre, Meghan R.; Matzkin, Aurora L.; Sargent, James D.; Heatherton, Todd F.; Titus-Ernstoff, Linda

2009-01-01

OBJECTIVE Movie smoking exposure is a strong predictor of smoking initiation by adolescents; however, we do not know whether it is a long-term predictor of established smoking. We conducted a prospective study to determine whether movie smoking exposure during early adolescence predicts established smoking in older teens and young adults. DESIGN We assessed movie smoking exposure and smoking status through a written school-based survey in 1999, when participants were 10 to 14 years of age. We enrolled 73% (n = 2603) of those who had never tried smoking in a follow-up study. In 2006–2007, we conducted telephone interviews with 69% (n = 1791) of the cohort to ascertain current smoking status. The primary outcome was established smoking, defined as having smoked >100 cigarettes. Mean age at follow-up was 18.7 years. RESULTS Thirteen percent (n = 235) progressed from never smoking to established smoking during the follow-up period. Eighty-nine percent (n = 209) of established smokers smoked during the 30 days before the survey. Even after controlling for a wide range of baseline characteristics, the relative risk for established smoking increased by one third with each successive quartile of movie smoking exposure. Those in the highest quartile for baseline movie smoking exposure were twice as likely to be established smokers at follow-up compared with those in the lowest quartile. CONCLUSIONS Movie smoking exposure significantly predicted progression to established smoking in long-term follow-up. We estimate that 34.9% of established smoking in this cohort can be attributed to movie smoking exposure. PMID:19336346

Estimated Demand for 1986 Graduates of Michigan Four-Year Colleges and Universities.

ERIC Educational Resources Information Center

Shingleton, John D.; And Others

The current employment market for 1986 college graduates from Michigan was assessed by placement directors from 29 Michigan four-year institutions. The directors rated supply and demand based on information obtained from follow-up studies of recent graduates, campus interviewing statistics on employer requests by major and degree level, numbers of…

Exploring College Counselor Spiritual Competency in Relation to Training and Professional Practice

ERIC Educational Resources Information Center

Conley, Abigail Holland

2012-01-01

The purpose of this mixed methods sequential explanatory study was to explore factors contributing to college counselors' spiritual competency by obtaining quantitative results from surveying 199 current members of the American College Counseling Association (ACCA) and then following up with 32 purposefully selected respondents based on high…

How to Recognize a Quality Technical Education Program.

ERIC Educational Resources Information Center

Doty, Charles R.

Criteria for the evaluation of quality technical educational programs must be identified if follow-up studies are to be effective. Current research shows that problems in the development of such criteria include the tendency to evaluate programs on the basis of organizational structure rather than on the quality of the instructional program…

The International prevalence and variability of non-adherence to the non-pharmacologic treatment regimen after heart transplantation: Findings from the cross-sectional bright study.

PubMed

Helmy, Remon; Duerinckx, Nathalie; De Geest, Sabina; Denhaerynck, Kris; Berben, Lut; Russell, Cynthia L; Van Cleemput, Johan; Crespo-Leiro, Maria G; Dobbels, Fabienne

2018-05-13

Heart transplant (HTx) recipients need to follow a complex therapeutic regimen. We assessed the international prevalence and variability in non-adherence to six non-pharmacologic treatment components (physical activity, sun protection, diet, alcohol use, non-smoking, and outpatient follow-up visits). We used self-report data of 1397 adult HTx recipients from the 36-HTx-center, 11-country, 4-continent, cross-sectional BRIGHT study (ClinicalTrials. gov ID: NCT01608477). The non-adherence definitions used were: Physical activity: <3 times/week 20 minutes' vigorous activity, <5 times/week 30 minutes' moderate activity, or <5 times/week a combination of either intensity; Sun protection: not "always" applying any sun protection; Diet: not "often" or "always" following recommended diet(s); Alcohol use: > 1 alcoholic drink/day (women) or > 2 drinks/day (men); Smoking: current smokers or stopped <1 year before; Follow-up visits: missing ≥1 of the last 5 outpatient follow-up visits. Overall prevalence figures were adjusted to avoid over- or underrepresentation of countries. Between-country variability was assessed within each treatment component via chi-square testing. The adjusted study-wide non-adherence prevalence figures were: 47.8% for physical activity (95% CI [45.2-50.5%]), 39.9% for sun protection (95% CI [37.3-42.5%]), 38.2% for diet recommendations (95% CI [35.1-41.3%]), 22.9% for alcohol consumption (95% CI [20.8%-25.1%]), 7.4% for smoking cessation (95% CI [6.1%-8.7%]), and 5.7% for follow-up visits (95% CI [4.6-6.9%]). Significant variability was observed between countries in all treatment components except follow-up visits. Non-adherence to the post-HTx non-pharmacologic treatment regimen is prevalent and shows significant variability internationally, suggesting a need for tailored adherence-enhancing interventions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The AES total ankle arthroplasty analysis of failures and survivorship at ten years.

PubMed

Di Iorio, Alexandre; Viste, Anthony; Fessy, Michel Henry; Besse, Jean Luc

2017-12-01

AES mobile-bearing total ankle replacement was developed from the Buechel Pappas model. It was withdrawn in 2009, after identification of a higher than expected complication rate. The purpose of the current study was to analyse clinical outcomes, failures and survival of the initial series of 50 AES published in 2009. In this single-centre continuous prospective study (2003-2006), 50 AES prostheses were included. Pre-operative osteoarthritis was mainly post-traumatic (50%) and secondary to instability (36%). All patients were assessed with clinical and radiographic follow-up at six months, one year, two years and every two to three years thereafter. A CT-scan was systematically performed before procedure, and at two years, five years and ten years. At last follow-up, all patients with TAR had a functional (SF 36, AOFAS) and clinical assessment. All complications or surgical events were analysed. The mean follow-up was ten ± two years (range, 9-13). The mean AOFAS score was 75 points (range, 26-100). The mean SF 36 score was 69 points (range, 35-97). There was a significant deterioration in AOFAS score at five years and at last follow-up (p < 0.05). Fifteen TARs underwent reoperation for cyst curettage-graft because of development of periprosthetic lesions. Six of them ended up with prosthesis removal-arthrodesis. At the last follow-up, 14 TARs were removed for arthrodesis. Of the 30 prostheses seen at last follow-up, four are awaiting prosthesis removal-arthrodesis and one for cyst curettage-graft. The ten year survivorships free of any prosthesis removal or arthrodesis and free of any reoperation were 68% (95% CI, 55-85) and 57% (95% CI, 44-74), respectively. Our data suggested a high rate of reoperation. Overall ten year survival was lower than with other designs, particularly due to cyst lesions. Level IV, prospective case series.

Exploring the efficacy of a 5-day course of transcranial direct current stimulation (TDCS) on depression and memory function in patients with well-controlled temporal lobe epilepsy.

PubMed

Liu, Anli; Bryant, Andrew; Jefferson, Ashlie; Friedman, Daniel; Minhas, Preet; Barnard, Sarah; Barr, William; Thesen, Thomas; O'Connor, Margaret; Shafi, Mouhsin; Herman, Susan; Devinsky, Orrin; Pascual-Leone, Alvaro; Schachter, Steven

2016-02-01

Depression and memory dysfunction significantly impact the quality of life of patients with epilepsy. Current therapies for these cognitive and psychiatric comorbidities are limited. We explored the efficacy and safety of transcranial direct current stimulation (TDCS) for treating depression and memory dysfunction in patients with temporal lobe epilepsy (TLE). Thirty-seven (37) adults with well-controlled TLE were enrolled in a double-blinded, sham-controlled, randomized, parallel-group study of 5 days of fixed-dose (2 mA, 20 min) TDCS. Subjects were randomized to receive either real or sham TDCS, both delivered over the left dorsolateral prefrontal cortex. Patients received neuropsychological testing and a 20-minute scalp EEG at baseline immediately after the TDCS course and at 2- and 4-week follow-up. There was improvement in depression scores immediately after real TDCS, but not sham TDCS, as measured by changes in the Beck Depression Inventory (BDI change: -1.68 vs. 1.27, p<0.05) and NDDI-E (-0.83 vs. 0.9091, p=0.05). There was no difference between the groups at the 2- or 4-week follow-up. There was no effect on delayed or working memory performance. Transcranial direct current stimulation was well-tolerated and did not increase seizure frequency or interictal discharge frequency. Transcranial direct current stimulation induced an increase in delta frequency band power over the frontal region and delta, alpha, and theta band power in the occipital region after real stimulation compared to sham stimulation, although the difference did not reach statistical significance. This study provides evidence for the use of TDCS as a safe and well-tolerated nonpharmacologic approach to improving depressive symptoms in patients with well-controlled TLE. However, there were no changes in memory function immediately following or persisting after a stimulation course. Further studies may determine optimal stimulation parameters for maximal mood benefit. Copyright © 2015. Published by Elsevier Inc.

Quality of life in patients with proton-treated pediatric medulloblastoma: Results of a prospective assessment with 5-year follow-up.

PubMed

Kamran, Sophia C; Goldberg, Saveli I; Kuhlthau, Karen A; Lawell, Miranda P; Weyman, Elizabeth A; Gallotto, Sara L; Hess, Clayton B; Huang, Mary S; Friedmann, Alison M; Abrams, Annah N; MacDonald, Shannon M; Pulsifer, Margaret B; Tarbell, Nancy J; Ebb, David H; Yock, Torunn I

2018-06-15

To the authors' knowledge, health-related quality of life (HRQOL) outcomes are not well described in patients with medulloblastoma. The use of proton radiotherapy (RT) may translate into an improved HRQOL. In the current study, the authors report long-term HRQOL in patients with proton-treated pediatric medulloblastoma. The current study was a prospective cohort HRQOL study of patients with medulloblastoma who were treated with proton RT and enrolled between August 5, 2002, and October 8, 2015. Both child report and parent-proxy report Pediatric Quality of Life Inventory (PedsQL) surveys were collected at baseline during RT and annually thereafter (score range on surveys of 0-100, with higher scores indicating better HRQOL). Patients were dichotomized by clinical/treatment variables and subgroups were compared. Mixed-model analysis was performed to determine the longitudinal trajectory of PedsQL scores. The Student t test was used to compare long-term HRQOL measures with published means from a healthy child population. Survey data were evaluable for 116 patients with a median follow-up of 5 years (range, 1-10.6 years); the median age at the time of diagnosis was 7.6 years (range, 2.1-18.1 years). At baseline, children reported a total core score (TCS) of 65.9, which increased by 1.8 points annually (P<.001); parents reported a TCS of 59.1, which increased by 2.0 points annually. Posterior fossa syndrome adversely affected baseline scores, but these scores significantly improved with time. At the time of last follow-up, children reported a TCS of 76.3, which was 3.3 points lower than that of healthy children (P = .09); parents reported a TCS of 69, which was 11.9 points lower than that of parents of healthy children (P<.001). Increased follow-up time from diagnosis correlated with improved HRQOL scores. HRQOL scores appear to increase over time after treatment in children treated with proton RT for medulloblastoma but remain lower compared with those of parent-proxy reports as well as published means from a healthy normative sample of children. Additional follow-up may translate into continued improvements in HRQOL. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Health status, quality of life and medical care in adult women with Turner syndrome

PubMed Central

Diana-Alexandra, Ertl; Andreas, Gleiss; Katharina, Schubert; Caroline, Culen; Peer, Hauck; Johannes, Ott; Alois, Gessl; Gabriele, Haeusler

2018-01-01

Background Previous studies have shown that only a minority of patients with Turner syndrome (TS) have adequate medical care after transfer to adult care. Aim of this study To assess the status of medical follow-up and quality of life (QoL) in adult women diagnosed with TS and followed up until transfer. To compare the subjective and objective view of the medical care quality and initiate improvements based on patients’ experiences and current recommendations. Methods 39 adult women with TS out of 64 patients contacted were seen for a clinical and laboratory check, cardiac ultrasound, standardized and structured questionnaires (SF-36v2 and Beck depression inventory). Results 7/39 of the patients were not being followed medically at all. Only 2/39 consulted all the specialists recommended. Comorbidities were newly diagnosed in 27/39 patients; of these, 11 related to the cardiovascular system. Patients in our cohort scored as high as the mean reference population for SF-36v2 in both mental and physical compartments. Obese participants had lower scores in the physical function section, whereas higher education was related to higher physical QoL scores. Adult height slightly correlated positively with physical health. Conclusion Medical follow-up was inadequate in our study cohort of adults with TS. Even though their medical follow-up was insufficient, these women felt adequately treated, leaving them vulnerable for premature illness. Initiatives in health autonomy and a structured transfer process as well as closer collaborations within specialities are urgently needed. PMID:29514898

An observational study of the effectiveness of alternative care providers in the management of obstructive sleep apnea.

PubMed

Pendharkar, Sachin R; Dechant, Anthony; Bischak, Diane P; Tsai, Willis H; Stevenson, Ann-Marie; Hanly, Patrick J

2016-04-01

Alternative care providers have been proposed as a substitute for physician-based management of obstructive sleep apnea. The purpose of this study was to describe the clinical course of patients with a new diagnosis of obstructive sleep apnea who were treated with continuous positive airway pressure and followed by alternative care providers at a tertiary care sleep clinic. It was hypothesized that care by alternative care providers would result in improvement of daytime sleepiness and satisfactory treatment adherence, and that a specific number of follow-up visits could be identified after which clinical outcomes no longer improved. The Epworth Sleepiness Scale score was measured for each patient at baseline and at each alternative care provider visit. Patients were discharged when they demonstrated a significant improvement in sleepiness and were adherent to therapy. The Epworth Sleepiness Scale score decreased by 3.9 points from baseline to discharge. Patients with three or more visits required more follow-up time to achieve the same clinical improvement as those with only two visits. Continuous positive airway pressure adherence was comparable to previous studies of physician-led care and improved with ongoing alternative care provider follow-up. The current results suggest that clinical care by alternative care providers leads to continued improvements in sleepiness in patients with obstructive sleep apnea who are treated with continuous positive airway pressure, and that a minority of patients require longer follow-up to achieve a satisfactory clinical response to therapy. © 2015 European Sleep Research Society.

The effect of individual counseling, line follow-up, and free nicotine replacement therapy on smoking cessation in the samples of Iranian smokers: Examination of transtheoretical model

PubMed Central

Sharifirad, Gholam Reza; Eslami, Ahmad Ali; Charkazi, Abdurrahman; Mostafavi, Firozeh; Shahnazi, Hossein

2012-01-01

Background: According to transtheoretical model (TTM), Stage matched interventions are more effective in quitting. The objective of current study was to investigate the effect of individual counseling, line follow-up, and free nicotine replacement therapy (NRT) on smoking cessation in smokers who are in preparation stage of smoking. Materials and Methods: In a randomized clinical trial design, through sending the short message system, potential participants in preparation stage of smoking were recruited and divided into control (n = 60)and treatment (n = 50) groups. The treatment group received an in-person counseling, line follow-up, and free NRT. TTM variables trend; pros and cons of smoking, behavioral and experiential processes, temptation, were assessed at baseline, 3 and 6 months follow-up along with point prevalence and continuous abstinence. Results: Continuous abstinence at 6-month follow-up were 3.3% (n = 2) in control group and 46% (n = 23) in the treatment group (x2 = 34.041, P < 0.001). Time Χ group analyses indicated that except cons of smoking (P > 0.05), all TTM constructs had significantly changed; temptation (F = 36.864, P < 0.001), pros (F = 12.172, P < 0.001), experiential processes (F = 3.377, P < 0.001), and behavioral processes (F = 11.131, P < 0.001). Conclusion: Interventions based on TTM variables increased the quite rate in prepared and motivated people. Our findings suggest that interventions through individual counseling along with free NRT and line follow-up in people who prepare for quitting are beneficial for our country. PMID:23853630

The cost effectiveness of NHS physiotherapy support for occupational health (OH) services.

PubMed

Phillips, Ceri J; Phillips Nee Buck, Rhiannon; Main, Chris J; Watson, Paul J; Davies, Shân; Farr, Angela; Harper, Christie; Noble, Gareth; Aylward, Mansel; Packman, Julie; Downton, Matt; Hale, Janine

2012-02-23

Musculoskeletal pain is detrimental to quality of life (QOL) and disruptive to activities of daily living. It also places a major economic burden on healthcare systems and wider society. In 2006, the Welsh Assembly Government (WAG) established a three tiered self-referral Occupational Health Physiotherapy Pilot Project (OHPPP) comprising: 1.) telephone advice and triage, 2.) face-to-face physiotherapy assessment and treatment if required, and 3.) workplace assessment and a return-to-work facilitation package as appropriate. This study aimed to evaluate the feasibility and cost-effectiveness of the pilot service. A pragmatic cohort study was undertaken, with all OHPPP service users between September 2008 and February 2009 being invited to participate. Participants were assessed on clinical status, yellow flags, sickness absence and work performance at baseline, after treatment and at 3 month follow up. Cost-effectiveness was evaluated from both top-down and bottom-up perspectives and cost per Quality Adjusted Life Year (cost/QALY) was calculated. The cost-effectiveness analysis assessed the increase in service cost that would be necessary before the cost-effectiveness of the service was compromised. A total of 515 patients completed questionnaires at baseline. Of these, 486 were referred for face to face assessment with a physiotherapist and were included in the analysis for the current study. 264 (54.3%) and 199 (40.9%) were retained at end of treatment and 3 month follow up respectively. An improvement was observed at follow up in all the clinical outcomes assessed, as well as a reduction in healthcare resource usage and sickness absence, and improvement in self-reported work performance. Multivariate regression indicated that baseline and current physical health were associated with work-related outcomes at follow up. The costs of the service were £194-£360 per service user depending on the method used, and the health gains contributed to a cost/QALY of £1386-£7760, which would represent value for money according to current UK thresholds. Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user. This pragmatic evaluation of the OHPPP indicated that it was likely to be feasible in terms of service usage and could potentially be cost effective in terms of QALYs. Further, the study confirmed that improving physical health status for musculoskeletal pain patients is important in reducing problems with work capacity and related costs. This study suggests that this type of service could be potentially be useful in reducing the burden of pain and should be further investigated, ideally via randomised controlled trials assessing effectiveness and cost-effectiveness.

Management of precancerous cervical lesions in iran: a cost minimizing study.

PubMed

Nahvijou, Azin; Sari, Ali Akbari; Zendehdel, Kazem; Marnani, Ahmad Barati

2014-01-01

Cervical cancer is a common, preventable and manageable disease in women worldwide. This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174 $ respectively. The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder: Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions.

PubMed

Vuijk, Richard; Arntz, Arnoud

2017-03-01

To our knowledge treatment of personality disorder (PD) comorbidity in adults with ASD is understudied and is still in its infancy. This study investigates the effectiveness of schema therapy for PD-psychopathology in adult patients with both ASD and PD. Twelve adult individuals (age > 18 years) with ASD and at least one PD are given a treatment protocol consisting of 30 weekly offered sessions. A concurrent multiple baseline design is used with baseline varying from 4 to 9 weeks, after which weekly supportive sessions varying from 1 to 6 weeks start with the study therapist. After baseline and 1 to 6 supportive sessions, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, and schema modes are explored, and information about the treatment is given. This is followed by 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions: patients are vice versa and randomly assigned to the interventions. Finally, there is a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and report weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs, and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after supportive sessions, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II is administered during screening procedure, at 5- and at 10-month follow-up. The Netherlands National Trial Register NTR5788. Registered 01 April 2016.

Follow-up care practices and barriers to breast cancer survivorship: perspectives from Asian oncology practitioners.

PubMed

Ng, Terence; Toh, Ming Ren; Cheung, Yin Ting; Chan, Alexandre

2015-11-01

The aim of this study is to evaluate the perspectives of Asian oncology practitioners on the physical and psychosocial issues experienced by breast cancer survivors (BCS), current survivorship care practices, and the barriers to follow-up care. This was a cross-sectional survey study. Oncology practitioners were recruited from a major cancer center in Singapore and through two regional cancer meetings that took place in Singapore and Malaysia in 2013. A total of 126 oncology practitioners from various Southeast Asian countries, mostly nurses (58.7 %) and physicians (37.3 %), were recruited. The majority of the respondents agreed that fatigue (78.4 %) and anxiety (69.1 %) were the most common physical and psychosocial problems experienced by BCS. Monitoring for physical and treatment-related adverse effects (80.7 %) and reviewing patients' noncancer medical history (65.3 %) were the most practiced aspects of follow-up care. Compared with the other practitioners, the physicians were more likely to communicate with other healthcare professionals (adjusted OR = 4.24, 95 % CI 1.54 to 11.72; p = 0.005). Most of the respondents also agreed that patient-specific barriers were the main impediments to follow-up care. This study provides insights into the various aspects of breast cancer survivorship care from the perspectives of oncology practitioners and shows that survivorship care is relatively inadequate in Asia. There is a need for new survivorship care models to meet the needs of Asian BCS and to complement the unique healthcare systems of Asia.

Long-term clinical evaluation of a 800-nm long-pulsed diode laser with a large spot size and vacuum-assisted suction for hair removal.

PubMed

Ibrahimi, Omar A; Kilmer, Suzanne L

2012-06-01

The long-pulsed diode (800-810-nm) laser is one of the most commonly used and effective lasers for hair removal. Limitations of currently available devices include a small treatment spot size, treatment-associated pain, and the need for skin cooling. To evaluate the long-term hair reduction capabilities of a long-pulsed diode laser with a large spot size and vacuum assisted suction. Thirty-five subjects were enrolled in a prospective, self-controlled, single-center study of axillary hair removal. The study consisted of three treatments using a long-pulsed diode laser with a large spot size and vacuum-assisted suction at 4- to 6-week intervals with follow-up visits 6 and 15 months after the last treatment. Hair clearance was quantified using macro hair-count photographs taken at baseline and at 6- and 15-month follow-up visits. Changes in hair thickness and color, levels of treatment-associated pain, and adverse events were additional study endpoints. There was statistically significant hair clearance at the 6 (54%) and 15-month (42%) follow-up visits. Remaining hairs were thinner and lighter at the 15-month follow-up visit, and the majority of subjects reported feeling up to mild to moderate pain during treatment without the use of pretreatment anesthesia or skin cooling. A long-pulsed diode laser with a large spot size and vacuum-assisted suction is safe and effective for long-term hair removal. This is the largest prospective study to evaluate long-term hair removal and the first to quantify decreases in hair thickness and darkness with treatment. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care.

PubMed

Gund, Anna; Lindecrantz, Kaj; Schaufelberger, Maria; Patel, Harshida; Sjöqvist, Bengt Arne

2012-11-28

eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high confidence in healthcare ICT. Possibilities for distance monitoring/follow-up are good according to 63% of the respondents, 78% thought that this leads to increased patient involvement, and 80% thought it would improve possibilities to deliver better care. Finally, 72% of the respondents said CHF patients would benefit from home monitoring/follow-up to some extent, and 19% to a large extent. However, the best method of follow-up was considered to be home visits by nurse, or phone contact. The results indicate that a majority of the healthcare professionals in this study are positive to both current and future use of ICT tools in healthcare and home follow-up. Consequently other factors have to play an important role in the slow penetration of out-of-hospital eHealth applications in daily healthcare practice.

Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): effects of exposure in vivo.

PubMed

de Jong, Jeroen R; Vlaeyen, Johan W S; van Eijsden, Marjon; Loo, Christoph; Onghena, Patrick

2012-10-01

There is increasing evidence that pain-related fear influences the development and maintenance of pain disability, presumably mediated through the fear-related avoidance of valued activities. Individually tailored graded exposure in vivo (GEXP) has been demonstrated to reduce pain-related fear and increase functional abilities in patients with chronic low back pain, neck pain, and complex regional pain syndrome. The current study aimed to test whether these effects generalize towards patients with work-related upper extremity pain. A sequential replicated and randomized single-case experimental phase design with multiple measurements was used. Within each participant, GEXP was compared to a no-treatment baseline period and a no-treatment 6-month follow-up period. Eight patients who reported a high level of pain-related fear were included in the study. Daily changes in pain catastrophizing, pain-related fear, and pain intensity were assessed using a diary, and subjected to randomization tests. Before the start of the baseline period, just after GEXP, and at 6-month follow-up, clinically relevant changes of pain catastrophizing, pain-related fear, perceived harmfulness of physical activity, pain disability, and participation/autonomy were verified. When GEXP was introduced, levels of pain catastrophizing and pain-related fear decreased significantly. Clinically relevant improvements were observed for pain disability, perceived participation, and autonomy. These favourable changes were maintained until 6-month follow-up. The findings of the current study underscore the external validity of a cognitive-behavioural GEXP treatment for patients with chronic pain reporting increased pain-related fear. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Meconium ileus in patients with cystic fibrosis is not a risk factor for clinical deterioration and survival: the Israeli Multicenter Study.

PubMed

Efrati, Ori; Nir, Judith; Fraser, Drora; Cohen-Cymberknoh, Malena; Shoseyov, David; Vilozni, Daphna; Modan-Moses, Dalit; Levy, Ran; Szeinberg, Amir; Kerem, Eitan; Rivlin, Joseph

2010-02-01

Patients with cystic fibrosis (CF) presenting with meconium ileus (MI) tend to have worse outcomes than those without MI. We evaluated the clinical characteristics and survival rates among Israeli patients with CF with and without MI after a prolonged follow-up (15-30 years). A multicenter retrospective study. Forty-nine patients with CF, representing 13.8% of all patients with CF in Israel, presented with MI (current age 17.4 +/- 7.9 years) between 1975 and 2006. They were compared with 38 patients with CF (current age 19.3 +/- 6.5 years) without MI matched by sex and CF transmembrane conductance regulator mutation. A total of 66.2% of patients with MI and 73.6% without MI were followed for a prolonged period (24.9 +/- 2.7 years). Of the patients with MI, 31 were managed operatively, whereas 18 were treated successfully with gastrograffin enema, with similar clinical outcomes. Five patients in the MI group and 3 in the control group died during the study period. Bacterial colonization, z score of body mass index, and pulmonary function tests were similar in patients with and without MI in the long term. In younger patients, many clinical parameters were more prevalent in patients with MI (P = 0.004). However, these differences disappeared after the long-term follow-up (up to 31-years). Patients with CF presenting with MI had similar pulmonary function and nutritional status, as well as survival rates as did the control patients without MI. The distinct genetic mutation found in our population may explain in part the favorable results compared with other studies. In addition, it seems that early diagnosis and treatment of MI in patients with CF may be beneficial, subsequently lowering morbidity, and increasing survival.

[Imaging and follow-up of children with first febrile Urinary Tract Infection (UTI)].

PubMed

Grossman, Zachi; Miron, Dan

2009-10-01

Urinary tract infection (UTI) in children might, in a minority of cases, cause renal scarring and permanent damage. Known risk factors for renal damage are: obstruction to urinary flow, vesicoureteric reflux and recurrent infections. The current recommendations for imaging and follow-up of children with first febrile UTI include renal ultrasound to rule out anatomic abnormalities, particularly obstruction, cystography for possible diagnosis of vesicoureteric reflux, and prophylactic antibiotic therapy to prevent recurrent infections in children with detected reflux. DMSA renal scanning for the detection of renal scars is recommended as part of the imaging protocol by some institutions. Recently, published data doubts the importance of the various imaging techniques, as well as the effectiveness of prophylactic antibiotic therapy. In the current review, the role of renal ultrasound is examined, especially with regards to familiar data from fetal ultrasound. The complex relationship between vesicoureteric reflux and renal scarring is presented, with the possible implications on the importance of performing routine cystography and DMSA scanning after UTI. Studies questioning the effectiveness of prophylactic antibiotic therapy emphasize the importance of rapid diagnosis and therapy of suspected recurrent UTI as the preferred approach to prevent renal damage. Imaging studies are only recommended for high risk groups and not as a routine following UTI.

Agoraphobia With and Without Panic Disorder: A 20-Year Follow-up of Integrated Exposure and Psychodynamic Therapy.

PubMed

Hoffart, Asle; Hedley, Liv M; Svanøe, Karol; Langkaas, Tomas Formo; Sexton, Harold

2016-02-01

The aim of the current study was to compare the 20-year outcome in panic disorder with agoraphobia (PD with AG) and agoraphobia without panic disorder (AG without PD) patients after inpatient psychological treatment. Of 53 eligible patients having completed a medication-free integrated exposure and psychodynamic treatment, 38 (71.7%)-25 PD with AG and 13 AG without PD patients-attended 20-year follow-up. AG without PD patients improved less than PD with AG patients did on primary outcome measures. In the PD with AG group, there were large uncontrolled effect sizes (<-2.30). More of the AG without PD patients had avoidant personality disorder at pretreatment, but the presence of this disorder did not predict outcome. The follow-up results support that PD with AG and AG without PD are two different disorders. The results also suggest that the very long-term outcome in PD with AG patients is excellent for this integrated treatment.

Current estimates of the cure fraction: a feasibility study of statistical cure for breast and colorectal cancer.

PubMed

Stedman, Margaret R; Feuer, Eric J; Mariotto, Angela B

2014-11-01

The probability of cure is a long-term prognostic measure of cancer survival. Estimates of the cure fraction, the proportion of patients "cured" of the disease, are based on extrapolating survival models beyond the range of data. The objective of this work is to evaluate the sensitivity of cure fraction estimates to model choice and study design. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER)-9 registries to construct a cohort of breast and colorectal cancer patients diagnosed from 1975 to 1985. In a sensitivity analysis, cure fraction estimates are compared from different study designs with short- and long-term follow-up. Methods tested include: cause-specific and relative survival, parametric mixture, and flexible models. In a separate analysis, estimates are projected for 2008 diagnoses using study designs including the full cohort (1975-2008 diagnoses) and restricted to recent diagnoses (1998-2008) with follow-up to 2009. We show that flexible models often provide higher estimates of the cure fraction compared to parametric mixture models. Log normal models generate lower estimates than Weibull parametric models. In general, 12 years is enough follow-up time to estimate the cure fraction for regional and distant stage colorectal cancer but not for breast cancer. 2008 colorectal cure projections show a 15% increase in the cure fraction since 1985. Estimates of the cure fraction are model and study design dependent. It is best to compare results from multiple models and examine model fit to determine the reliability of the estimate. Early-stage cancers are sensitive to survival type and follow-up time because of their longer survival. More flexible models are susceptible to slight fluctuations in the shape of the survival curve which can influence the stability of the estimate; however, stability may be improved by lengthening follow-up and restricting the cohort to reduce heterogeneity in the data. Published by Oxford University Press 2014.

Follow-Up Study of Students Who Enrolled in Small Business Non-Credit Courses at Harper College. Volume XXIV, Number 8.

ERIC Educational Resources Information Center

Lucas, John A.; Soto, Linda

As part of a review of its Small Business Management courses and seminars, William Rainey Harper College in Illinois conducted a study of students currently enrolled in spring 1995 and students who had enrolled from fall 1993 to fall 1994 to determine the students' characteristics, the effectiveness of marketing efforts, and students' perceptions…

Longitudinal Outcomes of U.S. Air Force Pilot Applicants With Waivered Astigmatism.

PubMed

Andrus, David E; Haynes, Jared T; Wright, Steven T

2017-03-01

Current U.S. Air Force medical standards allow applicants to enter pilot training with up to 1.50 D of astigmatism. However, waivers are considered for individuals with up to 3.00 D of astigmatism. Although typically a benign finding, higher levels of astigmatism may be progressive and can be associated with corneal ectasia (e.g., keratoconus or pellucid marginal degeneration) leading to reduced visual acuity with spectacles and/or soft contact lenses. The goal of this study was to evaluate the long-term outcomes of pilot applicants waivered into training with astigmatism exceeding the aeromedical standard. Subjects were identified on the basis of their enrollment in the Excessive Astigmatism Management Group maintained by the Aeromedical Consultation Service, Ophthalmology branch at Wright-Patterson Air Force Base, Ohio. Metrics evaluated included refractive status, visual acuity, aeromedical waiver status, safety data, and the development of corneal ectasia. Seventy-six subjects were tracked for up to 10 years, with an average follow-up period of 5.5 years. Mean astigmatism at initial examination was 1.91 D, although mean astigmatism on the basis of the most recent examination was 2.19 D. Subjects with excessive astigmatism who were waivered into pilot training showed an average increase in astigmatism of slightly less than 0.05 D annually, which equates to a total increase in astigmatism of approximately 0.25 D for the duration of the study. No subjects developed ectasia or were disqualified from flying for vision or refractive reasons. No mishaps were identified with vision being a causative or contributing factor. This study supports continuation of current Air Force waiver policy, although a longer follow-up period is required to consider modifying the aeromedical standard for astigmatism. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

[Sexuell assaults in therapeutic relationships: risk factors, consequences and legal steps].

PubMed

Eichenberg, Christiane; Dorniak, Judith; Fischer, Gottfried

2009-01-01

About 10 years ago, an initial empirical study was conducted in Germany about this topic. Since then, a penal code, paragraph 174 c StGB, was decreed, prohibiting sexual contact between therapists and their patients. A current follow-up survey was conducted in order to determine whether the results of previous surveys concerning situation conditions and after-effects converge with current results and if so, to what extent. Secondly, the survey was conducted to determine whether or not changes in the way the involved patients and authorities deal with this type of incident are evident. To ensure the comparability of the data, an online version of the Questionnaire about Sexual Contacts in Psychotherapy and Psychiatry (SKPP; Becker-Fischer, Fischer u. Jerouschek) was created and a survey of N = 77 affected patients was conducted. The majority of the participants in the study reported a serious decline in their overall well being following the incident, however, only very few undertook legal steps; only in three cases did it come to a legal procedure. The assumption that sexual contacts in psychotherapy result in extremely damaging consequences to patients, which the first study already revealed, was affirmed in the follow-up examination. Despite the changed legal situation, however, therapists in Germany are still not held legally responsible more often than they were 10 years ago. Georg Thieme Verlag KG Stuttgart-New York.

Evaluating the effectiveness of a post-license education program for young novice drivers in Belgium.

PubMed

Brijs, Kris; Cuenen, Ariane; Brijs, Tom; Ruiter, Robert A C; Wets, Geert

2014-05-01

The disproportionately large number of traffic accidents of young novice drivers highlights the need for an effective driver education program. The Goals for Driving Education (GDE) matrix shows that driver education must target both lower and higher levels of driver competences. Research has indicated that current education programs do not emphasize enough the higher levels, for example awareness and insight. This has raised the importance of insight programs. On the Road (OtR), a Flemish post-license driver education program, is such an insight program that aims to target these higher levels. The program focus is on risky driving behavior like speeding and drink driving. In addition, the program addresses risk detection and risk-related knowledge. The goal of the study was to do an effect evaluation of this insight program at immediate post-test and 2 months follow-up. In addition, the study aimed to generalize the results of this program to comparable programs in order to make usable policy recommendations. A questionnaire based on the Theory of Planned Behavior (TPB) was used in order to measure participants' safety consciousness of speeding and drink driving. Moreover, we focused on risk detection and risk-related knowledge. Participants (N=366) were randomly assigned to a baseline-follow-up group or a post-test-follow-up group. Regarding speeding and driving, we found OtR to have little effect on the TPB variables. Regarding risk detection, we found no significant effect, even though participants clearly needed substantial improvement when stepping into the program. Regarding risk-related knowledge, the program did result in a significant improvement at post-test and follow-up. It is concluded that the current program format is a good starting point, but that it requires further attention to enhance high level driving skills. Program developers are encouraged to work in a more evidence-based manner when they select target variables and methods to influence these variables. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical significance of tumor necrosis factor-α inhibitors in the treatment of sciatica: a systematic review and meta-analysis.

PubMed

Wang, Yun Fu; Chen, Ping You; Chang, Wei; Zhu, Fi Qi; Xu, Li Li; Wang, Song Lin; Chang, Li Ying; Luo, Jie; Liu, Guang Jian

2014-01-01

Currently, no satisfactory treatment is available for sciatica caused by herniated discs and/or spinal stenosis. The objective of this study is to assess the value of tumor necrosis factor (TNF)-α inhibitors in the treatment of sciatica. Without language restrictions, we searched PubMed, OVID, EMBASE, the Web of Science, the Clinical Trials Registers, the Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria. Nine prospective randomized controlled trials (RCTs) and two before-after controlled trials involving 531 patients met our inclusion criteria and were included in this study. Our systematic assessment and meta-analysis demonstrated that in terms of the natural course of the disease, compared with the control condition, TNF-α inhibitors neither significantly relieved lower back and leg pain (both p > 0.05) nor enhanced the proportion of patients who felt overall satisfaction (global perceived effect (satisfaction)) or were able to return to work (return to work) (combined endpoint; p > 0.05) at the short-term, medium-term and long-term follow-ups. In addition, compared with the control condition, TNF-α inhibitors could reduce the risk ratio (RR) of discectomy or radicular block (combined endpoint; RR = 0.51, 95% CI 0.26 to 1.00, p = 0.049) at medium-term follow-up, but did not decrease RR at the short-term (RR = 0.64, 95% CI 0.17 to 2.40, p = 0.508) and long-term follow-ups (RR = 0.64, 95% CI 0.40 to 1.03, p = 0.065). The currently available evidence demonstrated that other than reducing the RR of discectomy or radicular block (combined endpoint) at medium-term follow-up, TNF-α inhibitors showed limited clinical value in the treatment of sciatica caused by herniated discs and/or spinal stenosis.

Neural activation during response inhibition in adult Attention-Deficit/Hyperactivity Disorder: Preliminary findings on the effects of medication and symptom severity

PubMed Central

Congdon, Eliza; Altshuler, Lori L.; Mumford, Jeanette A.; Karlsgodt, Katherine H.; Sabb, Fred W.; Ventura, Joseph; McGough, James J.; London, Edythe D.; Cannon, Tyrone D.; Bilder, Robert M.; Poldrack, Russell A.

2014-01-01

Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop-Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N = 35) and healthy comparison subjects (N = 62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop-Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated with current medication, with individuals taking psychostimulants (N = 25) showing less stopping-related activation than those not currently receiving psychostimulant medication (N = 10). Follow-up analyses suggested that this difference in activation was independent of symptom severity. These results provide evidence that deficits in inhibition-related neural activation persist in a subset of adult ADHD individuals, namely those individuals currently taking psychostimulants. These findings help to explain some of the disparities in the literature, and advance our understanding of why deficits in response inhibition are more variable in adult, as compared with child and adolescent, ADHD patients. PMID:24581734

Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

PubMed Central

Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

2015-01-01

Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity, resilience was more strongly and robustly associated with economic and social factors than with the presence of mental disorder. PMID:25687898

Patient-specific and global convolutional neural networks for robust automatic liver tumor delineation in follow-up CT studies.

PubMed

Vivanti, Refael; Joskowicz, Leo; Lev-Cohain, Naama; Ephrat, Ariel; Sosna, Jacob

2018-03-10

Radiological longitudinal follow-up of tumors in CT scans is essential for disease assessment and liver tumor therapy. Currently, most tumor size measurements follow the RECIST guidelines, which can be off by as much as 50%. True volumetric measurements are more accurate but require manual delineation, which is time-consuming and user-dependent. We present a convolutional neural networks (CNN) based method for robust automatic liver tumor delineation in longitudinal CT studies that uses both global and patient specific CNNs trained on a small database of delineated images. The inputs are the baseline scan and the tumor delineation, a follow-up scan, and a liver tumor global CNN voxel classifier built from radiologist-validated liver tumor delineations. The outputs are the tumor delineations in the follow-up CT scan. The baseline scan tumor delineation serves as a high-quality prior for the tumor characterization in the follow-up scans. It is used to evaluate the global CNN performance on the new case and to reliably predict failures of the global CNN on the follow-up scan. High-scoring cases are segmented with a global CNN; low-scoring cases, which are predicted to be failures of the global CNN, are segmented with a patient-specific CNN built from the baseline scan. Our experimental results on 222 tumors from 31 patients yield an average overlap error of 17% (std = 11.2) and surface distance of 2.1 mm (std = 1.8), far better than stand-alone segmentation. Importantly, the robustness of our method improved from 67% for stand-alone global CNN segmentation to 100%. Unlike other medical imaging deep learning approaches, which require large annotated training datasets, our method exploits the follow-up framework to yield accurate tumor tracking and failure detection and correction with a small training dataset. Graphical abstract Flow diagram of the proposed method. In the offline mode (orange), a global CNN is trained as a voxel classifier to segment liver tumor as in [31]. The online mode (blue) is used for each new case. The input is baseline scan with delineation and the follow-up CT scan to be segmented. The main novelty is the ability to predict failures by trying the system on the baseline scan and the ability to correct them using the patient-specific CNN.

CLINICAL OUTCOMES AND SELF-REPORTED SYMPTOMS IN PATIENTS WITH ACROMEGALY: AN 8-YEAR FOLLOW-UP OF A LANREOTIDE STUDY.

PubMed

Khairi, Shafaq; Sagvand, Babak Torabi; Pulaski-Liebert, Karen J; Tritos, Nicholas A; Klibanski, Anne; Nachtigall, Lisa B

2017-01-01

The aim of this study was to evaluate the proportion of patients with acromegaly who remained on long-term lanreotide depot after completion of an open-label multicenter phase III clinical trial (SALSA: A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel), compare baseline and long-term follow-up symptoms scores, and correlate scores with individual longitudinal clinical outcomes. Records of all subjects previously enrolled at the Massachusetts General Hospital site of SALSA were reviewed. Those who remained on lanreotide were interviewed and asked to complete a questionnaire that they had filled out in SALSA in 2007 regarding their current symptomatology and injection side effects, as well as to complete the Acromegaly Quality of Life Questionnaire. Furthermore, clinical, biochemical, and radiographic data related to acromegaly and its comorbidities were tracked throughout follow-up. Six out of 7 patients chose to remain on lanreotide, and 5 of them continued lanreotide depot through last follow-up, for up to 8 years or in 1 case until death. In all cases, lanreotide remained well tolerated, and insulin-like growth factor-1 levels and pituitary imaging remained well controlled on stable doses. While comorbidities persisted or developed, the self-reported symptom score after up to 8 years of therapy showed a significant decrease in frequency or resolution in symptoms that were reported at baseline. This study shows a significant decrease in frequency or resolution in self-reported symptoms in well-controlled patients receiving long-term lanreotide therapy. AcroQoL = Acromegaly Quality of Life Questionnaire GH = growth hormone GI = gastrointestinal IGF-1 = insulin-like growth factor-1 SALSA = A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel.

Frequent Detection of Latent Tuberculosis Infection among Aged Underground Hard Coal Miners in the Absence of Recent Tuberculosis Exposure

PubMed Central

Ringshausen, Felix C.; Nienhaus, Albert; Schablon, Anja; Torres Costa, José; Knoop, Heiko; Hoffmeyer, Frank; Bünger, Jürgen; Merget, Rolf; Harth, Volker; Schultze-Werninghaus, Gerhard; Rohde, Gernot

2013-01-01

Background Miners are at particular risk for tuberculosis (TB) infection due to exposure to silica dust and silicosis. The objectives of the present observational cohort study were to determine the prevalence of latent TB infection (LTBI) among aged German underground hard coal miners with silicosis or chronic obstructive pulmonary disease (COPD) using two commercial interferon-gamma release assays (IGRAs) and to compare their performance with respect to predictors of test positivity. Methods Between October 2008 and June 2010, miners were consecutively recruited when routinely attending pneumoconiosis clinics for an expert opinion. Both IGRAs, the QuantiFERON®-TB Gold In-Tube (QFT) and the T-SPOT®.TB (T-SPOT), were performed at baseline. A standardized clinical interview was conducted at baseline and at follow-up. The cohort was prospectively followed regarding the development of active TB for at least two years after inclusion of the last study subject. Independent predictors of IGRA positivity were calculated using logistic regression. Results Among 118 subjects (mean age 75 years), none reported recent exposure to TB. Overall, the QFT and the T-SPOT yielded similarly high rates of positive results (QFT: 46.6%; 95% confidence interval 37.6–55.6%; T-SPOT: 61.0%; 95% confidence interval 52.2–69.8%). Positive results were independently predicted by age ≥80 years and foreign country of birth for both IGRAs. In addition, radiological evidence of prior healed TB increased the chance of a positive QFT result fivefold. While 28 subjects were lost to follow-up, no cases of active TB occurred among 90 subjects during an average follow-up of >2 years. Conclusions Considering the high prevalence of LTBI, the absence of recent TB exposure, and the currently low TB incidence in Germany, our study provides evidence for the persistence of specific interferon-gamma responses even decades after putative exposure. However, the clinical value of current IGRAs among our study population, although probably limited, remains uncertain. PMID:24312620

Long-term follow-up in optimally treated and stable heart failure patients: primary care vs. heart failure clinic. Results of the COACH-2 study.

PubMed

Luttik, Marie Louise A; Jaarsma, Tiny; van Geel, Peter Paul; Brons, Maaike; Hillege, Hans L; Hoes, Arno W; de Jong, Richard; Linssen, Gerard; Lok, Dirk J A; Berge, Marjolein; van Veldhuisen, Dirk J

2014-11-01

It has been suggested that home-based heart failure (HF) management in primary care may be an alternative to clinic-based management in HF patients. However, little is known about adherence to HF guidelines and adherence to the medication regimen in these home-based programmes. The aim of the current study was to determine whether long-term follow-up and treatment in primary care is equally effective as follow-up at a specialized HF clinic in terms of guideline adherence and patient adherence, in HF patients initially managed and up-titrated to optimal treatment at a specialized HF clinic. We conducted a multicentre, randomized, controlled study in 189 HF patients (62% male, age 72 ± 11 years), who were assigned to follow-up either in primary care (n = 97) or in a HF clinic (n = 92). After 12 months, no differences between guideline adherence, as estimated by the Guideline Adherence Indicator (GAI-3), and patient adherence, in terms of the medication possession ratio (MPR), were found between treatment groups. There was no difference in the number of deaths (n = 12 in primary care and n = 8 in the HF clinic; P = 0.48), and hospital readmissions for cardiovascular (CV) reasons were also similar. The total number of unplanned non-CV hospital readmissions, however, tended to be higher in the primary care group (n = 22) than in the HF clinic group (n = 10; P = 0.05). Patients discharged after initial management in a specialized HF clinic can be discharged to primary care for long-term follow-up with regard to maintaining guideline adherence and patient adherence. However, the complexity of the HF syndrome and its associated co-morbidities requires continuous monitoring. Close collaboration between healthcare providers will be crucial in order to provide HF patients with optimal, integrated care. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

A randomized controlled trial of brain training with non-action video games in older adults: results of the 3-month follow-up

PubMed Central

Ballesteros, Soledad; Mayas, Julia; Prieto, Antonio; Toril, Pilar; Pita, Carmen; Laura, Ponce de León; Reales, José M.; Waterworth, John A.

2015-01-01

This randomized controlled study (ClinicalTrials.gov NCT02007616) investigated the maintenance of training effects of 20 1-hr non-action video game training sessions with selected games from a commercial package on several age-declining cognitive functions and subjective wellbeing after a 3-month no-contact period. Two groups of cognitively normal older adults participated in both the post-training (posttest) and the present follow-up study, the experimental group who received training and the control group who attended several meetings with the research team during the study but did not receive training. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. Significant improvements in the trained group, and no variation in the control group had been previously found at posttest, in processing speed, attention and visual recognition memory, as well as in two dimensions of subjective wellbeing. In the current study, improvement from baseline to 3 months follow-up was found only in wellbeing (Affection and Assertivity dimensions) in the trained group whereas there was no change in the control group. Previous significant improvements in processing speed, attention and spatial memory become non-significant after the 3-month interval. Training older adults with non-action video games enhanced aspects of cognition just after training but this effect disappeared after a 3-month no-contact follow-up period. Cognitive plasticity can be induced in older adults by training, but to maintain the benefits periodic boosting sessions would be necessary. PMID:25926790

A randomized controlled trial of brain training with non-action video games in older adults: results of the 3-month follow-up.

PubMed

Ballesteros, Soledad; Mayas, Julia; Prieto, Antonio; Toril, Pilar; Pita, Carmen; Laura, Ponce de León; Reales, José M; Waterworth, John A

2015-01-01

This randomized controlled study (ClinicalTrials.gov NCT02007616) investigated the maintenance of training effects of 20 1-hr non-action video game training sessions with selected games from a commercial package on several age-declining cognitive functions and subjective wellbeing after a 3-month no-contact period. Two groups of cognitively normal older adults participated in both the post-training (posttest) and the present follow-up study, the experimental group who received training and the control group who attended several meetings with the research team during the study but did not receive training. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. Significant improvements in the trained group, and no variation in the control group had been previously found at posttest, in processing speed, attention and visual recognition memory, as well as in two dimensions of subjective wellbeing. In the current study, improvement from baseline to 3 months follow-up was found only in wellbeing (Affection and Assertivity dimensions) in the trained group whereas there was no change in the control group. Previous significant improvements in processing speed, attention and spatial memory become non-significant after the 3-month interval. Training older adults with non-action video games enhanced aspects of cognition just after training but this effect disappeared after a 3-month no-contact follow-up period. Cognitive plasticity can be induced in older adults by training, but to maintain the benefits periodic boosting sessions would be necessary.

Designing Epidemiology Studies to Determine the Incidence and Prevalence of Encapsulating Peritoneal Sclerosis (EPS).

PubMed

Nitsch, Dorothea; Davenport, Andrew

2015-12-01

The reported incidence and prevalence of encapsulating peritoneal sclerosis (EPS) varies markedly between North America, Europe, Japan, and Australia. Although this could reflect differences in clinical practice patterns and access to transplantation as there is no current test for early detection, and some patients may present many years after discontinuation of peritoneal dialysis (PD), there are concerns about under-reporting, particularly for those with milder forms. Currently, only PD vintage has been identified as a significant risk factor for developing EPS, although some patients can develop EPS within months of starting PD. As such, there is a need for epidemiological studies to determine the incidence and prevalence of EPS to allow for patient education and counselling in terms of dialysis modality choice and length of treatment. In addition, carefully designed epidemiological studies could potentially allow for the identification of risk factors and bio-markers that could then be used to identify patients at increased risk of developing EPS in the future. Typically, studies to date have been underpowered with inadequate longitudinal follow-up. We review the different types of epidemiological studies and provide information as to the number of patients to be recruited and the duration of follow-up required to determine the incidence and prevalence of EPS. Copyright © 2015 International Society for Peritoneal Dialysis.

Exploring the "legacy" of the Tuskegee Syphilis Study: a follow-up study from the Tuskegee Legacy Project.

PubMed

Katz, Ralph V; Green, B Lee; Kressin, Nancy R; James, Sherman A; Wang, Min Qi; Claudio, Cristina; Russell, Stephanie Luise

2009-02-01

The purpose of this follow-up 2003 3-City Tuskegee Legacy Project (TLP) Study was to validate or refute our prior findings from the 1999-2000 4 City TLP Study, which found no evidence to support the widely acknowledged "legacy" of the Tuskegee Syphilis Study (TSS), ie, that blacks are reluctant to participate in biomedical studies due to their knowledge of the TSS. The TLP Questionnaire was administered in this random-digit-dial telephone survey to a stratified random sample of 1162 black, white, and Puerto Rican Hispanic adults in 3 different US cities. The findings from this current 3-City TLP Study fail to support the widely acknowledged "legacy" of the TSS, as awareness of the TSS was not statistically associated with the willingness to participate in biomedical studies. These findings, being in complete agreement with our previous findings from our 1999-2000 4-City TLP, validate those prior findings.

Exploring the “Legacy” of the Tuskegee Syphilis Study: A Follow-up Study From the Tuskegee Legacy Project

PubMed Central

Katz, Ralph V.; Green, B. Lee; Kressin, Nancy R.; James, Sherman A.; Wang, Min Qi; Claudio, Cristina; Russell, Stephanie Luise

2009-01-01

The purpose of this follow-up 2003 3-City Tuskegee Legacy Project (TLP) Study was to validate or refute our prior findings from the 1999–2000 4 City TLP Study, which found no evidence to support the widely acknowledged “legacy” of the Tuskegee Syphilis Study (TSS), ie, that blacks are reluctant to participate in biomedical studies due to their knowledge of the TSS. The TLP Questionnaire was administered in this random-digit-dial telephone survey to a stratified random sample of 1162 black, white, and Puerto Rican Hispanic adults in 3 different US cities. The findings from this current 3-City TLP Study fail to support the widely acknowledged “legacy” of the TSS, as awareness of the TSS was not statistically associated with the willingness to participate in biomedical studies. These findings, being in complete agreement with our previous findings from our 1999–2000 4-City TLP, validate those prior findings. PMID:19378637

Maternal support following childhood sexual abuse: Associations with children's adjustment post-disclosure and at 9-month follow-up.

PubMed

Zajac, Kristyn; Ralston, M Elizabeth; Smith, Daniel W

2015-06-01

Maternal support has been widely cited as an important predictor of children's adjustment following disclosure of sexual abuse. However, few studies have examined these effects longitudinally. The current study examines the relationships between a multidimensional assessment of maternal support rated by both mothers and children and children's adjustment in various domains (internalizing, externalizing, anger, depression, and posttraumatic stress disorder symptoms) concurrently and longitudinally. Participants were 118 mother-child dyads recruited from a Child Advocacy Center where children were determined through a forensic evaluation to be victims of sexual abuse. Child and mother ratings of maternal support and child adjustment were collected shortly after the forensic evaluation and at 9-month follow-up. Results were consistent with findings from past studies that maternal support is significantly related to children's post-disclosure adjustment and extends these findings longitudinally. Additionally, the study sheds light on differential relations between dimensions of maternal support (Emotional Support, Blame/Doubt, Vengeful Arousal, and Skeptical Preoccupation) and child adjustment and suggests the importance of using both child and mother ratings of maternal support in future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Four-year durability of clinical and haemodynamic outcomes of transcatheter aortic valve implantation with the self-expanding CoreValve.

PubMed

Gulino, Simona; Barbanti, Marco; Deste, Wanda; Immè, Sebastiano; Aruta, Patrizia; Bottari, Vera; Benvenuto, Emanuele; Tamburino, Claudia; Di Landro, Alessio; Liberto, Daria; Santonoceto, Letizia; Sicuso, Rita; Di Stefano, Daniele; Todaro, Denise; Di Simone, Emanuela; Indelicato, Antonino; Giannazzo, Daniela; Sgroi, Carmelo; Tamburino, Corrado

2016-10-10

Long-term data on the durability of currently available transcatheter heart valves are limited. We sought to assess four-year clinical and echocardiographic outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis. Between June 2007 and February 2014, 450 consecutive patients with symptomatic severe aortic stenosis underwent TAVI in our institution. For the purposes of this study, we included only those patients undergoing successful TAVI with the CoreValve prosthesis who had a minimum follow-up of four years (n=125). Survival rates at one, two, three and four years were 83.2, 76.8, 73.6 and 66.3%, respectively. Aortic regurgitation was a common finding after the procedure, especially due to paravalvular regurgitation (PVR), which was observed in the majority of patients (71.5%), mostly mild (52.0%). Progression from mild acute PVR to moderate PVR at four-year follow-up was reported in three patients. No cases of severe PVR were observed. Prosthetic valve failure was reported in four patients (3.2%). Our study demonstrates that favourable outcomes after successful TAVI are associated with sustained clinical and functional cardiovascular benefits up to four-year follow-up. Signs of moderate prosthetic valve failure are present only in a small percentage of patients.

Teacher Attrition and Mobility: Results from the 2012-13 Teacher Follow-Up Survey. First Look. NCES 2014-077

ERIC Educational Resources Information Center

Goldring, Rebecca; Taie, Soheyla; Riddles, Minsun

2014-01-01

This report presents selected findings from the Current Teacher and Former Teacher Data Files of the 2012-13 Teacher Follow-up Survey (TFS). TFS is a nationally representative sample survey of public and private school K-12 teachers who participated in the previous year's Schools and Staffing Survey (SASS). First fielded in school year 1988-89,…

A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.

PubMed

van Lieshout, Marloes; Luman, Marjolein; Twisk, Jos W R; van Ewijk, Hanneke; Groenman, Annabeth P; Thissen, Andrieke J A M; Faraone, Stephen V; Heslenfeld, Dirk J; Hartman, Catharina A; Hoekstra, Pieter J; Franke, Barbara; Buitelaar, Jan K; Rommelse, Nanda N J; Oosterlaan, Jaap

2016-09-01

There are very few studies on the long-term outcome of children and adolescents with ADHD-combined type in Europe. The objective of the present study is to assess the 6-year outcome (including pharmacological treatment) of a large cohort of participants with ADHD-combined type (N = 347, mean age 11.4 years) in late adolescence and early adulthood. At study entry and follow-up (mean age 17.4 years), participants were comprehensively assessed on ADHD and comorbid disorders by structured psychiatric interviews and multi-informant questionnaires. Overall functioning was assessed by the Children's Global Assessment Scale. The retention rate was 75.6 %. The majority of participants (86.5 %) persisted in a DSM-5 ADHD diagnosis, 8.4 % had a subthreshold diagnosis, and 5.1 % remitted from the disorder at follow-up. Comorbidities decreased strongly; oppositional defiant disorder: 58 > 31 %, conduct disorder: 19 > 7 %. At follow-up, mood- and anxiety disorders were virtually non-existent following strict criteria (1-3 %). Percentage of children having had pharmacological treatment at any time increased from 79 to 91 %. On the Children's Global Assessment Scale, 48.5 % of participants were still functionally impaired at follow-up. Parental ADHD, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline positively predicted current ADHD symptom severity (R (2) = 20.9 %). Younger baseline age, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline were positively associated with poorer overall functioning (R (2) = 17.8 %). Pharmacological treatment had no (beneficial) impact on either ADHD symptom severity or overall functioning. Results confirm that ADHD is largely persistent into late adolescence with severity and family history for the disorder as important risk factors.

Motor, cognitive, and functional declines contribute to a single progressive factor in early HD.

PubMed

Schobel, Scott A; Palermo, Giuseppe; Auinger, Peggy; Long, Jeffrey D; Ma, Shiyang; Khwaja, Omar S; Trundell, Dylan; Cudkowicz, Merit; Hersch, Steven; Sampaio, Cristina; Dorsey, E Ray; Leavitt, Blair R; Kieburtz, Karl D; Sevigny, Jeffrey J; Langbehn, Douglas R; Tabrizi, Sarah J

2017-12-12

To identify an improved measure of clinical progression in early Huntington disease (HD) using data from prospective observational cohort studies and placebo group data from randomized double-blind clinical trials. We studied Unified Huntington Disease Rating Scale (UHDRS) and non-UHDRS clinical measures and brain measures of progressive atrophy in 1,668 individuals with early HD followed up prospectively for up to 30 to 36 months of longitudinal clinical follow-up. The results demonstrated that a composite measure of motor, cognitive, and global functional decline best characterized clinical progression and was most strongly associated with brain measures of progressive corticostriatal atrophy. Use of a composite motor, cognitive, and global functional clinical outcome measure in HD provides an improved measure of clinical progression more related to measures of progressive brain atrophy and provides an opportunity for enhanced clinical trial efficiency relative to currently used individual motor, cognitive, and functional outcome measures. © 2017 American Academy of Neurology.

A Follow-up Study of the Graduates of MiraCosta Adult High School Diploma Program 1982, 1983, 1984, 1985.

ERIC Educational Resources Information Center

Pereira, Cecelia

Selected characteristics and conditions of MiraCosta Adult High School Diploma Program graduates were investigated. Data were gathered from 129 respondents by a 35-item mailed questionnaire. Questions pertained to graduates' current status, analysis of their high school experience, and recommendations for improving the adult high school diploma…

Weight Suppression Predicts Time to Remission from Bulimia Nervosa

ERIC Educational Resources Information Center

Lowe, Michael R.; Berner, Laura A.; Swanson, Sonja A.; Clark, Vicki L.; Eddy, Kamryn T.; Franko, Debra L.; Shaw, Jena A.; Ross, Stephanie; Herzog, David B.

2011-01-01

Objective: To investigate whether, at study entry, (a) weight suppression (WS), the difference between highest past adult weight and current weight, prospectively predicts time to first full remission from bulimia nervosa (BN) over a follow-up period of 8 years, and (b) weight change over time mediates the relationship between WS and time to first…

Improving Follow-up Response Rate at Brevard Community College. Final Report from September 24, 1984 to August 31, 1985.

ERIC Educational Resources Information Center

Lawton, Robert E.

A plan was developed to improve followup study response rates by refining techniques for data collection and improving student motivation to respond to daily requests. Factors affecting response rate to followup surveys were investigated, and alternative approaches were recommended. Findings indicated that current procedures--two mailouts of…

Children's and Adolescents' Perception of the Authenticity of Smiles

ERIC Educational Resources Information Center

Thibault, Pascal; Gosselin, Pierre; Brunel, Marie-Lise; Hess, Ursula

2009-01-01

Recently, Thibault and colleagues described the Duchenne marker as a cultural dialect for the perception of smile authenticity. The current study had the goal to follow up on this finding and to investigate the cues that French Canadian children use to evaluate the authenticity of smiles from members of three ethnic groups. The authenticity of six…

Childhood Maltreatment and College Students' Current Suicidal Ideation: A Test of the Helplessness Theory.

ERIC Educational Resources Information Center

Gibb, Brandon E.; Alloy, Lauren B.; Abramson, Lyn Y.; Rose, Donna T.; Whitehouse, Wayne G.; Hogan, Michael E.

2001-01-01

This study evaluates the ability of the hopelessness theory of depression's etiological chain to account for this relation in a sample of 297 undergraduates. Results indicated that emotional, but not physical or sexual, maltreatment was uniquely related to average levels of suicidal ideation across a 2.5-year follow-up. (Author)

Peer Interaction in Text Chat: Qualitative Analysis of Chat Transcripts

ERIC Educational Resources Information Center

Golonka, Ewa M.; Tare, Medha; Bonilla, Carrie

2017-01-01

Prior research has shown that intermediate-level adult learners of Russian who worked interactively with partners using text chat improved their vocabulary and oral production skills more than students who worked independently (Tare et al., 2014). Drawing on the dataset from Tare et al. (2014), the current study follows up to explore the nature of…

School Suspensions: Are They Helping Children? A Report.

ERIC Educational Resources Information Center

Washington Research Project, Cambridge, MA. Children's Defense Fund.

This book examines the incidence and impact of school suspension and discusses its effectiveness as a disciplinary measure. Basically, this publication is intended to follow up and expand on a 1974 report on the use of school suspension, "Children out of School in America." Data for this current study were drawn from suspension data submitted to…

Course of cannabis use and clinical outcome in patients with non-affective psychosis: a 3-year follow-up study.

PubMed

van der Meer, F J; Velthorst, E

2015-07-01

Prospective studies on the relationship between course of cannabis use and clinical outcome in patients with non-affective psychotic disorders are inconclusive. The current study examined whether (1) persistent, recently started, discontinued and non-cannabis-using patients with a psychotic disorder differed with regard to illness outcome at 3-year follow-up, and (2) whether timing of cannabis discontinuation was associated with course of clinical outcome. This 3-year follow-up study was part of a multi-center study in the Netherlands and Belgium (Genetic Risk and Outcome of Psychosis; GROUP). We used mixed-model analyses to investigate the association between pattern of cannabis use and symptoms, global functioning and psychotic relapse. In our sample of 678 patients, we found persistent users to have more positive and general symptoms, worse global functioning and more psychotic relapses compared with non-users and discontinued users [Positive and Negative Syndrome Scale (PANSS) positive, p < 0.001; PANSS general, p < 0.001; Global Assessment of Functioning (GAF) symptoms, p = 0.017; GAF disability, p < 0.001; relapses, p = 0.038]. Patients who started using cannabis after study onset were characterized by worse functioning at baseline and showed an increase in general symptoms (including depression and anxiety) at the 3-year follow-up (p = 0.005). Timing of cannabis discontinuation was not associated with clinical outcome. These findings suggest that cannabis use in patients with a psychotic disorder has a long-lasting negative effect on illness outcome, particularly when persistent. Treatment should focus on discouraging cannabis use.

Occupational physical activity, overweight, and mortality: a follow-up study of 47,405 Norwegian women and men.

PubMed

Graff-Iversen, Sidsel; Selmer, Randi; Sørensen, Marit; Skurtveit, Svetlana

2007-06-01

This population-based 24-year follow-up study evaluated the association of occupational physical activity (OPA) with overweight and mortality in 47,405 men and women, healthy at baseline, and reporting OPA as sedentary (reference), light, moderately heavy, or heavy. The adjusted odds ratio for overweight was slightly less than 1 for all categories of current nonsedentary work in men but increased by OPA in women. Only heavy OPA conferred a lower mortality with an adjusted rate ratio of 0.84 (95 % confidence interval, 0.76-0.92) for men and 0.69 (95 % confidence interval, 0.52-0.91) for women. This observational study, with OPA recorded in the 1970s and 1980s, suggested a slight protective effect for overweight by nonsedentary work for men and lower mortality by heavy OPA for both genders.

Frequency and Characteristics Associated With Exposure to Tobacco Direct Mail Marketing and Its Prospective Effect on Smoking Behaviors Among Young Adults From the US Midwest

PubMed Central

Forster, Jean L.

2014-01-01

Objectives. We examined the exposure to tobacco direct mail marketing and its effect on subsequent smoking behaviors in a US Midwest regional cohort of young adults. Methods. Data were collected from 2622 young adults (mean age = 24 years) in 2010 to 2011 (baseline) and 2011 to 2012 (follow-up). We collected information on demographics, tobacco use, and exposure to tobacco direct mail materials in the previous 6 months at baseline. Smoking behaviors were reassessed at follow-up. We investigated the characteristics associated with receiving these materials at baseline, and the associations between receiving cigarette coupons in the mail at baseline and smoking behaviors at follow-up. Results. Thirteen percent of participants reported receiving tobacco direct mail materials in the previous 6 months. Receipt of these materials was associated with age, education, and tobacco use (P < .05). Among those who received these materials, 77% and 56% reported receiving coupons for cigarettes and other tobacco products, respectively. Among baseline nonsmokers and ex-smokers, receiving coupons was associated with becoming current smokers at follow-up (P < .05). Among baseline current smokers, receiving coupons was associated with lower likelihood of smoking cessation at follow-up (P < .05). Conclusions. Tobacco direct mail marketing promoted and sustained smoking behaviors among US Midwest young adults. Regulating this marketing strategy might reduce the prevalence of smoking in this population. PMID:25211739

Changes in stress and burden in families seeking therapy following traumatic brain injury: a follow-up study.

PubMed

Perlesz, A; O'Loughlan, M

1998-12-01

The current project is a preliminary investigation of changes in levels of distress and burden and family and marital adjustment in families following traumatic brain injury (TBI), replicating measures-used in the earlier Glasgow, TBI outcome research on relatives' stress and burden. Fifteen families (32 individuals) seeking family counselling in a publicly funded family therapy centre were monitored over a two year period: prior to commencing counselling; 12 months following the commencement of counselling; and 24 months following the commencement of counselling. The most significant and sustained changes in psychosocial outcome were a decrease in distress for both individuals with TBI and their carers as well as a reduction in relatives' burden and strain. Family conflict also reduced, just as family cohesion increased and adjustment within the family unit improved from pre-therapy to the time of follow-up 24 months later. However, reported levels of anger, despite significantly reducing during the first 12 months of the study, actually increased back to their original levels at the 24 month follow-up. Marital adjustment also worsened in the latter half of the study, with couples reporting a similar level of marital adjustment to that which they had experienced prior to counselling. These findings are discussed and recommendations made for more rigorous, controlled, longitudinal studies of the effectiveness of family therapy. It was also recommended that marital couples receive longer-term counselling to address their specific needs, and that the issue of anger be further investigated with a view to either reducing family members' anger, or bearing witness to the legitimacy of their anger in the longer-term, and assisting with anger-management programmes.

Intradiscal electrothermal therapy used to manage chronic discogenic low back pain: new directions and interventions.

PubMed

Wetzel, F Todd; McNally, Thomas A; Phillips, Frank M

2002-11-15

Retrospective literature review. To review the data on the clinical efficacy of intradiscal electrothermal annuloplasty found at this writing in the peer-reviewed literature to date, to discuss the methodologic strengths and flaws of the studies, to discuss the pitfalls of clinical study designs, to emphasize the need for prospective randomized studies and for increased basic science investigation. Studies published or presented at peer-reviewed societies concerning the clinical efficacy of intradiscal electrothermal annuloplasty are reviewed, including background studies on deafferentation and application of thermal energy to alter biomechanical and structural properties. A proposal for future investigations is presented. Background data from intracapsular annuloplasty highlighting the safety and efficacy of intradiscal electrothermal annuloplasty are presented. Current studies on this procedure, including those in the National Registry are reviewed. All the studies share a common study design: prospective cohort with historical or noninterventional groups used as controls. The patients reviewed are similar. All have nonradicular low back pain of at least 3 months duration, failed conservative care, normal neurologic examination, and MRI showing only nondegenerative disc disease and positive concordant discography. All the patients underwent intradiscal electrothermal annuloplasty lesion at one or two levels according to standard protocols. Follow-up evaluation was performed at various intervals up to 2 years. All the studies used data from a visual analog scale, with most using the Short Form 36 (SF-36) as outcome instruments. The reported follow-up periods for the studies ranged from 6 months to 2 years. Three published studies, one with a 6-month follow-up period and two with a 1-year follow-up period, were published in the peer-reviewed literature. Two recent reports presented to the North American Spine Society were reviewed: a study of patients on a manufacturer-sponsored registry with a 1-year follow-up period and a multicenter prospective cohort study of 75 patients in an intent-to-treat group, with a 1-year follow-up period. Using the 7-point criteria of Deyo et al, all the studies suggested a positive effect of treatment, with a decrease in visual analog scale ratings and improvement in SF-36 scales, particularly those for physical function and bodily pain. The studies published so far suggest that the pain resulting from lumbar disc disease may be diminished by intradiscal electrothermal annuloplasty. All these studies project a positive therapeutic effect. However, all the studies suffer from the same methodologic flaws. A prospective cohort design or a nonrandomized prospective design is used with a biased control. The scientific validity of various study designs is discussed, and a randomized prospective study is recommended. Additionally, more investigation into the basic science of the action of intradiscal electrothermal annuloplasty is required.

Quantitative and qualitative analysis of bone flap resorption in patients undergoing cranioplasty after decompressive craniectomy.

PubMed

Korhonen, Tommi K; Salokorpi, Niina; Niinimäki, Jaakko; Serlo, Willy; Lehenkari, Petri; Tetri, Sami

2018-02-23

OBJECTIVE Autologous bone cranioplasty after decompressive craniectomy entails a notable burden of difficult postoperative complications, such as infection and bone flap resorption (BFR), leading to mechanical failure. The prevalence and significance of asymptomatic BFR is currently unclear. The aim of this study was to radiologically monitor the long-term bone flap survival and bone quality change in patients undergoing autologous cranioplasty. METHODS The authors identified all 45 patients who underwent autologous cranioplasty at Oulu University Hospital, Finland, between January 2004 and December 2014. Using perioperative and follow-up CT scans, the volumes and radiodensities of the intact bone flap prior to surgery and at follow-up were calculated. Relative changes in bone flap volume and radiodensity were then determined to assess cranioplasty survival. Sufficient CT scans were obtainable from 41 (91.1%) of the 45 patients. RESULTS The 41 patients were followed up for a median duration of 3.79 years (25th and 75th percentiles = 1.55 and 6.66). Thirty-seven (90.2%) of the 41 patients had some degree of BFR and 13 (31.7%) had a remaining bone flap volume of less than 80%. Patients younger than 30 years of age had a mean decrease of 15.8% in bone flap volume compared with the rest of the cohort. Bone flap volume was not found to decrease linearly with the passing of time, however. The effects of lifestyle factors and comorbidities on BFR were nonsignificant. CONCLUSIONS In this study BFR was a very common phenomenon, occurring at least to some degree in 90% of the patients. Decreases in bone volume were especially prominent in patients younger than 30 years of age. Because the progression of resorption during follow-up was nonlinear, routine follow-up CT scans appear unnecessary in monitoring the progression of BFR; instead, clinical follow-up with mechanical stability assessment is advised. Partial resorption is most likely a normal physiological phenomenon during the bone revitalization process.

Long-term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction.

PubMed

Jeuken, Ralph M; Schotanus, Martijn G M; Kort, Nanne P; Deenik, Axel; Jong, Bob; Hendrickx, Roel P M

2016-07-01

Hallux valgus is one of the most common foot deformities. This long-term follow-up study compared the results of 2 widely used operative treatments for hallux valgus: the scarf and chevron osteotomy. Conventional weight bearing anteroposterior (AP) radiographs of the foot were made for evaluating the intermetatarsal angle and hallux valgus angle. For clinical evaluation, the American Orthopaedic Foot & Ankle Society (AOFAS) rating system for the hallux metatarsophalangeal-interphalangeal scale was used together with physical examination of the foot. These data were compared with the results from the original study. The Short Form 36 questionnaire, the Manchester-Oxford Foot Questionnaire (MOXFQ), and a general questionnaire including a visual analog scale (VAS) pain score were used for subjective evaluation. The primary outcome measures were the radiologic recurrence of hallux valgus and reoperation rate of the same toe. Secondary outcome measures were the results from the radiographs and subjective and clinical evaluation. The response rate was 76% at the follow-up of 14 years; in the chevron group, 37 feet were included compared with 36 feet in the scarf group. Twenty-eight feet in the chevron group and 27 in the scarf group developed recurrence of hallux valgus (P = .483). One patient in the scarf group had a reoperation of the same toe compared with none in the chevron group (P = .314). Current VAS pain scores and results from the SF-36, MOXFQ, and AOFAS did not significantly differ between groups. Both techniques showed similar results after 2 years of follow-up. At 14 years of follow-up, neither technique was superior in preventing recurrence. Level II, randomized controlled trial. © The Author(s) 2016.

Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial

PubMed Central

Strauß, Bernhard; Altmann, Uwe; Manes, Susanne; Tholl, Anne; Koranyi, Susan; Nolte, Tobias; Beutel, Manfred E.; Wiltink, Jörg; Herpertz, Stephan; Hiller, Wolfgang; Hoyer, Jürgen; Joraschky, Peter; Nolting, Björn; Ritter, Viktoria; Stangier, Ulrich; Willutzki, Ulrike; Salzer, Simone; Leibing, Eric; Leichsenring, Falk; Kirchmann, Helmut

2018-01-01

Objectives Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments. Research design and methods 495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up. The Liebowitz Social Anxiety Scale (LSAS) was administered at pre-treatment, post-treatment, and at 6-month and 1-year follow-up. ECR-R scores were first compared to a representative healthy sample (n = 2508) in order to demonstrate that the clinical sample differed significantly from the non-clinical sample with respect to attachment anxiety and avoidance. Results LSAS scores correlated significantly with both ECR-R subscales. Post-therapy, patients treated with CBT revealed significant changes in attachment anxiety and avoidance whereas patients treated with PDT showed no significant changes. Changes between post-treatment and the two follow-ups were significant in both conditions, with minimal (insignificant) differences between treatments at the 12- month follow-up. Conclusions The current study supports recent reviews of mostly naturalistic studies indicating changes in attachment as a result of psychotherapy. Although there were differences between conditions at the end of treatment, these largely disappeared during the follow-up period which is line with the other results of the SOPHO-NET trial. Trial registration Controlled-trials.com ISRCTN53517394 PMID:29518077

Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain

PubMed Central

Brose, Leonie S.; Brown, Jamie; Robson, Debbie; McNeill, Ann

2015-01-01

Introduction: E-cigarettes can be categorized into two basic types, (1) cigalikes, that are disposable or use pre-filled cartridges and (2) tanks, that can be refilled with liquids. The aims of this study were to examine: (1) predictors of using the two e-cigarette types, and (2) the association between type used, frequency of use (daily vs. non-daily vs. no use), and quitting. Methods: Online longitudinal survey of smokers in Great Britain was first conducted in November 2012. Of 4064 respondents meeting inclusion criteria at baseline, this study included (N = 1643) current smokers followed-up 1 year later. Type and frequency of e-cigarette use were measured at follow-up. Results: At follow-up, 64% reported no e-cigarette use, 27% used cigalikes, and 9% used tanks. Among e-cigarette users at follow-up, respondents most likely to use tanks versus cigalikes included: 40–54 versus 18–24 year olds and those with low versus moderate/high education. Compared to no e-cigarette use at follow-up, non-daily cigalike users were less likely to have quit smoking since baseline (P = .0002), daily cigalike or non-daily tank users were no more or less likely to have quit (P = .3644 and P = .4216, respectively), and daily tank users were more likely to have quit (P = .0012). Conclusions: Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education. PMID:25896067

Preliminary effectiveness of surviving the teens(®) suicide prevention and depression awareness program on adolescents' suicidality and self-efficacy in performing help-seeking behaviors.

PubMed

King, Keith A; Strunk, Catherine M; Sorter, Michael T

2011-09-01

Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens® Suicide Prevention and Depression Awareness Program on students' suicidality and perceived self-efficacy in performing help-seeking behaviors. High school students in Greater Cincinnati schools were administered a 3-page survey at pretest, immediate posttest, and 3-month follow-up. A total of 1030 students participated in the program, with 919 completing matched pretests and posttests (89.2%) and 416 completing matched pretests and 3-month follow-ups (40.4%). Students were significantly less likely at 3-month follow-up than at pretest to be currently considering suicide, to have made a suicidal plan or attempted suicide during the past 3 months, and to have stopped performing usual activities due to feeling sad and hopeless. Students' self-efficacy and behavioral intentions toward help-seeking behaviors increased from pretest to posttest and were maintained at 3-month follow-up. Students were also more likely at 3-month follow-up than at pretest to know an adult in school with whom they felt comfortable discussing their problems. Nine in 10 (87.3%) felt the program should be offered to all high school students. The findings of this study lend support for suicide prevention education in schools. The results may be useful to school professionals interested in implementing effective suicide prevention programming to their students. © 2011, American School Health Association.

[Attention therapy for children - long-term affects of the ATTENTIONER].

PubMed

Jacobs, Claus; Petermann, Franz

2008-11-01

A high percentage of children are affected by attention deficit disorders. For a large proportion the cardinal symptom is inattention; in particular, deficits in selective attention prevail. The ATTENTIONER offers an effective training method for the treatment of selective attention deficit. In 2007, long-term effects of therapy were already reported by Jacobs and Petermann, who examined children ten weeks after therapy on average. In the current study three measurements were conducted: pre-intervention, post-intervention, and at follow-up ten to 76 months after post-intervention. Significant long-term effects on measures of selective attention were observed. At follow-up the majority of patients achieved average results which were not clinically relevant. For most children stable therapy effects can be achieved with the ATTENTIONER.

A Longitudinal Study of Predictors of Housing Stability, Housing Quality, and Mental Health Functioning Among Single Homeless Individuals Staying in Emergency Shelters.

PubMed

Aubry, Tim; Duhoux, Arnaud; Klodawsky, Fran; Ecker, John; Hay, Elizabeth

2016-09-01

The current study examined risk and resilience factors at multiple levels that affect homeless individuals' ability to exit homelessness and achieve housing stability. It also examined the relationship between housing status, housing quality and mental health functioning. The methodology is a longitudinal study of single homeless individuals staying in emergency shelters in a medium-sized Canadian city who were followed for a 2 year period. Data were collected from participants at a baseline interview when they were homeless and at a 2-year follow-up. There were 329 participants interviewed at baseline and 197 (59.9%) participants interviewed at follow-up. Results from a structural equation modelling analysis found that having interpersonal and community resources were predictive of achieving housing stability. Specifically, having a larger social support network, access to subsidized housing, and greater income was related to achieving housing stability. On the other hand, having a substance use problem was a risk factor associated with a failure to achieving housing stability. Being female, feeling personally empowered, having housing that is perceived of being of higher quality were directly predictive of mental health functioning at follow-up. Findings are discussed in the context of previous research and their policy implications. © Society for Community Research and Action 2016.

Incidence of ventricular tachyarrhythmias during permanent pacemaker therapy in low-risk patients results from the German multicentre EVENTS study.

PubMed

Faber, Thomas S; Gradinger, Robert; Treusch, Sven; Morkel, Carsten; Brachmann, Johannes; Bode, Christoph; Zehender, Manfred

2007-09-01

Current studies found an incidence of 12-31% ventricular tachyarrhythmias and sudden cardiac death during cardiac pacing months or even years after pacemaker insertion. MADIT(12) and MUSTT(13) demonstrated that patients with poor LV function after Myocardial infarction (MI) showing non-sustained ventricular tachycardia (nsVT) and inducibility during electrophysiologic testing benefit from an ICD. The present study was dedicated to assess the global incidence of non-sustained ventricular arrhythmias in a general population of pacemaker patients. Special regard was on patients with a potential ICD indication, e.g. those matching the MADIT/MUSTT criteria. Two hundred and thirty-one patients (72 +/- 11 years; 134 men) with an indication for dual chamber pacing entered the study. In all patients pacemaker systems capable of automatic storing of intracardiac electrocardiograms were implanted (Pulsar, Discovery, Guidant). Follow-up time was 15 months after inclusion. In 54 (25.7%) of 210 patients with at least one follow-up, episodes of nsVT were documented by stored electrocardiograms (up to >30 beats, >200 b.p.m.). Multiple-up to nine-episodes of ventricular tachycardia were retrieved in 31 of these patients. Three out of 14 patients with an LVEF <40% after MI presented nsVT during the follow-up. One of these patients received an ICD. A significant number of pacemaker patients present with ventricular tachycardia. Intracardiac electrocardiograms and alert functions from pacemakers may enhance physicians' awareness of the patient's intrinsic arrhythmic profile and help uncover underlying mechanisms of arrhythmias by storing the initiation of the arrhythmia.

A 12-year prognosis of adult-onset asthma: Seinäjoki Adult Asthma Study.

PubMed

Tuomisto, Leena E; Ilmarinen, Pinja; Niemelä, Onni; Haanpää, Jussi; Kankaanranta, Terhi; Kankaanranta, Hannu

2016-08-01

Long-term prognosis of adult-onset asthma is poorly known. To evaluate 12-year prognosis of adult-onset asthma and the factors associated with disease prognosis. Seinäjoki Adult-onset Asthma Study (SAAS) is a 12-year real-life single-center follow-up study of new-onset asthma diagnosed at adult age and treated in primary and specialized care. Remission was defined by no symptoms and no asthma medication use for 6 months. Asthma control was evaluated according to Global Initiative for Asthma 2010. Factors associated with current asthma control were analyzed by multinomial multivariate logistic regression. A total of 203 patients (79% of the baseline population) were followed for 12 years. Remission occurred in 6 (3%) patients. In 34% asthma was controlled, in 36% it was partially controlled and in 30% uncontrolled. Uncontrolled asthma was predicted by elevated body-mass index at baseline, smoking (pack-years) and current allergic or persistent rhinitis. Elevated blood eosinophils and good lung function (FEV1) at baseline protected from uncontrolled asthma. In contrast, gender, age at the onset or baseline symptoms (Airways Questionnaire 20) were not significant predictors of uncontrolled disease. During a 12-year follow-up, remission of adult-onset asthma was rare occurring in only 3% of patients. The majority of patients (66%) presented either with uncontrolled or partially controlled asthma. This study is registered at ClinicalTrials.gov with identifier number NCT02733016. Copyright © 2016 Elsevier Ltd. All rights reserved.

A single-center retrospective study of pediatric hepatoblastoma

PubMed Central

Zhang, Yi; Zhang, Weiling; Tang, Suoqin; Chen, Liping; Yi, You; Zhang, Pinwei; Liu, Aiping; Zhi, Tian; Huang, Dongsheng

2016-01-01

Hepatoblastoma is a malignant liver tumor generally diagnosed in infants and children <3 years old. The current retrospective study aimed to investigate the associations of tumor stage, pathological type, metastasis and chemotherapy with clinical outcomes. In the current study, a total of 102 patients with hepatoblastoma were enrolled between September 2006 and June 2014. Clinical records and follow-up information for each of patient were obtained to conduct a Kaplan-Meier survival analysis and log-rank test. The median age of the subjects was 1.5 years, and 98 patients had stage III or IV hepatoblastoma. Complete or partial remittance occurred in 72 subjects, and 91 underwent surgical operation. The survival rate differed significantly among patients with different tumor stages (P=0.015, χ2=8.359). The mortality rate of stage IV subjects with intrahepatic metastasis was significantly higher than that of those without (P=0.004). Among the 45 subjects with relapsed hepatoblastoma, the mortality rate was higher in the subjects that abandoned chemotherapy than in patients who continued regular chemotherapy. In total, 27 of 45 subjects with relapsed hepatoblastoma succumbed to the disease; 20 of them abandoned chemotherapy treatment; and the remaining 7 patients underwent regular chemotherapy and succumbed to the disease by the end of follow-up. The present study indicates that the increased mortality rate was associated with postoperative residual-induced intrahepatic metastasis and relapsed hepatoblastoma; and that regular chemotherapy is necessary for patient to achieve complete or partial remission following surgical operation. PMID:27895749

Outpatient follow-up system using a personal computer for patients with hepatocellular carcinoma after surgery.

PubMed

Itasaka, H; Matsumata, T; Taketomi, A; Yamamoto, K; Yanaga, K; Takenaka, K; Akazawa, K; Sugimachi, K

1994-12-01

A simple outpatient follow-up system was developed with a laptop personal computer to assist management of patients with hepatocellular carcinoma after hepatic resections. Since it is based on a non-relational database program and the graphical user interface of Macintosh operating system, those who are not a specialist of the computer operation can use it. It is helpful to promptly recognize current status and problems of the patients, to diagnose recurrences of the disease and to prevent lost from follow-up cases. A portability of the computer also facilitates utilization of these data everywhere, such as in clinical conferences and laboratories.

HIV screening among TB patients and co-trimoxazole preventive therapy for TB/HIV patients in Addis Ababa: facility based descriptive study.

PubMed

Denegetu, Amenu Wesen; Dolamo, Bethabile Lovely

2014-01-01

Collaborative TB/HIV management is essential to ensure that HIV positive TB patients are identified and treated appropriately, and to prevent tuberculosis (TB) in HIV positive patients. The purpose of this study was to assess HIV case finding among TB patients and Co-trimoxazole Preventive Therapy (CPT) for HIV/TB patients in Addis Ababa. A descriptive cross-sectional, facility-based survey was conducted between June and July 2011. Data was collected by interviewing 834 TB patients from ten health facilities in Addis Ababa. Both descriptive and inferential statistics were used to summarize and analyze findings. The proportion of TB patients who (self reported) were offered for HIV test, tested for HIV and tested HIV positive during their anti-TB treatment follow-up were; 87.4%, 69.4% and 20.2%; respectively. Eighty seven HIV positive patients were identified, who knew their status before diagnosed for the current TB disease, bringing the cumulative prevalence of HIV among TB patients to 24.5%. Hence, the proportion of TB patients who knew their HIV status becomes 79.9%. The study revealed that 43.6% of those newly identified HIV positives during anti-TB treatment follow-up were actually treated with CPT. However, the commutative proportion of HIV positive TB patients who were ever treated with CPT was 54.4%; both those treated before the current TB disease and during anti-TB treatment follow-up. HIV case finding among TB patients and provision of CPT for TB/HIV co-infected patients needs boosting. Hence, routine offering of HIV test and provision of CPT for PLHIV should be strengthened in-line with the national guidelines.

THAO-CHILD HEALTH PROGRAMME: COMMUNITY BASED INTERVENTION FOR HEALTHY LIFESTYLES PROMOTION TO CHILDREN AND FAMILIES: RESULTS OF A COHORT STUDY.

PubMed

Gómez Santos, Santiago Felipe; Estévez Santiago, Rocío; Palacios Gil-Antuñano, Nieves; Leis Trabazo, Maria Rosaura; Tojo Sierra, Rafael; Cuadrado Vives, Carmen; Beltrán de Miguel, Beatriz; Ávila Torres, José Manuel; Varela Moreiras, Gregorio; Casas Esteve, Rafael

2015-12-01

childhood obesity is one of the main public health concerns. The multifactorial and multilevel causes require complex interventions such the community based interventions (CBI). Thao-Child Health Programme is a CBI implemented in Spain since 2007. show the Thao methodology and the latest cross-sectional and longitudinal results. longitudinal cohort study (4 years of follow- up) and cross sectional study. the longitudinal study found an increase of 1% in the overweight prevalence after a follow-up of 4 years of Thao-Programme implementation in 10 municipalities with 6 697 children involved. The cross-sectional study carried out with 20 636 children from 22 municipalities found a childhood overweight prevalence of 26.6%. currently a brake in the increase of childhood overweight prevalence is considered a success due to the high prevalence worldwide. More studies well methodologically performed are needed to know the efficacy of the CBI's in this field. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area.

PubMed

Rodríguez Cristóbal, Juan José; Panisello Royo, Josefa Ma; Alonso-Villaverde Grote, Carlos; Pérez Santos, José Ma; Muñoz Lloret, Anna; Rodríguez Cortés, Francisca; Travé Mercadé, Pere; Benavides Márquez, Francisca; Martí de la Morena, Pilar; González Burgillos, Ma José; Delclós Baulies, Marta; Bleda Fernández, Domingo; Quillama Torres, Elida

2010-03-18

The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. ClinicalTrials.gov Identifier: NCT01006213.

TEA DRINKING AND COGNITIVE FUNCTION IN OLDEST-OLD CHINESE

PubMed Central

Feng, L.; Li, J.; Ng, T.-P.; Lee, T.-S.; Kua, E.-H.; Zeng, Y.

2013-01-01

Objective We examined the longitudinal association between tea drinking frequency and cognitive function in a large sample of oldest-old Chinese. Design population-based longitudinal cohort study. Setting The Chinese Longitudinal Healthy Longevity Survey (CLHLS). Participants 7139 participants aged 80 to 115 (mean age 91.4 years) who provided complete data at baseline (year 1998). Measurements Current frequency of tea drinking and past frequency at age 60 were ascertained at baseline, and baseline and follow-up cognitive assessments were performed in the years 1998 (n=7139), 2000 (n=4081), 2002 (n=2288) and 2005 (n=913) respectively. Verbal fluency test was used as measure of cognitive function. Results Tea drinking was associated at baseline with higher mean (SD) verbal fluency scores: daily=10.7 (6.6), occasional=9.2 (5.8), non-drinker=9.0 (5.5). In linear mixed effects model that adjusted for age, gender, years of schooling, physical exercise and activities score, the regression coefficient for daily drinking (at age 60) and occasional drinking was 0.72 (P<0.0001) and 0.41(P=0.01) respectively. Tea drinkers had higher verbal fluency scores throughout the follow-up period but concurrently had a steeper slope of cognitive decline as compared with non-drinkers (coefficient for the interaction term Time*Daily drinking= −0.12, P=0.02; ‘Time’ was defined as the time interval from baseline to follow-up assessments in years). Similar results were found for current tea drinking status at study baseline year (1998) as predictor variable. Conclusion Regular tea drinking is associated with better cognitive function in oldest-old Chinese. PMID:23131816

Tea drinking and cognitive function in oldest-old Chinese.

PubMed

Feng, L; Li, J; Ng, T-P; Lee, T-S; Kua, E-H; Zeng, Y

2012-01-01

We examined the longitudinal association between tea drinking frequency and cognitive function in a large sample of oldest-old Chinese. population-based longitudinal cohort study. The Chinese Longitudinal Healthy Longevity Survey (CLHLS). 7139 participants aged 80 to 115 (mean age 91.4 years) who provided complete data at baseline (year 1998). Current frequency of tea drinking and past frequency at age 60 were ascertained at baseline, and baseline and follow-up cognitive assessments were performed in the years 1998 (n=7139), 2000 (n=4081), 2002 (n=2288) and 2005 (n=913) respectively. Verbal fluency test was used as measure of cognitive function. Tea drinking was associated at baseline with higher mean (SD) verbal fluency scores: daily=10.7 (6.6), occasional=9.2 (5.8), non-drinker=9.0 (5.5). In linear mixed effects model that adjusted for age, gender, years of schooling, physical exercise and activities score, the regression coefficient for daily drinking (at age 60) and occasional drinking was 0.72 (P<0.0001) and 0.41(P=0.01) respectively. Tea drinkers had higher verbal fluency scores throughout the follow-up period but concurrently had a steeper slope of cognitive decline as compared with non-drinkers (coefficient for the interaction term Time*Daily drinking= -0.12, P=0.02; "Time" was defined as the time interval from baseline to follow-up assessments in years). Similar results were found for current tea drinking status at study baseline year (1998) as predictor variable. Regular tea drinking is associated with better cognitive function in oldest-old Chinese.

Influences of tobacco advertising exposure and conduct problems on smoking behaviors among adolescent males and females.

PubMed

Mays, Darren; Gilman, Stephen E; Rende, Richard; Luta, George; Tercyak, Kenneth P; Niaura, Raymond S

2014-06-01

Adolescents with conduct problems are more likely to smoke, and tobacco advertising exposure may exacerbate this risk. Males' excess risk for conduct problems and females' susceptibility to advertising suggest gender-specific pathways to smoking. We investigated the associations between gender, conduct problems, and lifetime smoking and adolescents' exposure to tobacco advertising, and we examined prospective relationships with smoking behaviors. Adolescents completed baseline (2001-2004; n = 541) and 5-year follow-up (2007-2009; n =320) interviews for a family study of smoking risk. Baseline interviews assessed conduct problems and tobacco advertising exposure; smoking behavior was assessed at both timepoints. Generalized linear models analyzed gender differences in the relationship between conduct problems, advertising exposure, and smoking behavior at baseline and longitudinally. At baseline, among males, conduct problems were associated with greater advertising exposure independent of demographics and lifetime smoking. Among females at baseline, conduct problems were associated with greater advertising exposure only among never-smokers after adjusting for demographics. In longitudinal analyses, baseline advertising exposure predicted subsequent smoking initiation (i.e., smoking their first cigarette between baseline and follow-up) for females but not for males. Baseline conduct problems predicted current (i.e., daily or weekly) smoking at follow-up for all adolescents in adjusted models. The findings of this study reinforce that conduct problems are a strong predictor of subsequent current smoking for all adolescents and reveal important differences between adolescent males and females in the relationship between conduct problems, tobacco advertising behavior, and smoking behavior. The findings suggest gender-specific preventive interventions targeting advertising exposure may be warranted.

1981 Follow-Up Study of Students Enrolled and Previously Enrolled in the Michigan School for the Blind and the Michigan School for the Deaf.

ERIC Educational Resources Information Center

Livingston-White, Deborah J. H.

A followup study of currently and previously enrolled students of the Michigan School for the Blind (MSB) and the Michigan School for the Deaf (MSD) is reported. Eligibility guidelines, services, enrollment, costs, and nature of the student body at each institution are described. Development and use of four questionnaires to evaluate eight…

Alternatives to inpatient mental health care for children and young people

PubMed Central

Shepperd, Sasha; Doll, Helen; Gowers, Simon; James, Anthony; Fazel, Mina; Fitzpatrick, Ray; Pollock, Jon

2014-01-01

Background Current policy in the UK and elsewhere places emphasis on the provision of mental health services in the least restrictive setting, whilst also recognising that some children will require inpatient care. As a result, there are a range of mental health services to manage young people with serious mental health problems who are at risk of being admitted to an inpatient unit in community or outpatient settings. Objectives 1. To assess the effectiveness, acceptability and cost of mental health services that provide an alternative to inpatient care for children and young people. 2. To identify the range and prevalence of different models of service that seek to avoid inpatient care for children and young people. Search methods Our search included the Cochrane Effective Practice and Organisation of Care Group Specialised Register (2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, issue 4), MEDLINE (1966 to 2007), EMBASE (1982 to 2006), the British Nursing Index (1994 to 2006), RCN database (1985 to 1996), CINAHL (1982 to 2006) and PsycInfo (1972 to 2007). Selection criteria Randomised controlled trials of mental health services providing specialist care, beyond the scope of generic outpatient provision, as an alternative to inpatient mental health care, for children or adolescents aged from five to 18 years who have a serious mental health condition requiring specialist services beyond the capacity of generic outpatient provision. The control group received mental health services in an inpatient or equivalent setting. Data collection and analysis Two authors independently extracted data and assessed study quality. We grouped studies according to the intervention type but did not pool data because of differences in the interventions and measures of outcome. Where data were available we calculated confidence intervals (CIs) for differences between groups at follow up. We also calculated standardised mean differences (SMDs) and 95% CIs for each outcome in terms of mean change from baseline to follow up using the follow-up SDs. We calculated SMDs (taking into account the direction of change and the scoring of each instrument) so that negative SMDs indicate results that favour treatment and positive SMDs favour the control group. Main results We included seven randomised controlled trials (recruiting a total of 799 participants) evaluating four distinct models of care: multi-systemic therapy (MST) at home, specialist outpatient service, intensive home treatment and intensive home-based crisis intervention (‘Homebuilders’ model for crisis intervention). Young people receiving home-based MST experienced some improved functioning in terms of externalising symptoms and they spent fewer days out of school and out-of-home placement. At short term follow up the control group had a greater improvement in terms of adaptability and cohesion; this was not sustained at four months follow up. There were small, significant patient improvements reported in both groups in the trial evaluating the intensive home-based crisis intervention using the ‘Homebuilders’ model. No differences at follow up were reported in the two trials evaluating intensive home treatment, or in the trials evaluating specialist outpatient services. Authors’ conclusions The quality of the evidence base currently provides very little guidance for the development of services. If randomised controlled trials are not feasible then consideration should be given to alternative study designs, such as prospective systems of audit conducted across several centres, as this has the potential to improve the current level of evidence. These studies should include baseline measurement at admission along with demographic data, and outcomes measured using a few standardised robust instruments. PMID:19370634

Diagnostic accuracy of PCR in gambiense sleeping sickness diagnosis, staging and post-treatment follow-up: a 2-year longitudinal study.

PubMed

Deborggraeve, Stijn; Lejon, Veerle; Ekangu, Rosine Ali; Mumba Ngoyi, Dieudonné; Pati Pyana, Patient; Ilunga, Médard; Mulunda, Jean Pierre; Büscher, Philippe

2011-02-22

The polymerase chain reaction (PCR) has been proposed for diagnosis, staging and post-treatment follow-up of sleeping sickness but no large-scale clinical evaluations of its diagnostic accuracy have taken place yet. An 18S ribosomal RNA gene targeting PCR was performed on blood and cerebrospinal fluid (CSF) of 360 T. brucei gambiense sleeping sickness patients and on blood of 129 endemic controls from the Democratic Republic of Congo. Sensitivity and specificity (with 95% confidence intervals) of PCR for diagnosis, disease staging and treatment failure over 2 years follow-up post-treatment were determined. Reference standard tests were trypanosome detection for diagnosis and trypanosome detection and/or increased white blood cell concentration in CSF for staging and detection of treatment failure. PCR on blood showed a sensitivity of 88.4% (84.4-92.5%) and a specificity of 99.2% (97.7-100%) for diagnosis, while for disease staging the sensitivity and specificity of PCR on cerebrospinal fluid were 88.4% (84.8-91.9%) and 82.9% (71.2-94.6%), respectively. During follow-up after treatment, PCR on blood had low sensitivity to detect treatment failure. In cerebrospinal fluid, PCR positivity vanished slowly and was observed until the end of the 2 year follow-up in around 20% of successfully treated patients. For T.b. gambiense sleeping sickness diagnosis and staging, PCR performed better than, or similar to, the current parasite detection techniques but it cannot be used for post-treatment follow-up. Continued PCR positivity in one out of five cured patients points to persistence of living or dead parasites or their DNA after successful treatment and may necessitate the revision of some paradigms about the pathophysiology of sleeping sickness.

Is there a need for routine follow-up after primary total hip arthroplasty?

PubMed

Hacking, Craig; Weinrauch, Patrick; Whitehouse, Sarah L; Crawford, Ross W; Donnelly, William J

2010-10-01

The objective of routine outpatient assessment of well-functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow-up of patients after THA. A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a four-year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow-up information were recorded and cross-referenced with Australian Orthopaedic Association National Joint Replacement Registry data. One hundred ten THAs in 104 patients (average age 70.4 (SD 9.8 years)). There were 70 (63.6%) in total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri-prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only four (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3)) follow-up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years. We conclude that patients with prostheses with excellent long-term clinical results as validated by joint registries, routine follow-up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow-up of asymptomatic THA may be excessively costly and unnecessary, and a less resource-intensive review method may be more appropriate. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

Rationale and design of the MONITOR-ICD study: a randomized comparison of economic and clinical effects of automatic remote MONITORing versus control in patients with Implantable Cardioverter Defibrillators.

PubMed

Zabel, Markus; Müller-Riemenschneider, Falk; Geller, J Christoph; Brachmann, Johannes; Kühlkamp, Volker; Dissmann, Rüdiger; Reinhold, Thomas; Roll, Stephanie; Lüthje, Lars; Bode, Frank; Eckardt, Lars; Willich, Stefan N

2014-10-01

Implantable cardioverter defibrillator (ICD) remote follow-up and ICD remote monitoring (RM) are established means of ICD follow-up. The reduction of the number of in-office visits and the time to decision is proven, but the true clinical benefit is still unknown. Cost and cost-effectiveness of RM remain leading issues for its dissemination. The MONITOR-ICD study has been designed to assess costs, cost-effectiveness, and clinical benefits of RM versus standard-care follow-up in a prospective multicenter randomized controlled trial. Patients indicated for single- or dual-chamber ICD are eligible for the study and are implanted an RM-capable Biotronik ICD (Lumax VR-T or Lumax DR-T; Biotronik SE & Co KG, Berlin, Germany). Implantable cardioverter defibrillator programming and alert-based clinical responses in the RM group are highly standardized by protocol. As of December 2011, recruitment has been completed, and 416 patients have been enrolled. Subjects are followed-up for a minimum of 12months and a maximum of 24months, ending in January 2013. Disease-specific costs from a societal perspective have been defined as primary end point and will be compared between RM and standard-care groups. Secondary end points include ICD shocks (including appropriate and inappropriate shocks), cardiovascular hospitalizations and cardiovascular mortality, and additional health economic end points. The MONITOR-ICD study will be an important randomized RM study to report data on a primary economic end point in 2014. Its results on ICD shocks will add to the currently available evidence on clinical benefit of RM. Copyright © 2014 Mosby, Inc. All rights reserved.

The impact of alcohol marketing on youth drinking behaviour: a two-stage cohort study.

PubMed

Gordon, Ross; MacKintosh, Anne Marie; Moodie, Crawford

2010-01-01

To examine whether awareness of, and involvement with alcohol marketing at age 13 is predictive of initiation of drinking, frequency of drinking and units of alcohol consumed at age 15. A two-stage cohort study, involving a questionnaire survey, combining interview and self-completion, was administered in respondents' homes. Respondents were drawn from secondary schools in three adjoining local authority areas in the West of Scotland, UK. From a baseline sample of 920 teenagers (aged 12-14, mean age 13), in 2006, a cohort of 552 was followed up 2 years later (aged 14-16, mean age 15). Data were gathered on multiple forms of alcohol marketing and measures of drinking initiation, frequency and consumption. At follow-up, logistic regression demonstrated that, after controlling for confounding variables, involvement with alcohol marketing at baseline was predictive of both uptake of drinking and increased frequency of drinking. Awareness of marketing at baseline was also associated with an increased frequency of drinking at follow-up. Our findings demonstrate an association between involvement with, and awareness of, alcohol marketing and drinking uptake or increased drinking frequency, and we consider whether the current regulatory environment affords youth sufficient protection from alcohol marketing.

Direct pulp capping in primary molars using a resin-modified Portland cement-based material (TheraCal) compared to MTA with 12-month follow-up: a randomised clinical trial.

PubMed

Erfanparast, L; Iranparvar, P; Vafaei, A

2018-05-16

This study was to compare the success of resin-modified Portland cement-based material (TheraCal) with MTA in direct pulp capping (DPC) of primary molars. Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5-7 years were included in this split-mouth randomised clinical trial. DPC for small non-contaminated pulp exposures using either TheraCal or MTA were randomly performed in symmetrical molars. Thereafter, teeth were restored with amalgam. Clinical and radiographic evaluations were performed at 6 and 12 month follow-ups. Data were analysed using Chi square test at a significance level of 0.05. At the final follow-up session 74 teeth were available. After 12 months, the overall success rates for MTA and TheraCal were 94.5 and 91.8%, respectively. The difference between outcomes of the two groups was not statistically significant (P > 0.05). Within the limitations of the current study, radiographic and clinical findings revealed that TheraCal exhibited a comparable outcome to MTA in DPC of primary molars after 12 months.

6-Month Trajectory of Suicidal Ideation in Adolescents with Borderline Personality Disorder

PubMed Central

Selby, Edward A.; Yen, Shirley

2013-01-01

Few studies have longitudinally examined suicidal ideation in those with adolescent-onset BPD. The current study aimed to examine the trajectory of suicidal ideation in adolescents with BPD longitudinally over six months, with follow-ups at 2, 4, and 6 months post-hospitalization for elevated suicide risk. Resulted indicated that the BPD group exhibited a greater decrease in suicidal ideation in the months following hospitalization than those without a BPD diagnosis. The findings of this study indicated that suicidal ideation in adolescents with BPD is not stable, and although ideation may decrease quickly after hospitalization, regular assessment of ideation is recommended. PMID:24112120

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents

PubMed Central

Mejia, Raul; Pérez, Adriana; Peña, Lorena; Kollath-Cattano, Christy; Morello, Paola; Braun, Sandra; Hardin, James W.; Thrasher, James F.; Sargent, James

2016-01-01

Objective To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. Study design School-based longitudinal study involving 33 secondary schools in Argentina. The sample included 2502 never smokers (average age at entry =12.5y), 1,700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco, and then asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated adjusted odds ratio (AOR) for the following transitions: non-susceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). Results At follow-up, 34.4% of non-susceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.6% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Higher exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (AOR1st vs 3rd tertile = 1.77, 95% confidence interval 1.30–2.41), of trying smoking (AOR1st vs 3rd tertile = 1.54, 1.14–2.08), and marginally associated with current smoking (AOR1st vs 3rd tertile = 1.54, 0.99–2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. Conclusion In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies. PMID:28029343

Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study.

PubMed

Chang, Alex; Van Horn, Linda; Jacobs, David R; Liu, Kiang; Muntner, Paul; Newsome, Britt; Shoham, David A; Durazo-Arvizu, Ramon; Bibbins-Domingo, Kirsten; Reis, Jared; Kramer, Holly

2013-08-01

Modifiable lifestyle-related factors are associated with risk of coronary heart disease and may also influence kidney disease risk. Community-based prospective cohort study. 2,354 African American and white participants aged 28-40 years without baseline microalbuminuria or estimated glomerular filtration rate <60 mL/min/1.73 m² recruited from 4 US centers: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA. Current smoking, physical activity, fast food habits, obesity, and diet quality, which was based on 8 fundamental components of the Dietary Approaches to Stop Hypertension (DASH) diet, including increased intake of fruits, vegetables, low-fat dairy products, whole grains, and nuts and legumes and reduced intake of sodium, sugar-sweetened beverages, and red and processed meats. Spot urine albumin-creatinine ratios were obtained at baseline (1995-1996) and three 5-year follow-up examinations (5, 10, and 15 years' follow-up). Incident microalbuminuria was defined as the presence of age- and sex-adjusted albumin-creatinine ratio ≥25 mg/g at 2 or more of the successive follow-up examinations. During the 15-year follow-up, 77 (3.3%) individuals developed incident microalbuminuria. After multivariable adjustment, poor diet quality (OR, 2.0; 95% CI, 1.1-3.4) and obesity (OR, 1.9; 95% CI, 1.1-3.3) were associated significantly with microalbuminuria; current smoking (OR, 1.6; 95% CI, 0.9-2.8) was associated with microalbuminuria, although the CI crossed 1.0. Neither low physical activity (OR, 1.0; 95% CI, 0.5-1.8) nor fast food consumption (OR, 1.2; 95% CI, 0.7-2.3) was associated with microalbuminuria. Compared with individuals with no unhealthy lifestyle-related factors (poor diet quality, current smoking, and obesity), adjusted odds of incident microalbuminuria were 131%, 273%, and 634% higher for the presence of 1 (OR, 2.3; 95% CI, 1.3-4.3), 2 (OR, 3.7; 95% CI, 1.8-7.7), and 3 (OR, 7.3; 95% CI, 2.1-26.1) unhealthy lifestyle-related factors. Self-reported dietary history and physical activity, low number of outcomes. Consuming an unhealthy diet and obesity are associated with incident microalbuminuria. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The quest for population-level cancer recurrence data; current deficiencies and targets for improvement.

PubMed

In, Haejin; Simon, Cassie A; Phillips, Jerri Linn; Posner, Mitchell C; Ko, Clifford Y; Winchester, David P

2015-05-01

Cancer recurrence is a critical outcome in cancer care. However, population-level recurrence information is currently unavailable. Tumor registries provide an opportunity to generate this information, but require major reform. Our objectives were to (1) determine causes for variability in collection of recurrence, and (2) identify targets for intervention. On-site interviews and observations of tumor registry follow-up procedures were conducted at Commission on Cancer (CoC) accredited hospitals. Information regarding registry resources (caseload, staffing, chart availability), follow-up methods and perceived causes for difficulty in obtaining recurrence information was obtained. Seven NCI/academic, 5 comprehensive community and 2 community centers agreed to participate. Hospitals were inconsistent in their investigation of cancer recurrence, resulting in underreporting of rates of recurrence. Hospital characteristics, registry staffing, staff qualifications and medical chart access influenced follow-up practices. Coding standards and definitions for recurrence were suboptimal, resulting in hospital variability of recurrence reporting. Finally, inability to identify cases lost to follow-up in collected data prevents accurate analysis of recurrence rates. Tumor registries collect varying degrees of recurrence information and provide the underpinnings to capture population-level cancer recurrence data. Targets for intervention are listed, and provide a roadmap to obtain this critical information in cancer care. © 2015 Wiley Periodicals, Inc.

Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage: a double-blind randomized controlled trial.

PubMed

Mortensen, Jesper; Figlewski, Krystian; Andersen, Henning

2016-01-01

To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH). A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT). Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158). Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH. Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.

Systems Analysis Approach for the NASA Environmentally Responsible Aviation Project

NASA Technical Reports Server (NTRS)

Kimmel, William M.

2011-01-01

This conference paper describes the current systems analysis approach being implemented for the Environmentally Responsible Aviation Project within the Integrated Systems Research Program under the NASA Aeronautics Research Mission Directorate. The scope and purpose of these systems studies are introduced followed by a methodology overview. The approach involves both top-down and bottoms-up components to provide NASA s stakeholders with a rationale for the prioritization and tracking of a portfolio of technologies which enable the future fleet of aircraft to operate with a simultaneous reduction of aviation noise, emissions and fuel-burn impacts to our environment. Examples of key current results and relevant decision support conclusions are presented along with a forecast of the planned analyses to follow.

Journey of a cystinuric patient with a long-term follow-up from a medical stone clinic: necessity to be SaFER (stone and fragments entirely removed).

PubMed

Moore, Sacha L; Somani, Bhaskar K; Cook, Paul

2018-04-25

There is a lack of studies looking at the longitudinal follow-up of patients with cystine stones. We wanted to assess the journey of cystinuric patients through our specialist metabolic stone clinic to improve the understanding of episodes, interventions and current outcomes in this patient cohort. After ethical approval, all patients who attended our metabolic stone clinic from 1994 to 2014 with at least one cystine stone episode were included in our study. Data were retrospectively analysed for patient demographics, stone episodes or intervention, clinical parameters and patient compliance. Over a period of 21 years, 16 patients with a median age of 15.5 years underwent a mean follow-up of 8.6 years (1-21 years). The mean number of surgical interventions was 3.1 (1-8/patient), but patients who were stone free after their first treatment had lower recurrences (p = 0.91) and lower number of interventions during their follow-up (2.7/patient, compared to those who were not stone free at 4/patient). During their follow-up period, patients with < 3 interventions had a significantly better renal function than those with ≥ 3 surgical interventions (p = 0.04). Additionally, linear regression analysis showed that eGFR was demonstrated to decline with increasing numbers of stone episodes (r 2  = 0.169). It was also noted that patients who began early medical management remained stone free during follow-up compared to those who had medical management after ≥ 2 stone episodes, of whom all had a recurrent episode. Our long-term longitudinal study of cystine stone formers highlights that patients who are stone free and receive early metabolic stone screening and medical management after their initial presentation have the lowest recurrence rates and tend to preserve their renal function. Hence, prompt referral for metabolic assessment, and the stone and fragments entirely removed (SaFER) principles are key to preventing stone episodes and improving long-term function.

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

PubMed Central

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

2013-01-01

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

[Previous abstinence time as a predictive factor at 12 months follow-up in a multi-component smoking cessation program].

PubMed

Moreno-Arnedillo, J J; Morante-Benadero, M E; Sánchez-Vegazo-Sánchez, E

2014-01-01

The objective of this study is to analyze the length of the longest period of previous abstinence time as a predictor of the results of a smoking cessation program at 12 months follow-up. A cross-sectional study was conducted on a sample of 475 smokers who had participated in a multi-component smoking cessation group therapy program. The independent variable is the longest abstinence time passed, measured in weeks, before the current treatment. Success was defined as self-reported abstinence. Bivariate analyses were applied to the independent variable and to other variables in order to determine the factors that would be part of a logistic regression model using contrasts Student t or χ(2) comparisons, as appropriate. Those that showed statistical significance were entered into a multivariate logistic regression model. Within the studied variables, previous abstinence time and sex were the only predictive variables of success at 12 month follow-up. The probability of being abstinent at 12 months follow-up was significantly associated with the length of the previous longest period of abstinence, and this is the best of the predictors considered. Successful cessation programs depend more on the relationship with the consumer biographical aspects than with biological factors. The history of previous attempts is a more valuable source of information for designing treatments than others traditionally considered. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

[Professional outcomes and psychological health after workplace bullying: an exploratory follow-up study].

PubMed

Fiabane, Elena; Flachi, Daniela; Giorgi, Ines; Crepaldi, Ilaria; Candura, Stefano M; Mazzacane, Fulvio; Argentero, Piergiorgio

2015-07-08

The literature shows that workplace bullying can lead to negative consequences for both individuals' health and professional outcomes. Most of these studies used cross-sectional designs and self-report questionnaires and further research is needed in order to explore long-term effects of workplace bullying. This follow-up study aimed to explore professional and psychological outcomes in a sample of subjects who required a specialized and multidisciplinary assessment for psychological problems related, in their opinion, to workplace bullying. The sample includes 71 patients with a baseline diagnosis of work-related psychological disorder who were assessed at follow-up by means of a structured telephone interview. The interview included structured questions about professional career developments and psycho-somatic health, and administration of the General Health Questionnaire-12. 62.0% of the participants were currently working and, of these, 59.1% had changed workplace after experiencing mobbing. Patients who changed workplace scored significantly higher on job satisfaction levels (p<0.01) and showed lower levels of social dysfunction (p<0.01) compared to those who did not change their job. Patients with a baseline diagnosis of Adjustment disorder/Post-Traumatic Stress disorder had higher levels of general dysphoria (p<0.04) and social dysfunction (p<0.01) at follow-up than other patients. These findings  stress the importance of an accurate diagnostic assessment of mobbing-related psychopathological disorder. Victims of workplace bullying require early and continuous psychological support in order to promote their psychological well-being and work reinstatement.

Evaluation of Alcohol-Related Personalized Normative Feedback With and Without an Injunctive Message

PubMed Central

Steers, Mai-Ly N.; Coffman, Amelia D.; Wickham, Robert E.; Bryan, Jennifer L.; Caraway, Lisa; Neighbors, Clayton

2016-01-01

Objective: Personalized normative feedback (PNF) has been used extensively to reduce alcohol consumption, particularly among heavy drinkers. However, the majority of PNF studies have used only descriptive norms (real or perceived pervasiveness of a given behavior). The purpose of the current study was to explore the efficacy of PNF both with and without an injunctive message indicating approval or disapproval based on the participants’ standing relative to other students’ drinking levels. This randomized trial evaluated two brief web-based alcohol intervention conditions (descriptive-norms-feedback–only condition versus a descriptive-plus-injunctive-message condition relative to an assessment-only control condition). Method: Participants included 176 students who had reported at least one heavy drinking episode in the past month. Participants completed baseline and follow-up assessments of perceived norms and drinking. Follow-up assessments were completed at 2 weeks post-intervention by 165 (94%) participants. Results: Analyses were conducted using zero-inflated negative binomial regression models. As expected, the descriptive-norms–only condition was effective in reducing drinking among heavier baseline drinkers at follow-up relative to the control condition. However, contrary to expectations, the descriptive-plus-injunctive-message condition did not predict less drinking at follow-up. Conclusions: This study was unique in using an injunctive message as an adjunct to descriptive-norms feedback within the context of drinking. Findings highlight the need for additional research into the role of defensiveness, which may serve as an impediment to using injunctive norms/messages in interventions for problematic substance use and other potentially stigmatizing behaviors. PMID:26997192

The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris.

PubMed

Liu, Yale; Zeng, Weihui; Hu, Die; Jha, Smita; Ge, Qin; Geng, Songmei; Xiao, Shengxiang; Hu, Guanglei; Wang, Xiaoxiao

2016-04-01

We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15-30 mJ/cm(2) fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20%) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7% after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72% at the half-year follow-up, 79 at the 1-year follow-up and 75% at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.

Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies.

PubMed

König, M A; Jehan, S; Boszczyk, A A; Boszczyk, B M

2012-05-01

U-shaped sacral fractures usually result from axial loading of the spine with simultaneous sacral pivoting due to a horizontal fracture which leads to a highly unstable spino-pelvic dissociation. Due to the rarity of these fractures, there is lack of an agreed treatment strategy. A thorough literature search was carried out to identify current treatment concepts. The studies were analysed for mechanism of injury, diagnostic imaging, associated injuries, type of surgery, follow-up times, complications, neurological, clinical and radiological outcome. Sixty-three cases were found in 12 articles. No Class I, II or III evidence was found in the literature. The most common mechanism of injury was a fall or jump from height. Pre-operative neurological deficit was noted in 50 (94.3%) out of 53 cases (not available in 10 patients). The most used surgical options were spino-pelvic fixation with or without decompression and ilio-sacral screws. Post-operative complications occurred in 24 (38.1%) patients. Average follow-up time was 18.6 months (range 2-34 months). Full neurological recovery was noted in 20 cases, partial recovery in 14 and 9 patients had no neurological recovery (5 patients were lost in follow-up). Fracture healing was mentioned in 7 articles with only 1 case of fracture reduction loss. From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.

Genetic susceptibility to type 2 diabetes and obesity: follow-up of findings from genome-wide association studies.

PubMed

Basile, Kevin J; Johnson, Matthew E; Xia, Qianghua; Grant, Struan F A

2014-01-01

Elucidating the underlying genetic variations influencing various complex diseases is one of the major challenges currently facing clinical genetic research. Although these variations are often difficult to uncover, approaches such as genome-wide association studies (GWASs) have been successful at finding statistically significant associations between specific genomic loci and disease susceptibility. GWAS has been especially successful in elucidating genetic variants that influence type 2 diabetes (T2D) and obesity/body mass index (BMI). Specifically, several GWASs have confirmed that a variant in transcription factor 7-like 2 (TCF7L2) confers risk for T2D, while a variant in fat mass and obesity-associated protein (FTO) confers risk for obesity/BMI; indeed both of these signals are considered the most statistically associated loci discovered for these respective traits to date. The discovery of these two key loci in this context has been invaluable for providing novel insight into mechanisms of heritability and disease pathogenesis. As follow-up studies of TCF7L2 and FTO have typically lead the way in how to follow up a GWAS discovery, we outline what has been learned from such investigations and how they have implications for the myriad of other loci that have been subsequently reported in this disease context.

An atrophic, telangiectatic patch at the distal border of the tongue: a mucous membrane manifestation of xeroderma pigmentosum.

PubMed

Bologna, Sheyla Batista; Harumi Nakajima Teshima, Tathyane; Lourenço, Silvia Vanessa; Nico, Marcello Menta Simonsen

2014-01-01

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by clinical and cellular sensitivity, pigmentary changes, and early development of malignancies in sun-exposed mucocutaneous and ocular structures due to a defective ability to repair intracellular DNA damage. Individuals with XP also have a greater frequency of oral cancer, particularly squamous cell carcinoma of the anterior third of the tongue. The current study reports four cases of XP that exhibited a characteristic crescent-shaped, atrophic, telangiectatic area on the distal border of the tongue and correlates this lesion with the development of tumors at this site during follow-up. The tongue lesion was photographed and biopsied in the four patients. During routine follow-up visits, new biopsies were performed if additional tongue lesions were observed. The studied lesions were similar in the four patients. During follow-up, squamous cell carcinoma developed in one patient and pyogenic granuloma developed in three patients and was relapsing in one. The lesion remained stable in one patient during the study. The atrophic and telangiectatic patches probably occur because of chronic sun damage to the exposed portion of the tongue, and this area has a high predisposition for the development of benign and malignant tumors. © 2014 Wiley Periodicals, Inc.

Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two-year prospective study.

PubMed

Ducasse, D; Jaussent, I; Guillaume, S; Azorin, J M; Bellivier, F; Belzeaux, R; Bougerol, T; Etain, B; Gard, S; Henry, C; Kahn, J P; Leboyer, M; Loftus, J; Passerieux, C; Olié, E; Courtet, P

2017-05-01

The aim of our study was to investigate, in bipolar patients, whether affect lability was associated with suicidal ideation incidence during 2-year follow-up, and which subtype of affect lability was associated with suicidal ideation. A total of 319 euthymic or mildly depressed bipolar outpatients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into two subgroups according to the occurrence of suicidal ideation during a 2-year follow-up. Affect lability was assessed by the French version of the Affect Lability Scale. Bipolar patients with high affect lability were more likely to report suicidal ideation during follow-up, even after adjustment for age, study level, rapid cycling, current depression level, anxiety disorder, and lifetime history SA (OR = 2.47; 95% CI [1.15-5.30], P = 0.01). The risk of suicidal ideation increased with the level of affect lability. More specifically, the propensity to switch from neutral to elation affect, from anxious to depressive affect (or inversely), and from neutral to anger affect predicted suicidal ideation. Reducing affective lability could become a new therapeutic target of suicidal prevention in bipolar disorder. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Smoking-Cessation Interventions for Urban Hospital Patients: A Randomized Comparative Effectiveness Trial.

PubMed

Sherman, Scott E; Link, Alissa R; Rogers, Erin S; Krebs, Paul; Ladapo, Joseph A; Shelley, Donna R; Fang, Yixin; Wang, Binhuan; Grossman, Ellie

2016-10-01

Hospitalization is a unique opportunity for smoking cessation, but prior interventions have measured efficacy with narrowly defined populations. The objective of this study was to enroll smokers admitted to two "safety net" hospitals and compare the effectiveness of two post-discharge cessation interventions. A randomized comparative effectiveness trial was conducted. At two New York City public hospitals, every hospitalized patient identified as a smoker (based on admission records) was approached. Inclusion criteria were: smoked cigarettes in the past 30 days; spoke English, Spanish, or Mandarin; had a U.S. phone number; not discharged to an institution where follow-up or smoking was limited; and not pregnant/breastfeeding. Of 18,797 patients identified as current smokers between July 2011 and April 2014, a total of 3,047 (16%) were discharged before being approached, 3,273 (17%) were not current smokers, 4,026 (21%) had no U.S. phone number, 2,831 (15%) were ineligible for other reasons, and 3,983 (21%) refused participation. In total, 1,618 (9%) participants enrolled in the study. During follow-up, 69% of participants were reached at 2 months and 68% at 6 months. At discharge, participants were randomized to multisession telephone counseling from study staff (n=804) or referral to the state quitline for proactive outreach and counseling (n=814). Self-reported abstinence at 6 months was measured. Analyses were conducted in late 2015. One quarter of participants were homeless or in unstable housing, 60% had a history of substance abuse, 43% reported current hazardous drinking, and half had a psychiatric diagnosis other than substance abuse. At follow-up, the rate of abstinence (30-day point prevalence) was higher in the intensive counseling arm than the quitline arm at 2 months (29.0% vs 20.7%; relative risk=1.40; 95% CI=1.13, 1.73) and 6 months (37.4% vs 31.5%; relative risk=1.19; 95% CI=1.01, 1.40). Intensive counseling was more effective than referral to the state quitline. Long-term abstinence was excellent in both groups. Many patients were not eligible for enrollment despite minimal exclusion criteria. This study is registered at www.clinicaltrials.gov NCT01363245. Published by Elsevier Inc.

Impact of a board-game approach on current smokers: a randomized controlled trial

PubMed Central

2013-01-01

Background The main objective of our study was to assess the impact of a board game on smoking status and smoking-related variables in current smokers. To accomplish this objective, we conducted a randomized controlled trial comparing the game group with a psychoeducation group and a waiting-list control group. Methods The following measures were performed at participant inclusion, as well as after a 2-week and a 3-month follow-up period: “Attitudes Towards Smoking Scale” (ATS-18), “Smoking Self-Efficacy Questionnaire” (SEQ-12), “Attitudes Towards Nicotine Replacement Therapy” scale (ANRT-12), number of cigarettes smoked per day, stages of change, quit attempts, and smoking status. Furthermore, participants were assessed for concurrent psychiatric disorders and for the severity of nicotine dependence with the Fagerström Test for Nicotine Dependence (FTND). Results A time × group effect was observed for subscales of the ANRT-12, ATS-18 and SEQ-12, as well as for the number of cigarettes smoked per day. At three months follow-up, compared to the participants allocated to the waiting list group, those on Pick-Klop group were less likely to remain smoker. Outcomes at 3 months were not predicted by gender, age, FTND, stage of change, or psychiatric disorders at inclusion. Conclusions The board game seems to be a good option for smokers. The game led to improvements in variables known to predict quitting in smokers. Furthermore, it increased smoking-cessation rates at 3-months follow-up. The game is also an interesting alternative for smokers in the precontemplation stage. PMID:23327643

Long-term effects of peroxisome proliferator-activated receptor ligand bezafibrate on N-terminal pro-B type natriuretic peptide in patients with advanced functional capacity impairment

PubMed Central

Node, Koichi; Inoue, Teruo; Boyko, Valentin; Goldberg, Ilan; Fisman, Enrique Z; Adler, Yehuda; Schwammenthal, Ehud; Matas, Zipora; Behar, Solomon; Tenenbaum, Alexander

2009-01-01

Background The effects of pan-peroxisome proliferator-activated receptor (PPAR) ligand bezafibrate on N-terminal pro-B type natriuretic peptide (ProBNP) level in patients with coronary artery disease (CAD) is unknown. The current study aimed to investigate the long-term effects of bezafibrate on ProBNP level in patients with pre-existing CAD and advanced functional capacity impairment. Methods Metabolic and inflammatory parameters were analyzed from stored frozen serum samples obtained from 108 patients enrolled in the Bezafibrate Infarction Prevention (BIP) Study. They presented with New York Heart Association (NYHA) functional class III, comprising 58 patients in the bezafibrate group and 50 in the placebo groups, and completed a 2-year prospective, double-blind, placebo-controlled follow-up. Results During follow-up ProBNP level did not change significantly in the placebo group, whereas it increased slightly in the bezafibrate group, which was older and with lower baseline ProBNP values. No significant differences between the groups were found for ProBNP levels after 2 year of follow-up. Analysis-of-covariance (ANCOVA) -taking into account age and baseline ProBNP level- showed that bezafibrate was not associated with longitudinal ProBNP changes during the follow-up period (p = 0.3). Conclusion Long-term treatment by bezafibrate was not associated with longitudinal ProBNP changes in patients with pre-existing CAD and advanced functional capacity impairment. PMID:19173749

Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care

PubMed Central

2012-01-01

Background eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. Method This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Results Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high confidence in healthcare ICT. Possibilities for distance monitoring/follow-up are good according to 63% of the respondents, 78% thought that this leads to increased patient involvement, and 80% thought it would improve possibilities to deliver better care. Finally, 72% of the respondents said CHF patients would benefit from home monitoring/follow-up to some extent, and 19% to a large extent. However, the best method of follow-up was considered to be home visits by nurse, or phone contact. Conclusion The results indicate that a majority of the healthcare professionals in this study are positive to both current and future use of ICT tools in healthcare and home follow-up. Consequently other factors have to play an important role in the slow penetration of out-of-hospital eHealth applications in daily healthcare practice. PMID:23190602

The Effectiveness of Enhanced Cognitive Behavioural Therapy (CBT-E): A Naturalistic Study within an Out-Patient Eating Disorder Service.

PubMed

Signorini, Rachel; Sheffield, Jeanie; Rhodes, Natalie; Fleming, Carmel; Ward, Warren

2018-01-01

The effectiveness of enhanced cognitive behavioural Therapy (CBT-E) for adults with a range of eating disorder presentations within routine clinical settings has been examined in only two known published studies, neither of which included a follow-up assessment period. The current study aimed to evaluate the effectiveness of CBT-E within an out-patient eating disorder service in Brisbane, Queensland, Australia, and incorporated a follow-up assessment period of approximately 20 weeks post-treatment. The study involved 114 adult females with a diagnosed eating disorder, who attended an average of 20-40 individual CBT-E sessions with a psychologist or a psychiatry registrar between 2009 and 2013. Of those who began treatment, 50% did not complete treatment, and the presence of psychosocial and environmental problems predicted drop-out. Amongst treatment completers, statistically and clinically significant improvements in eating disorder and general psychopathology were observed at post-treatment, which were generally maintained at the 20-week follow-up. Statistically significant improvements in eating disorder and general psychopathology were observed amongst the total sample. The findings, which were comparable to the previous Australian effectiveness study of CBT-E, indicate that CBT-E is an effective treatment for adults with all eating disorders within out-patient settings. Given the high attrition rate, however, minimizing drop-out appears to be an important consideration when implementing CBT-E within clinical settings.

ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

ERIC Educational Resources Information Center

Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

2015-01-01

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

Smooth Sailing or Stormy Seas? Atlantic Canadian Physical Educators on the State and Future of Physical Education

ERIC Educational Resources Information Center

Robinson, Daniel B.; Randall, Lynn

2016-01-01

This article summarizes results from a recently completed study that focused upon the current state and possible future of physical education within Canada's four Atlantic provinces. Data from both large-scale surveys and eight follow-up focus group interviews are shared as they relate to the state and future of physical education, possible…

Thermal Expansion: Using Calculator-Based Laboratory Technology to Observe the Anomalous Behavior of Water

ERIC Educational Resources Information Center

Branco, Mario; Soletta, Isabella

2005-01-01

An experiment that consists of following the changes in temperature at different depths in a precooled liquid while the liquid slowly warms up to the temperature of the surrounding environment is presented. The experiment might be used in a course on temperature, on heat transmission, and in particular in the study of convection currents.

Academic Outcomes of the Chicago School Readiness Project in First Grade: Do Children's Approaches to Learning Mediate Treatment Effects on Academic Skills?

ERIC Educational Resources Information Center

Li-Grining, Christine; Haas, Kelly

2010-01-01

The Chicago School Readiness Project (CSRP), a randomized, classroom-based mental health intervention, aimed to improve teachers' behavior management of preschoolers' dysregulated behavior. The current follow-up study examines potential impacts on academic skills of first graders by enhancing their ATL. This investigation seeks to answer three…

School Performance and Gender Differences in Suicidal Behaviour--A 30-Year Follow-Up of a Stockholm Cohort Born in 1953

ERIC Educational Resources Information Center

Rojas, Yerko

2013-01-01

Astonishingly little is known about the relationship between high educational achievements and suicidal behaviour among women. This is remarkable given that a woman breaking into traditionally male-dominant spheres is a well established example of social-role marginality. The current study combines fatal and non-fatal suicidal behaviour and…

Who Am I? A Life Story Intervention for Persons with Intellectual Disability and Psychiatric Problems

ERIC Educational Resources Information Center

Westerhof, Gerben J.; Beernink, Janny; Sools, Anneke

2016-01-01

This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative…

Partial breast radiation for early-stage breast cancer.

PubMed

McCormick, Beryl

2012-02-01

This review is to provide an update on the current status of partial breast irradiation (PBI) for women presenting with early-stage breast cancer, as an alternate radiation technique to fractionated, whole breast radiation, following conservation surgery. As more women are asking for and receiving this treatment, both on and off protocols, understanding recent additions to the literature is important to physicians caring for this patient population. Newly published retrospective studies, with follow-up times out to 10 years and the status of both recently completed and still open large prospective phase III trials will be covered, with emphasis on unexpected side effects reported, and some hypothesis-generating radiobiology observations. A recent consensus treatment guideline for PBI use is also discussed. Selected retrospective studies continue to report outcomes matching those achieved with whole breast radiation; however, results from large prospective randomized trials comparing PBI to whole breast radiation have been reported only with short follow-up times, or in two studies, are still pending. A recent consensus guideline is useful at present in selecting patients for discussion of this treatment.

A post-earthquake psychopathological investigation in Armenia: methodology, summary of findings, and follow-up.

PubMed

Khachadourian, Vahe; Armenian, Haroutune; Demirchyan, Anahit; Melkonian, Arthur; Hovanesian, Ashot

2016-07-01

The post-earthquake psychopathological investigation (PEPSI) was designed to probe the short-and long-term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub-sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow-up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post-traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis-à-vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Factors associated with study attrition among HIV-infected risky drinkers in St. Petersburg, Russia.

PubMed

Kiriazova, T; Cheng, D M; Coleman, S M; Blokhina, E; Krupitsky, E; Lira, M C; Bridden, C; Raj, A; Samet, J H

2014-01-01

Participant attrition in HIV longitudinal studies may introduce bias and diminish research quality. The identification of participant characteristics that are predictive of attrition might inform retention strategies. The study aimed to identify factors associated with attrition among HIV-infected Russian risky drinkers from the secondary HIV prevention HERMITAGE trial. We examined whether current injection drug use (IDU), binge drinking, depressive symptoms, HIV status nondisclosure, stigma, and lifetime history of incarceration were predictors of study attrition. We also explored effect modification due to gender. Complete loss to follow-up (LTFU), defined as no follow-up visits after baseline, was the primary outcome, and time to first missed visit was the secondary outcome. We used multiple logistic regression models for the primary analysis, and Cox proportional hazards models for the secondary analysis. Of 660 participants, 101 (15.3%) did not return after baseline. No significant associations between independent variables and complete LTFU were observed. Current IDU and HIV status nondisclosure were significantly associated with time to first missed visit (adjusted hazard ratio [AHR], 1.39; 95% CI, 1.03-1.87; AHR, 1.38; 95% CI, 1.03-1.86, respectively). Gender stratified analyses suggested a larger impact of binge drinking among men and history of incarceration among women with time to first missed visit. Although no factors were significantly associated with complete LTFU, current IDU and HIV status nondisclosure were significantly associated with time to first missed visit in HIV-infected Russian risky drinkers. An understanding of these predictors may inform retention efforts in longitudinal studies.

EHLS at School: school-age follow-up of the Early Home Learning Study cluster randomized controlled trial.

PubMed

Westrupp, Elizabeth M; Bennett, Clair; Cullinane, Meabh; Hackworth, Naomi J; Berthelsen, Donna; Reilly, Sheena; Mensah, Fiona K; Gold, Lisa; Bennetts, Shannon K; Levickis, Penny; Nicholson, Jan M

2018-05-02

Targeted interventions during early childhood can assist families in providing strong foundations that promote children's health and wellbeing across the life course. There is growing recognition that longer follow-up times are necessary to assess intervention outcomes, as effects may change as children develop. The Early Home Learning Study, or 'EHLS', comprised two cluster randomized controlled superiority trials of a brief parenting intervention, smalltalk, aimed at supporting parents to strengthen the early childhood home learning environment of infants (6-12 months) or toddlers (12-36 months). Results showed sustained improvements in parent-child interactions and the home environment at the 32 week follow-up for the toddler but not the infant trial. The current study will therefore follow up the EHLS toddler cohort to primary school age, with the aim of addressing a gap in literature concerning long-term effects of early childhood interventions focused on improving school readiness and later developmental outcomes. 'EHLS at School' is a school-aged follow-up study of the toddler cluster randomized controlled trial (n = 1226). Data will be collected by parent-, child- and teacher-report questionnaires, recorded observations of parent-child interactions, and direct child assessment when children are aged 7.5 years old. Data linkage will provide additional data on child health and academic functioning at ages 5, 8 and 10 years. Child outcomes will be compared for families allocated to standard/usual care (control) versus those allocated to the smalltalk program (group program only or group program with additional home coaching). Findings from The Early Home Learning Study provided evidence of the benefits of the smalltalk intervention delivered via facilitated playgroups for parents of toddlers. The EHLS at School Study aims to examine the long-term outcomes of this initiative to determine whether improvements in the quality of the parent-child relationship persist over time and translate into benefits for children's social, academic and behavioral skills that last into the school years. 8 September 2011; ACTRN12611000965909 (for the original EHLS).

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

PubMed Central

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

2009-01-01

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

The long-term effectiveness of cognitive behavior therapy for psychosis within a routine psychological therapies service

PubMed Central

Peters, Emmanuelle; Crombie, Tessa; Agbedjro, Deborah; Johns, Louise C.; Stahl, Daniel; Greenwood, Kathryn; Keen, Nadine; Onwumere, Juliana; Hunter, Elaine; Smith, Laura; Kuipers, Elizabeth

2015-01-01

Randomised controlled trials (RCTs) have shown the efficacy of CBTp, however, few studies have considered its long-term effectiveness in routine services. This study reports the outcomes of clients seen in a psychological therapies clinic, set up following positive results obtained from an RCT (Peters et al., 2010). The aims were to evaluate the effectiveness of CBTp, using data from the service’s routine assessments for consecutive referrals over a 12 years period, and assess whether gains were maintained at a 6+ months’ follow-up. Of the 476 consenting referrals, all clients (N = 358) who received ≥5 therapy sessions were offered an assessment at four time points (baseline, pre-, mid-, and end of therapy) on measures assessing current psychosis symptoms, emotional problems, general well-being and life satisfaction. A sub-set (N = 113) was assessed at a median of 12 months after finishing therapy. Following the waiting list (median of 3 months) clients received individualized, formulation-based CBTp for a median number of 19 sessions from 121 therapists with a range of experience receiving regular supervision. Clients showed no meaningful change on any measure while on the waiting list (Cohen’s d <= 0.23). In contrast, highly significant improvements following therapy, all of which were significantly greater than changes during the waiting list, were found on all domains assessed (Cohen’s d: 0.44–0.75). All gains were maintained at follow-up (Cohen’s d: 0.29–0.82), with little change between end of therapy and follow-up (Cohen’s d <= 0.18). Drop-out rate from therapy was low (13%). These results demonstrate the positive and potentially enduring impact of psychological therapy on a range of meaningful outcomes for clients with psychosis. The follow-up assessments were conducted on only a sub-set, which may not generalize to the full sample. Nevertheless this study is the largest of its kind in psychosis, and has important implications for the practice of CBTp in clinical services. PMID:26579041

The long-term effects of using telehomecare technology on functional health literacy: results from a randomized trial.

PubMed

Hæsum, L K E; Ehlers, L H; Hejlesen, O K

2017-09-01

The association between the use of telehomecare technology and functional health literacy is rather unexplored in the current literature. This relationship could prove important in the future management of chronic diseases, as technology has become a more integrated part of modern healthcare systems. Therefore, the purpose of this study was to explore how the use of telehomecare technology affects the level of functional health literacy over a period of 10 months. Randomized controlled trial. Our sample comprised 116 patients diagnosed with chronic obstructive pulmonary disease. A face-to-face interview and an objective test of functional health literacy were conducted with each patient at baseline and again at follow-up after 10 months. Twenty-six patients were lost to follow-up and thus, providing a total of 47 chronic obstructive pulmonary disease patients in the intervention group and 43 in the control group for this follow-up study. The level of functional health literacy was assessed with the Danish Test of Functional Health Literacy in Adults. The difference from baseline to follow-up, in both the functional health literacy score and the mean response time to the entire Danish Test of Functional Health Literacy in Adults (TOFHLA), was tested for statistical significance between the intervention group and the control group. A significant increase in functional health literacy is observed in both the groups from baseline to follow-up, but there is no statistical difference between groups (P-value = 0.62). A significant increase in the functional health literacy score was observed in both groups, but the findings of this present study provide no information on what causes the increase, so further research is needed to explore the increase in functional health literacy score more thoroughly and establish if the use of telehomecare technology is a part of the explanation. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana.

PubMed

Staveteig, Sarah

2017-01-01

Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women's reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception.

Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana

PubMed Central

2017-01-01

Introduction Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women’s reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. Methods A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Results Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS, particularly the risk of menstrual side effects, personal or partner opposition to family planning, and religious opposition to contraception. PMID:28759624

Intensive follow-up for women with breast cancer: review of clinical, economic and patient's preference domains through evidence to decision framework.

PubMed

Lafranconi, Alessandra; Pylkkänen, Liisa; Deandrea, Silvia; Bramesfeld, Anke; Lerda, Donata; Neamțiu, Luciana; Saz-Parkinson, Zuleika; Posso, Margarita; Rigau, David; Sola, Ivan; Alonso-Coello, Pablo; Martinez-Zapata, Maria José

2017-10-19

Women treated for breast cancer are followed-up for monitoring of treatment effectiveness and for detecting recurrences at an early stage. The type of follow-up received may affect women's reassurance and impact on their quality of life. Anxiety and depression among women with breast cancer has been described, but little is known about how the intensity of the follow-up can affect women's psychological status. This study was undertaken to evaluate the effects of intensive vs. less-intensive follow-up on different health outcomes, to determine what are women's preferences and values regarding the follow-up received, and also assess the costs of these different types of follow-up. A systematic review following standard Cochrane Collaboration methods was carried out to assess the efficacy of intensive follow-up versus non-intensive follow-up in breast cancer patients. Two additional reviews on women's preferences and economic evidence were also carried out. The search was performed up to January 2016 in: MEDLINE, EMBASE, PDQ, McMaster Health Systems Evidence, CENTRAL, and NHS EED (through The Cochrane Library). The quality of evidence was assessed by GRADE (for quantitative studies) and CerQUAL (for qualitative studies). Several outcomes including mortality, breast cancer recurrences, quality of life, and patient satisfaction were evaluated. Six randomised trials (corresponding to 3534 women) were included for the evaluation of health outcomes; three studies were included for women's values and preferences and four for an economic assessment. There is moderate certainty of evidence showing that intensive follow-up, including more frequent diagnostic tests or visits, does not have effects on 5- or 10-year overall mortality and recurrences in women with breast cancer, compared with less intensive follow-up. Regarding women's preferences and values, there was important variability among studies and within studies (low confidence due to risk of bias and inconsistency). Furthermore, intensive follow-up, as opposed to less intensive follow-up, is not likely to be cost-effective. Less intensive follow-up appears to be justified and can be recommended over intensive follow-up. Resources could thus be mobilised to other aspects of breast cancer care, or other areas of healthcare.

Assessing the Employment Experiences of Community College Vocational Program Graduates: A Review of Institutional Follow-Up Studies.

ERIC Educational Resources Information Center

Palmer, Jim

This paper reviews a sample of follow-up studies conducted by community colleges to determine the employment experiences of occupational program graduates. Part I discusses the types of follow-up studies conducted, including institutional follow-up studies of graduates from individual vocational programs, of all vocational graduates, and of…

Is the Use of Protective Behavioral Strategies Associated With College Sexual Assault Victimization? A Prospective Examination

PubMed Central

Gilmore, Amanda K.; Maples-Keller, Jessica L.; Pinsky, Hanna T.; Shepard, Molly E.; Lewis, Melissa A.; George, William H.

2016-01-01

Sexual assault protective behavioral strategies (PBS) may be negatively associated with sexual assault victimization. However, no studies to date have prospectively examined whether the use of sexual assault PBS is negatively associated with subsequent sexual assault experiences. The current study examined the association between the use of sexual assault PBS and subsequent sexual assault victimization severity. College women who reported engaging in heavy episodic drinking (n = 77) were assessed online for their use of sexual assault PBS and history of sexual assault victimization. In addition, a 3-month follow-up survey was given assessing sexual assault victimization severity in the past 3 months. The use of sexual assault PBS was negatively associated with sexual assault severity in the 3-month follow-up period. Future research should further examine these PBS to create more college-specific PBS and to determine whether they are useful as risk-reduction strategies. PMID:26856359

Predicting Improvement After a Bystander Program for the Prevention of Sexual and Dating Violence.

PubMed

Hines, Denise A; Palm Reed, Kathleen M

2015-07-01

Although evidence suggests that bystander prevention programs are promising interventions for decreasing sexual violence and dating violence on college campuses, there have been no studies to date evaluating moderators of bystander program effectiveness. The current study evaluates whether different demographic characteristics, attitudes, knowledge, and behaviors at pretest predict change over a 6-month follow-up for students who participated in a bystander prevention program. Participants in the three assessments (pretest, posttest, 6-month follow-up) included 296 college students who were mandated to attend a bystander program during their first year orientation. Analyses showed that with few exceptions, the bystander program worked best for students who were most at risk given their pretest demographics and levels of attitudes condoning dating violence and sexual violence, bystander efficacy, and bystander behaviors. Results are discussed in terms of suggestions for future research. © 2014 Society for Public Health Education.

Neural activation during response inhibition in adult attention-deficit/hyperactivity disorder: preliminary findings on the effects of medication and symptom severity.

PubMed

Congdon, Eliza; Altshuler, Lori L; Mumford, Jeanette A; Karlsgodt, Katherine H; Sabb, Fred W; Ventura, Joseph; McGough, James J; London, Edythe D; Cannon, Tyrone D; Bilder, Robert M; Poldrack, Russell A

2014-04-30

Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop-Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N=35) and healthy comparison subjects (N=62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop-Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated with current medication, with individuals taking psychostimulants (N=25) showing less stopping-related activation than those not currently receiving psychostimulant medication (N=10). Follow-up analyses suggested that this difference in activation was independent of symptom severity. These results provide evidence that deficits in inhibition-related neural activation persist in a subset of adult ADHD individuals, namely those individuals currently taking psychostimulants. These findings help to explain some of the disparities in the literature, and advance our understanding of why deficits in response inhibition are more variable in adult, as compared with child and adolescent, ADHD patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

High-throughput sequencing in acute lymphoblastic leukemia: Follow-up of minimal residual disease and emergence of new clones.

PubMed

Salson, Mikaël; Giraud, Mathieu; Caillault, Aurélie; Grardel, Nathalie; Duployez, Nicolas; Ferret, Yann; Duez, Marc; Herbert, Ryan; Rocher, Tatiana; Sebda, Shéhérazade; Quief, Sabine; Villenet, Céline; Figeac, Martin; Preudhomme, Claude

2017-02-01

Minimal residual disease (MRD) is known to be an independent prognostic factor in patients with acute lymphoblastic leukemia (ALL). High-throughput sequencing (HTS) is currently used in routine practice for the diagnosis and follow-up of patients with hematological neoplasms. In this retrospective study, we examined the role of immunoglobulin/T-cell receptor-based MRD in patients with ALL by HTS analysis of immunoglobulin H and/or T-cell receptor gamma chain loci in bone marrow samples from 11 patients with ALL, at diagnosis and during follow-up. We assessed the clinical feasibility of using combined HTS and bioinformatics analysis with interactive visualization using Vidjil software. We discuss the advantages and drawbacks of HTS for monitoring MRD. HTS gives a more complete insight of the leukemic population than conventional real-time quantitative PCR (qPCR), and allows identification of new emerging clones at each time point of the monitoring. Thus, HTS monitoring of Ig/TR based MRD is expected to improve the management of patients with ALL. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sustaining High Quality Teaching and Evidence-based Curricula: Follow-up Assessment of Teachers in the REDI Project

PubMed Central

Bierman, Karen L; DeRousie, Rebecca M. Sanford; Heinrichs, Brenda; Domitrovich, Celene E.; Greenberg, Mark T.; Gill, Sukhdeep

2013-01-01

Recent research has validated the power of evidence-based preschool interventions to improve teaching quality and promote child school readiness when implemented in the context of research trials. However, very rarely are follow-up assessments conducted with teachers in order to evaluate the maintenance of improved teaching quality or sustained use of evidence-based curriculum components after the intervention trial. In the current study, we collected follow-up assessments of teachers one year after their involvement in the REDI research trial to evaluate the extent to which intervention teachers continued to implement the REDI curriculum components with high-quality, and to explore possible pre-intervention predictors of sustained implementation. In addition, we conducted classroom observations to determine whether general improvements in the teaching quality of intervention teachers (relative to control group teachers) were sustained. Results indicated sustained high-quality implementation of some curriculum components (the PATHS curriculum), but decreased implementation of other components (the language-literacy components). Sustained intervention effects were evident on most aspects of general teaching quality targeted by the intervention. Implications for practice and policy are discussed. PMID:24204101

Do X-ray-occult fractures play a role in chronic pain following a whiplash injury?

PubMed

Hertzum-Larsen, Rasmus; Petersen, Henrik; Kasch, Helge; Bendix, Tom

2014-08-01

Whiplash trauma in motor vehicle accidents (MVA) may involve various painful soft tissue damages, but weeks/months later a minority of victims still suffers from various long-lasting and disabling symptoms, whiplash-associated disorders (WAD). The etiology is currently unknown, but X-ray-occult fractures may be one cause in some cases. The purpose of this prospective study was to examine the association between occult fractures, as seen on bone single photon emission computed tomography (SPECT), with neck-, head- and arm pain. An inception cohort of 107 patients presenting with acute whiplash symptoms following an MVA was invited to have a cervical SPECT shortly post injury and again 6 months later. Associations between occult fractures and pain levels at baseline, 6 and 12 months of follow-up were analyzed. Eighty-eight patients had baseline SPECT performed at median 15 days (range 3-28) post injury, but only 49 patients accepted to have the follow-up SPECT at 6 months. Abnormal SPECT, defined as minimum one area of focal uptake, was seen in 32 patients at baseline, reflecting an occult fracture. Occult fractures were not associated with pain levels, neither at baseline nor at follow-up. Occult fractures do not seem to play a role for development of chronic pain after whiplash.

A preliminary prospective study of nutritional, psychological and combined therapies for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in a private care setting.

PubMed

Arroll, Megan Anne; Howard, Alex

2012-01-01

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a condition characterised by severe and persistent fatigue, neurological disturbances, autonomic and endocrine dysfunctions and sleep difficulties that have a pronounced and significant impact on individuals' lives. Current National Institute for Health and Clinical Excellence guidelines within the UK suggest that this condition should be treated with cognitive behavioural therapy and/or graded exercise therapy, where appropriate. There is currently a lack of an evidence base concerning alternative techniques that may be beneficial to those with ME/CFS. This study aimed to investigate whether three modalities of psychology, nutrition and combined treatment influenced symptom report measures in those with ME/CFS over a 3-month time period and whether there were significant differences in these changes between groups. This is a preliminary prospective study with one follow-up point conducted at a private secondary healthcare facility in London, UK. 138 individuals (110 females, 79.7%; 42 participants in psychology, 44 in nutrition and 52 in combined) participated at baseline and 72 participants completed the battery of measures at follow-up (52.17% response rate; 14, 27 and 31 participants in each group, respectively). Self-reported measures of ME/CFS symptoms, functional ability, multidimensional fatigue and perceived control. Baseline comparisons showed those in the combined group had higher levels of fatigue. At follow-up, all groups saw improvements in fatigue, functional ability and symptomatology; those within the psychology group also experienced a shift in perceived control over time. This study provides early evidence that psychological, nutritional and combined techniques for the treatment of ME/CFS may influence symptomatology, fatigue, function and perceived control. However, these results must be viewed with caution as the allocation to groups was not randomised, there was no control group and the study suffered from high drop-out rates.

Three-year safety and visual acuity results of epimacular 90 strontium/90 yttrium brachytherapy with bevacizumab for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration.

PubMed

Avila, Marcos P; Farah, Michael E; Santos, Arturo; Carla, Livia; Fuji, Gildo; Rossi, Juliana; Nau, Jeffrey

2012-01-01

To evaluate the long-term safety and visual acuity outcomes associated with epimacular strontium 90 brachytherapy combined with intravitreal bevacizumab for the treatment of subfoveal choroidal neovascularization because of age-related macular degeneration. Thirty-four treatment-naive patients with predominantly classic, minimally classic, and occult subfoveal choroidal neovascularization lesions participated in this prospective, 2-year, nonrandomized multicenter study. Subjects from 1 center (n = 19) were reconsented and followed-up for 3 years. Each subject received a single 24-Gy beta irradiation treatment via an intraocular delivery device and 2 planned injections of bevacizumab at treatment and 1 month later. Additional bevacizumab therapy was permitted based on prespecified retreatment criteria. Adverse events were observed, and best-corrected visual acuity was measured using Early Treatment Diabetic Retinopathy Study vision charts. Subjects were evaluated every 3 months during the first year of follow-up and every 6 months during Years 2 and 3 of follow-up. All 34 subjects were followed-up for 24 months and 19 were followed-up through 36 months. With up to 24 months of follow-up, 12 of 24 phakic patients (50%) exhibited ≥ 2 grades of progression in Lens Opacification Classification System (LOCS) II lens classification; 5 eyes underwent cataract extraction before the Month 36 visit. There was 1 case of nonproliferative retinopathy identified at 36 months of follow-up that did not have an adverse effect on visual acuity, was stable at 43 months of follow-up, and was isolated to the parafoveal region. Mean best-corrected visual acuity demonstrated an average gain of +15.0 and -4.9 letters at 12 months and 24 months, respectively; the drop in mean gain at Month 24 was largely attributable to cataract formation. At 36 months (n = 19), the mean best-corrected visual acuity was +3.9, 90% (17 of 19) of eyes had lost <15 letters from baseline, 53% (10 of 19) had gained ≥ 1 letter, and 21% (4 of 19) had gained ≥ 15 letters. Through 36 months, 11 eyes required additional bevacizumab retreatment therapy and received a mean of 3.0 injections (range, 2-7 injections). Epimacular brachytherapy shows promise as a therapeutic option for subfoveal neovascular age-related macular degeneration. The procedure was safe and well tolerated, with a reasonable risk-benefit profile that warrants further study in larger subject populations. The most common adverse event was cataract progression/formation. Surgical complications are similar to those expected from standard vitrectomy trials. This novel device is currently being evaluated in two prospective, randomized, controlled trials in treatment-naive subjects (CABERNET) and in subjects already treated with anti-vascular endothelial growth factor therapy (MERLOT).

Childhood maltreatment and college students' current suicidal ideation: a test of the hopelessness theory.

PubMed

Gibb, B E; Alloy, L B; Abramson, L Y; Rose, D T; Whitehouse, W G; Hogan, M E

2001-01-01

Few studies have examined the relation between childhood maltreatment and adult suicidality within the context of a coherent theoretical model. The current study evaluates the ability of the hopelessness theory of depression's (Abramson, Metalsky, & Alloy, 1989) etiological chain to account for this relation in a sample of 297 undergraduates. Supporting the model, emotional, but not physical or sexual, maltreatment was uniquely related to average levels of suicidal ideation across a 2.5-year follow-up. Further, students' cognitive styles and average levels of hopelessness partially mediated this relation. Although these results cannot speak to causality, they support the developmental model evaluated.

Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion: cytohistologic correlation study with diagnostic pitfalls.

PubMed

Mokhtar, Ghadeer A; Delatour, Nicolas L D Roustan; Assiri, Ali H; Gilliatt, M Angela; Senterman, Mary; Islam, Shahidul

2008-01-01

In the current study, we explore the diagnostic parameters and pitfalls in the follow-up of 123 cases of Pap smears diagnosed as high-grade atypical squamous cells (ASC-H) at our institution. A computer database search was performed from the archives of the Ottawa Hospital Cytopathology Service for cases diagnosed with ASC-H between January 2003 and July 2005. Follow-up of the 123 cases of ASC-H showed high grade squamous intraepithelial lesion (HSIL) in 73 patients (59.4%), low grade squamous intraepithelial lesion (LSIL) in 11 (8.9%), immature squamous metaplasia in 23 (18.7%), reactive squamous cell changes in 12 (9.8%), benign glandular lesions (endocervical atypia, degenerated glandular cells) in 2 (1.6%) and atrophy in 2 (1.6%). In our study, 83 patients were younger than 40 years (67.4%), with biopsy-proven HSIL found in 54 patients (65.1%). The remaining 40 patients (32.6%) were older than 40 years of age, and follow-up biopsies showed HSIL in 19 patients (47.5%). In our study, 59.4% of the cases that were diagnosed cytologically as ASC-H were found to have HSIL on subsequent biopsies. This correlation was stronger in patients below the age of 40 years (65.1% vs. 47.5%). The cytopathologic feature most strongly associated with HSIL was the presence of coarse nuclear chromatin (84%).

The role of contrast-enhanced ultrasound in imaging carotid arterial diseases.

PubMed

Clevert, Dirk A; Paprottka, Philipp; Sommer, Wieland H; Helck, Andreas; Reiser, Maximilian F; Zengel, Pamela

2013-06-01

The standard of care for the initial diagnosis of carotid artery bifurcation diseases is carotid duplex ultrasound. Carotid abnormalities or difficult examinations may represent a diagnostic challenge in patients with clinical symptoms as well as in the follow-up after carotid endarterectomy, carotid artery stenting or other interventions. A promising new method in the diagnosis and follow-up of pathologic carotid diseases is contrast-enhanced ultrasound (CEUS). In comparison with magnetic resonance imaging or computed tomography, the contrast agents used for CEUS remain within the vascular space and hence can be used to study vascular disease and could provide additional information on carotid arterial diseases. This review describes the current carotid duplex ultrasound examination and compares the pathologic findings with CEUS. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants' profile.

PubMed

Azmat, Syed Khurram; Hameed, Waqas; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Khan, Omar Farooq; Abbas, Ghazunfer; Munroe, Erik

2015-03-18

Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users. A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate. The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system.

Military status and alcohol problems: Former soldiers may be at greater risk.

PubMed

Vest, Bonnie M; Homish, D Lynn; Fillo, Jennifer; Homish, Gregory G

2018-04-13

The goal of this study was to explore differences in alcohol problems as a function of military status (current soldier, previous soldier and civilian spouses), and the possible interaction between sex and military status. We hypothesized that 1) soldiers would be at greater risk for alcohol problems than civilian spouses, and 2) former soldiers would be at greater risk compared to current soldiers. Data were drawn from Operation: SAFETY, a longitudinal study examining physical and mental health among U.S. Army Reserve and National Guard soldiers and their partners. The analytic sample included male and female participants who completed both the baseline and first follow-up assessments (N = 772). Negative binomial regression models were used to examine differences between military status group on alcohol problems at follow-up, controlling for sex and alcohol consumption at baseline. Interactions between military status and sex were also examined. Among current soldiers, males experienced significantly more alcohol problems compared to women (4.47, 3.46; p = 0.005). Likewise, among previous soldiers, males experienced significantly more alcohol problems compared to women (6.69, 2.92; p = 0.002). Male previous soldiers had significantly more alcohol problems compared to both male current soldiers and male civilian spouses (6.69, 4.47, p = 0.04; 6.69, 3.96; p = 0.02). Among women, there were no significant differences by military status. Our results indicate that male previous soldiers are at greater risk of alcohol problems than both current soldiers and civilian spouses. Health care and service providers should consider screening and monitoring soldiers who separate from the military, as alcohol use may increase. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of a program supporting scholarly productivity for new investigators.

PubMed

Mavis, Brian; Katz, Michael

2003-07-01

Like many groups, the March of Dimes Birth Defects Foundation has a long-term interest in funding new investigators. This study documents the career outcomes related to scientific productivity, research support, and current faculty positions of new investigators funded by the Foundation. All successful applicants from 1983 to 1987 (n = 244) were compared with unsuccessful applicants from 1986 and 1987 (n = 195). Outcomes over a ten-year period were examined. Online databases were used to measure quantity and quality of scholarship, as well as federal grant awards. Institutional prestige was based on the 1982 and 1995 reports from the Conference Board of Associated Research Councils. A follow-up survey of successful applicants identified current employment and research activities. Successful and unsuccessful applicants did not differ significantly except that women were underrepresented among successful applicants. Applicants receiving funding were more productive in terms of the quantity and quality of publications as well as federal grant support. A greater proportion of successful applicants came from top-ranked institutions and at follow-up the proportion of successful applicants in top-ranked programs increased. At follow-up, most successful applicants had tenure-track appointments with significant time dedicated to research. The findings document the Foundation's investment in new investigators to promote scholarly productivity and career development and validate the criteria and process used to select successful applicants. The award provides new investigators with control over resources to facilitate their research programs and enhances the confidence and recognition of recipients.

RELICS: Reionization Lensing Cluster Survey

NASA Astrophysics Data System (ADS)

Coe, Dan A.; RELICS Team

2017-01-01

Hubble and Spitzer imaging programs observing galaxy cluster lenses have delivered some of the highest redshift galaxy candidates to date (z ~ 9 - 11, or 540 - 410 Myr after the Big Bang). These magnified galaxies are intrinsically faint, and thus more representative of the sources believed to be primarily responsible for reionization. Magnified galaxies are also observed brightly enough to be prime targets for detailed follow-up study with current and future observatories, including JWST. Building on the successes of CLASH and the Frontier Fields, we have begun RELICS, the Reionization Lensing Cluster Survey. By observing 41 massive clusters for the first time at infrared wavelengths, RELICS will deliver more of the best and brightest high-redshift candidates to the community in time for the November 2017 JWST GO Cycle 1 call for proposals. I will present our early results. I will also discuss prospects for JWST to follow-up known candidates and discover new galaxies at even higher redshifts (z > 11). The discovery efficiency gains from lensing will be even more pronounced at z > 11 if luminosity function faint end slopes are steeper than alpha ~ -2, as suggested by current models and observational extrapolations.

Receptivity to alcohol marketing predicts initiation of alcohol use.

PubMed

Henriksen, Lisa; Feighery, Ellen C; Schleicher, Nina C; Fortmann, Stephen P

2008-01-01

This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined. Data were obtained from in-class surveys of sixth, seventh, and eighth graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n = 1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics. At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity), and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline. Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents' receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors' marketing tactics.

Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

PubMed

Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov

2017-03-29

Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes burden in the population and might be a suitable target for public health intervention.

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia.

PubMed

Devcic, Sime; Sekulic, Damir; Ban, Divo; Kutlesa, Zvonimir; Rodek, Jelena; Sajber, Dorica

2018-05-14

Background : The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods : The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18⁻3.72), higher sport result (OR: 3.15, 95% CI: 1.19⁻8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67⁻64.62) were predictive of HD initiation. Conclusions : The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between junior (amateur) and senior (professional) level. The results did not allow interpretation of the cause-effect relationship between scholastic failure and HD in the studied period.

Psychodynamic day treatment programme for patients with schizophrenia spectrum disorders: Dynamics and predictors of therapeutic change.

PubMed

Pec, Ondrej; Bob, Petr; Pec, Jan; Hrubcova, Adela

2018-06-01

The purpose of this study was to test whether a psychodynamically based group psychotherapeutic programme might improve symptoms, social functions, or quality of life in patients with schizophrenia spectrum disorders and to investigate factors that might predict clinical improvement or dropouts from the programme. A quantitative prospective cohort study. We have investigated 81 patients with schizophrenia spectrum disorders who participated in a 9-month psychodynamically based psychotherapeutic day programme. The patients were assessed at the beginning and end of the programme, and then at 1-year follow-up. The assessment included psychotic manifestations (HoNOS), quality of life (WHOQOL-BREF), demographic data, and daily doses of medication. 21 patients dropped out from the programme, and 46 patients succeeded in undergoing follow-up assessment. The psychotic manifestations (self-rating version of HoNOS) and quality of life measured with WHOQOL-BREF (domains of social relationships and environment) were significantly improved at the end of the programme and at follow-up. However, the manifestations on the version for external evaluators of HoNOS were improved only at follow-up. Years of psychiatric treatment, number of hospitalizations or suicide attempts, and experience of relationships with a partner were negatively related to clinical improvement, whereas symptom severity, current working, or study activities were related positively. The results show that a group psychodynamic programme may improve the clinical status and quality of life of patients with schizophrenia spectrum disorders. This type of programme is more beneficial for patients with higher pre-treatment symptom severity and the presence of working or study activities. A psychodynamically based group programme improves the clinical status and quality of life in patients with schizophrenia spectrum disorders. Data indicate that changes on the subjective level are detectable by the end of the programme, while changes on the objective level are detectable at follow-up assessment. Symptom severity and working or study activities are positively related to the clinical improvement in this type of programme, while a high number of years in psychiatric treatment or psychiatric hospitalizations are negatively related. The doses of medication (antipsychotics or antidepressants) show no significant relationship to clinical improvement. © 2017 The British Psychological Society.

Current education versus peer-education on walking in type 2 diabetic patients based on Health Belief Model: a randomized control trial study.

PubMed

Baghianimoghadam, M H; Hadavandkhani, M; Mohammadi, M; Fallahzade, H; Baghianimoghadam, B

2012-01-01

Diabetes is a disease with several metabolic and organic symptoms. Physical activity plays a key role in controlling type 2 diabetes. Several researches confirm that educational strategies can lead to healthy behaviors and its continuation is effective and can indicate what type of relationship with the client is better. The purpose of this study is comparing the Effect of Current Education and Peer-Education on Walking in Type 2 Diabetic Patients based on Health Belief Model (HBM). This was a clinical trial (RCT) study done on 80 people with type 2 diabetes. Patients were divided into two groups, Current education and Peer education groups. Data were collected using a questionnaire based on the health belief model, a checklist related to patients' practice and recording patients' HbA1c, 2HPP and FBS levels. Results were documented before and three months after intervention. The patients participated in 2 educational classes during three months of intervention, as the follow-up of the intervention. Mean scores for HBM Model variables, i.e. perceived susceptibility, perceived severity, perceived benefit and self-efficacy, were significantly increased in the peer education group compared to current education group after intervention. Also, behavioral walking, rates of HbA1c and FBS and 2HPP levels were improved significantly among the peer education group. Applying walking training program developed for diabetic patients and its implementation by the peers in order to control blood sugar using the health belief model is very useful and effective. During implementation of these control programs, monitoring and follow-up training is recommended.

A pilot investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation upon low back pain in people with multiple sclerosis.

PubMed

Al-Smadi, J; Warke, K; Wilson, I; Cramp, A F L; Noble, G; Walsh, D M; Lowe-Strong, A S

2003-11-01

To investigate the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) upon low back pain (LBP) in people with multiple sclerosis (MS). A randomized double-blind placebo controlled clinical pilot study. Fifteen people with MS were recruited and randomly allocated to one of the following groups under double blind conditions (n = 5 per group): TENS 1 (4 Hz, 200 micros), TENS 2 (110 Hz, 200 micros), placebo TENS. Treatment was applied for 45 minutes three times a week for six weeks with a four-week follow-up. The following outcome measures were taken at weeks 1, 6, and 10: visual analogue scale (VAS) (for current LBP, right leg pain, left leg pain); Leeds Multiple Sclerosis Quality of Life Questionnaire; Roland Morris Disability Questionnaire; Short Form-36 (SF-36) Version 1; and the McGill Pain Questionnaire (MPQ). VAS for current LBP, right and left leg pain were also taken before and after treatment, and once a week during the follow-up period. Analysis showed no statistically significant effects for any of the data. However, both active treatment groups showed a trend of improvement in the majority of the outcome measures. Active TENS was more effective than placebo TENS in decreasing VAS scores following each treatment although results were not statistically significant. Further work in this area is warranted and should include a larger number of participants in the form of a randomized controlled clinical trial to determine the efficacy of this modality.

Impact of retreatment with an artemisinin-based combination on malaria incidence and its potential selection of resistant strains: study protocol for a randomized controlled clinical trial

PubMed Central

2013-01-01

Background Artemisinin-based combination therapy is currently recommended by the World Health Organization as first-line treatment of uncomplicated malaria. Recommendations were adapted in 2010 regarding rescue treatment in case of treatment failure. Instead of quinine monotherapy, it should be combined with an antibiotic with antimalarial properties; alternatively, another artemisinin-based combination therapy may be used. However, for informing these policy changes, no clear evidence is yet available. The need to provide the policy makers with hard data on the appropriate rescue therapy is obvious. We hypothesize that the efficacy of the same artemisinin-based combination therapy used as rescue treatment is as efficacious as quinine + clindamycin or an alternative artemisinin-based combination therapy, without the risk of selecting drug resistant strains. Design We embed a randomized, open label, three-arm clinical trial in a longitudinal cohort design following up children with uncomplicated malaria until they are malaria parasite free for 4 weeks. The study is conducted in both the Democratic Republic of Congo and Uganda and performed in three steps. In the first step, the pre-randomized controlled trial (RCT) phase, children aged 12 to 59 months with uncomplicated malaria are treated with the recommended first-line drug and constitute a cohort that is passively followed up for 42 days. If the patients experience an uncomplicated malaria episode between days 14 and 42 of follow-up, they are randomized either to quinine + clindamycin, or an alternative artemisinin-based combination therapy, or the same first-line artemisinin-based combination therapy to be followed up for 28 additional days. If between days 14 and 28 the patients experience a recurrent parasitemia, they are retreated with the recommended first-line regimen and actively followed up for another 28 additional days (step three; post-RCT phase). The same methodology is followed for each subsequent failure. In any case, all patients without an infection at day 28 are classified as treatment successes and reach a study endpoint. The RCT phase allows the comparison of the safety and efficacy of three rescue treatments. The prolonged follow-up of all children until they are 28 days parasite-free allows us to assess epidemiological-, host- and parasite-related predictors for repeated malaria infection. Trial registration NCT01374581 and PACTR201203000351114 PMID:24059911

Six-year trajectory of objective physical function in persons with depressive and anxiety disorders.

PubMed

Lever-van Milligen, Bianca A; Lamers, Femke; Smit, Jan H; Penninx, Brenda W J H

2017-02-01

Depression and anxiety have been related to poorer self-reported physical functioning over time; however, objective measures of physical function are less frequently examined. This study assessed the 6-year trajectory of hand-grip strength and lung function in persons with depressive and/or anxiety disorders. At four waves (baseline, 2, 4, and 6 years) hand-grip strength and lung function were assessed in 2,480 participants, aged 18-65 years, of the Netherlands Study of Depression and Anxiety. Linear mixed models were used to examine the association between baseline psychiatric status (current and remitted depression and anxiety, healthy controls) and physical function during 6-year follow-up, adjusted for sociodemographics, lifestyle, and health indicators. Although there were no differences in the rate of decline over time, women with current, but not remitted, depression and anxiety had poorer hand-grip strength (B = -1.34, P < .001) and poorer lung function (B = -11.91, P =.002) compared to healthy women during the entire 6-year follow-up. Associations with depression and anxiety severity measures confirmed dose-response relationships with objective physical function. In men, stronger 6-year decline of lung function was found in those with current disorders (current diagnosis-by-time: B = -11.72, P = .002) and even in those with remitted disorders (remitted diagnosis by time: B = -10.11, P = .04) compared to healthy men. Depression and anxiety are associated with consistently poorer hand-grip strength in women and poorer lung function in women and men over 6 years of time, implicating their long-lasting impact on physical functioning. © 2016 Wiley Periodicals, Inc.

Leksell Gamma Knife radiosurgery of the jugulotympanic glomus tumor: long-term results.

PubMed

Liscak, Roman; Urgosik, Dusan; Chytka, Tomas; Simonova, Gabriela; Novotny, Josef; Vymazal, Josef; Guseynova, Khumar; Vladyka, Vilibald

2014-12-01

Glomus tumors usually display indolent behavior, and the effectiveness of radiation in stopping their growth can be assessed after long-term follow-up. Currently only midterm results of radiosurgery are available, so the authors included patients treated by Gamma Knife at least 10 years ago in this study to obtain a perspective of long-term results. During the period from 1992 to 2003, the Gamma Knife was used to treat 46 patients with glomus tumors. The age of the patients ranged from 21 to 79 years (median 56 years). Gamma Knife radiosurgery was the primary treatment in 17 patients (37%). Open surgery preceded radiosurgery in 46% of cases, embolization in 17%, and fractionated radiotherapy in 4%. The volume of the tumor ranged from 0.2 to 24.3 cm(3) (median 3.6 cm(3)). The minimal dose to the tumor margin ranged between 10 and 30 Gy (median 20 Gy). One patient was lost for follow-up after radiosurgery. Clinical follow-up was available in 45 patients and 44 patients were followed with MRI in a follow-up period that ranged from 12 to 217 months (median 118 months). Neurological deficits improved in 19 (42%) of 45 patients and deteriorated in 2 patients (4%). Tumor size decreased in 34 (77%) of 44 patients with imaging follow-up, while an increase in volume was observed in 1 patient (2%) 182 months after radiosurgery and Gamma Knife treatment was repeated. One patient underwent another Gamma Knife treatment for secondary induced meningioma close to the glomus tumor 98 months after initial radiosurgical treatment. Seven patients died 22-96 months after radiosurgery (median 48 months), all for unrelated reasons. Radiosurgery has proved to be a safe treatment with a low morbidity rate and a reliable long-term antiproliferative effect.

Protocol for the ProCare Trial: a phase II randomised controlled trial of shared care for follow-up of men with prostate cancer

PubMed Central

Emery, Jon; Doorey, Juanita; Jefford, Michael; King, Madeleine; Pirotta, Marie; Hayne, Dickon; Martin, Andrew; Trevena, Lyndal; Lim, Tee; Constable, Roger; Hawks, Cynthia; Hyatt, Amelia; Hamid, Akhlil; Violet, John; Gill, Suki; Frydenberg, Mark; Schofield, Penelope

2014-01-01

Introduction Men with prostate cancer require long-term follow-up to monitor disease progression and manage common adverse physical and psychosocial consequences of treatment. There is growing recognition of the potential role of primary care in cancer follow-up. This paper describes the protocol for a phase II multisite randomised controlled trial of a novel model of shared care for the follow-up of men after completing treatment for low-moderate risk prostate cancer. Methods and analysis The intervention is a shared care model of follow-up visits in the first 12 months after completing treatment for prostate cancer with the following specific components: a survivorship care plan, general practitioner (GP) management guidelines, register and recall systems, screening for distress and unmet needs and patient information resources. Eligible men will have completed surgery and/or radiotherapy for low-moderate risk prostate cancer within the previous 8 weeks and have a GP who consents to participate. Ninety men will be randomised to the intervention or current hospital follow-up care. Study outcome measures will be collected at baseline, 3, 6 and 12 months and include anxiety, depression, unmet needs, prostate cancer-specific quality of life and satisfaction with care. Clinical processes and healthcare resource usage will also be measured. The principal emphasis of the analysis will be on obtaining estimates of the treatment effect size and assessing feasibility in order to inform the design of a subsequent phase III trial. Ethics and dissemination Ethics approval has been granted by the University of Western Australia and from all hospital recruitment sites in Western Australia and Victoria. Results of this phase II trial will be reported in peer-reviewed publications and in conference presentations. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12610000938000 PMID:24604487

Cox model with interval-censored covariate in cohort studies.

PubMed

Ahn, Soohyun; Lim, Johan; Paik, Myunghee Cho; Sacco, Ralph L; Elkind, Mitchell S

2018-05-18

In cohort studies the outcome is often time to a particular event, and subjects are followed at regular intervals. Periodic visits may also monitor a secondary irreversible event influencing the event of primary interest, and a significant proportion of subjects develop the secondary event over the period of follow-up. The status of the secondary event serves as a time-varying covariate, but is recorded only at the times of the scheduled visits, generating incomplete time-varying covariates. While information on a typical time-varying covariate is missing for entire follow-up period except the visiting times, the status of the secondary event are unavailable only between visits where the status has changed, thus interval-censored. One may view interval-censored covariate of the secondary event status as missing time-varying covariates, yet missingness is partial since partial information is provided throughout the follow-up period. Current practice of using the latest observed status produces biased estimators, and the existing missing covariate techniques cannot accommodate the special feature of missingness due to interval censoring. To handle interval-censored covariates in the Cox proportional hazards model, we propose an available-data estimator, a doubly robust-type estimator as well as the maximum likelihood estimator via EM algorithm and present their asymptotic properties. We also present practical approaches that are valid. We demonstrate the proposed methods using our motivating example from the Northern Manhattan Study. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A longitudinal study of low back pain and daily vibration exposure in professional drivers.

PubMed

Bovenzi, Massimo

2010-01-01

The aim of this study was to investigate the relation between low back pain (LBP) outcomes and measures of daily exposure to whole-body vibration (WBV) in professional drivers. In a study population of 202 male drivers, who were not affected with LBP at the initial survey, LBP in terms of duration, intensity, and disability was investigated over a two-year follow-up period. Vibration measurements were made on representative samples of machines and vehicles. The following measures of daily WBV exposure were obtained: (i) 8-h energy-equivalent frequency-weighted acceleration (highest axis), A(8)(max) in ms(-2) r.m.s.; (ii) A(8)(sum) (root-sum-of-squares) in ms(-2) r.m.s.; (iii) Vibration Dose Value (highest axis), VDV(max) in ms(-1.75); (iv) VDV(sum) (root-sum-of-quads) in ms(-1.75). The cumulative incidence of LBP over the follow-up period was 38.6%. The incidence of high pain intensity and severe disability was 16.8 and 14.4%, respectively. After adjustment for several confounders, VDV(max) or VDV(sum) gave better predictions of LBP outcomes over time than A(8)(max) or A(8)(sum), respectively. Poor predictions were obtained with A(8)(max), which is the currently preferred measure of daily WBV exposure in European countries. In multivariate data analysis, physical work load was a significant predictor of LBP outcomes over the follow-up period. Perceived psychosocial work environment was not associated with LBP.

The Preventative Effects of a Brief, Early Intervention for Preschool-Aged Children at Risk for Internalising: Follow-up into Middle Adolescence

ERIC Educational Resources Information Center

Rapee, Ronald M.

2013-01-01

Background: There are few evaluations of very early intervention for the prevention of internalising disorders and those that exist generally evaluate outcomes to a maximum of 12 months. The current study evaluated the very long term effects (11 years) of a brief internalising prevention program presented to parents of preschool aged children.…

An open trial of individualized face-to-face cognitive behavior therapy for psychological distress in parents of children after end of treatment for childhood cancer including a cognitive behavioral conceptualization.

PubMed

Ljungman, Lisa; Cernvall, Martin; Ghaderi, Ata; Ljungman, Gustaf; von Essen, Louise; Ljótsson, Brjánn

2018-01-01

A subgroup of parents of children who have been treated for childhood cancer report high levels of psychological distress. To date there is no empirically supported psychological treatment targeting cancer-related psychological distress in this population. The aim of the current study was to test the feasibility and preliminarily evaluate the effect of individualized face-to-face cognitive behavior therapy (CBT) for parents of children after the end of treatment for childhood cancer. A secondary aim was to present a cognitive behavioral conceptualization of cancer-related distress for these parents. An open trial was conducted where 15 parents of children who had completed successful treatment for cancer three months to five years earlier and who reported psychological distress related to a child's previous cancer disease were provided CBT at a maximum of 15 sessions. Participants were assessed at baseline, post-intervention, and three-month follow-up using self-reported psychological distress (including posttraumatic stress symptoms (PTSS), depression, and anxiety) and the diagnostic Mini-International Neuropsychiatric Interview. Feasibility outcomes relating to recruitment, data collection, and delivery of the treatment were also examined. Individual case formulations for each participant guided the intervention and these were aggregated and presented in a conceptualization detailing core symptoms and their suggested maintenance mechanisms. A total of 93% of the participants completed the treatment and all of them completed the follow-up assessment. From baseline to post-assessment, parents reported significant improvements in PTSS, depression, and anxiety with medium to large effect sizes (Cohen's d = 0.65-0.92). Results were maintained or improved at a three-month follow-up. At baseline, seven (47%) participants fulfilled the diagnostic criteria for major depressive disorder and four (29%) fulfilled the criteria for posttraumatic stress disorder, compared to none at a post-assessment and a follow-up assessment. The resulting cognitive behavioral conceptualization suggests traumatic stress and depression as the core features of distress, and avoidance and inactivity is suggested as the core maintenance mechanisms. The treatment was feasible and acceptable to the participants. Significant improvements in distress were observed during the study. Overall, results suggest that the psychological treatment for parents of children after end of treatment for childhood cancer used in the current study is promising and should be tested and evaluated in future studies.

The Brightest Galaxies at Cosmic Dawn: Securing the Largest Samples of z=9-11 galaxies for JWST by leveraging the HST archive with Spitzer/IRAC.

NASA Astrophysics Data System (ADS)

Bouwens, Rychard; Trenti, Michele; Calvi, Valentina; Bernard, Stephanie; Labbe, Ivo; Oesch, Pascal; Coe, Dan; Holwerda, Benne; Bradley, Larry; Mason, Charlotte; Schmidt, Kasper; Illingworth, Garth

2015-10-01

Hubble's WFC3 has been a game changer for studying early galaxy formation in the first 700 Myr after the Big Bang. Reliable samples of sources up to z~10, which can be discovered only from space, are now constraining the evolution of the galaxy luminosity function into the epoch of reionization. Despite these efforts, the size of the highest redshift galaxy samples (z >9 and especially z > 10) is still very small, particularly at high luminosities (L > L*). To deliver transformational results, much larger numbers of bright z > 9 galaxies are needed both to map out the bright end of the luminosity/mass function and for spectroscopic follow-up (with JWST and otherwise). One especially efficient way of expanding current samples is (1) to leverage the huge amounts of pure-parallel data available with HST to identify large numbers of candidate z ~ 9 - 11 galaxies and (2) to follow up each candidate with shallow Spitzer/IRAC observations to distinguish the bona- fide z ~ 9 - 11 galaxies from z ~ 2 old, dusty galaxies. For this program we are requesting shallow Spitzer/IRAC follow-up of 20 candidate z ~ 9 - 11 galaxies we have identified from 130 WFC3/IR pointings obtained from more than 4 separate HST programs with no existing IRAC coverage. Based on our previous CANDELS/GOODS searches, we expect to confirm 5 to 10 sources as L > L* galaxies at z >= 9. Our results will be used to constrain the bright end of the LF at z >= 9, to provide targets for Keck spectroscopy to constrain the ionization state of the z > 8 universe, and to furnish JWST with bright targets for spectroscopic follow-up studies.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

PubMed Central

2010-01-01

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. Trial Registration ClinicalTrials.gov Identifier: NCT01006213 PMID:20298557

Influences of Tobacco Advertising Exposure and Conduct Problems on Smoking Behaviors Among Adolescent Males and Females

PubMed Central

2014-01-01

Introduction: Adolescents with conduct problems are more likely to smoke, and tobacco advertising exposure may exacerbate this risk. Males’ excess risk for conduct problems and females’ susceptibility to advertising suggest gender-specific pathways to smoking. We investigated the associations between gender, conduct problems, and lifetime smoking and adolescents’ exposure to tobacco advertising, and we examined prospective relationships with smoking behaviors. Methods: Adolescents completed baseline (2001–2004; n = 541) and 5-year follow-up (2007–2009; n =320) interviews for a family study of smoking risk. Baseline interviews assessed conduct problems and tobacco advertising exposure; smoking behavior was assessed at both timepoints. Generalized linear models analyzed gender differences in the relationship between conduct problems, advertising exposure, and smoking behavior at baseline and longitudinally. Results: At baseline, among males, conduct problems were associated with greater advertising exposure independent of demographics and lifetime smoking. Among females at baseline, conduct problems were associated with greater advertising exposure only among never-smokers after adjusting for demographics. In longitudinal analyses, baseline advertising exposure predicted subsequent smoking initiation (i.e., smoking their first cigarette between baseline and follow-up) for females but not for males. Baseline conduct problems predicted current (i.e., daily or weekly) smoking at follow-up for all adolescents in adjusted models. Conclusions: The findings of this study reinforce that conduct problems are a strong predictor of subsequent current smoking for all adolescents and reveal important differences between adolescent males and females in the relationship between conduct problems, tobacco advertising behavior, and smoking behavior. The findings suggest gender-specific preventive interventions targeting advertising exposure may be warranted. PMID:24590388

Comprehensive self-control training benefits depressed college students: A six-month randomized controlled intervention trial.

PubMed

Yang, Xueling; Zhao, Jiubo; Chen, Yu; Zu, Simeng; Zhao, Jingbo

2018-01-15

Depressive disorder was associated with dysfunctional self-regulation. The current study attempted to design and test a comprehensive self-control training (CSCT) program with an overall emphasis on behaviral activation in depressed Chinese college students. Participants included 74 students who had diagnosed with major depression, they were randomly assigned to one of the two groups: intervention group (n=37), and control group (n=37). The intervention participants received an eight-week CSCT and four-month follow-up consolidation program, as compared to the control group who received only pre-post-and-follow-up measurements. All participants measured Beck Depression Inventory (BDI-Ⅱ) and Self-control Scale (SCS) at three time points: baseline, post-training, and four-month follow-up. The dropout rates were 6 (8.1%) in the intervention group and 3 (4.1%) in the control group at the end of six-month intervention. The general linear model repeated measures analysis of variance revealed that comparing with the control group, the intervention group participants had more increase in their trait self-control score, at the meantime, their depressive symptoms had significantly improved. Univariate and logistic regression analyses revealed that participants with milder baseline depressive symptoms were more likely to benefit from CSCT interventions; depression improvement was also associated with the number of sessions attended. The main limitation was related to the small sample size which consisted of college students who were relatively young and well educated. The current study demonstrates that CSCT program could temporarily enhance self-control capacity as well as improve depressive symptoms; participants who are mildly to moderately depressed, and who could adhere to the training protocol are more likely to benefit from the intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk factors for relapse to problem drinking among current and former US military personnel: a prospective study of the Millennium Cohort.

PubMed

Williams, Emily C; Frasco, Melissa A; Jacobson, Isabel G; Maynard, Charles; Littman, Alyson J; Seelig, Amber D; Crum-Cianflone, Nancy F; Nagel, Anna; Boyko, Edward J

2015-03-01

Military service members may be prone to relapse to problem drinking after remission, given a culture of alcohol use as a coping mechanism for stressful or traumatic events associated with military duties or exposures. However, the prevalence and correlates of relapse are unknown. We sought to identify socio-demographic, military, behavioral, and health characteristics associated with relapse among current and former military members with remittent problem drinking. Participants in the longitudinal Millennium Cohort Study who reported problem drinking at baseline (2001-2003) and were remittent at first follow-up (2004-2006) were included (n=6909). Logistic regression models identified demographic, military service, behavioral, and health characteristics that predicted relapse (report of ≥1 past-year alcohol-related problem on the validated Patient Health Questionnaire) at the second follow-up (2007-2008). Sixteen percent of those with remittent problem drinking relapsed. Reserve/National Guard members compared with active-duty members (odds ratio [OR]=1.71, 95% confidence interval [CI]: 1.45-2.01), members separated from the military during follow-up (OR=1.46, 95% CI: 1.16-1.83), and deployers who reported combat exposure (OR=1.32, 95% CI: 1.07-1.62, relative to non-deployers) were significantly more likely to relapse. Those with multiple deployments were significantly less likely to relapse (OR=0.73, 95% CI: 0.58-0.92). Behavioral factors and mental health conditions also predicted relapse. Relapse was common and associated with military and non-military factors. Targeted intervention to prevent relapse may be indicated for military personnel in particular subgroups, such as Reservists, veterans, and those who deploy with combat exposure. Copyright © 2015. Published by Elsevier Ireland Ltd.

Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia.

PubMed

Simms, Kate T; Hall, Michaela; Smith, Megan A; Lew, Jie-Bin; Hughes, Suzanne; Yuill, Susan; Hammond, Ian; Saville, Marion; Canfell, Karen

2017-01-01

Several countries are implementing a transition to HPV testing for cervical screening in response to the introduction of HPV vaccination and evidence indicating that HPV screening is more effective than cytology. In Australia, a 2017 transition from 2-yearly conventional cytology in 18-20 to 69 years to 5-yearly primary HPV screening in 25 to 74 years will involve partial genotyping for HPV 16/18 with direct referral to colposcopy for this higher risk group. The objective of this study was to determine the optimal management of women positive for other high-risk HPV types (not 16/18) ('OHR HPV'). We used a dynamic model of HPV transmission, vaccination, natural history and cervical screening to determine the optimal management of women positive for OHR HPV. We assumed cytology triage testing was used to inform management in this group and that those with high-grade cytology would be referred to colposcopy and those with negative cytology would receive 12-month surveillance. For those with OHR HPV and low-grade cytology (considered to be a single low-grade category in Australia incorporating ASC-US and LSIL), we evaluated (1) the 20-year risk of invasive cervical cancer assuming this group are referred for 12-month follow-up vs. colposcopy, and compared this to the risk in women with low-grade cytology under the current program (i.e. an accepted benchmark risk for 12-month follow-up in Australia); (2) the population-level impact of the whole program, assuming this group are referred to 12-month surveillance vs. colposcopy; and (3) the cost-effectiveness of immediate colposcopy compared to 12-month follow-up. Evaluation was performed both for HPV-unvaccinated cohorts and cohorts offered vaccination (coverage ~72%). The estimated 20-year risk of cervical cancer is ≤1.0% at all ages if this group are referred to colposcopy vs. ≤1.2% if followed-up in 12 months, both of which are lower than the ≤2.6% benchmark risk in women with low-grade cytology in the current program (who are returned for 12-month follow-up). At the population level, immediate colposcopy referral provides an incremental 1-3% reduction in cervical cancer incidence and mortality compared with 12-month follow-up, but this is in the context of a predicted 24-36% reduction associated with the new HPV screening program compared to the current cytology-based program. Furthermore, immediate colposcopy substantially increases the predicted number of colposcopies, with >650 additional colposcopies required to avert each additional case of cervical cancer compared to 12-month follow-up. Compared to 12-month follow-up, immediate colposcopy has an incremental cost-effectiveness ratio (ICER) of A$104,600/LYS (95%CrI:A$100,100-109,100) in unvaccinated women and A$117,100/LYS (95%CrI:A$112,300-122,000) in cohorts offered vaccination [Indicative willingness-to-pay threshold: A$50,000/LYS]. In primary HPV screening programs, partial genotyping for HPV16/18 or high-grade triage cytology in OHR HPV positive women can be used to refer the highest risk group to colposcopy, but 12-month follow-up for women with OHR HPV and low-grade cytology is associated with a low risk of developing cervical cancer. Direct referral to colposcopy for this group would be associated with a substantial increase in colposcopy referrals and the associated harms, and is also cost-ineffective; thus, 12-month surveillance for women with OHR HPV and low-grade cytology provides the best balance between benefits, harms and cost-effectiveness.

Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia

PubMed Central

Hall, Michaela; Lew, Jie-Bin; Hughes, Suzanne; Yuill, Susan; Hammond, Ian; Saville, Marion; Canfell, Karen

2017-01-01

Background Several countries are implementing a transition to HPV testing for cervical screening in response to the introduction of HPV vaccination and evidence indicating that HPV screening is more effective than cytology. In Australia, a 2017 transition from 2-yearly conventional cytology in 18–20 to 69 years to 5-yearly primary HPV screening in 25 to 74 years will involve partial genotyping for HPV 16/18 with direct referral to colposcopy for this higher risk group. The objective of this study was to determine the optimal management of women positive for other high-risk HPV types (not 16/18) ('OHR HPV'). Methods We used a dynamic model of HPV transmission, vaccination, natural history and cervical screening to determine the optimal management of women positive for OHR HPV. We assumed cytology triage testing was used to inform management in this group and that those with high-grade cytology would be referred to colposcopy and those with negative cytology would receive 12-month surveillance. For those with OHR HPV and low-grade cytology (considered to be a single low-grade category in Australia incorporating ASC-US and LSIL), we evaluated (1) the 20-year risk of invasive cervical cancer assuming this group are referred for 12-month follow-up vs. colposcopy, and compared this to the risk in women with low-grade cytology under the current program (i.e. an accepted benchmark risk for 12-month follow-up in Australia); (2) the population-level impact of the whole program, assuming this group are referred to 12-month surveillance vs. colposcopy; and (3) the cost-effectiveness of immediate colposcopy compared to 12-month follow-up. Evaluation was performed both for HPV-unvaccinated cohorts and cohorts offered vaccination (coverage ~72%). Findings The estimated 20-year risk of cervical cancer is ≤1.0% at all ages if this group are referred to colposcopy vs. ≤1.2% if followed-up in 12 months, both of which are lower than the ≤2.6% benchmark risk in women with low-grade cytology in the current program (who are returned for 12-month follow-up). At the population level, immediate colposcopy referral provides an incremental 1–3% reduction in cervical cancer incidence and mortality compared with 12-month follow-up, but this is in the context of a predicted 24–36% reduction associated with the new HPV screening program compared to the current cytology-based program. Furthermore, immediate colposcopy substantially increases the predicted number of colposcopies, with >650 additional colposcopies required to avert each additional case of cervical cancer compared to 12-month follow-up. Compared to 12-month follow-up, immediate colposcopy has an incremental cost-effectiveness ratio (ICER) of A$104,600/LYS (95%CrI:A$100,100–109,100) in unvaccinated women and A$117,100/LYS (95%CrI:A$112,300–122,000) in cohorts offered vaccination [Indicative willingness-to-pay threshold: A$50,000/LYS]. Conclusions In primary HPV screening programs, partial genotyping for HPV16/18 or high-grade triage cytology in OHR HPV positive women can be used to refer the highest risk group to colposcopy, but 12-month follow-up for women with OHR HPV and low-grade cytology is associated with a low risk of developing cervical cancer. Direct referral to colposcopy for this group would be associated with a substantial increase in colposcopy referrals and the associated harms, and is also cost-ineffective; thus, 12-month surveillance for women with OHR HPV and low-grade cytology provides the best balance between benefits, harms and cost-effectiveness. PMID:28095411

Clinical Trial Enrollment is Associated With Improved Follow-up Rates Among Survivors of Childhood Cancer.

PubMed

Hutchins, Kelley K; Savaşan, Süreyya; Thomas, Ronald L; Strathdee, Laura A; Wang, Zhihong J; Taub, Jeffrey W

2018-04-17

Fortunately >80% of children diagnosed with cancer become long-term survivors; however, this population is at a significantly increased risk of morbidity and mortality as a result of their previous cancer therapy, and long-term follow-up (LTFU) is critical. Multiple barriers to receiving adequate LTFU care have been studied. We investigated whether lack of enrollment in a therapeutic clinical trial may be a barrier to receiving LTFU care. We conducted a review of 353 patient records at the Children's Hospital of Michigan enrolled in our Children's Oncology Group registry between January 1, 2005 and December 31, 2010. In total, 71 patients were excluded (death before follow-up, n=61; currently receiving therapy, n=5; known transfer of care, n=4; insufficient information, n=1). In total, 158 (56%) patients were enrolled in a therapeutic clinical trial. Follow-up rates at 1-, 2- and 5-years following completion of therapy for patients enrolled in a therapeutic clinical trial were 96.8% (153/158), 93.7% (148/158), and 81.7% (103/126), respectively, compared with 83.1% (103/124; P<0.001), 74.2% (92/124; P<0.001), and 66.7% (72/108; P=0.001) for patients not enrolled. Our findings suggest patients enrolled in a therapeutic clinical trial have better LTFU rates and supports the importance of patient enrollment in therapeutic clinical trials when possible. Additional resources may be warranted to improve LTFU for patients not enrolled.

Continuity of care of emergency surgical admissions: impact on SpR training.

PubMed

Ledwidge, S F C; Bryden, E; Halestrap, P; Galland, R B

2008-06-01

Continuity of patient care is an important component of surgical education. This study assesses continuity of care in the current working climate. Data were collected prospectively on consecutive emergency general surgical admissions during one month. Our SpR rota is a partial shift 24 hour on call with the SpR's own consultant. The SpR is free of commitments the next day following post-take work. The on call general surgery SpR was designated the 'assessor'. Data were analysed according to involvement of the 'assessor' at subsequent stages of the admission--consent, operation, review during admission and review on discharge. Data were also collected defining whether the 'assessor' and operator followed-up the patient. There were 200 admissions; 108 female and 92 male. Overall 23% admissions had the same 'assessor' for all stages of patient care. The 'assessor' dealt with an aspect of patient care in 11% of admissions who underwent an operation and 29% of admissions who were conservatively managed. SpR follow-up of admissions on whom they operated was 70% but only 41% of admissions who were conservatively managed were followed-up by the assessing SpR. Complete in-hospital continuity of care was poor, although SpR follow-up of patients on whom they had operated was better. Introduction of shift patterns has reduced continuity of patient care. This will have a negative impact on both surgical training and patient care.

25-hydroxyvitamin D and breast cancer, colorectal cancer, and colorectal adenomas: case-control versus nested case-control studies.

PubMed

Grant, William B

2015-02-01

Existing literature includes concerns regarding reliability of case-control studies of breast cancer incidence with respect to 25-hydroxyvitamin D (25(OH)D) concentrations. For breast cancer, only case-control studies consistently find inverse correlations between 25(OH)D and breast cancer. However, for colorectal cancer, nested case-control studies find significant inverse correlations with respect to 25(OH)D concentrations at baseline for mean follow-up times of 7 years. This is a review of results currently existing in literature. I provide evidence that 25(OH)D concentration values are only useful for short follow-up times for breast cancer since it develops rapidly. To support the robust nature of breast cancer case-control studies, I show that results from 11 studies from seven countries align in a robust power-law fit to the odds ratio versus mean 25(OH)D concentrations. Case-control studies of breast cancer incidence rates provide reliable results. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Knee manipulation under anaesthetic following total knee arthroplasty: a matched cohort design.

PubMed

Dzaja, I; Vasarhelyi, E M; Lanting, B A; Naudie, D D; Howard, J L; Somerville, L; McCalden, R W; MacDonald, S J

2015-12-01

The purpose of this study was to compare clinical outcomes of total knee arthroplasty (TKA) after manipulation under anaesthesia (MUA) for post-operative stiffness with a matched cohort of TKA patients who did not requre MUA. In total 72 patients (mean age 59.8 years, 42 to 83) who underwent MUA following TKA were identified from our prospective database and compared with a matched cohort of patients who had undergone TKA without subsequent MUA. Patients were evaluated for range of movement (ROM) and clinical outcome scores (Western Ontario and McMaster Universities Arthritis Index, Short-Form Health Survey, and Knee Society Clinical Rating System) at a mean follow-up of 36.4 months (12 to 120). MUA took place at a mean of nine weeks (5 to 18) after TKA. In patients who required MUA, mean flexion deformity improved from 10° (0° to 25°) to 4.4° (0° to 15°) (p < 0.001), and mean range of flexion improved from 79.8° (65° to 95°) to 116° (80° to 130°) (p < 0.001). There were no statistically significant differences in ROM or functional outcome scores at three months, one year, or two years between those who required MUA and those who did not. There were no complications associated with manipulation. At most recent follow-up, patients requiring MUA achieved equivalent ROM and clinical outcome scores when compared with a matched control group. While other studies have focused on ROM after manipulation, the current study adds to current literature by supplementing this with functional outcome scores. ©2015 The British Editorial Society of Bone & Joint Surgery.

Persistent Genital Tract HIV-1 RNA Shedding After Change in Treatment Regimens in Antiretroviral-Experienced Women with Detectable Plasma Viral Load

PubMed Central

DeLong, Allison K.; Kantor, Rami; Chapman, Stacey; Ingersoll, Jessica; Kurpewski, Jaclynn; De Pasquale, Maria Pia; D'Aquila, Richard; Caliendo, Angela M.; Cu-Uvin, Susan

2013-01-01

Abstract Objective To longitudinally assess the association between plasma viral load (PVL) and genital tract human immunodeficiency virus (GT HIV) RNA among HIV-1 infected women changing highly active antiretroviral therapy (HAART) because of detectable PVL on current treatment. Methods Women were eligible for the study if they had detectable PVL (defined as two consecutive samples with PVL>1000 copies/mL) and intended to change their current HAART regimen at the time of enrollment. Paired plasma and GT HIV-1 RNA were measured prospectively over 3 years. Longitudinal analyses examined rates of GT HIV-1 RNA shedding and the association with PVL. Results Sixteen women were followed for a median of 11 visits contributing a total of 205 study visits. At study enrollment, all had detectable PVL and 69% had detectable GT HIV-1 RNA. Half of the women changed to a new HAART regimen with ≥3 active antiretroviral drugs. The probability of having detectable PVL ≥30 days after changing HAART was 0.56 (95% CI: 0.37 to 0.74). Fourteen women (88%) had detectable PVL on a follow-up visit ≥30 or 60 days after changing HAART; and 12 women (75%) had detectable GT HIV-1 RNA on a follow-up visit ≥30 or 60 days after changing HAART. When PVL was undetectable, GT shedding occurred at 11% of visits, and when PVL was detectable, GT shedding occurred at 47% of visits. Conclusions Some treatment-experienced HIV-infected women continue to have detectable virus in both the plasma and GT following a change in HAART, highlighting the difficulty of viral suppression in this patient population. PMID:23531097

Way forward in case of a false positive in vitro genotoxicity result for a cosmetic substance?

PubMed

Doktorova, Tatyana Y; Ates, Gamze; Vinken, Mathieu; Vanhaecke, Tamara; Rogiers, Vera

2014-02-01

The currently used regulatory in vitro mutagenicity/genotoxicity test battery has a high sensitivity for detecting genotoxicants, but it suffers from a large number of irrelevant positive results (i.e. low specificity) thereby imposing the need for additional follow-up by in vitro and/or in vivo genotoxicity tests. This could have a major impact on the cosmetic industry in Europe, seen the imposed animal testing and marketing bans on cosmetics and their ingredients. Afflicted, but safe substances could therefore be lost. Using the example of triclosan, a cosmetic preservative, we describe here the potential applicability of a human toxicogenomics-based in vitro assay as a potential mechanistically based follow-up test for positive in vitro genotoxicity results. Triclosan shows a positive in vitro chromosomal aberration test, but is negative during in vivo follow-up tests. Toxicogenomics analysis unequivocally shows that triclosan is identified as a compound acting through non-DNA reactive mechanisms. This proof-of-principle study illustrates the potential of genome-wide transcriptomics data in combination with in vitro experimentation as a possible weight-of-evidence follow-up approach for de-risking a positive outcome in a standard mutagenicity/genotoxicity battery. As such a substantial number of cosmetic compounds wrongly identified as genotoxicants could be saved for the future. Copyright © 2013 Elsevier Ltd. All rights reserved.

Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence.

PubMed

Fierstra, Jorn; van Niftrik, Bas; Piccirelli, Marco; Burkhardt, Jan Karl; Pangalu, Athina; Kocian, Roman; Valavanis, Antonios; Weller, Michael; Regli, Luca; Bozinov, Oliver

2016-07-01

Current MRI sequences are limited in identifying brain areas at risk for high grade glioma recurrence. We employed intraoperative 3-Tesla functional MRI to assess cerebrovascular reactivity (CVR) after high-grade glioma resection and analyzed regional CVR responses in areas of tumor recurrence on clinical follow-up imaging. Five subjects with high-grade glioma that underwent an intraoperative Blood Oxygen-Level Dependent (BOLD) MRI CVR examination and had a clinical follow-up of at least 18months were selected from a prospective database. For this study, location of tumor recurrence was spatially matched to the intraoperative imaging to assess CVR response in that particular area. CVR is defined as the percent BOLD signal change during repeated cycles of apnea. Of the 5 subjects (mean age 44, 2 females), 4 were diagnosed with a WHO grade III and 1 subject with a WHO grade IV glioma. Three subjects exhibited a tumor recurrence on clinical follow-up MRI (mean: 15months). BOLD CVR measured in the spatially matched area of tumor recurrence was on average 94% increased (range-32% to 183%) as compared to contralateral hemisphere CVR response, 1.50±0.81 versus 1.03±0.46 respectively (p=0.31). For this first analysis in a small cohort, we found altered intraoperative CVR in brain areas exhibiting high grade glioma recurrence on clinical follow-up imaging. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk factors for acute exacerbations of COPD in a primary care population: a retrospective observational cohort study

PubMed Central

Müllerová, Hana; Shukla, Amit; Hawkins, Adam; Quint, Jennifer

2014-01-01

Objectives To evaluate risk factors associated with exacerbation frequency in primary care. Information on exacerbations of chronic obstructive pulmonary disease (COPD) has mainly been generated by secondary care-based clinical cohorts. Design Retrospective observational cohort study. Setting Electronic medical records database (England and Wales). Participants 58 589 patients with COPD aged ≥40 years with COPD diagnosis recorded between 1 April 2009 and 30 September 2012, and with at least 365 days of follow-up before and after the COPD diagnosis, were identified in the Clinical Practice Research Datalink. Mean age: 69 years; 47% female; mean forced expiratory volume in 1s 60% predicted. Outcome measures Data on moderate or severe exacerbation episodes defined by diagnosis and/or medication codes 12 months following cohort entry were retrieved, together with demographic and clinical characteristics. Associations between patient characteristics and odds of having none versus one, none versus frequent (≥2) and one versus frequent exacerbations over 12 months follow-up were evaluated using multivariate logistic regression models. Results During follow-up, 23% of patients had evidence of frequent moderate-to-severe COPD exacerbations (24% one; 53% none). Independent predictors of increased odds of having exacerbations during the follow-up, either frequent episodes or one episode, included prior exacerbations, increasing dyspnoea score, increasing grade of airflow limitation, females and prior or current history of several comorbidities (eg, asthma, depression, anxiety, heart failure and cancer). Conclusions Primary care-managed patients with COPD at the highest risk of exacerbations can be identified by exploring medical history for the presence of prior exacerbations, greater COPD disease severity and co-occurrence of other medical conditions. PMID:25524545

A numerical study of the South China Sea Warm Current during winter monsoon relaxation

NASA Astrophysics Data System (ADS)

Zhang, Cong; Ding, Yang; Bao, Xianwen; Bi, Congcong; Li, Ruixiang; Zhang, Cunjie; Shen, Biao; Wan, Kai

2018-03-01

Using a Finite-Volume Community Ocean Model, we investigated the dynamic mechanism of the South China Sea Warm Current (SCSWC) in the northern South China Sea (NSCS) during winter monsoon relaxation. The model reproduces the mean surface circulation of the NSCS during winter, while model-simulated subtidal currents generally capture its current pattern. The model shows that the current over the continental shelf is generally southwestward, under a strong winter monsoon condition, but a northeastward counter-wind current usually develops between 50-and 100-m isobaths, when the monsoon relaxes. Model experiments, focusing on the wind relaxation process, show that sea level is elevated in the northwestern South China Sea (SCS), related to the persistent northeasterly monsoon. Following wind relaxation, a high sea level band builds up along the mid-shelf, and a northeastward current develops, having an obvious vertical barotropic structure. Momentum balance analysis indicates that an along-shelf pressure gradient provides the initial driving force for the SCSWC during the first few days following wind relaxation. The SCSWC subsequently reaches a steady quasi-geostrophic balance in the cross-shelf direction, mainly linked to sea level adjustment over the shelf. Lagrangian particle tracking experiments show that both the southwestward coastal current and slope current contribute to the northeastward movement of the SCSWC during winter monsoon relaxation.

Follow-up methods for retrospective cohort studies in New Zealand.

PubMed

Fawcett, Jackie; Garrett, Nick; Bates, Michael N

2002-01-01

To define a general methodology for maximising the success of follow-up processes for retrospective cohort studies in New Zealand, and to illustrate an approach to developing country-specific follow-up methodologies. We recently conducted a cohort study of mortality and cancer incidence in New Zealand professional fire fighters. A number of methods were used to trace vital status, including matching with records of the New Zealand Health Information Service (NZHIS), pension records of Work and Income New Zealand (WINZ), and electronic electoral rolls. Non-electronic methods included use of paper electoral rolls and the records of the Registrar of Births Deaths and Marriages. 95% of the theoretical person-years of follow-up of the cohort were traced using these methods. In terms of numbers of cohort members traced to end of follow-up, the most useful tracing methods were fire fighter employment records, the NZHIS, WINZ, and the electronic electoral rolls. The follow-up process used for the cohort study was highly successful. On the basis of this experience, we propose a generic, but flexible, model for follow-up of retrospective cohort studies in New Zealand. Similar models could be constructed for other countries. Successful follow-up of cohort studies is possible in New Zealand using established methods. This should encourage the use of cohort studies for the investigation of epidemiological issues. Similar models for follow-up processes could be constructed for other countries.

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents.

PubMed

Mejia, Raul; Pérez, Adriana; Peña, Lorena; Kollath-Cattano, Christy; Morello, Paola; Braun, Sandra; Hardin, James W; Thrasher, James F; Sargent, James D

2017-01-01

To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aOR first vs third tertile  1.77, 95% CI 1.30-2.41), of trying smoking (aOR first vs third tertile  1.54, 1.14-2.08), and marginally associated with current smoking (AOR first vs third tertile  1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies. Copyright © 2016 Elsevier Inc. All rights reserved.

Predictors of hyperglycaemic individuals who do not follow up with physicians after screening in Japan: a cohort study.

PubMed

Tsujimura, Yuka; Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Kuriyama, Akira; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Kimura, Shinya; Nakayama, Takeo

2014-08-01

Although people screened as being hyperglycaemic often fail to follow up with physicians for clinical assessment, epidemiologic findings on the frequency and predictors of not following up (hereafter, "no follow-up") are lacking. The purpose of this study was to examine the no follow-up rate with physicians after screening for diabetes and predictors of no follow-up. We assessed cases of no follow-up with physicians within six months after screening based on medical claims data from employee-based social health insurance programs in Japan, for people aged 20 to 68 years from 2005 to 2010. Among 3878 screened participants with hyperglycaemia, 2527 (65%) did not follow up with their physicians within six months after screening. Multiple logistic regression analysis revealed that younger age and lower blood glucose level predicted no follow-up among both men and women, while lower body mass index and negative proteinuria also predicted no follow-up among men. Treatment for dyslipidaemia facilitated follow-up among both genders, and treatment for hypertension or depression facilitated follow-up among men. Approximately two thirds of individuals screened as having hyperglycaemia did not follow up with their physicians within six months after screening. Predictors of no follow-up were younger age and milder hyperglycaemia. Being on treatment for co-morbidities tended to facilitate follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Results of total knee replacement with a cruciate-retaining model for severe valgus deformity--a study of 48 patients followed for an average of 9 years.

PubMed

Koskinen, Esa; Remes, Ville; Paavolainen, Pekka; Harilainen, Arsi; Sandelin, Jerker; Tallroth, Kaj; Kettunen, Jyrki; Ylinen, Pekka

2011-06-01

The objectives of the present study were to find out the results and the factors affecting survival after primary knee arthroplasty with a cruciate-retaining prosthesis in severe valgus deformity. Forty-eight patients (52 knees) participated in the current follow-up study. All patients were followed at least 5 years or to first revision. Mean follow-up time was 9 years (range, 1 to 17 years).The Kaplan-Meier analysis revealed 79% (95% CI 68% to 91%) survival rate with revision for any reason and 81% (95% CI 70% to 93%) survival rate with revision for instability as an endpoint at 10 years. Preoperatively TFA was 23° (range, 15°-51°) in valgus and 7° (range, 21° valgus-4° varus) in valgus postoperatively. Of the 14 re-operated patients, eight were revised because of progressive postoperative medial collateral ligament instability. All re-operations were performed during the first 4 years of the follow-up. The mean TFA was 15.5° valgus postoperatively for those eight and the odds ratio for a revision was 2 (95% CI 1-3, p = 0.025) when compared to the rest of the study population. The residual valgus deformity increases the risk of re-operation and it should be avoided. If proper soft-tissue balance cannot be achieved or there is no functional medial collateral ligament present more constrained implants should be used. In selected cases where both bony correction and ligament balancing have properly been achieved the use of a cruciate-retaining type of prosthesis is justified. Copyright © 2010 Elsevier B.V. All rights reserved.

Slightly increased BMI at young age is a risk factor for future hypertension in Japanese men

PubMed Central

Tamura, Yoshifumi; Kohmura, Yoshimitsu; Aoki, Kazuhiro; Kawai, Sachio; Daida, Hiroyuki

2018-01-01

Background Hypertension is developed easily in Asian adults with normal body mass index (BMI) (~23 kg/m2), compared with other ethnicities with similar BMI. This study tested the hypothesis that slightly increased BMI at young age is a risk factor for future hypertension in Japanese men by historical cohort study. Methods The study participants were 636 male alumni of the physical education school. They had available data on their physical examination at college age and follow-up investigation between 2007 and 2011. The participants were categorized into six categories: BMI at college age of <20.0 kg/m2, 20.0–21.0kg/m2, 21.0–22.0kg/m2, 22.0–23.0kg/m2, 23.0–24.0kg/m2, and ≥24.0kg/m2, and the incidence of hypertension was compared. Results This study covered 27-year follow-up period (interquartile range: IQR: 23–31) which included 17,059 person-years of observation. Subjects were 22 (22–22) years old at graduated college, and 49 (45–53) years old at first follow-up investigation. During the period, 120 men developed hypertension. The prevalence rates of hypertension for lowest to highest BMI categories were 9.4%, 14.6%, 16.1%, 17.5%, 30.3%, and 29.3%, respectively (p<0.001 for trend), and their hazard ratios were 1.00 (reference), 1.80 (95%CI: 0.65–4.94), 2.17 (0.83–5.64), 2.29 (0.89–5.92), 3.60 (1.37–9.47) and 4.72 (1.78–12.48), respectively (p<0.001 for trend). This trend was similar after adjustment for age, year of graduation, smoking, current exercise status and current dietary intake. Conclusion Slightly increased BMI at young age is a risk factor for future hypertension in Japanese men. PMID:29324821

Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups.

PubMed

Rozental, Alexander; Forsström, David; Lindner, Philip; Nilsson, Simon; Mårtensson, Lina; Rizzo, Angela; Andersson, Gerhard; Carlbring, Per

2018-03-01

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen's d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further. Copyright © 2017. Published by Elsevier Ltd.

Associations of Renin-Angiotensin-Aldosterone System Genes With Blood Pressure Changes and Hypertension Incidence.

PubMed

He, William J; Li, Changwei; Rao, Dabeeru C; Hixson, James E; Huang, Jianfeng; Cao, Jie; Rice, Treva K; Shimmin, Lawrence C; Gu, Dongfeng; Kelly, Tanika N

2015-11-01

The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressure (BP) regulation. The current study uses single-marker and gene-based analyses to examine the association between RAAS genes and longitudinal BP phenotypes in a Han Chinese population. A total of 1,768 participants from the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) follow-up study were included in the current study. Twenty-seven BP measurements were taken using random-zero sphygmomanometers at baseline and 2 follow-up visits. Mixed-effect models were used to assess the additive associations of 106 single-nucleotide polymorphisms (SNPs) in 10 RAAS genes with longitudinal BP changes and hypertension incidence. Gene-based analyses were conducted using the truncated product method. Attempts were made to replicate significant findings among Asian participants of the Multi-ethnic Study of Atherosclerosis (MESA). False discovery rate procedures were used to adjust for multiple testing. During an average of 7.2 years of follow-up, average systolic and diastolic BP increased, and 32.1% (512) of participants free from hypertension at baseline developed hypertension. NR3C2 SNPs rs7694064 and rs6856803 were significantly associated with longitudinal changes in systolic BP (P interaction = 6.9×10(-5) and 8.2×10(-4), respectively). Through gene-based analysis, NR3C2 was found to be significantly associated with longitudinal systolic BP change (P value of 1.00×10(-7)), even after removal of significant markers rs7694064 and rs6856803 from the analysis. The association between NR3C2 and longitudinal systolic BP change was replicated in Asian MESA participants (P value of 1.00×10(-4)). These findings indicate that NR3C2 may play an important role in BP progression and development of hypertension. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Long-term effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a one-year follow-up analysis of a previous randomized controlled trial.

PubMed

Park, Yeon Cheol; Koh, Pil Seong; Seo, Byung Kwan; Lee, Jung Woo; Cho, Nam Su; Park, Hyung Soon; Park, Dong Suk; Baek, Yong Hyeon

2014-12-01

An earlier randomized controlled trial (RCT) study showed that bee venom acupuncture (BVA) in combination with physiotherapy can be more effective in functional improvement and pain reduction in patients with adhesive capsulitis (AC). The objective of the current study was to examine the long-term effect of BVA in combination with physiotherapy on AC of the shoulder. Retrospective 1-year follow-up analysis of a previous RCT using a telephone interview method. Outpatient joint center at the Gang Dong Kyung Hee University Hospital of Seoul, Republic of Korea. A total of 192 patients had been enrolled in the previous study, and 124 of these were excluded from the current study. Sixty-eight patients who had been treated with combined BVA and physiotherapy for AC of the shoulder for 2 months were interviewed at approximately 1 year after treatment by telephone. Sixty of 68 patients were included in the follow-up analysis. Twenty received BV 1 treatment (1:10,000 concentration BVA plus physiotherapy), 22 received BV 2 treatment (1:30,000 concentration BVA plus physiotherapy), and 18 received control treatment (normal saline injection plus physiotherapy). The primary outcome measure was Shoulder Pain And Disability Index (SPADI) score. Secondary outcome measure was score on verbal rating scale for pain and patient satisfaction. Baseline characteristics of the groups did not significantly differ. SPADI scores at 1 year significantly differed between the BV 1 group and the control group (p=0.043). No significant differences were found in pain verbal rating scores after 1 year. Treatment satisfaction with therapy was also assessed, and the BV 1 and BV 2 groups showed significantly greater satisfaction compared with the control group. BVA combined with physiotherapy remains clinically effective 1 year after treatment and may help improve long-term quality of life in patients with AC of the shoulder.

Feasibility of a group cessation program for co-smokers of cannabis and tobacco.

PubMed

Becker, Julia; Haug, Severin; Kraemer, Thomas; Schaub, Michael P

2015-07-01

This study aims to evaluate the feasibility and effects of a group cessation program for cannabis and tobacco co-smokers. Using a repeated-measures design with pre-, post- and six months follow-up assessments, feasibility (intervention utilisation, safety and acceptability) and changes in substance use behaviour and mental health were evaluated. The intervention consisted of five to six group sessions and was based on current treatment techniques (e.g. motivational interviewing, cognitive-behavioural therapy, and self-control training). In total, 77 adults who used cannabis at least once weekly and cigarettes or similar products at least once daily participated in the study. Within nine months, the target sample size was reached. Treatment retention was 62.3%, and only three participants discontinued treatment due to severe problems (concentration problems, sleeping problems, depressive symptoms, and/or distorted perceptions). In total, 41.5% and 23.4% reported abstinence from cigarettes, cannabis or both at the end of treatment and the follow-up, respectively. The individual abstinence rates for cigarettes and cannabis were 32.5% and 23.4% (end of treatment) and 10.4% and 19.5% (follow-up), and 13% (end of treatment) and 5.2% (follow-up) achieved dual abstinence validated for tobacco abstinence. Over the study period, significant decreases in tobacco and cannabis use frequencies and significant improvements in additional outcomes (drinking problems, symptoms of cannabis use disorder, nicotine dependence, depression and anxiety) were achieved. The evaluated intervention for co-smokers is feasible regarding recruitment, intervention retention and safety. The promising results regarding substance use and mental health support a randomised controlled trial to evaluate effectiveness. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Are comorbid anxiety disorders a risk factor for suicide attempts in patients with mood disorders? A two-year prospective study.

PubMed

Abreu, L N; Oquendo, M A; Galfavy, H; Burke, A; Grunebaum, M F; Sher, L; Sullivan, G M; Sublette, M E; Mann, J; Lafer, B

2018-01-01

Comorbid anxiety disorders have been considered a risk factor for suicidal behavior in patients with mood disorders, although results are controversial. The aim of this two-year prospective study was to determine if lifetime and current comorbid anxiety disorders at baseline were risk factors for suicide attempts during the two-year follow-up. We evaluated 667 patients with mood disorders (504 with major depression and 167 with bipolar disorder) divided in two groups: those with lifetime comorbid anxiety disorders (n=229) and those without (n=438). Assessments were performed at baseline and at 3, 12, and 24 months. Kaplan-Meier survival analysis and log-rank test were used to evaluate the relationship between anxiety disorders and suicide attempts. Cox proportional hazard regression was performed to investigate clinical and demographic variables that were associated with suicide attempts during follow-up. Of the initial sample of 667 patients, 480 had all three follow-up interviews. During the follow-up, 63 patients (13.1%) attempted suicide at least once. There was no significant difference in survival curves for patients with and without comorbid anxiety disorders (log-rank test=0.269; P=0.604). Female gender (HR=3.66, P=0.001), previous suicide attempts (HR=3.27, P=0.001) and higher scores in the Buss-Durkee Hostility Inventory (HR=1.05, P≤0.001) were associated with future suicide attempts. Our results suggest that comorbid anxiety disorders were not risk factors for suicide attempts. Further studies were needed to determine the role of anxiety disorders as risk factors for suicide attempts. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Prospective study of body mass index, height, physical activity and incidence of bladder cancer in US men and women.

PubMed

Holick, Crystal N; Giovannucci, Edward L; Stampfer, Meir J; Michaud, Dominique S

2007-01-01

We evaluated prospectively the association between body mass index (BMI), height, recreational physical activity and the risk of bladder cancer among US adults. Data were used from 2 ongoing cohorts, the Health Professionals Follow-up Study and the Nurses' Health Study, with 3,542,012 years of follow-up and 866 incident bladder cancer cases (men = 507; women = 359) for the anthropometric analysis and 1,890,476 years of follow-up and 706 incident bladder cancer cases (men = 502; women = 204) for the physical activity analysis. Cox proportional hazard models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between BMI, height, physical activity and bladder cancer risk adjusting for age, pack-years of cigarette smoking and current smoking. Estimates from each cohort were pooled using a random-effects model. We observed no association between baseline BMI and bladder cancer risk, even when we compared a BMI of > or =30 kg/m(2) to a BMI of 18-22.9 kg/m(2) [pooled multivariate (MV) RR, 1.16; 95% CI: 0.89-1.52]. A weak, but statistically significant, association was observed for the same comparison after excluding bladder cancer cases diagnosed within the first 4 years of follow-up (pooled MV RR, 1.33; 95% CI: 1.01-1.76). Height was not related to bladder cancer risk (pooled MV RR, 0.82; 95% CI: 0.65-1.03, top vs. bottom quintile). Total recreational physical activity also was not associated with the risk of bladder cancer (pooled MV RR, 0.97; 95% CI: 0.77-1.24, top vs. bottom quintile). Our findings do not support a role for BMI, height or physical activity in bladder carcinogenesis.

Further evaluation of a brief, intensive teacher-training model.

PubMed

Lerman, Dorothea C; Tetreault, Allison; Hovanetz, Alyson; Strobel, Margaret; Garro, Joanie

2008-01-01

The purpose of this study was to further evaluate the outcomes of a model program that was designed to train current teachers of children with autism. Nine certified special education teachers participating in an intensive 5-day summer training program were taught a relatively large number of specific skills in two areas (preference assessment and direct teaching). The teachers met the mastery criteria for all of the skills during the summer training. Follow-up observations up to 6 months after training suggested that the skills generalized to their classrooms and were maintained for most teachers with brief feedback only.

Cancer incidence among copper smelting and nickel refining workers in Finland.

PubMed

Pavela, Markku; Uitti, Jukka; Pukkala, Eero

2017-01-01

Among workers employed at a nickel refinery in Harjavalta, Finland an increased risk of lung and sinus cancer has been demonstrated in two previous studies. The current study adds 16 more years of follow-up to these studies. A total of 1,115 persons exposed to nickel and 194 non-exposed workers in the Harjavalta nickel smelter and refinery were followed up for cancer from 1967 to 2011 through the Finnish Cancer Registry. The total number of cancer cases in men was 251 (Standardized incidence ratio (SIR) 1.05) and in women 12 (SIR 1.22). In the most nickel-exposed work site (refinery), there were 14 lung cancers (SIR 2.01) and 3 sinonasal cancers (SIR 26.7, 95%). It is likely that exposure to nickel compounds is the main reason for elevated nasal cancer risk among the nickel refinery employees and may also contribute to the excess risk of lung cancer. Am. J. Ind. Med. 60:87-95, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Functional outcome and health-related quality of life 10 years after moderate-to-severe traumatic brain injury.

PubMed

Andelic, N; Hammergren, N; Bautz-Holter, E; Sveen, U; Brunborg, C; Røe, C

2009-07-01

To describe the functional outcome and health-related quality of life (HRQL) 10 years after moderate-to-severe traumatic brain injury (TBI). A retrospective, population-based study of 62 survivors of working-age with moderate-to-severe TBI injured in 1995/1996, and hospitalized at the Trauma Referral Center in Eastern Norway. Functional status was measured by the Glasgow Outcome Scale-Extended (GOS-E). HRQL was assessed by the SF-36 questionnaire. The mean current-age was 40.8 years. The frequency of epilepsy was 19% and the depression rate 31%. A majority had good recovery (48%) or moderate disability (44%). Employment rate was 58%. Functional and employment status were associated with initial injury severity in contrast to HRQL. Study patients had significantly lower scores in all SF-36 dimensions when compared with the general Norwegian population. At 10-years follow-up, our study population is still in their most productive years and affected domains should be considered in long-term follow-up and intervention programs.

Brachytherapy in early prostate cancer--early experience.

PubMed

Jose, B O; Bailen, J L; Albrink, F H; Steinbock, G S; Cornett, M S; Benson, D C; Schmied, W K; Medley, R N; Spanos, W J; Paris, K J; Koerner, P D; Gatenby, R A; Wilson, D L; Meyer, R

1999-01-01

Use of brachytherapy with radioactive seeds in the management of early prostate cancer is commonly used in the United States. The early experience has been reported from the prostate treatment centers in Seattle for the last 10 years. In this manuscript we are reporting our early experience of 150 radioactive seed implantations in early stage prostate cancer using either Iodine 125 or Palladium 103 seeds. The average age of the patient is 66 years and the median Gleason score is 5.4 with a median PSA of 6. A brief description of the evolution of the treatment of prostate cancer as well as the preparation for the seed implantation using the volume study with ultrasound of the prostate, pubic arch study using CT scan of the pelvis and the complete planning using the treatment planning computers are discussed. We also have described the current technique which is used in our experience based on the Seattle guidelines. We plan a follow-up report with the results of the studies with longer follow-up.

The Lifeways Cross-Generation Study: design, recruitment and data management considerations.

PubMed

O'Mahony, D; Fallon, U B; Hannon, F; Kloeckner, K; Avalos, G; Murphy, A W; Kelleher, C C

2007-09-01

The Lifeways Cross-Generation Cohort Study was first established in 2001 and is a unique longitudinal database in Ireland, with currently over three and a half thousand family participants derived from 1124 mothers recruited initially during pregnancy, mainly during 2002. The database comprises a) baseline self-reported health data for all mothers, a third of fathers and at least one grandparent b) clinical hospital data at recruitment, c) three year follow-up data from the families' General Practitioners, and d) linkage to hospital and vaccination databases. Data collection for the five-year follow-up with parents is underway, continuing through 2007. Because there is at present no single national/regional health information system in Ireland, original data instruments were designed to capture data directly from family members and through their hospitals and healthcare providers. A system of relational databases was designed to coordinate data capture for a complex array of study instruments and to facilitate tracking of family members at different time points.

Weightbearing Versus Nonweightbearing After Meniscus Repair.

PubMed

VanderHave, Kelly L; Perkins, Crystal; Le, Michael

2015-01-01

Optimal rehabilitation after meniscal repair remains controversial. To review the current literature on weightbearing status after meniscal repairs and to provide evidence-based recommendations for postoperative rehabilitation. MEDLINE (January 1, 1993 to July 1, 2014) and Embase (January 1, 1993 to July 1, 2014) were queried with use of the terms meniscus OR/AND repair AND rehabilitation. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. Systematic review. Level 4. Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years follow-up were extracted. Successful clinical outcomes ranged from 70% to 94% with conservative rehabilitation. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. Outcomes after both conservative (restricted weightbearing) protocols and accelerated rehabilitation (immediate weightbearing) yielded similar good to excellent results; however, lack of similar objective criteria and consistency among surgical techniques and existing studies makes direct comparison difficult. © 2015 The Author(s).

Electrical stimulation for gastroesophageal reflux disease: current state of the art.

PubMed

Kim, Sharon E; Soffer, Edy

2016-01-01

Patients with gastroesophageal reflux disease (GERD) who are not satisfied with acid suppression therapy can benefit primarily from fundoplication, a surgical intervention. Fundoplication has been the standard surgical procedure for GERD. It is effective but is associated with adverse effects, resulting in a declining number of interventions, creating a need for alternative interventions that are effective, yet have a better adverse effect profile. One such alternative involves the application of electrical stimulation to the lower esophageal sphincter. A number of animal studies showed that such stimulation can increase resting lower esophageal sphincter pressure. An acute human study confirmed this effect, and was followed by two open-label studies, with a follow-up of up to 3 years. Results thus far show that the therapy is associated with a significant improvement in symptoms, a significant reduction in esophageal acid exposure, and a very good safety profile. This review will describe the evolution of electrical stimulation therapy for GERD, as well as the safety and efficacy of this intervention.

"Am I Becoming a Serial Killer?" A Case Study of Cognitive Behavioral Therapy for Mental Illness Anxiety.

PubMed

Gelinas, Bethany L; Hadjistavropoulos, Heather

2016-05-01

Although mental illness anxiety is described in the literature, there is very little information on which to draw when treating individuals who present with fears and worries about mental health. In fact, we identified no previous case descriptions focused on this form of anxiety and treated from a cognitive behavioral perspective. The current case study aims to advance the understanding of the clinical picture of mental illness anxiety, and facilitate the understanding of how cognitive behavioral techniques for health anxiety can be effectively adapted and implemented for such a case. A case study approach was adopted in which a baseline condition and repeated assessments were conducted during an 8-week treatment and 2-month follow-up period. In the current case study, we discuss the assessment, conceptualization, and cognitive behavioral treatment of a 24-year old woman who presented with mental illness anxiety. Several common health anxiety assessment tools and cognitive behavioural techniques were adapted for her particular clinical presentation. Consistent with research evidence for health anxiety, significant improvements in health anxiety and anxiety sensitivity were seen after eight sessions of therapy and maintained at 2-month follow-up. The results provide preliminary evidence that cognitive behavioral techniques for health anxiety can be effectively and efficiently adapted for mental illness anxiety. However, the lack of available research pertaining to mental illness anxiety contributes to challenges in conceptualization, assessment and treatment.

Did our current initial treatment practice change after EAU/ESPU vesicoureteral reflux risk grouping?

PubMed

Tokat, Eda; Gurocak, Serhat; Ure, Iyimser; Acar, Cenk; Sınık, Zafer; Tan, Mustafa Ozgur

2018-06-02

The "European Association of Urology (EAU) Guidelines on Vesicoureteral Reflux (VUR) in Children (September 2012)" established risk classification by analyzing and defining risk factors for each patient. In this study we aimed to investigate how our initial treatment procedures were affected by EAU/ESPU guideline vesicoureteral reflux risk grouping and to compare the early clinical results of treatments performed before and after the risk classification in our patients with VUR. 334 renal units with regular clinical follow-up who were treated owing to VUR (vesicoureteral reflux) between years 2009 and 2017 were retrospectively reviewed. Preoperative clinical parameters such as grade and laterality of reflux, presence of renal scar, initial and follow-up treatments, findings of medical treatment and surgical procedures were analyzed. The initial medical and surgical methods were compared by categorizing patients according to risk groups before and after 2013. Mean age and follow-up duration were 71.4(6-216) months and 47(4-141) months, respectively. Among the preoperative parameters, only high EAU risk group (p = 0.01) and treating lower urinary tract symptoms (p < 0.001) were determining the postoperative success rates significantly, while age, sex, and presence of renal scar at DMSA were not affecting the success of treatment significantly. While no significant difference in medical and surgical treatment rates is observed after risk grouping system in low risk group, the percentages of patients who are treated with surgical methods initially were significantly decreased in moderate and high risk groups (p = 0.002 and p = 0.012, respectively). We determined that VUR risk grouping did not change clinical success significantly in all risk groups. Despite the fact that EAU/ESPU VUR risk classification changed our current practice in terms of initial treatment method, this different approach did not seem to affect early clinical success positively. There is still an absolute need for studies with larger sample size and long-term follow-up to reach more reliable results. Therapeutic. Level 4. Copyright © 2018 Elsevier Inc. All rights reserved.

Moving a randomized clinical trial into an observational cohort.

PubMed

Goodman, Phyllis J; Hartline, Jo Ann; Tangen, Catherine M; Crowley, John J; Minasian, Lori M; Klein, Eric A; Cook, Elise D; Darke, Amy K; Arnold, Kathryn B; Anderson, Karen; Yee, Monica; Meyskens, Frank L; Baker, Laurence H

2013-02-01

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double-blind, placebo-controlled prostate cancer prevention study funded by the National Cancer Institute (NCI) and conducted by the Southwest Oncology Group (SWOG). A total of 35,533 men were assigned randomly to one of the four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, and placebo + placebo). The independent Data and Safety Monitoring Committee (DSMC) recommended the discontinuation of study supplements because of the lack of efficacy for risk reduction and because futility analyses demonstrated no possibility of benefit of the supplements to the anticipated degree (25% reduction in prostate cancer incidence) with additional follow-up. Study leadership agreed that the randomized trial should be terminated but believed that the cohort should be maintained and followed as the additional follow-up would contribute important information to the understanding of the biologic consequences of the intervention. Since the participants no longer needed to be seen in person to assess acute toxicities or to be given study supplements, it was determined that the most efficient and cost-effective way to follow them was via a central coordinated effort. A number of changes were necessary at the local Study Sites and SELECT Statistical Center to transition to following participants via a Central Coordinating Center. We describe the transition process from a randomized clinical trial to the observational Centralized Follow-Up (CFU) study. The process of transitioning SELECT, implemented at more than 400 Study Sites across the United States, Canada, and Puerto Rico, entailed many critical decisions and actions including updates to online documents such as the SELECT Workbench and Study Manual, a protocol amendment, reorganization of the Statistical Center, creation of a Transition Committee, development of materials for SELECT Study Sites, development of procedures to close Study Sites, and revision of data collection procedures and the process by which to contact participants. At the time of the publication of the primary SELECT results in December 2008, there were 32,569 men alive and currently active in the trial. As of 31 December 2011, 17,761 participants had been registered to the CFU study. This number is less than had been anticipated due to unforeseen difficulties with local Study Site institutional review boards (IRBs). However, from this cohort, we estimate that an additional 580 prostate cancer cases and 215 Gleason 7 or higher grade cancers will be identified. Over 109,000 individual items have been mailed to participants. Active SELECT ancillary studies have continued. The substantial SELECT biorepository is available to researchers; requests to use the specimens are reviewed for feasibility and scientific merit. As of April 2012, 12 proposals had been approved. The accrual goal of the follow-up study was not met, limiting our power to address the study objectives satisfactorily. The CFU study is also dependent on a number of factors including continued funding, continued interest of investigators in the biorepository, and the continued contribution of the participants. Our experience may be less pertinent to investigators who wish to follow participants in a treatment trial or participants in prevention trials in other medical areas. Extended follow-up of participants in prevention research is important to study the long-term effects of the interventions, such as those used in SELECT. The approach taken by SELECT investigators was to continue to follow participants centrally via an annual questionnaire and with a web-based option. The participants enrolled in the CFU study represent a large, well-characterized, generally healthy cohort. The CFU has enabled us to collect additional prostate and other cancer endpoints and longer follow-up on the almost 18,000 participants enrolled. The utility of the extensive biorepository that was developed during the course of the SELECT is enhanced by longer follow-up.

Moving a Randomized Clinical Trial into an Observational Cohort

PubMed Central

Goodman, Phyllis J.; Hartline, Jo Ann; Tangen, Catherine M.; Crowley, John J.; Minasian, Lori M.; Klein, Eric A.; Cook, Elise D.; Darke, Amy K.; Arnold, Kathryn B.; Anderson, Karen; Yee, Monica; Meyskens, Frank L.; Baker, Laurence H.

2013-01-01

Background The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double blind, placebo-controlled prostate cancer prevention study funded by the National Cancer Institute and conducted by SWOG (Southwest Oncology Group). A total of 35,533 men were assigned randomly to one of four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, placebo + placebo. The independent Data and Safety Monitoring Committee recommended the discontinuation of study supplements because of the lack of efficacy for risk reduction and because futility analyses demonstrated no possibility of benefit of the supplements to the anticipated degree (25% reduction in prostate cancer incidence) with additional follow-up. Study leadership agreed that the randomized trial should be terminated but believed that the cohort should be maintained and followed as the additional follow-up would contribute important information to the understanding of the biologic consequences of the intervention. Since the participants no longer needed to be seen in person to assess acute toxicities or to be given study supplements, it was determined that the most efficient and cost-effective way to follow them was via a central coordinated effort. Purpose A number of changes were necessary at the local Study Sites and SELECT Statistical Center to transition to following participants via a Central Coordinating Center. We describe the transition process from a randomized clinical trial to the observational Centralized Follow-up (CFU) study. Methods The process of transitioning SELECT, implemented at more than 400 Study Sites across the United States, Canada and Puerto Rico, entailed many critical decisions and actions including updates to online documents such as the SELECT Workbench and Study Manual, a protocol amendment, reorganization of the Statistical Center, creation of a Transition Committee, development of materials for SELECT Study Sites, development of procedures to close Study Sites, and revision of data collection procedures and the process by which to contact participants. Results At the time of the publication of the primary SELECT results in December 2008, there were 32,569 men alive and currently active in the trial. As of December 31, 2011, 17,761 participants had been registered to the CFU study. This number is less than had been anticipated due to unforeseen difficulties with local Study Site IRBs. However, from this cohort we estimate that an additional 580 prostate cancer cases and 215 Gleason 7 or higher cancers will be identified. Over 109,000 individual items have been mailed to participants. Active SELECT ancillary studies have continued. The substantial SELECT biorepository is available to researchers; requests to use the specimens are reviewed for feasibility and scientific merit. As of April 2012, 12 proposals had been approved. Limitations The accrual goal of the follow-up study was not met, limiting our power to address the study objectives satisfactorily. The CFU study is also dependent on a number of factors including continued funding, continued interest of investigators in the biorepository and the continued contribution of the participants. Our experience may be less pertinent to investigators who wish to follow participants in a treatment trial or participants in prevention trials in other medical areas. Conclusions Extended follow-up of participants in prevention research is important to study the long-term effects of the interventions, such as those used in SELECT. The approach taken by SELECT investigators was to continue to follow participants centrally via an annual questionnaire and with a web-based option. The participants enrolled in the CFU study represent a large, well-characterized, generally healthy cohort. The CFU has enabled us to collect additional prostate and other cancer endpoints and longer follow-up on the almost 18,000 participants enrolled. The utility of the extensive biorepository that was developed during the course of the SELECT is enhanced by longer follow-up. PMID:23064404

Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer.

PubMed

Alimi, Marjan; Njoku, Innocent; Hofstetter, Christoph P; Tsiouris, Apostolos J; Kesavabhotla, Kartik; Boockvar, John; Navarro-Ramirez, Rodrigo; Härtl, Roger

2016-04-17

Interposition grafts combined with anterior plating currently remain the gold standard for anterior cervical discectomy and fusion. The use of anterior plates increases fusion rates but may be associated with higher rates of postoperative dysphagia. The aim of the current study was to determine the clinical and radiological outcomes following anterior cervical discectomy and fusion (ACDF) using zero-profile anchored spacers versus standard interposition grafts with anterior plating. This was a retrospective case series. A total of 53 male and 51 female consecutive patients (164 total operated levels) who underwent ACDF between 2007 and 2011 were included. The mean clinical follow-up was 15.7 ± 1.2 (SEM) months for patients with zero-profile implants and 14.8 ± 2.1 months for patients with conventional ACDF with anterior plating. Patient demographics, operative details, clinical outcomes, complications, and radiographic imaging were reviewed. Dysphagia was determined using the Bazaz criteria. Clinical outcome scores improved in both groups as measured by the modified Japanese Orthopedic Association and Nurick scores. Zero-profile constructs gave rise to significantly less prevertebral soft tissue swelling compared to constructs with anterior plates postoperatively (15.74 ± 0.52 as compared to 20.48 ± 0.85 mm, p < 0.001) and at the latest follow-up (10.88 ± 0.39 mm vs. 13.72 ± 0.67 mm, p < 0.001). There was a significant difference in the incidence of dysphagia at the latest follow-up (1.5% vs. 20%, p=0.001, zero-profile vs. anterior plate, respectively). Zero-profile implants lead to functional outcomes similar to standard anterior plate constructs. Avoiding the use of an anterior locking plate may decrease the risk of persistent postoperative dysphagia.

Expert Consensus on the Management of Patients with Postmenopausal Osteoporosis in the Spanish Healthcare System.

PubMed

Del Pino-Montes, Javier; Blanch, Josep; Nogués, Xavier; Moro, María Jesús; Valero, María Del Carmen; Canals, Laura; Lizán, Luis

2016-04-01

The management of postmenopausal osteoporosis (PMO) in routine clinical practice differs considerably from guideline recommendations. The objective of our study was to reach a consensus on the management of PMO, considering prevention, diagnosis, treatment and follow-up, according to expert opinion in Spain. A two-round Delphi technique was conducted, including 38 experts. The questionnaire contained 35 sections, each one including 1-10 questions (n = 308) based on a literature review and contributions from the scientific steering committee. Each question was scored by experts from the current (1 = no occurrence, 9 = occurrence in all cases), wish (1 = total rejection; 9 = wish) and prediction (1 = no occurrence at all; 9 = occurs with maximum probability) perspectives. Consensus (wish and prediction perspectives) was considered when ≥75% of experts scored 7-9 (agreement) or 1-3 (disagreement). Overall, consensus was achieved on 75% of questions. While protocols of clinical management and consultation/referral should be followed, their implementation is unlikely. Furthermore, the medical specialties currently involved in PMO management are poorly defined. PMO patients without fracture should be managed (prevention, diagnosis, treatment and follow-up) in both primary care and rheumatology settings; however, experts predicted that only treatment and follow-up will be assumed by these specialties. A multidisciplinary team should be involved in patients with fracture. No assessment tools are usually applied, and prediction indicated that they will not be used. Efforts should be focused on questions with high divergence between wishes and predictions, defining actions that will improve PMO management. Collaboration between scientific societies and health authorities to address the identified opportunities of improvement is proposed. Amgen S.A.

eTEST: Developing a Smart Home HIV Testing Kit that Enables Active, Real-Time Follow-Up and Referral After Testing.

PubMed

Wray, Tyler; Chan, Philip A; Simpanen, Erik; Operario, Don

2017-05-08

Men who have sex with men (MSM) are the group at highest risk for contracting human immunodeficiency virus (HIV) in the United States, but many do not test as frequently as recommended. Home-based self-testing (HBST) for HIV holds promise for promoting regular testing among these individuals, but currently available HBSTs have limited follow-up options, providing only a 1-800 number that participants can call. Failure to actively conduct follow-up counseling and referrals after HBST use could result in delays in seeking confirmatory testing and care among users receiving reactive (preliminary positive) test results. HBST also fails to connect users who test negative with other prevention services that can reduce their future risk for HIV. The aim of our study was to use qualitative research methods with high-risk MSM to inform development of a "smart" HBST kit. The kit utilizes existing Internet-of-Things (IoT) technologies to monitor HBST use in real-time and enable delivery of timely, active follow-up counseling and referrals over the phone. In phase 1, individual interviews (n=10) explored how participants might use HBST and their views and preferences for conducting counseling and referral after HBST. Based on these perspectives, we developed a smartphone app (iOS, Android) that uses data from light sensors on Bluetooth low energy (BLE) beacons to monitor when HBST kits are opened, facilitating timely follow-up phone contact with users. In phase 2, a usability study conducted among high-risk MSM (n=10) examined the acceptability and feasibility of this system and provided user perspectives after using the system along with HBST. Phase 1 themes suggested that MSM preferred HBST, that most thought active follow-up after HBST would be valuable, and that doing so over the phone within 24 h after testing was preferable. Phase 2 results showed that the eTEST system successfully detected HBST use in nearly all cases. Participant perspectives also suggested that the timing, method (ie, phone call), and duration of follow-up were appropriate and helpful. Using BLE beacons and a smartphone app to enable follow-up counseling and referral over the phone after HBST use is feasible and acceptable to high-risk MSM. Future research is needed to compare the effects of follow-up counseling on rates of repeat testing and receipt of referral services (eg, testing for sexually transmitted infections and initiation of preexposure prophylaxis) and to explore the acceptability of the eTEST system over longer periods of time. ©Tyler Wray, Philip A Chan, Erik Simpanen, Don Operario. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.05.2017.

eTEST: Developing a Smart Home HIV Testing Kit that Enables Active, Real-Time Follow-Up and Referral After Testing

PubMed Central

Chan, Philip A; Simpanen, Erik; Operario, Don

2017-01-01

Background Men who have sex with men (MSM) are the group at highest risk for contracting human immunodeficiency virus (HIV) in the United States, but many do not test as frequently as recommended. Home-based self-testing (HBST) for HIV holds promise for promoting regular testing among these individuals, but currently available HBSTs have limited follow-up options, providing only a 1-800 number that participants can call. Failure to actively conduct follow-up counseling and referrals after HBST use could result in delays in seeking confirmatory testing and care among users receiving reactive (preliminary positive) test results. HBST also fails to connect users who test negative with other prevention services that can reduce their future risk for HIV. Objective The aim of our study was to use qualitative research methods with high-risk MSM to inform development of a “smart” HBST kit. The kit utilizes existing Internet-of-Things (IoT) technologies to monitor HBST use in real-time and enable delivery of timely, active follow-up counseling and referrals over the phone. Methods In phase 1, individual interviews (n=10) explored how participants might use HBST and their views and preferences for conducting counseling and referral after HBST. Based on these perspectives, we developed a smartphone app (iOS, Android) that uses data from light sensors on Bluetooth low energy (BLE) beacons to monitor when HBST kits are opened, facilitating timely follow-up phone contact with users. In phase 2, a usability study conducted among high-risk MSM (n=10) examined the acceptability and feasibility of this system and provided user perspectives after using the system along with HBST. Results Phase 1 themes suggested that MSM preferred HBST, that most thought active follow-up after HBST would be valuable, and that doing so over the phone within 24 h after testing was preferable. Phase 2 results showed that the eTEST system successfully detected HBST use in nearly all cases. Participant perspectives also suggested that the timing, method (ie, phone call), and duration of follow-up were appropriate and helpful. Conclusions Using BLE beacons and a smartphone app to enable follow-up counseling and referral over the phone after HBST use is feasible and acceptable to high-risk MSM. Future research is needed to compare the effects of follow-up counseling on rates of repeat testing and receipt of referral services (eg, testing for sexually transmitted infections and initiation of preexposure prophylaxis) and to explore the acceptability of the eTEST system over longer periods of time. PMID:28483744

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.

Association between midlife health behaviours and transitions out of employment from midlife to early old age: Whitehall II cohort study.

PubMed

Hagger-Johnson, Gareth; Carr, Ewan; Murray, Emily; Stansfeld, Stephen; Shelton, Nicola; Stafford, Mai; Head, Jenny

2017-01-17

It is important to determine whether unhealthy behaviours might influence transitions out of employment from midlife to old age, given the anticipated need for adults to work for longer. Our aim was to determine the association between repeated assessments of cigarette smoking, heavy/problem alcohol drinking, low physical activity and poor diet at midlife, in relation to work exit from midlife to old age. Data from 7704 participants (5392 men) from the Whitehall II cohort study in employment at midlife were used to evaluate the association between unhealthy behaviours and a subsequent transition out of work during 22 years follow-up, using logistic regression models. Men who smoked cigarettes, consistently drank alcohol heavily, or reported problem drinking, were more likely to leave employment over follow-up. Women with a consistently poor diet were more likely to leave employment. Associations were stronger when the reason for leaving was health grounds, and stronger among those with persistently unhealthy behaviours over follow-up. The size of the effects were broadly equivalent to one advancing year of age on employment. Physical health functioning over follow-up only partly accounted for the associations with work exit, whereas physical and mental functioning accounted for most of the associations with work exit on health grounds. Unhealthy behaviours in midlife are associated with transitions out of employment into old age. Promoting healthy behaviours at midlife might support current policy initiatives aimed at extending working life. Future research should consider possible mechanisms that link behaviours to transitions out of employment, and consider sex differences in larger cohorts.

Effect of co-payment on behavioral response to consumer genomic testing.

PubMed

Liu, Wendy; Outlaw, Jessica J; Wineinger, Nathan; Boeldt, Debra; Bloss, Cinnamon S

2018-01-29

Existing research in consumer behavior suggests that perceptions and usage of a product post-purchase depends, in part, on how the product was marketed, including price paid. In the current study, we examine the effect of providing an out-of-pocket co-payment for consumer genomic testing (CGT) on consumer post-purchase behavior using both correlational field evidence and a hypothetical online experiment. Participants were enrolled in a longitudinal cohort study of the impact of CGT and completed behavioral assessments before and after receipt of CGT results. Most participants provided a co-payment for the test (N = 1668), while others (N = 369) received fully subsidized testing. The two groups were compared regarding changes in health behaviors and post-test use of health care resources. Participants who paid were more likely to share results with their physician (p = .012) and obtain follow-up health screenings (p = .005) relative to those who received fully subsidized testing. A follow-up online experiment in which participants (N = 303) were randomized to a "fully-subsidized" versus "co-payment" condition found that simulating provision of a co-payment significantly increased intentions to seek follow-up screening tests (p = .050) and perceptions of the test results as more trustworthy (p = .02). Provision of an out-of-pocket co-payment for CGT may influence consumer's post-purchase behavior consistent with a price placebo effect. Cognitive dissonance or sunk cost may help explain the increase in screening propensity among paying consumers. Such individuals may obtain follow-up screenings to validate their initial decision to expend personal resources to obtain CGT. © Society of Behavioral Medicine 2018.

Reward-related attentional bias and adolescent substance use: a prognostic relationship?

PubMed

van Hemel-Ruiter, Madelon E; de Jong, Peter J; Ostafin, Brian D; Oldehinkel, Albertine J

2015-01-01

Current cognitive-motivational addiction theories propose that prioritizing appetitive, reward-related information (attentional bias) plays a vital role in substance abuse behavior. Previous cross-sectional research has shown that adolescent substance use is related to reward-related attentional biases. The present study was designed to extend these findings by testing whether these reward biases have predictive value for adolescent substance use at three-year follow-up. Participants (N = 657, mean age = 16.2 yrs at baseline) were a sub-sample of Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal community cohort study. We used a spatial orienting task as a behavioral index of appetitive-related attentional processes at baseline and a substance use questionnaire at both baseline and three years follow-up. Bivariate correlational analyses showed that enhanced attentional engagement with cues that predicted potential reward and nonpunishment was positively associated with substance use (alcohol, tobacco, and cannabis) three years later. However, reward bias was not predictive of changes in substance use. A post-hoc analysis in a selection of adolescents who started using illicit drugs (other than cannabis) in the follow-up period demonstrated that stronger baseline attentional engagement toward cues of nonpunishment was related to a higher level of illicit drug use three years later. The finding that reward bias was not predictive for the increase in substance use in adolescents who already started using substances at baseline, but did show prognostic value in adolescents who initiated drug use in between baseline and follow-up suggests that appetitive bias might be especially important in the initiation stages of adolescent substance use.

Reward-Related Attentional Bias and Adolescent Substance Use: A Prognostic Relationship?

PubMed Central

van Hemel-Ruiter, Madelon E.; de Jong, Peter J.; Ostafin, Brian D.; Oldehinkel, Albertine J.

2015-01-01

Current cognitive-motivational addiction theories propose that prioritizing appetitive, reward-related information (attentional bias) plays a vital role in substance abuse behavior. Previous cross-sectional research has shown that adolescent substance use is related to reward-related attentional biases. The present study was designed to extend these findings by testing whether these reward biases have predictive value for adolescent substance use at three-year follow-up. Participants (N = 657, mean age = 16.2 yrs at baseline) were a sub-sample of Tracking Adolescents’ Individual Lives Survey (TRAILS), a large longitudinal community cohort study. We used a spatial orienting task as a behavioral index of appetitive-related attentional processes at baseline and a substance use questionnaire at both baseline and three years follow-up. Bivariate correlational analyses showed that enhanced attentional engagement with cues that predicted potential reward and nonpunishment was positively associated with substance use (alcohol, tobacco, and cannabis) three years later. However, reward bias was not predictive of changes in substance use. A post-hoc analysis in a selection of adolescents who started using illicit drugs (other than cannabis) in the follow-up period demonstrated that stronger baseline attentional engagement toward cues of nonpunishment was related to a higher level of illicit drug use three years later. The finding that reward bias was not predictive for the increase in substance use in adolescents who already started using substances at baseline, but did show prognostic value in adolescents who initiated drug use in between baseline and follow-up suggests that appetitive bias might be especially important in the initiation stages of adolescent substance use. PMID:25816295

Endovascular interventions for TASC II D femoropopliteal lesions.

PubMed

Baril, Donald T; Chaer, Rabih A; Rhee, Robert Y; Makaroun, Michel S; Marone, Luke K

2010-06-01

Advances in endovascular techniques have provided new options in the treatment of complex infrainguinal occlusive lesions. The purpose of this study was to evaluate outcomes of endovascular interventions on TransAtlantic InterSociety (TASC) II D femoropopliteal occlusive disease. All patients undergoing endovascular interventions for femoropopliteal occlusive disease between July 2004 and July 2009 were reviewed. Patient demographics, pre- and postprocedure ankle-brachial indices (ABI) and anatomic factors were analyzed. Outcomes evaluated included primary patency, assisted-patency, secondary patency, predictors of restenosis, and wound healing. Five hundred eighty-five limbs were treated during the period reviewed. The study group included 79 TASC D limbs in 74 patients (mean age 76.5 +/- 11.9 years, male sex: 53%). Fifty-six limbs (71%) underwent treatment for critical limb ischemia, including 42 (53%) with tissue loss. Eleven patients (15%) had previous failed bypasses. Preoperative ABIs were unobtainable for 23 patients, while the remaining 56 had a mean baseline ABI of 0.54 +/- 0.28. There was one periprocedural mortality. Five patients (6.3%) had periprocedural complications. Mean increase in ABI postprocedure was 0.49 +/- 0.35. Follow-up was available for 74 limbs at a mean of 10.7 months (range, 1-35). There were 18 mortalities (24.3%) during the follow-up period. No patient required a major amputation during this follow-up period. Twenty-one limbs (26.6%) experienced restenosis and nine limbs (11.4%) experienced occlusion. Twenty-nine limbs underwent reintervention during the follow-up time, including nine which underwent multiple reinterventions. Primary, assisted-primary, and secondary patency rates at 12 and 24 months were 52.2%, 88.4%, 92.6% and 27.5%, 74.2%, and 88.9%, respectively. Predictors of restenosis/occlusion included hypercholesterolemia, the presence of a popliteal artery stent, and patients who were current or former smokers. Endovascular interventions for TASC II D lesions can be safely performed with excellent hemodynamic improvement and limb salvage rates. Restenosis is not uncommon in this population, which mandates strict follow-up. Further follow-up is necessary to determine the long-term efficacy of these interventions. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

MR Angiography Follow-Up 10 Years after Cryptogenic Nonperimesencephalic Subarachnoid Hemorrhage

PubMed Central

Wenz, Holger; Wenz, Ralf; al Mahdi, Mohamad-Motaz; Scharf, Johann; Groden, Christoph; Schmiedek, Peter; Seiz-Rosenhagen, Marcel

2015-01-01

Objectives Long-term magnetic resonance angiography (MRA) follow-up studies regarding cryptogenic nonperimesencephalic subarachnoid hemorrhage (nSAH) are scarce. This single-centre study identified all patients with angiographically verified cryptogenic nSAH from 1998 to 2007: The two main objectives were to prospectively assess the incidence of de novo aneurysm with 3.0-MRI years after cryptogenic nSAH in patients without evidence for further hemorrhage, and retrospectively assess patient demographics and outcome. Methods From prospectively maintained report databases all patients with angiographically verified cryptogenic nSAH were identified. 21 of 29 patients received high-resolution 3T-MRI including time-of-flight and contrast-enhanced angiography, 10.2 ± 2.8 years after cryptogenic nSAH. MRA follow-up imaging was compared with initial digital subtraction angiography (DSA) and CT/MRA. Post-hemorrhage images were related to current MRI with reference to persistent lesions resulting from delayed cerebral ischemia (DCI) and post-hemorrhagic siderosis. Patient-based objectives were retrospectively abstracted from clinical databases. Results 29 patients were identified with cryptogenic nSAH, 17 (59%) were male. Mean age at time of hemorrhage was 52.9 ± 14.4 years (range 4 – 74 years). 21 persons were available for long-term follow-up. In these, there were 213.5 person years of MRI-follow-up. No de novo aneurysm was detected. Mean modified Rankin Scale (mRS) during discharge was 1.28. Post-hemorrhage radiographic vasospasm was found in three patients (10.3%); DCI-related lesions occurred in one patient (3.4%). Five patients (17.2%) needed temporary external ventricular drainage; long-term CSF shunt dependency was necessary only in one patient (3.4%). Initial DSA retrospectively showed a 2 x 2 mm aneurysm of the right distal ICA in one patient, which remained stable. Post-hemorrhage siderosis was detected 8.1 years after the initial bleeding in one patient (4.8%). Conclusion Patients with cryptogenic nSAH have favourable outcomes and do not exhibit higher risks for de novo aneurysms. Therefore the need for long-term follow up after cryptogenic nSAH is questionable. PMID:25688554

Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

PubMed

Morse, D R; Furst, M L; Belott, R M; Lefkowitz, R D; Spritzer, I B; Sideman, B H

1987-07-01

Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

Sarcoidosis in Black Women in the United States

PubMed Central

Berman, Jeffrey S.; Palmer, Julie R.; Boggs, Deborah A.; Serlin, David M.; Rosenberg, Lynn

2011-01-01

Background: Sarcoidosis is a systemic granulomatous disorder of unknown cause that occurs among men and women of all races. In the United States, black women are most frequently and most severely affected. There have been few epidemiologic studies of sarcoidosis focusing on black women. Methods: In this article, we present data on incidence, prevalence, and clinical characteristics of sarcoidosis among participants in the Black Women’s Health Study, a cohort study of 59,000 black women from across the United States. Data on incident disease and potential risk factors are obtained through biennial questionnaires. Follow-up has been > 80% through six completed cycles. Results: There were 685 prevalent cases of sarcoidosis at baseline in 1995 and 435 incident cases reported during 611,585 person-years of follow-up through 2007, for an average annual incidence rate of 71/100,000 and a current prevalence of 2.0%. The sarcoid diagnosis was confirmed in 96% of self-reported cases for whom medical records or physician checklists were obtained. The most frequently affected site was the lung. Most patients also had extrapulmonary involvement, with the most common sites being lymph nodes, skin, and eyes. Prednisone had the highest prevalence of use, followed by inhaled corticosteroids. Conclusions: This study confirms previous reports of high incidence and prevalence of sarcoidosis among black women, as well as the extent of extrapulmonary disease, frequent need for steroid therapy, and comorbid conditions in this population. The prospective identification of sarcoidosis cases from a defined population will enable a valid assessment of risk factors for incident disease as follow-up continues. PMID:20595459

Evaluating a 4-marker signature of aggressive prostate cancer using time-dependent AUC.

PubMed

Gerke, Travis A; Martin, Neil E; Ding, Zhihu; Nuttall, Elizabeth J; Stack, Edward C; Giovannucci, Edward; Lis, Rosina T; Stampfer, Meir J; Kantoff, Phillip W; Parmigiani, Giovanni; Loda, Massimo; Mucci, Lorelei A

2015-12-01

We previously identified a protein tumor signature of PTEN, SMAD4, SPP1, and CCND1 that, together with clinical features, was associated with lethal outcomes among prostate cancer patients. In the current study, we sought to validate the molecular model using time-dependent measures of AUC and predictive values for discriminating lethal from non-lethal prostate cancer. Using data from the initial study, we fit survival models for men with prostate cancer who were participants in the Physicians' Health Study (PHS; n = 276). Based on these models, we generated prognostic risk scores in an independent population, the Health Professionals Follow-up Study (HPFS; n = 347) to evaluate external validity. In each cohort, men were followed prospectively from cancer diagnosis through 2011 for development of distant metastasis or cancer mortality. We measured protein tumor expression of PTEN, SMAD4, SPP1, and CCND1 on tissue microarrays. During a median of 11.9 and 14.3 years follow-up in the PHS and HPFS cohorts, 24 and 32 men (9%) developed lethal disease. When used as a prognostic factor in a new population, addition of the four markers to clinical variables did not improve discriminatory accuracy through 15 years of follow-up. Although the four markers have been identified as key biological mediators in metastatic progression, they do not provide independent, long-term prognostic information beyond clinical factors when measured at diagnosis. This finding may underscore the broad heterogeneity in aggressive prostate tumors and highlight the challenges that may result from overfitting in discovery-based research. © 2015 Wiley Periodicals, Inc.

Predictors of a favourable outcome in patients with fibromyalgia: results of 1-year follow-up.

PubMed

Kim, Ji-Eun; Park, Dong-Jin; Choi, Sung-Eun; Kang, Ji-Hyoun; Yim, Yi-Rang; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Seong-Kyu; Choe, Jung-Yoon; Lee, Shin-Seok

2016-01-01

To determine the outcomes of Korean patients with fibromyalgia (FM) and to identify prognostic factors associated with improvement at 1-year follow-up. Forty-eight patients with FM were enrolled and examined every 3 months for 1 year. At the time of enrollment, we interviewed all patients using a structured questionnaire that recorded socio-demographic data, current or past FM symptoms, and current use of relevant medications. Tender point counts and scores were assessed by thumb palpation. Patients were asked to complete the Korean versions of the Fibromyalgia Impact Questionnaire (FIQ), the Brief Fatigue Inventory, the SF-36, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI), the Self-Efficacy Scale, and the Social Support Scale. Tender points, FIQ scores, and the use of relevant medications were recorded during one year of follow-up. Of the 48 patients, 32 (66.7%) had improved FIQ scores 1 year after enrollment. Improved patients had higher baseline FIQ scores (68.4±13.9 vs. 48.4±20.8, p=0.001) and STAI-II scores (55.8±10.9 vs. 11.5±11.5, p=0.022). Patients treated with pregabalin were more likely to improve after 1 year, based on the FIQ scores (71.9% vs. 37.5%, p=0.031). On multivariate logistic regression analysis, a higher STAI-II score at the time of enrollment and pregabalin treatment during one year of follow-up were the predictors of improvement. Two-thirds of our Korean FM patients experienced some clinical improvement by 1-year follow-up. A high baseline STAI-II score and treatment with pregabalin were the important predictor of improved FM.

Effect of simulator training on fitness-to-drive after stroke: a 5-year follow-up of a randomized controlled trial.

PubMed

Devos, Hannes; Akinwuntan, Abiodun Emmanuel; Nieuwboer, Alice; Ringoot, Isabelle; Van Berghen, Karen; Tant, Mark; Kiekens, Carlotte; De Weerdt, Willy

2010-01-01

No long-term studies have been reported on the effect of training programs on driving after stroke. The authors' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke. A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving. In a previously reported randomized controlled trial, 83 stroke survivors received 15 hours of simulator training (n = 42) or cognitive therapy (n = 41). In this 5-year follow-up study, 61 participants were reassessed. Fitness-to-drive decisions were obtained from medical, visual, neuropsychological, and on-road tests; 44 participants (simulator group, n = 21; cognitive group, n = 23) completed all assessments. The primary outcome measures were fitness-to-drive decision and current driving status. The authors found that 5 years after stroke, 18 of 30 participants (60%) in the simulator group were considered fit to drive, compared with 15 of 31 (48%) in the cognitive group (P = .36); 34 of 61 (56%) participants were driving. Current drivers were younger (P = .04), had higher Barthel scores (P = .008), had less comorbidity (P = .01), and were less severely depressed (P = .02) than those who gave up driving. The advantage of simulator-based driving training over cognitive rehabilitation therapy, evident at 6 months poststroke, had faded 5 years later. Poststroke drivers were younger and less severely affected and depressed than nondrivers.

Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review

PubMed Central

Gajria, Kavita; Lu, Mei; Sikirica, Vanja; Greven, Peter; Zhong, Yichen; Qin, Paige; Xie, Jipan

2014-01-01

Untreated attention-deficit/hyperactivity disorder (ADHD) can lead to substantial adverse social, economic, and emotional outcomes for patients. The effectiveness of current pharmacologic treatments is often reduced, due to low treatment adherence and medication discontinuation. This current systematic literature review analyzes the current state of knowledge surrounding ADHD medication discontinuation, focusing on: 1) the extent of patient persistence; 2) adherence; and 3) the underlying reasons for patients’ treatment discontinuation and how discontinuation rates and reasons vary across patient subgroups. We selected 91 original studies (67 with persistence/discontinuation results, 26 with adherence results, and 41 with reasons for discontinuation, switching, or nonadherence) and 36 expert opinion reviews on ADHD medication discontinuation, published from 1990 to 2013. Treatment persistence on stimulants, measured by treatment duration during the 12-month follow-up periods, averaged 136 days for children and adolescents and 230 days for adults. Owing to substantial study heterogeneity, comparisons across age or medication type subgroups were generally inconclusive; however, long-acting formulations and amphetamines were associated with longer treatment duration than short-acting formulations and methylphenidates. The medication possession ratio, used to measure adherence, was <0.7 for all age groups and medication classes during a 12-month period. Adverse effects were the most commonly cited reason for discontinuation in all studies. Original research studies reported the lack of symptom control as a common discontinuation reason, followed by dosing inconvenience, social stigma associated with ADHD medication, and the patient’s attitude. In summary, although there was a lack of consistency in the measurement of adherence and persistence, these findings indicate that drug adherence and persistence are generally poor among patients with ADHD. Clinicians may be able to help improve adherence and persistence to ADHD treatment by educating caregivers and patients on treatment goals, administering long-acting medications, and following-up with patients to verify if medication is still effective and well-tolerated. PMID:25187718

The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia: study protocol for a randomized controlled study and ancillary studies.

PubMed

Pinder, Margaret; Conteh, Lesong; Jeffries, David; Jones, Caroline; Knudsen, Jakob; Kandeh, Balla; Jawara, Musa; Sicuri, Elisa; D'Alessandro, Umberto; Lindsay, Steve W

2016-06-03

In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide better protection against clinical malaria in children than LLINs alone in The Gambia. The unit of randomization will be the household, defined as a house and its occupants. A total of 800 households will be enrolled and will receive LLINs, and 400 will receive improved housing before clinical follow-up. One child aged 6 months to 13 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Episodes of clinical malaria will be the primary endpoint. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection, parasite density, and the prevalence of anemia. Exposure to malaria parasites will be assessed using light traps, followed by detection of Anopheles gambiae species and sporozoite infection. Ancillary economic and social science studies will undertake a cost-effectiveness analysis and use qualitative and participatory methods to explore the acceptability of the housing modifications and to design strategies for scaling-up housing interventions. The study is the first of its kind to measure the efficacy of housing on reducing clinical malaria, assess the incremental cost-effectiveness of improved housing, and identify mechanisms for scaling up housing interventions. Trial findings will help inform policy makers on improved housing for malaria control in sub-Saharan Africa. ISRCTN Registry, ISRCTN02622179 . Registered on 23 September 2014.

Smoking Habits and Body Weight Over the Adult Lifespan in Postmenopausal Women.

PubMed

Kabat, Geoffrey C; Heo, Moonseong; Allison, Matthew; Johnson, Karen C; Ho, Gloria Y F; Tindle, Hilary A; Asao, Keiko; LaMonte, Michael J; Giovino, Gary A; Rohan, Thomas E

2017-03-01

The inter-relationships between smoking habits and weight gain are complex. However, few studies have examined the association of smoking habits with weight gain over the life course. Major smoking parameters and weight gain over time were examined in a large cohort of postmenopausal women aged 50-79 years at enrollment between 1993 and 1998 (N=161,808) and followed through 2014 (analyses conducted in 2016). Cross-sectional analyses were used to assess the association of smoking and body weight at baseline. Retrospective data were used to correlate smoking status with body weight over a 45-year period prior to enrollment. In addition, the association of smoking with weight gain over 6 years of follow-up was examined. At baseline, women who had quit smoking prior to enrollment weighed 4.7 kg more than current smokers and 2.6 kg more than never smokers. Former, never, and current smokers all gained weight over the 45-year period from age 18 years to time of enrollment (average age, 63 years): 16.8, 16.4, and 14.6 kg, respectively. In prospective analyses, women who were current smokers at baseline but who quit smoking during follow-up gained more than 5 kg by Year 6 compared with current smokers at baseline who continued to smoke. Among long-term quitters, greater intensity of smoking and more recent quitting were associated with greater weight gain. These results suggest that excess weight gain associated with smoking cessation occurs soon after quitting and is modest relative to weight gain in never smokers over the adult lifespan. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Internet-Based Device-Assisted Remote Monitoring of Cardiovascular Implantable Electronic Devices

PubMed Central

Pron, G; Ieraci, L; Kaulback, K

2012-01-01

Executive Summary Objective The objective of this Medical Advisory Secretariat (MAS) report was to conduct a systematic review of the available published evidence on the safety, effectiveness, and cost-effectiveness of Internet-based device-assisted remote monitoring systems (RMSs) for therapeutic cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. The MAS evidence-based review was performed to support public financing decisions. Clinical Need: Condition and Target Population Sudden cardiac death (SCD) is a major cause of fatalities in developed countries. In the United States almost half a million people die of SCD annually, resulting in more deaths than stroke, lung cancer, breast cancer, and AIDS combined. In Canada each year more than 40,000 people die from a cardiovascular related cause; approximately half of these deaths are attributable to SCD. Most cases of SCD occur in the general population typically in those without a known history of heart disease. Most SCDs are caused by cardiac arrhythmia, an abnormal heart rhythm caused by malfunctions of the heart’s electrical system. Up to half of patients with significant heart failure (HF) also have advanced conduction abnormalities. Cardiac arrhythmias are managed by a variety of drugs, ablative procedures, and therapeutic CIEDs. The range of CIEDs includes pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. Bradycardia is the main indication for PMs and individuals at high risk for SCD are often treated by ICDs. Heart failure (HF) is also a significant health problem and is the most frequent cause of hospitalization in those over 65 years of age. Patients with moderate to severe HF may also have cardiac arrhythmias, although the cause may be related more to heart pump or haemodynamic failure. The presence of HF, however, increases the risk of SCD five-fold, regardless of aetiology. Patients with HF who remain highly symptomatic despite optimal drug therapy are sometimes also treated with CRT devices. With an increasing prevalence of age-related conditions such as chronic HF and the expanding indications for ICD therapy, the rate of ICD placement has been dramatically increasing. The appropriate indications for ICD placement, as well as the rate of ICD placement, are increasingly an issue. In the United States, after the introduction of expanded coverage of ICDs, a national ICD registry was created in 2005 to track these devices. A recent survey based on this national ICD registry reported that 22.5% (25,145) of patients had received a non-evidence based ICD and that these patients experienced significantly higher in-hospital mortality and post-procedural complications. In addition to the increased ICD device placement and the upfront device costs, there is the need for lifelong follow-up or surveillance, placing a significant burden on patients and device clinics. In 2007, over 1.6 million CIEDs were implanted in Europe and the United States, which translates to over 5.5 million patient encounters per year if the recommended follow-up practices are considered. A safe and effective RMS could potentially improve the efficiency of long-term follow-up of patients and their CIEDs. Technology In addition to being therapeutic devices, CIEDs have extensive diagnostic abilities. All CIEDs can be interrogated and reprogrammed during an in-clinic visit using an inductive programming wand. Remote monitoring would allow patients to transmit information recorded in their devices from the comfort of their own homes. Currently most ICD devices also have the potential to be remotely monitored. Remote monitoring (RM) can be used to check system integrity, to alert on arrhythmic episodes, and to potentially replace in-clinic follow-ups and manage disease remotely. They do not currently have the capability of being reprogrammed remotely, although this feature is being tested in pilot settings. Every RMS is specifically designed by a manufacturer for their cardiac implant devices. For Internet-based device-assisted RMSs, this customization includes details such as web application, multiplatform sensors, custom algorithms, programming information, and types and methods of alerting patients and/or physicians. The addition of peripherals for monitoring weight and pressure or communicating with patients through the onsite communicators also varies by manufacturer. Internet-based device-assisted RMSs for CIEDs are intended to function as a surveillance system rather than an emergency system. Health care providers therefore need to learn each application, and as more than one application may be used at one site, multiple applications may need to be reviewed for alarms. All RMSs deliver system integrity alerting; however, some systems seem to be better geared to fast arrhythmic alerting, whereas other systems appear to be more intended for remote follow-up or supplemental remote disease management. The different RMSs may therefore have different impacts on workflow organization because of their varying frequency of interrogation and methods of alerts. The integration of these proprietary RM web-based registry systems with hospital-based electronic health record systems has so far not been commonly implemented. Currently there are 2 general types of RMSs: those that transmit device diagnostic information automatically and without patient assistance to secure Internet-based registry systems, and those that require patient assistance to transmit information. Both systems employ the use of preprogrammed alerts that are either transmitted automatically or at regular scheduled intervals to patients and/or physicians. The current web applications, programming, and registry systems differ greatly between the manufacturers of transmitting cardiac devices. In Canada there are currently 4 manufacturers—Medtronic Inc., Biotronik, Boston Scientific Corp., and St Jude Medical Inc.—which have regulatory approval for remote transmitting CIEDs. Remote monitoring systems are proprietary to the manufacturer of the implant device. An RMS for one device will not work with another device, and the RMS may not work with all versions of the manufacturer’s devices. All Internet-based device-assisted RMSs have common components. The implanted device is equipped with a micro-antenna that communicates with a small external device (at bedside or wearable) commonly known as the transmitter. Transmitters are able to interrogate programmed parameters and diagnostic data stored in the patients’ implant device. The information transfer to the communicator can occur at preset time intervals with the participation of the patient (waving a wand over the device) or it can be sent automatically (wirelessly) without their participation. The encrypted data are then uploaded to an Internet-based database on a secure central server. The data processing facilities at the central database, depending on the clinical urgency, can trigger an alert for the physician(s) that can be sent via email, fax, text message, or phone. The details are also posted on the secure website for viewing by the physician (or their delegate) at their convenience. Research Questions The research directions and specific research questions for this evidence review were as follows: To identify the Internet-based device-assisted RMSs available for follow-up of patients with therapeutic CIEDs such as PMs, ICDs, and CRT devices. To identify the potential risks, operational issues, or organizational issues related to Internet-based device-assisted RM for CIEDs. To evaluate the safety, acceptability, and effectiveness of Internet-based device-assisted RMSs for CIEDs such as PMs, ICDs, and CRT devices. To evaluate the safety, effectiveness, and cost-effectiveness of Internet-based device-assisted RMSs for CIEDs compared to usual outpatient in-office monitoring strategies. To evaluate the resource implications or budget impact of RMSs for CIEDs in Ontario, Canada. Research Methods Literature Search The review included a systematic review of published scientific literature and consultations with experts and manufacturers of all 4 approved RMSs for CIEDs in Canada. Information on CIED cardiac implant clinics was also obtained from Provincial Programs, a division within the Ministry of Health and Long-Term Care with a mandate for cardiac implant specialty care. Various administrative databases and registries were used to outline the current clinical follow-up burden of CIEDs in Ontario. The provincial population-based ICD database developed and maintained by the Institute for Clinical Evaluative Sciences (ICES) was used to review the current follow-up practices with Ontario patients implanted with ICD devices. Search Strategy A literature search was performed on September 21, 2010 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from 1950 to September 2010. Search alerts were generated and reviewed for additional relevant literature until December 31, 2010. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Inclusion Criteria published between 1950 and September 2010; English language full-reports and human studies; original reports including clinical evaluations of Internet-based device-assisted RMSs for CIEDs in clinical settings; reports including standardized measurements on outcome events such as technical success, safety, effectiveness, cost, measures of health care utilization, morbidity, mortality, quality of life or patient satisfaction; randomized controlled trials (RCTs), systematic reviews and meta-analyses, cohort and controlled clinical studies. Exclusion Criteria non-systematic reviews, letters, comments and editorials; reports not involving standardized outcome events; clinical reports not involving Internet-based device assisted RM systems for CIEDs in clinical settings; reports involving studies testing or validating algorithms without RM; studies with small samples (<10 subjects). Outcomes of Interest The outcomes of interest included: technical outcomes, emergency department visits, complications, major adverse events, symptoms, hospital admissions, clinic visits (scheduled and/or unscheduled), survival, morbidity (disease progression, stroke, etc.), patient satisfaction, and quality of life. Summary of Findings The MAS evidence review was performed to review available evidence on Internet-based device-assisted RMSs for CIEDs published until September 2010. The search identified 6 systematic reviews, 7 randomized controlled trials, and 19 reports for 16 cohort studies—3 of these being registry-based and 4 being multi-centered. The evidence is summarized in the 3 sections that follow. 1. Effectiveness of Remote Monitoring Systems of CIEDs for Cardiac Arrhythmia and Device Functioning In total, 15 reports on 13 cohort studies involving investigations with 4 different RMSs for CIEDs in cardiology implant clinic groups were identified in the review. The 4 RMSs were: Care Link Network® (Medtronic Inc,, Minneapolis, MN, USA); Home Monitoring® (Biotronic, Berlin, Germany); House Call 11® (St Jude Medical Inc., St Pauls, MN, USA); and a manufacturer-independent RMS. Eight of these reports were with the Home Monitoring® RMS (12,949 patients), 3 were with the Care Link® RMS (167 patients), 1 was with the House Call 11® RMS (124 patients), and 1 was with a manufacturer-independent RMS (44 patients). All of the studies, except for 2 in the United States, (1 with Home Monitoring® and 1 with House Call 11®), were performed in European countries. The RMSs in the studies were evaluated with different cardiac implant device populations: ICDs only (6 studies), ICD and CRT devices (3 studies), PM and ICD and CRT devices (4 studies), and PMs only (2 studies). The patient populations were predominately male (range, 52%–87%) in all studies, with mean ages ranging from 58 to 76 years. One study population was unique in that RMSs were evaluated for ICDs implanted solely for primary prevention in young patients (mean age, 44 years) with Brugada syndrome, which carries an inherited increased genetic risk for sudden heart attack in young adults. Most of the cohort studies reported on the feasibility of RMSs in clinical settings with limited follow-up. In the short follow-up periods of the studies, the majority of the events were related to detection of medical events rather than system configuration or device abnormalities. The results of the studies are summarized below: The interrogation of devices on the web platform, both for continuous and scheduled transmissions, was significantly quicker with remote follow-up, both for nurses and physicians. In a case-control study focusing on a Brugada population–based registry with patients followed-up remotely, there were significantly fewer outpatient visits and greater detection of inappropriate shocks. One death occurred in the control group not followed remotely and post-mortem analysis indicated early signs of lead failure prior to the event. Two studies examined the role of RMSs in following ICD leads under regulatory advisory in a European clinical setting and noted: – Fewer inappropriate shocks were administered in the RM group. – Urgent in-office interrogations and surgical revisions were performed within 12 days of remote alerts. – No signs of lead fracture were detected at in-office follow-up; all were detected at remote follow-up. Only 1 study reported evaluating quality of life in patients followed up remotely at 3 and 6 months; no values were reported. Patient satisfaction was evaluated in 5 cohort studies, all in short term follow-up: 1 for the Home Monitoring® RMS, 3 for the Care Link® RMS, and 1 for the House Call 11® RMS. – Patients reported receiving a sense of security from the transmitter, a good relationship with nurses and physicians, positive implications for their health, and satisfaction with RM and organization of services. – Although patients reported that the system was easy to implement and required less than 10 minutes to transmit information, a variable proportion of patients (range, 9% 39%) reported that they needed the assistance of a caregiver for their transmission. – The majority of patients would recommend RM to other ICD patients. – Patients with hearing or other physical or mental conditions hindering the use of the system were excluded from studies, but the frequency of this was not reported. Physician satisfaction was evaluated in 3 studies, all with the Care Link® RMS: – Physicians reported an ease of use and high satisfaction with a generally short-term use of the RMS. – Physicians reported being able to address the problems in unscheduled patient transmissions or physician initiated transmissions remotely, and were able to handle the majority of the troubleshooting calls remotely. – Both nurses and physicians reported a high level of satisfaction with the web registry system. 2. Effectiveness of Remote Monitoring Systems in Heart Failure Patients for Cardiac Arrhythmia and Heart Failure Episodes Remote follow-up of HF patients implanted with ICD or CRT devices, generally managed in specialized HF clinics, was evaluated in 3 cohort studies: 1 involved the Home Monitoring® RMS and 2 involved the Care Link® RMS. In these RMSs, in addition to the standard diagnostic features, the cardiac devices continuously assess other variables such as patient activity, mean heart rate, and heart rate variability. Intra-thoracic impedance, a proxy measure for lung fluid overload, was also measured in the Care Link® studies. The overall diagnostic performance of these measures cannot be evaluated, as the information was not reported for patients who did not experience intra-thoracic impedance threshold crossings or did not undergo interventions. The trial results involved descriptive information on transmissions and alerts in patients experiencing high morbidity and hospitalization in the short study periods. 3. Comparative Effectiveness of Remote Monitoring Systems for CIEDs Seven RCTs were identified evaluating RMSs for CIEDs: 2 were for PMs (1276 patients) and 5 were for ICD/CRT devices (3733 patients). Studies performed in the clinical setting in the United States involved both the Care Link® RMS and the Home Monitoring® RMS, whereas all studies performed in European countries involved only the Home Monitoring® RMS. 3A. Randomized Controlled Trials of Remote Monitoring Systems for Pacemakers Two trials, both multicenter RCTs, were conducted in different countries with different RMSs and study objectives. The PREFER trial was a large trial (897 patients) performed in the United States examining the ability of Care Link®, an Internet-based remote PM interrogation system, to detect clinically actionable events (CAEs) sooner than the current in-office follow-up supplemented with transtelephonic monitoring transmissions, a limited form of remote device interrogation. The trial results are summarized below: In the 375-day mean follow-up, 382 patients were identified with at least 1 CAE—111 patients in the control arm and 271 in the remote arm. The event rate detected per patient for every type of CAE, except for loss of atrial capture, was higher in the remote arm than the control arm. The median time to first detection of CAEs (4.9 vs. 6.3 months) was significantly shorter in the RMS group compared to the control group (P < 0.0001). Additionally, only 2% (3/190) of the CAEs in the control arm were detected during a transtelephonic monitoring transmission (the rest were detected at in-office follow-ups), whereas 66% (446/676) of the CAEs were detected during remote interrogation. The second study, the OEDIPE trial, was a smaller trial (379 patients) performed in France evaluating the ability of the Home Monitoring® RMS to shorten PM post-operative hospitalization while preserving the safety of conventional management of longer hospital stays. Implementation and operationalization of the RMS was reported to be successful in 91% (346/379) of the patients and represented 8144 transmissions. In the RM group 6.5% of patients failed to send messages (10 due to improper use of the transmitter, 2 with unmanageable stress). Of the 172 patients transmitting, 108 patients sent a total of 167 warnings during the trial, with a greater proportion of warnings being attributed to medical rather than technical causes. Forty percent had no warning message transmission and among these, 6 patients experienced a major adverse event and 1 patient experienced a non-major adverse event. Of the 6 patients having a major adverse event, 5 contacted their physician. The mean medical reaction time was faster in the RM group (6.5 ± 7.6 days vs. 11.4 ± 11.6 days). The mean duration of hospitalization was significantly shorter (P < 0.001) for the RM group than the control group (3.2 ± 3.2 days vs. 4.8 ± 3.7 days). Quality of life estimates by the SF-36 questionnaire were similar for the 2 groups at 1-month follow-up. 3B. Randomized Controlled Trials Evaluating Remote Monitoring Systems for ICD or CRT Devices The 5 studies evaluating the impact of RMSs with ICD/CRT devices were conducted in the United States and in European countries and involved 2 RMSs—Care Link® and Home Monitoring ®. The objectives of the trials varied and 3 of the trials were smaller pilot investigations. The first of the smaller studies (151 patients) evaluated patient satisfaction, achievement of patient outcomes, and the cost-effectiveness of the Care Link® RMS compared to quarterly in-office device interrogations with 1-year follow-up. Individual outcomes such as hospitalizations, emergency department visits, and unscheduled clinic visits were not significantly different between the study groups. Except for a significantly higher detection of atrial fibrillation in the RM group, data on ICD detection and therapy were similar in the study groups. Health-related quality of life evaluated by the EuroQoL at 6-month or 12-month follow-up was not different between study groups. Patients were more satisfied with their ICD care in the clinic follow-up group than in the remote follow-up group at 6-month follow-up, but were equally satisfied at 12- month follow-up. The second small pilot trial (20 patients) examined the impact of RM follow-up with the House Call 11® system on work schedules and cost savings in patients randomized to 2 study arms varying in the degree of remote follow-up. The total time including device interrogation, transmission time, data analysis, and physician time required was significantly shorter for the RM follow-up group. The in-clinic waiting time was eliminated for patients in the RM follow-up group. The physician talk time was significantly reduced in the RM follow-up group (P < 0.05). The time for the actual device interrogation did not differ in the study groups. The third small trial (115 patients) examined the impact of RM with the Home Monitoring® system compared to scheduled trimonthly in-clinic visits on the number of unplanned visits, total costs, health-related quality of life (SF-36), and overall mortality. There was a 63.2% reduction in in-office visits in the RM group. Hospitalizations or overall mortality (values not stated) were not significantly different between the study groups. Patient-induced visits were higher in the RM group than the in-clinic follow-up group. The TRUST Trial The TRUST trial was a large multicenter RCT conducted at 102 centers in the United States involving the Home Monitoring® RMS for ICD devices for 1450 patients. The primary objectives of the trial were to determine if remote follow-up could be safely substituted for in-office clinic follow-up (3 in-office visits replaced) and still enable earlier physician detection of clinically actionable events. Adherence to the protocol follow-up schedule was significantly higher in the RM group than the in-office follow-up group (93.5% vs. 88.7%, P < 0.001). Actionability of trimonthly scheduled checks was low (6.6%) in both study groups. Overall, actionable causes were reprogramming (76.2%), medication changes (24.8%), and lead/system revisions (4%), and these were not different between the 2 study groups. The overall mean number of in-clinic and hospital visits was significantly lower in the RM group than the in-office follow-up group (2.1 per patient-year vs. 3.8 per patient-year, P < 0.001), representing a 45% visit reduction at 12 months. The median time from onset of first arrhythmia to physician evaluation was significantly shorter (P < 0.001) in the RM group than in the in-office follow-up group for all arrhythmias (1 day vs. 35.5 days). The median time to detect clinically asymptomatic arrhythmia events—atrial fibrillation (AF), ventricular fibrillation (VF), ventricular tachycardia (VT), and supra-ventricular tachycardia (SVT)—was also significantly shorter (P < 0.001) in the RM group compared to the in-office follow-up group (1 day vs. 41.5 days) and was significantly quicker for each of the clinical arrhythmia events—AF (5.5 days vs. 40 days), VT (1 day vs. 28 days), VF (1 day vs. 36 days), and SVT (2 days vs. 39 days). System-related problems occurred infrequently in both groups—in 1.5% of patients (14/908) in the RM group and in 0.7% of patients (3/432) in the in-office follow-up group. The overall adverse event rate over 12 months was not significantly different between the 2 groups and individual adverse events were also not significantly different between the RM group and the in-office follow-up group: death (3.4% vs. 4.9%), stroke (0.3% vs. 1.2%), and surgical intervention (6.6% vs. 4.9%), respectively. The 12-month cumulative survival was 96.4% (95% confidence interval [CI], 95.5%–97.6%) in the RM group and 94.2% (95% confidence interval [CI], 91.8%–96.6%) in the in-office follow-up group, and was not significantly different between the 2 groups (P = 0.174). The CONNECT Trial The CONNECT trial, another major multicenter RCT, involved the Care Link® RMS for ICD/CRT devices in a15-month follow-up study of 1,997 patients at 133 sites in the United States. The primary objective of the trial was to determine whether automatically transmitted physician alerts decreased the time from the occurrence of clinically relevant events to medical decisions. The trial results are summarized below: Of the 575 clinical alerts sent in the study, 246 did not trigger an automatic physician alert. Transmission failures were related to technical issues such as the alert not being programmed or not being reset, and/or a variety of patient factors such as not being at home and the monitor not being plugged in or set up. The overall mean time from the clinically relevant event to the clinical decision was significantly shorter (P < 0.001) by 17.4 days in the remote follow-up group (4.6 days for 172 patients) than the in-office follow-up group (22 days for 145 patients). – The median time to a clinical decision was shorter in the remote follow-up group than in the in-office follow-up group for an AT/AF burden greater than or equal to 12 hours (3 days vs. 24 days) and a fast VF rate greater than or equal to 120 beats per minute (4 days vs. 23 days). Although infrequent, similar low numbers of events involving low battery and VF detection/therapy turned off were noted in both groups. More alerts, however, were noted for out-of-range lead impedance in the RM group (18 vs. 6 patients), and the time to detect these critical events was significantly shorter in the RM group (same day vs. 17 days). Total in-office clinic visits were reduced by 38% from 6.27 visits per patient-year in the in-office follow-up group to 3.29 visits per patient-year in the remote follow-up group. Health care utilization visits (N = 6,227) that included cardiovascular-related hospitalization, emergency department visits, and unscheduled clinic visits were not significantly higher in the remote follow-up group. The overall mean length of hospitalization was significantly shorter (P = 0.002) for those in the remote follow-up group (3.3 days vs. 4.0 days) and was shorter both for patients with ICD (3.0 days vs. 3.6 days) and CRT (3.8 days vs. 4.7 days) implants. The mortality rate between the study arms was not significantly different between the follow-up groups for the ICDs (P = 0.31) or the CRT devices with defribillator (P = 0.46). Conclusions There is limited clinical trial information on the effectiveness of RMSs for PMs. However, for RMSs for ICD devices, multiple cohort studies and 2 large multicenter RCTs demonstrated feasibility and significant reductions in in-office clinic follow-ups with RMSs in the first year post implantation. The detection rates of clinically significant events (and asymptomatic events) were higher, and the time to a clinical decision for these events was significantly shorter, in the remote follow-up groups than in the in-office follow-up groups. The earlier detection of clinical events in the remote follow-up groups, however, was not associated with lower morbidity or mortality rates in the 1-year follow-up. The substitution of almost all the first year in-office clinic follow-ups with RM was also not associated with an increased health care utilization such as emergency department visits or hospitalizations. The follow-up in the trials was generally short-term, up to 1 year, and was a more limited assessment of potential longer term device/lead integrity complications or issues. None of the studies compared the different RMSs, particularly the different RMSs involving patient-scheduled transmissions or automatic transmissions. Patients’ acceptance of and satisfaction with RM were reported to be high, but the impact of RM on patients’ health-related quality of life, particularly the psychological aspects, was not evaluated thoroughly. Patients who are not technologically competent, having hearing or other physical/mental impairments, were identified as potentially disadvantaged with remote surveillance. Cohort studies consistently identified subgroups of patients who preferred in-office follow-up. The evaluation of costs and workflow impact to the health care system were evaluated in European or American clinical settings, and only in a limited way. Internet-based device-assisted RMSs involve a new approach to monitoring patients, their disease progression, and their CIEDs. Remote monitoring also has the potential to improve the current postmarket surveillance systems of evolving CIEDs and their ongoing hardware and software modifications. At this point, however, there is insufficient information to evaluate the overall impact to the health care system, although the time saving and convenience to patients and physicians associated with a substitution of in-office follow-up by RM is more certain. The broader issues surrounding infrastructure, impacts on existing clinical care systems, and regulatory concerns need to be considered for the implementation of Internet-based RMSs in jurisdictions involving different clinical practices. PMID:23074419

The impact of follow-up type and missed deaths on population-based cancer survival studies for Hispanics and Asians.

PubMed

Pinheiro, Paulo S; Morris, Cyllene R; Liu, Lihua; Bungum, Timothy J; Altekruse, Sean F

2014-11-01

The accuracy of cancer survival statistics relies on the quality of death linkages and follow-up information collected by population-based cancer registries. Methodological issues on survival data by race-ethnicity in the United States, in particular for Hispanics and Asians, have not been well studied and may undermine our understanding of survival disparities. Based on Surveillance, Epidemiology, and End Results (SEER)-18 data, we analyzed existing biases in survival statistics when comparing the four largest racial-ethnic groups in the United States, whites, blacks, Hispanics and Asians. We compared the "reported alive" method for calculation of survival, which is appropriate when date of last alive contact is available for all cases, with the "presumed alive" method used when dates of last contact are unavailable. Cox regression was applied to calculate the likelihood of incomplete follow-up (those with less than 5 years of vital status information) according to racial-ethnic group and stage of diagnosis. Finally, potentially missed deaths were estimated based on the numbers of cases with incomplete follow-up for highly fatal cancers. The presumed alive method overestimated survival compared with the reported alive method by as much as 0.9-6.2 percentage points depending on the cancer site among Hispanics and by 0.4-2.7 percentage points among Asians. In SEER data, Hispanics and Asians are more likely to have incomplete follow-up than whites or blacks. The assumption of random censoring across race-ethnicity is not met, as among non-white cases, those who have a worse prognosis are more likely to have incomplete follow-up than those with a better prognosis (P < .05). Moreover, death ascertainment is not equal across racial-ethnic groups. Overall, 3% of cancer deaths were missed among Hispanics and Asians compared with less than 0.5% among blacks and whites. Cancer survival studies involving Hispanics and Asians should be interpreted with caution because the current available data overtly inflates survival in these populations. Censoring is clearly nonrandom across race-ethnicity meaning that findings of Hispanic and Asian survival advantages may be biased. Problematic death linkages among Hispanics and Asians contribute to missing deaths and overestimated survival. More complete follow-up with at least 5 years of information on vital status as well as improved death linkages will decisively increase the validity of survival estimates for these growing populations. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Flare-ups incidence and severity after using calcium hydroxide as intracanal dressing.

PubMed

Ghoddusi, Jamileh; Javidi, Maryam; Zarrabi, Mohammad Hasan; Bagheri, Hossein

2006-01-01

Acute pain and swelling following endodontic treatment are a challenge for both the patient and the dentist. According to previous studies, the incidence of flare-ups increases after endodontic treatment of teeth with necrotic pulps. Calcium hydroxide is currently used as a multi-purpose drug in root canal therapy. The aim of this study was to evaluate the incidence and severity of flare-ups after treatment of pulpless teeth using calcium hydroxide as an intracanal dressing. Sixty patients with single-root necrotic teeth participated in this study. These patients were randomly divided into three groups of 20. The patients were treated in Group A in a single-visit approach, in group B with a two-visit approach without any intracanal dressing and group C with a two-visit approach using calcium hydroxide as an intracanal dressing for one week. All of the patients were followed for 72 hours after each treatment session. The information about the incidence and severity of pain and swelling was recorded in tables, using a modified Visual Analogue Scale for pain severity measurement and a scale with four degrees for measuring the severity of swelling. The data were analyzed by chi-square test and GENMODE procedure.

Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior

PubMed Central

Shaw, Daniel S.; Connell, Arin; Dishion, Thomas J.; Wilson, Melvin N.; Gardner, Frances

2009-01-01

Maternal depression has been consistently linked to the development of child problem behavior, particularly in early childhood, but few studies have examined whether reductions in maternal depression serve as a mediator in relation to changes associated with a family-based intervention. The current study addressed this issue with a sample of 731 families receiving services from a national food supplement and nutrition program. Families with toddlers between ages 2 and 3 were sereened and then randomized to a brief family intervention, the Family Check-Up, which included linked interventions that were tailored and adapted to the families needs. Follow-up intervention services were provided at age 3 and follow-up of child outcomes oecurred at ages 3 and 4. Latent growth models revealed intervention effects for early externalizing and internalizing problems from 2 to 4, and reductions in maternal depression from ages 2 to 3. In addition, reductions in maternal depression mediated improvements in both child externalizing and internalizing problem behavior after accounting for the potential mediating effects of improvements in positive parenting. The results are discussed with respect to targeting maternal depression in future intervention studies aimed at improving early child problem behavior. PMID:19338691

Improving low-wage, midsized employers' health promotion practices: a randomized controlled trial.

PubMed

Hannon, Peggy A; Harris, Jeffrey R; Sopher, Carrie J; Kuniyuki, Alan; Ghosh, Donetta L; Henderson, Shelly; Martin, Diane P; Weaver, Marcia R; Williams, Barbara; Albano, Denise L; Meischke, Hendrika; Diehr, Paula; Lichiello, Patricia; Hammerback, Kristen E; Parks, Malcolm R; Forehand, Mark

2012-08-01

The Guide to Community Preventive Services (Community Guide) offers evidence-based intervention strategies to prevent chronic disease. The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center co-developed ACS Workplace Solutions (WPS) to improve workplaces' implementation of Community Guide strategies. To test the effectiveness of WPS for midsized employers in low-wage industries. Two-arm RCT; workplaces were randomized to receive WPS during the study (intervention group) or at the end of the study (delayed control group). Forty-eight midsized employers (100-999 workers) in King County WA. WPS provides employers one-on-one consulting with an ACS interventionist via three meetings at the workplace. The interventionist recommends best practices to adopt based on the workplace's current practices, provides implementation toolkits for the best practices the employer chooses to adopt, conducts a follow-up visit at 6 months, and provides technical assistance. Employers' implementation of 16 best practices (in the categories of insurance benefits, health-related policies, programs, tracking, and health communications) at baseline (June 2007-June 2008) and 15-month follow-up (October 2008-December 2009). Data were analyzed in 2010-2011. Intervention employers demonstrated greater improvement from baseline than control employers in two of the five best-practice categories; implementing policies (baseline scores: 39% program, 43% control; follow-up scores: 49% program, 45% control; p=0.013) and communications (baseline scores: 42% program, 44% control; follow-up scores: 76% program, 55% control; p=0.007). Total best-practice implementation improvement did not differ between study groups (baseline scores: 32% intervention, 37% control; follow-up scores: 39% intervention, 42% control; p=0.328). WPS improved employers' health-related policies and communications but did not improve insurance benefits design, programs, or tracking. Many employers were unable to modify insurance benefits and reported that the time and costs of implementing best practices were major barriers. This study is registered at clinicaltrials.gov NCT00452816. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

PubMed

Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

2014-01-01

The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

[Suicidal attempts in child and adolescent and bipolar disorders].

PubMed

Dugand, N; Thümmler, S; Pradier, C; Askenazy, F

2017-03-02

Child and adolescent psychiatrists are frequently confronted with suicide attempts and comorbid mood disorders. Diagnoses of juvenile bipolar disorders (BD) are rare and controversial and standardized assessment is helpful for a reliable diagnosis. The main objective of this study was to identify the number of juvenile bipolar disorder diagnoses according to DSM-5 criteria in a population of children and adolescents hospitalized for suicide attempts. Secondary objectives were the assessment of a patient's characteristics and the comparison of suicide attempt recurrence during 12 months of follow-up. This current practice study consecutively included children and adolescents aged 6 to 18 years and hospitalized for a suicide attempt in a French University Pediatric Hospital over a 4-month period. Patients were assessed at baseline, at 3 months and at 12 months. The standardized assessment was realized by the investigator using semi-structured interview K-SADS-PL (2013) to diagnose juvenile bipolar disorders based on DSM-5 criteria. Clinical diagnoses based on medical charts and according to ICD-10 criteria were also collected at 12-month follow-up. Standardized assessment was completed by the French validated K-SADS-PL (2004) for comorbidities (DSM-IV), dimensional assessment by MADRS-YMRS-ARI-C-SSR, and C-GAS at inclusion. Patients were divided into two groups: (1) those presenting juvenile bipolar disorder according to DSM 5 (BD+) and (2) those without criteria for bipolar disorder (BD-). Suicide risk factors and suicide attempt relapse were assessed at 3 and 12 months of follow-up. Twenty-six inpatients (22 female and 4 male) aged 14.5 years (SD 1,5) were consecutively included. Twenty patients were followed up during the 12-month period. At baseline, 5 patients (19.2 %) presented a diagnosis of BD (DSM-5): 1 BD type 2, 2 non specified BD, 2 cyclothymic disorders. According to the medical charts (ICD-10), none of the patients had been diagnosed with BD but had diagnoses of dysthymia, of borderline personality disorder and of conduct disorder corresponding to DMDD in 3, 2 and 1 patient respectively. During the 12-month follow-up, 9 patients of the BD- group and none of the BD+ presented recurrence of suicide attempt with 67 % during the first 3 months and 3 patients with multi-relapses. These 3 patients were female adolescents out of care and carrying at least three suicide risk factors. Six patients have been lost to follow-up (1 BD+, 5 BD-). In the BD+ group, 3 patients out of 4 had a persistent diagnosis (DSM-5) of BD at 12 months. In our adolescent population hospitalized for suicidal attempt, 19,2 % present BD using DSM-5 criteria. Diagnoses are stable during 12 months of follow-up, but under diagnosed in current clinical practice. DSM-5 standardized assessment appears to be very important to diagnose juvenile BD, mandatory for medium and long-term psychiatric follow-up, especially for suicide prevention and psychopharmacologic therapeutics. Nevertheless, no recurrence of suicide attempts has been observed in our BP+ group, contrary to BP-, possibly due the absence of BP 1 disorder. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Recall of Point-of-Sale Marketing Predicts Cigar and E-Cigarette Use among Texas Youth.

PubMed

Pasch, Keryn E; Nicksic, Nicole E; Opara, Samuel C; Jackson, Christian; Harrell, Melissa B; Perry, Cheryl L

2017-10-23

While research has documented associations between recall of point-of sale tobacco marketing and youth tobacco use, much of the research is cross-sectional and focused on cigarettes. The present longitudinal study examined recall of tobacco marketing at the point-of-sale and multiple types of tobacco use six months later. The Texas Adolescent Tobacco Advertising and Marketing Surveillance System (TATAMS) is a large-scale, representative study of 6th, 8th, and 10th graders in 79 middle and high schools in five counties in Texas. Weighted logistic regression examined associations between recall of tobacco advertisements and products on display at baseline and ever use, current use, and susceptibility to use for cigarette, e-cigarette, cigar, and smokeless products six months later. Students' recall of signs marketing e-cigarettes at baseline predicted ever e-cigarette use and increased susceptibility to use e-cigarettes at follow-up across all store types. Recall of e-cigarette displays only predicted susceptibility to use e-cigarettes at follow-up, across all store types. Both recall of signs marketing cigars and cigar product displays predicted current and ever cigar smoking and increased susceptibility to smoking cigars at follow-up, across all store types. Recall of cigarette and smokeless product marketing and displays was not associated with tobacco use measures. The point-of-sale environment continues to be an important influence on youth tobacco use. Restrictions on point-of-sale marketing, particularly around schools, are warranted. Cross-sectional studies have shown that exposure to point-of-sale cigarette marketing is associated with use of cigarettes among youth, though longitudinal evidence of the same is sparse and mixed. Cross-sectional studies have found that recall of cigars, smokeless product, and e-cigarette tobacco marketing at point-of-sale is associated with curiosity about tobacco use or intentions to use tobacco among youth, but limited longitudinal research has been conducted. Findings from the present longitudinal study suggest that recall of tobacco marketing at retail point-of-sale predicts ever use of e-cigarettes and cigars, current use of cigars, and susceptibility to cigar and e-cigarette use among youth. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Thermocathode radio-frequency gun for the Budker Institute of Nuclear Physics free-electron laser

NASA Astrophysics Data System (ADS)

Volkov, V.; Getmanov, Ya.; Kenjebulatov, E.; Kolobanov, E.; Krutikhin, S.; Kurkin, G.; Ovchar, V.; Petrov, V. M.; Sedlyarov, I.

2016-12-01

A radio-frequency (RF) gun for a race-track microtron-recuperator injector driving the free-electron laser (FEL) (Budker Institute of Nuclear Physics) is being tested at a special stand. Electron bunches of the RF gun have an energy of up to 300 keV and a repetition rate of up to 90 MHz. The average electro-beam current can reach 100 mA in the continuous operation regime. The advantages of the new injector are as follows: long lifetime of the cathode for high average beam current; simple scheme of longitudinal beam bunching, which does not require an additional bunching resonator in the injector; absence of dark-current contamination of the injector beam; and comfortable RF gun operation due to the absence of a high potential of 300 kV at the cathode control circuits. In this study we describe the RF gun design, present the main characteristics of the injector with the RF gun, and give the results of testing.

Behavioral Interventions to Prevent or Delay Dementia: Protocol for a Randomized Comparative Effectiveness Study

PubMed Central

Chandler, Melanie; Locke, Dona EC; Fields, Julie; Phatak, Vaishali; Crook, Julia; Hanna, Sherrie; Lunde, Angela; Morris, Miranda; Graff-Radford, Michelle; Hughes, Christine A; Lepore, Susan; Cuc, Andrea; Caselli, Maria; Hurst, Duane; Wethe, Jennifer; Francone, Andrea; Eilertsen, Jeanne; Lucas, Pauline; Hoffman Snyder, Charlene; Kuang, LeeAnn; Becker, Marigrace; Dean, Pamela; Diehl, Nancy; Lofquist, Marvin; Vanderhook, Shirley; Myles, Diana; Cochran, Denise

2017-01-01

Background Currently, people at risk for dementia and their caregivers are confronted with confusing choices about what behavioral interventions are most effective. Objective The objective of this study is to determine which empirically supported behavioral interventions most impact the outcomes highly valued by patients with mild cognitive impairment and their partners. Methods This protocol describes a comparative effectiveness trial targeting 300 participants with mild cognitive impairment and their study partners. The trial is being conducted at the Mayo Clinic campuses in Arizona, Florida, Minnesota, and the University of Washington in Seattle. The study examines the contribution of five behavioral interventions (yoga, memory compensation training, computerized cognitive training, support groups, and wellness education) on primary outcomes of participant and partner quality of life and self-efficacy. In this unique 10-day multicomponent intervention, groups of couples were randomized to have one of the five interventions withheld while receiving the other four. Although the longitudinal follow-up is still under way, enrollment results are available and reported. Results In total, 272 couples have been enrolled in the trial and follow-up visits continue. Outcomes will be assessed at the end-of-intervention and 6-, 12-, and 18-month follow-ups. We anticipate reporting on our primary and secondary outcomes across time points in the next 2 years. Conclusions This paper describes the protocol for a randomized comparative effectiveness study of behavioral interventions to prevent or delay dementia. We describe of the rationale, design, power analysis, and analysis plan. Also because enrollment is complete and we are in follow-up phases of the study, we have included enrollment data from the trial. Trial Registration  ClinicalTrials.gov NCT02265757; http://clinicaltrials.gov/ctsshow/ NCT02265757 (Archived by WebCite at http://www.webcitation.org/6ueRfwSYv) PMID:29180344

Response of imported malaria patients to antimalarial medicines in Sri Lanka following malaria elimination.

PubMed

Dharmawardena, Priyani; Rodrigo, Chaturaka; Mendis, Kamini; de A W Gunasekera, W M Kumudu T; Premaratne, Risintha; Ringwald, Pascal; Fernando, Deepika

2017-01-01

After eliminating local malaria transmission and being certified as a malaria-free country, Sri Lanka is facing the challenge of imported malaria. At the same time, the country has the unique opportunity to be a case study for other countries in a similar situation by approaching this issue systematically, guided by evidence. This study demonstrates the importance of developing a mechanism to detect imported malaria and adopting an evidence-based approach to study the resistance of imported malaria to anti-malarial medicines. This is a prospective study of patients diagnosed with imported malaria in Sri Lanka and treated according to the national treatment guidelines, over 24 months (2015/2016). The clinical features, time to diagnosis, origin of the infection, infecting species, parasite density and the treatment given were recorded. All patients were followed up for 28 days, and in the case of Plasmodium vivax and P. ovale infections, the follow up period was extended to 12 months to establish treatment failures and relapses. Fifty nine uncomplicated and 15 severe imported malaria cases were reported in Sri Lanka during the study period. Most of these infections originated in either Sub-Saharan Africa or South and Southeast Asia. Having a P. vivax infection and low parasitic counts were significantly associated with relative diagnostic delay. One of the 14 uncomplicated P. falciparum patients and two of the 12 severe P. falciparum malaria patients who were followed up till day 28 had a late clinical failure. The others responded adequately to treatment both clinically and parasitologically. There was no treatment failure reported amongst any other species. This study, which is the first to assess the therapeutic response of imported malaria in Sri Lanka after elimination, demonstrates that the current antimalarial treatment policies and strategies in Sri Lanka have been effective against infections acquired overseas up until the end of year 2016.

Effects of EAP follow-up on prevention of relapse among substance abuse clients.

PubMed

Foote, A; Erfurt, J C

1991-05-01

Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

Reported Changes in Dietary Behavior Following a First Clinical Diagnosis of Central Nervous System Demyelination.

PubMed

Russell, Rebecca D; Lucas, Robyn M; Brennan, Vanessa; Sherriff, Jill L; Begley, Andrea; Black, Lucinda J

2018-01-01

Although the current evidence is insufficient to recommend a special diet for people with multiple sclerosis (MS), dietary advice for people with MS is prolific online and in the media. This study aimed to describe dietary changes made in the year following a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. We used follow-up data from the Ausimmune Study, a multicentre matched case-control study examining the environmental risk factors for a FCD. A total of 244 cases (60 male, 184 female) completed a 1-year follow-up interview, which included a question about dietary changes. We described the number and proportion (%) of participants who reported making dietary changes and the type of change made. We investigated independent predictors of making a dietary change using a multivariable logistic regression model. A total of 38% ( n  = 92) of participants at the 1-year follow-up reported making at least one dietary change over the last year. There were no statistically significant independent associations between any participant characteristic and odds of making a dietary change. Of those who made at least one dietary change, the most common changes were increasing fruit and/or vegetable intake (27%, n  = 25) and following a low-fat diet (25%, n  = 23). A considerable proportion of the study population reported making at least one dietary change in the year following a FCD, with the majority of changes being toward a healthier diet. Further research is warranted to investigate the reasons behind any dietary changes adopted by people with a FCD or with MS, and whether making a dietary change has benefits for the progression of demyelinating diseases, e.g., to a diagnosis of MS, as well as for general health and well-being.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOLLOW UP QUESTIONNAIRE (UA-D-11.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data...

Porcine dermis implants in soft-tissue reconstruction: current status

PubMed Central

Smart, Neil J; Bryan, Nicholas; Hunt, John A; Daniels, Ian R

2014-01-01

Soft-tissue reconstruction for a variety of surgical conditions, such as abdominal wall hernia or pelvic organ prolapse, remains a challenge. There are numerous meshes available that may be simply categorized as either synthetic or biologic. Within biologic meshes, porcine dermal meshes have come to dominate the market. This review examines the current evidence for their use and the limitations of knowledge. Although there is increasing evidence to support their safety, long-term follow-up studies that support their efficacy are lacking. Numerous clinical trials that remain ongoing may help elucidate their precise role in soft-tissue reconstruction. PMID:24648721

Practice status of specialized agencies for occupational health management of small- to medium-size enterprises and the factors improving their performance: a cross-sectional survey study.

PubMed

Lee, Saerom; Myong, Jun-Pyo; Kim, Eun-A; Eom, Huisu; Choi, Bowha; Kang, Young Joong

2017-01-01

We examined the current status of specialized agencies for occupational health management (SAs) and their workforce. Furthermore, we aimed to clarify the current practice status of SA healthcare professionals and factors that influence their performance. To examine the current SA workforce, we analyzed data from the 2014 Survey of Current Status of SA and their Workforce from the Ministry of Employment and Labor (MOEL). Furthermore, we mailed out an original questionnaire to SA professionals to determine their current health management status and factors that affect their performance. Data from the respondents ( N  = 384) were analyzed. In 2014, the workforce performing health management in SAs comprised 232 physicians, 507 nurses, and 312 occupational hygienists, with no significant regional differences in the distribution of physicians and nurses. According to the findings of the questionnaire, the average daily number of worker consultations by physicians and nurses was 22.8, while the average time taken for health management ranged from 74.3 to 104.3 min, depending on the size of the firm. Most of the respondents (41.5%) answered that they were following-up on more than 80% of individuals with illnesses. Among health management tasks, performance scores of "consultations for general diseases" and "consultations for lifestyle habits" were relatively high, whereas health promotion activities at workplaces were relatively low. There was a significant correlation between the utilization of general and special health examination results and task performance. Among health management tasks, follow-up management of individuals with illnesses and consultations for disease/lifestyle habits were relatively well performed, whereas health promotion activities at workplaces were not performed well. Among factors that positively influenced SA performance at workplaces, only the utilization of health examination results had significant effects. Therefore, to accomplish health management goals and perform effective health management at workplaces, there is a need to establish a comprehensive system of occupational health service outsourcing integrating health examinations and health management services. Furthermore, the current task system, which focuses on follow-up management, should be expanded to incorporate preventive and health promotion functions-the fundamental functions of occupational health services (OHS).

Hormone replacement therapy is not associated with an increased risk of leukemia (United States).

PubMed

Ross, Julie A; Sinner, Penny J; Blair, Cindy K; Cerhan, James R; Folsom, Aaron R

2005-06-01

Recent studies have reported an increased risk of certain cancers associated with hormone replacement therapy (HRT), possibly due to stimulation of estrogen receptors. Since estrogen receptors are expressed on certain hematopoietic cells, it is possible that HRT use may also increase the risk of leukemia. A cohort of 37,172 post-menopausal Iowa women ages 55-69 years with no history of prior cancer was linked annually to the population-based state cancer registry through 2001. In addition to other self-reported cancer risk factors, participants were asked about current and former use of HRT in 1986 and on four subsequent follow-up questionnaires. A total of 201 cases of leukemia were identified over 16 years of follow-up including 74 acute myeloid leukemias (AMLs) and 87 chronic lymphocytic leukemias (CLLs). Compared to never users of HRT at study baseline, current [multivariate relative risk (RR), 1.09; 95% confidence interval (CI) 0.70-1.71)] and former users (RR=0.82, 95% CI=0.59-1.15) were at no increased risk of developing leukemia. For AML, current users also had no increased risk (RR=0.83, 95% CI=0.37-1.84) and there was a suggestion that former users had a slightly decreased risk (RR=0.66, 95% CI=0.37-1.17). For CLL, all RRs were around unity. We conclude that HRT is unlikely to be an appreciable risk factor for leukemia.

Swift and RXTE follow up observations of the transient currently active in the globular cluster Terzan 5

NASA Astrophysics Data System (ADS)

Altamirano, D.; Degenaar, N.; Heinke, C. O.; Homan, J.; Pooley, D.; Sivakoff, G. R.; Wijnands, R.

2011-10-01

Following the detection of an X-ray outburst in the direction of Terzan 5 (ATEL #3714), we obtained a Swift observation and additional RXTE observations. The XRT aboard Swift observed Terzan 5 on Oct. 26, 2011 in imaging mode for a total exposure time of 967 s. The source was detected at high count rates causing significant pile-up (the core is saturated), and a bad column intersects the point-spread function.

Spinal Cystic Echinococcosis – A Systematic Analysis and Review of the Literature: Part 2. Treatment, Follow-up and Outcome

PubMed Central

Neumayr, Andreas; Tamarozzi, Francesca; Goblirsch, Sam; Blum, Johannes; Brunetti, Enrico

2013-01-01

Bone involvement in human cystic echinococcosis (CE) is rare, but affects the spine in approximately 50% of cases. Despite significant advances in diagnostic imaging techniques, surgical treatment and introduction of pharmacological therapy, spinal echinococcosis remains associated with a high degree of morbidity, disability and mortality. We systematically reviewed the published literature of the last five decades to update and summarize the currently existing data on treatment, follow-up and outcome of spinal CE. PMID:24069501

Update on current care guideline: Cytological changes in the cervix, vagina and vulva.

PubMed

Annually approximately 160 new cervical cancers are diagnosed in Finland. Screening has decreased both incidence and mortality by 80%. Both primary HPV-testing and Pap smear can be used in screening. In the future HPV vaccination will decrease the number of cervical cancers. Abnormal findings in Pap smears indicate management. LSIL lesions are followed up especially among young women and HSIL lesions treated. Follow-up after treatment should be reliably arranged, because increased risk of cancer remains ever after treatment.

Exercise as an Intervention to Reduce Study-Related Fatigue among University Students: A Two-Arm Parallel Randomized Controlled Trial.

PubMed

de Vries, Juriena D; van Hooff, Madelon L M; Geurts, Sabine A E; Kompier, Michiel A J

2016-01-01

Many university students experience high levels of study-related fatigue. This high prevalence, and the negative impact of fatigue on health and academic performance, call for prevention and reduction of these symptoms. The primary aim of the current study was to investigate to what extent an exercise intervention is effective in reducing three indicators of study-related fatigue (emotional exhaustion, overall fatigue, and need for recovery). Effects of exercise on secondary outcomes (sleep quality, self-efficacy, physical fitness, and cognitive functioning) were also investigated. Participants were students with high levels of study-related fatigue, currently not exercising or receiving other psychological or pharmacological treatments, and with no medical cause of fatigue. They were randomly assigned to either a six-week exercise intervention (low-intensity running three times a week, n = 49) or wait list (no intervention, n = 48). All participants were measured before the intervention (T0), and immediately after the intervention (T1). Exercisers were also investigated 4 weeks (T2) and 12 weeks (T3) after the intervention. Participants in the exercise condition showed a larger decrease in two of the three indicators of study-related fatigue (i.e., overall fatigue and need for recovery) as compared to controls. Additionally, sleep quality and some indicators of cognitive functioning improved more among exercisers than among controls. No effects were found for self-efficacy, and physical fitness. The initial effects of the exercise intervention lasted at follow-up (T2 and T3). At 12-week follow up (T3), 80% of participants in the exercise condition still engaged in regular exercise, and further enhancements were seen for emotional exhaustion, overall fatigue, and sleep quality. These results underline the value of low-intensity exercise for university students with high levels of study-related fatigue. The follow-up effects that were found in this study imply that the intervention has the potential to promote regular exercise and accompanying beneficial effects in the longer run. Netherlands Trial Register NTR4412.

Longitudinal relations between children's exposure to TV violence and their aggressive and violent behavior in young adulthood: 1977-1992.

PubMed

Huesmann, L Rowell; Moise-Titus, Jessica; Podolski, Cheryl-Lynn; Eron, Leonard D

2003-03-01

Although the relation between TV-violence viewing and aggression in childhood has been clearly demonstrated, only a few studies have examined this relation from childhood to adulthood, and these studies of children growing up in the 1960s reported significant relations only for boys. The current study examines the longitudinal relations between TV-violence viewing at ages 6 to 10 and adult aggressive behavior about 15 years later for a sample growing up in the 1970s and 1980s. Follow-up archival data (N = 450) and interview data (N = 329) reveal that childhood exposure to media violence predicts young adult aggressive behavior for both males and females. Identification with aggressive TV characters and perceived realism of TV violence also predict later aggression. These relations persist even when the effects of socioeconomic status, intellectual ability, and a variety of parenting factors are controlled.

Biological Stress Systems, Adverse Life Events, and the Improvement of Chronic Multisite Musculoskeletal Pain Across a 6-Year Follow-Up.

PubMed

Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Dekker, Joost; Penninx, Brenda W J H

2017-02-01

Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1) function of biological stress systems, 2) adverse life events, and 3) their combination predict the improvement of chronic multisite musculoskeletal pain. Subjects of the Netherlands Study of Depression and Anxiety (NESDA) with chronic multisite musculoskeletal pain at baseline (N = 665) were followed-up 2, 4, and 6 years later. The Chronic Pain Grade Questionnaire was used to determine improvement (not meeting the criteria) of chronic multisite musculoskeletal pain at follow-up. Baseline assessment of biological stress systems included function of hypothalamic-pituitary-adrenal axis (1-hour cortisol awakening response, evening level, and post dexamethasone level), the immune system (basal and lipopolysaccharide-stimulated inflammatory markers), the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, and respiratory sinus arrhythmia). The number of adverse life events were assessed at baseline and 2-year follow-up using the List of Threatening Events Questionnaire. We showed that hypothalamic-pituitary-adrenal axis, immune system, and autonomic nervous system functioning and adverse life events were not associated with the improvement of chronic multisite musculoskeletal pain, either as a main effect or in interaction. This longitudinal study could not confirm that biological stress system dysfunction and adverse life events affect the course of chronic multisite musculoskeletal pain. Biological stress systems and adverse life events are not associated with the improvement of chronic multisite musculoskeletal pain over 6 years of follow-up. Other determinants should thus be considered in future research to identify in which persons pain symptoms will improve. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time?

PubMed

Husson, Olga; Zebrack, Bradley J; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve

2017-07-15

The objective of the current study was to examine social functioning among adolescents and young adults (AYAs) within the first 2 years after a cancer diagnosis and compare their scores with population norms and identify trajectories of social functioning over time and its correlates. A multicenter, longitudinal study was conducted among 215 AYA patients with cancer aged 14 to 39 years. A total of 141 patients completed a self-report measure of social functioning within the first 4 months of diagnosis and again at 12 months and 24 months later. AYA patients with cancer were found to have significantly worse social functioning scores around the time of diagnosis (52.0 vs 85.1; P<.001), at the 12-month follow-up (73.1 vs 85.1; P<.001), and at the 24-month follow-up (69.2 vs 85.1; P<.001) when compared with population norms. Significant improvements in social functioning from baseline to the 12-month follow-up were observed; however, social functioning levels remained stable thereafter. Among participants, 9% demonstrated consistently high/normal social functioning, 47% demonstrated improved social functioning, 13% were found to have worsening social functioning, and 32% demonstrated consistently low social functioning. AYA patients with cancer who had consistently low social functioning were more often off treatment at the time of follow-up, reported more physical symptoms and higher levels of distress at baseline and follow-up, and perceived less social support at baseline compared with the other 3 groups. Although improved over time, social functioning still was found to be compromised 24 months after the primary diagnosis. Nearly one-third of these patients remain at risk of poor social functioning. Reducing physical symptoms and psychological distress and enhancing social support by interventions during the period after treatment may potentially help these young survivors to better reintegrate into society. Cancer 2017;123:2743-51. © 2017 American Cancer Society. © 2017 American Cancer Society.

Pituitary and/or hypothalamic dysfunction following moderate to severe traumatic brain injury: Current perspectives

PubMed Central

Javed, Zeeshan; Qamar, Unaiza; Sathyapalan, Thozhukat

2015-01-01

There is an increasing deliberation regarding hypopituitarism following traumatic brain injury (TBI) and recent data have suggested that pituitary dysfunction is very common among survivors of patients having moderate-severe TBI which may evolve or resolve over time. Due to high prevalence of pituitary dysfunction after moderate-severe TBI and its association with increased morbidity and poor recovery and the fact that it can be easily treated with hormone replacement, it has been suggested that early detection and treatment is necessary to prevent long-term neurological consequences. The cause of pituitary dysfunction after TBI is still not well understood, but evidence suggests few possible primary and secondary causes. Results of recent studies focusing on the incidence of hypopituitarism in the acute and chronic phases after TBI are varied in terms of severity and time of occurrence. Although the literature available does not show consistent values and there is difference in study parameters and diagnostic tests used, it is clear that pituitary dysfunction is very common after moderate to severe TBI and patients should be carefully monitored. The exact timing of development cannot be predicted but has suggested regular assessment of pituitary function up to 1 year after TBI. In this narrative review, we aim to explore the current evidence available regarding the incidence of pituitary dysfunction in acute and chronic phase post-TBI and recommendations for screening and follow-up in these patients. We will also focus light over areas in this field worthy of further investigation. PMID:26693424

Effects of Multisystemic Therapy through Midlife: A 21.9-Year Follow-Up to a Randomized Clinical Trial with Serious and Violent Juvenile Offenders

ERIC Educational Resources Information Center

Sawyer, Aaron M.; Borduin, Charles M.

2011-01-01

Objective: Although current evidence suggests that the positive effects of multisystemic therapy (MST) on serious crime reach as far as young adulthood, the longer term impact of MST on criminal and noncriminal outcomes in midlife has not been evaluated. In the present study, the authors examined a broad range of criminal and civil court outcomes…

Spouses/Family Members of Service Members at Risk for PTSD or Suicide

DTIC Science & Technology

2015-10-01

are experiencing symptoms of PTSD or severe depression . The study is multi-method, with an initial qualitative phase (Phase 1), and a follow-up...Unfortunately, spouses of service members or veterans with symptoms of PTSD or depression have significantly elevated levels of psychological and... depression experience significant distress, but there currently are almost no empirical data about relatives other than spouses or children. Based on

EMCS Installation Follow-Up Study. Volume 2.

DTIC Science & Technology

1984-03-01

softwaLe is currently being developed by Power;. 4. The system includc;s an equation processor which p~ovi,.’ arithmetic, logicaL, and timing...packages are actually written using the equation processor. 5. The system colorgraphics capability was demonstrated. The system can be operated...extremely important. The AsteroAI drawings were reviewed by the Navy only on a cursory basis. This proved to be inad- equate . 15. The specifications

Is the Grass Greener? Current and Former Music Teachers' Perceptions a Year after Moving to a Different School or Leaving the Classroom

ERIC Educational Resources Information Center

Hancock, Carl B.

2016-01-01

This study is the fourth in a series investigating the retention and turnover of music teachers using nationally representative data from the National Center for Educational Statistics. I identified records for music teachers in the Teacher Follow-Up Survey and determined how they viewed their careers one year after moving to a different school or…

The preliminary analysis of the reliability and validity of the Chinese Edition of the CSBS DP.

PubMed

Lin, Chu-Sui; Chang, Shu-Hui; Cheng, Shu-Fen; Chao, Pen-Chiang; Chiu, Chun-Hao

2015-03-01

This study marked a preliminary attempt to standardize the Chinese Edition of the Communication and Symbolic Behavior Scales Developmental Profile (Wetherby & Prizant, 2002; CSBS DP) to assist in the early identification of young children with special needs in Taiwan. The study was conducted among 171 infants and toddlers aged 1-2. It also included a follow-up study one year after the initial test. Three domestically developed standardized child development inventories were used to measure the concurrent validity and predictive validity. The Chinese Edition of the CSBS DP demonstrated overall good test-retest and inter-rater reliability. It also showed good concurrent and predictive validity. The current study yields preliminary evidence that the Chinese Edition of the CSBS DP could be a valuable assessment tool worthy of wider distribution. Future research should employ random sampling to establish a true national norm. Additionally, the follow-up study needs to include atypical groups and to expand to children aged 6-12 months to strengthen the applicability of the instrument in Taiwan. Copyright © 2014 Elsevier Ltd. All rights reserved.

Facebook: an effective tool for participant retention in longitudinal research.

PubMed

Mychasiuk, R; Benzies, K

2012-09-01

Facebook is currently one of the world's most visited websites, and home to millions of users who access their accounts on a regular basis. Owing to the website's ease of accessibility and free service, demographic characteristics of users span all domains. As such, Facebook may be a valuable tool for locating and communicating with participants in longitudinal research studies. This article outlines the benefit gained in a longitudinal follow-up study, of an intervention programme for at-risk families, through the use of Facebook as a search engine. Using Facebook as a resource, we were able to locate 19 participants that were otherwise 'lost' to follow-up, decreasing attrition in our study by 16%. Additionally, analysis indicated that hard-to-reach participants located with Facebook differed significantly on measures of receptive language and self-esteem when compared to their easier-to-locate counterparts. These results suggest that Facebook is an effective means of improving participant retention in a longitudinal intervention study and may help improve study validity by reaching participants that contribute differing results. © 2011 Blackwell Publishing Ltd.