Sample records for endoleak prevention preliminary

  1. Prophylactic Residual Aneurysmal Sac Embolization with Expandable Hydrogel Embolic Devices for Endoleak Prevention: Preliminary Study in Dogs

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

    Hiraki, Takao; Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu; Uchida, Barry T.

    2005-05-15

    Objective. To explore the feasibility and efficacy of residual aneurysmal sac (RAS) embolization with the expandable hydrogel embolic device (EHED) in prevention of endoleaks in a surgically created and endoluminally treated abdominal aortic aneurysm (AAA). Methods. In eight dogs, an AAA was created by means of side-to-side anastomosis between the infrarenal abdominal aorta and inferior vena cava (IVC) with ligation of the IVC above and below the anastomotic end, followed by deployment of an endograft with holes. The RAS was then embolized with the EHED. One animal was killed immediately after RAS embolization and one animal died 12 hr aftermore » the procedure. Follow-up aortograms were obtained in six animals after 1 day (1 animal), 2 weeks and 6 months (1 animal), and 8 weeks (4 animals). Results. Four animals had no endoleaks on the follow-up aortograms. The remaining two animals with incomplete RAS embolization had moderate type III endoleaks. Type I or II endoleaks were not seen in any animals. Complications included RAS wall penetration by the devices with platinum wires in two animals (nos. 1 and 2), device migration into an aortic circulation through the endograft holes in two animals (nos. 2 and 3) or through distal interstices between the aortic wall and endograft in one animal (no. 8), aortic occlusion in three animals (nos. 3, 7, and 8), and RAS rupture in one animal (no. 7). Histologic examination showed expanded hydrogels occupying the RAS with associated mature or immature organized thrombus, fibrinous thrombus, or degenerate blood cells. Conclusion. RAS embolization was feasible with the EHED, although additional modifications to the device are required to avoid complications. Angiographic and histologic results suggested that RAS embolization with the EHED may help in the prevention of endoleaks.« less

  2. Chitosan-doxycycline hydrogel: An MMP inhibitor/sclerosing embolizing agent as a new approach to endoleak prevention and treatment after endovascular aneurysm repair.

    PubMed

    Zehtabi, Fatemeh; Ispas-Szabo, Pompilia; Djerir, Djahida; Sivakumaran, Lojan; Annabi, Borhane; Soulez, Gilles; Mateescu, Mircea Alexandru; Lerouge, Sophie

    2017-12-01

    The success of endovascular repair of abdominal aortic aneurysms remains limited due to the development of endoleaks. Sac embolization has been proposed to manage endoleaks, but current embolizing materials are associated with frequent recurrence. An injectable agent that combines vascular occlusion and sclerosing properties has demonstrated promise for the treatment of endoleaks. Moreover, the inhibition of aneurysmal wall degradation via matrix metalloproteinases (MMPs) may further prevent aneurysm progression. Thus, an embolization agent that promotes occlusion, MMP inhibition and endothelial ablation was hypothesized to provide a multi-faceted approach for endoleak treatment. In this study, an injectable, occlusive chitosan (CH) hydrogel containing doxycycline (DOX)-a sclerosant and MMP inhibitor-was developed. Several CH-DOX hydrogel formulations were characterized for their mechanical and sclerosing properties, injectability, DOX release rate, and MMP inhibition. An optimized formulation was assessed for its short-term ability to occlude blood vessels in vivo. All formulations were injectable and gelled rapidly at body temperature. Only hydrogels prepared with 0.075M sodium bicarbonate and 0.08M phosphate buffer as the gelling agent presented sufficient mechanical properties to immediately impede physiological flow. DOX release from this gel was in a two-stage pattern: a burst release followed by a slow continuous release. Released DOX was bioactive and able to inhibit MMP-2 activity in human glioblastoma cells. Preliminary in vivo testing in pig renal arteries showed immediate and delayed embolization success of 96% and 86%, respectively. Altogether, CH-DOX hydrogels appear to be promising new multifunctional embolic agents for the treatment of endoleaks. An injectable embolizing chitosan hydrogel releasing doxycycline (DOX) was developed as the first multi-faceted approach for the occlusion of blood vessels. It combines occlusive properties with DOX

  3. Aneurysm Shrinkage Is Compatible With Massive Endoleak in the Presence of an Aortocaval Fistula: Potential Therapeutic Implications for Endoleaks and Spinal Cord Ischemia.

    PubMed

    Sveinsson, Magnus; Sonesson, Björn; Resch, Timothy A; Dias, Nuno V; Holst, Jan; Malina, Martin

    2016-06-01

    To present a patient with ruptured abdominal aortic aneurysm (AAA) and aortocaval fistula who was successfully treated with endovascular aneurysm repair in spite of developing a massive endoleak. A 70-year-old man with ruptured AAA and aortocaval fistula was treated with endovascular aneurysm repair (EVAR). During 8 years of follow-up, he had massive perfusion of the aneurysm sac by retrograde flow from the inferior mesenteric artery into the caval vein through the aortocaval fistula. The aneurysm diameter decreased continuously in spite of the type II endoleak. This observation illustrates the mechanisms of sac expansion and may have therapeutic implications for complicated type II endoleaks and prevention of spinal cord ischemia in thoracic stent-grafting. EVAR can be applied in this rare setting because the ensuing high-flow endoleak is associated with sac shrinkage owing to depressurization by the caval shunt. © The Author(s) 2016.

  4. Outcomes of persistent intraoperative type Ia endoleak after standard endovascular aneurysm repair.

    PubMed

    Millen, Alistair M; Osman, Khabab; Antoniou, George A; McWilliams, Richard G; Brennan, John A; Fisher, Robert K

    2015-05-01

    This study analyzed outcomes for patients with persistent intraoperative type Ia endoleaks after standard endovascular aneurysm repair (EVAR). The study group was identified from a consecutive cohort of 209 patients undergoing EVAR in a tertiary center in the United Kingdom during a 2-year period. Data prospectively collected on departmental computerized databases were retrospectively analyzed. Primary outcome parameters were defined as freedom from type Ia endoleak, EVAR-related reintervention, aneurysm rupture, and aneurysm-related mortality. A completion angiogram identified 44 patients (21%) as having a type Ia endoleak, and 33 (75%) had a persistent endoleak after intraoperative adjunctive procedures, including repeated balloon moulding, aortic cuff extension, and Palmaz stent (Cordis, Miami Lakes, Fla) deployment. In the 11 patients (25%) whose endoleak was successfully abolished intraoperatively, there was no recurrence of type Ia endoleak or secondary intervention to treat type 1a endoleak during a median follow-up period of 27 months. Of the 33 patients with persistent endoleak, 31 (94%) demonstrated resolution of the endoleak on first surveillance computed tomography angiography. One patient was lost to follow-up. Embolization of the endoleak in another patient was successful using Onyx (Micro Therapeutics, Inc, Irvine, Calif) 8 days after the initial procedure. No type Ia endoleak was identified after this on any surveillance imaging, and the patient was alive 28 months later with a stable aneurysm size. In the rest of the patients, no recurrence of the endoleak in any subsequent imaging was noticed, and no secondary intervention was required during follow-up. No aneurysm-related deaths occurred, and 91% of the patients had a stable or shrinking aneurysm. Despite adjunctive intraoperative maneuvers, persistent type Ia endoleaks can be relatively common. Our study indicates that they may be observed in selected patients. Further research is required to

  5. Type II Endoleak After Endovascular Repair of Abdominal Aortic Aneurysm: Effectiveness of Embolization

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

    Nevala, Terhi, E-mail: Terhi.Nevala@ppshp.f; Biancari, Fausto; Manninen, Hannu

    2010-04-15

    The purpose of this study was to report our experience in treating type II endoleaks after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. Two hundred eighteen patients underwent EVAR with a Zenith stent-graft from January 2000 to December 2005. During a follow-up period of 4.5 {+-} 2.3 years, solely type II endoleak was detected in 47 patients (22%), and 14 of them underwent secondary interventions to correct this condition. Ten patients had transarterial embolization, and four patients had translumbar/transabdominal embolization. The embolization materials used were coils, thrombin, gelatin, Onyx (ethylene-vinyl alcohol copolymer), and glue. Disappearance of the endoleak withoutmore » enlargement of the aneurysm sac after the first secondary intervention was achieved in only five of these patients (5/13). One patient without surveillance imaging was excluded from analyses of clinical success. After additional interventions in four patients and the spontaneous disappearance of type II endoleak in two patients, overall clinical success was achieved in eight patients (8/12). One patient did not have surveillance imaging after the second secondary intervention. Clinical success after the first secondary intervention was achieved in two patients (2/9) in the transarterial embolization group and three patients (3/4) in the translumbar embolization group. The results of secondary interventions for type II endoleak are unsatisfactory. Although the small number of patients included in this study prevents reliable comparisons between groups, the results seem to favor direct translumbar embolization in comparison to transarterial embolization.« less

  6. Ruptured Aortic Aneurysm From Late Type II Endoleak Treated by Transarterial Embolization

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

    Gunasekaran, Senthil, E-mail: sgunasekaran@lumc.edu; Funaki, Brian, E-mail: bfunaki@radiology.bsd.uchicago.edu; Lorenz, Jonathan, E-mail: jlorenz@radiology.bsd.uchicago.edu

    2013-02-15

    Endoleak is the most common complication after endovascular aneurysm repair. The most common type of endoleak, a type II endoleak, typically follows a benign course and is only treated when associated with increasing aneurysm size. In this case report, we describe a ruptured abdominal aortic aneurysm due to a late, type II endoleak occurring 10 years after endovascular aneurysm repair that was successfully treated by transarterial embolization.

  7. Percutaneous protective coil occlusion of the proximal inferior mesenteric artery before N-butyl cyanoacrylate embolization of type II endoleaks after endovascular repair of abdominal aortic aneurysms.

    PubMed

    Chao, Christine P; Paz-Fumagalli, Ricardo; Walser, Eric M; McKinney, J Mark; Stockland, Andrew H; Falkensammer, Jürgen; Hakaim, Albert G; Oldenburg, W Andrew

    2006-11-01

    Bowel ischemia can complicate treatment of type II endoleak with liquid or semiliquid agents such as n-butyl cyanoacrylate (NBCA) if nontarget embolization of the inferior mesenteric artery (IMA) occurs. The current report describes four cases of type II endoleak in which the IMA was the main outflow vessel and was prophylactically occluded with embolization coils before NBCA injection into the endoleak nidus. The purpose was to prevent unintentional embolization of the NBCA into IMA branches. If feasible, protective IMA coil occlusion should be considered in type II endoleaks with IMA outflow in cases of NBCA embolization.

  8. The repair of a type Ia endoleak following thoracic endovascular aortic repair using a stented elephant trunk procedure.

    PubMed

    Qi, Rui-Dong; Zhu, Jun-Ming; Liu, Yong-Min; Chen, Lei; Li, Cheng-Nan; Xing, Xiao-Yan; Sun, Li-Zhong

    2018-04-01

    Type Ia endoleaks are not uncommon complications that occur after thoracic endovascular aortic repair (TEVAR). Because aortic arch vessels prevent extension of the landing zone, it is very difficult to manipulate a type Ia endoleak using an extension cuff or stent-graft, especially when the aortic arch is involved. Here, we retrospectively review our experience of surgical treatment of type Ia endoleak after TEVAR using a stented elephant trunk procedure. From July 2010 to August 2016, we treated 17 patients diagnosed with a type Ia endoleak following TEVAR using stented elephant trunk procedure. The mean age of our patients was 52 ± 8 years. The mean interval between TEVAR and the open surgical repair was 38 ± 43 months. All cases of type Ia endoleak (100%) were repaired successfully. There were no in-hospital deaths. One case required reintubation and continuous renal replacement therapy due to renal failure; this patient recovered smoothly before discharge. One other patient suffered a stroke and renal failure and did not fully recover following discharge, or follow-up. During follow-up, there were 3 deaths. Acceptable results were obtained using a stented elephant trunk procedure in patients with a type Ia endoleak after TEVAR. This technique allowed us to repair the proximal aortic arch lesions, surgically correct the type Ia endoleak, and promote false lumen thrombosis in the distal aorta. Implantation of a stented elephant trunk, with or without a concomitant aortic arch procedure, is an alternative approach for this type of lesion. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  9. Treatment of type I endoleaks using transcatheter embolization with onyx.

    PubMed

    Eberhardt, Karla Maria; Sadeghi-Azandaryani, Mojtaba; Worlicek, Stefanie; Koeppel, Thomas; Reiser, Maximilian F; Treitl, Marcus

    2014-02-01

    To report a single-center experience with transcatheter embolization of type I endoleaks using the liquid embolic agent Onyx, an ethylene vinyl alcohol copolymer. Eight patients (4 men; mean age 74.8 years, range 63-86) with 10 type I endoleaks (6 abdominal and 4 thoracic) diagnosed 2 days to 9 years after endovascular repair were treated with Onyx embolization because cuff extension was precluded by an insufficient landing zone in 6 cases and an unsuitable aortic diameter in 2. Endoleaks were accessed with a 4-F diagnostic catheter and a coaxially introduced dimethylsulfoxide-compatible microcatheter. Onyx-34 was predominantly applied due to its high viscosity; patent side branches were coil embolized prior to Onyx delivery in 3 cases. Technical success of the procedure was achieved in all cases. The mean volume of Onyx used for abdominal endoleaks was 11.8 mL (range 3.0-25.5) and 19.4 mL (range 4.5-31.5) for thoracic endoleaks. The average duration of the procedure was 76.7 minutes (range 34.5-110.6), and the average radiation dose area product was 18.8 cGy*cm (2) (range 10.6-55.8). Reperfusion of the endoleak was detected in one case 2 days after the procedure. A second case showed an occluded endoleak but a small trace of contrast between the aortic wall and the stent-graft. Non-target embolization was not found in any case. Mean follow-up was 13.2 months (range 8-24). The mean reduction in diameters for thoracic aneurysms after 6 and 12 months was 0.4 and 0.9 cm, respectively, and 0.6 and 1.2 cm, respectively, for abdominal aneurysms. Transcatheter embolization of type I endoleaks using Onyx is a simple, safe, and sustainable treatment option with a high primary success rate for cases in which stent-graft extension is not possible. The benefit of additional coil embolization remains uncertain.

  10. Osteomyelitis and Discitis Following Translumbar Repair of a Type II Endoleak

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

    Sella, David M., E-mail: Sella.david@mayo.edu; Frey, Gregory T., E-mail: Frey.gregory@mayo.edu; Giesbrandt, Kirk, E-mail: giesbrandt.kirk@mayo.edu

    2016-03-15

    Here we present the case of an 80-year-old man who developed a type II endoleak following endovascular abdominal aortic aneurysm repair. Initial attempts at treating the endoleak via a transarterial approach were unsuccessful; therefore the patient underwent percutaneous translumbar endoleak embolization. Approximately 1 month following the translumbar procedure, he developed back pain, with subsequent workup revealing osteomyelitis and discitis as a complication following repair via the translumbar approach.

  11. Natural History of Gutter-Related Type Ia Endoleaks after Snorkel/Chimney EVAR

    PubMed Central

    Ullery, Brant W.; Tran, Kenneth; Itoga, Nathan K.; Dalman, Ronald L.; Lee, Jason T.

    2018-01-01

    Objective Alternative endovascular strategies utilizing parallel or snorkel/chimney (ch-EVAR) techniques have been developed to address the lack of widespread availability and manufacturing limitations with branched/fenestrated aortic devices for the treatment of complex abdominal aortic aneurysms. Despite high technical success and mid-term patency of snorkel stent configurations, concerns remain regarding the perceived increased incidence of early gutter-related type Ia endoleaks. We aimed to evaluate the incidence and natural history of gutter-related type Ia endoleaks following ch-EVAR. Methods Review of medical records and available imaging studies, including completion angiography and serial computed tomographic angiography, was performed for all patients undergoing ch-EVAR at our institution between September 2009 and January 2015. Only procedures involving ≥1 renal artery with or without visceral snorkel stents were included. Primary outcomes of the study were presence and persistence or resolution of early gutter-related type Ia endoleak. Secondary outcomes included aneurysm sac shrinkage and need for secondary intervention related to the presence of type Ia gutter endoleak. Results Sixty patients (mean age, 75.8 ± 7.6 years; male, 70.0%) underwent ch-EVAR with a total of 111 snorkel stents (97 renal [33 bilateral renal], 12 SMA, 2 celiac). A median of 2 (range, 1-4) snorkel stents were placed per patient. Early gutter-related type Ia endoleaks were noted on 30.0% (n=18) of initial postoperative imaging studies. Follow-up imaging revealed spontaneous resolution of these gutter endoleaks in 47.3% and 71.8% of patients at 6- and 12 months post-procedure, respectively. Long-term anticoagulation, degree of oversizing, stent type and diameter, and other clinical/anatomic variables were not significantly associated with presence of gutter endoleaks. Two patients (3.3%) required secondary intervention related to persistent gutter endoleak. At a mean radiologic

  12. Management of Immediate Post-Endovascular Aortic Aneurysm Repair Type Ia Endoleaks and Late Outcomes

    PubMed Central

    AbuRahma, Ali F; Hass, Stephen M; AbuRahma, Zachary T; Yacoub, Michael; Mousa, Albeir Y; Abu-Halimah, Shadi; Dean, L Scott; Stone, Patrick A

    2017-01-01

    BACKGROUND Post-endovascular aortic aneurysm repair (EVAR) endoleaks and the need for reintervention are challenging. Additional endovascular treatment is advised for type Ia endoleaks detected on post-EVAR completion angiogram. This study analyzed management and late outcomes of these endoleaks. STUDY DESIGN This was a retrospective review of prospectively collected data from EVAR patients during a 10-year period. All post-EVAR type Ia endoleaks on completion angiogram were identified (group A) and their early (30-day) and late outcomes were compared with outcomes of patients without endoleaks (group B). Kaplan-Meier analysis was used for survival analysis, sac expansion, late type Ia endoleak, and reintervention. RESULTS Seventy-one of 565 (12.6%) patients had immediate post-EVAR type Ia endoleak. Early intervention (proximal aortic cuffs and/or stenting) was used in 56 of 71 (79%) in group A vs 31 of 494 (6%) in group B (p < 0.0001). Late type Ia endoleak was noted in 9 patients (13%) in group A at a mean follow-up of 28 months vs 10 patients (2%) in group B at a mean follow-up of 32 months (p < 0.0001). Late sac expansion and reintervention rates were 9% and 10% for group A vs 5% and 3% for group B (p = 0.2698 and p = 0.0198), respectively. Freedom rates from late type Ia endoleaks at 1, 3, and 5 years for group A were 88%, 85%, and 80% vs 98%, 98%, and 96% for group B (p < 0.001); and for late intervention, were 94%, 92%, and 77% for group A, and 99%, 97%, and 95% for group B (p = 0.007), respectively. Survival rates were similar. CONCLUSIONS Immediate post-EVAR type Ia endoleaks are associated with higher rates of early interventions, late endoleaks and reintervention, which will necessitate strict post-EVAR surveillance. PMID:28017805

  13. Select early type IA endoleaks after endovascular aneurysm repair will resolve without secondary intervention.

    PubMed

    O'Donnell, Thomas F X; Corey, Michael R; Deery, Sarah E; Tsougranis, Gregory; Maruthi, Rohit; Clouse, W Darrin; Cambria, Richard P; Conrad, Mark F

    2018-01-01

    Although it is traditionally considered ominous, the natural history of early proximal attachment site endoleaks (IA) after endovascular aneurysm repair (EVAR) is not well known. Our aim was to identify risk factors for persistent type IA endoleaks and to determine their effect on long-term outcomes after EVAR. All patients who underwent infrarenal EVAR at a single institution between 1998 and 2015 were identified. Preoperative axial imaging and intraoperative arteriograms were reviewed, and those patients with a type IA endoleak were further studied. Aneurysm features were characterized by two reviewers and were studied for predictors of persistent endoleaks at the conclusion of the case. Patient records and the Social Security Death Index were used to record 1-year and overall survival. We identified 1484 EVARs, 122 (8%) of which were complicated by a type IA endoleak on arteriography after graft deployment, with a median follow-up of 4 years. The majority of patients underwent additional ballooning of the proximal site (52 [43%]) or placement of an aortic cuff (47 [39%]); 30 patients (25%) received a Palmaz stent, and four patients were treated with coils or anchors. At case end, only 43 (35%) of the type IA endoleaks remained; at 1 month, only 16 endoleaks persisted (13%), and only six persisted at 1 year (6%). In multivariable analysis, the only independent predictor of persistence of type IA endoleak at the conclusion of the case was the presence of extensive neck calcifications (odds ratio [OR], 9.9; 95% confidence interval [CI], 1.4-67.9; P = .02). Thirteen patients (11%) underwent reintervention for type IA endoleaks, with a time frame ranging from 3 days postoperatively to 11 years. There were three patients (2.4%) who experienced aneurysm rupture. Postoperative type IA endoleak was associated with lower survival at 1 year (79% vs 91%; relative risk, 2.5; 95% CI, 1.1-5.4; P = .02), but it did not affect long-term survival (log-rank, P = .45

  14. Quality Improvement Guidelines for Imaging Detection and Treatment of Endoleaks following Endovascular Aneurysm Repair (EVAR)

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

    Rand, T., E-mail: Thomas.Rand@wienkav.at; Uberoi, R.; Cil, B.

    2013-02-15

    Major concerns after aortic aneurysm repair are caused by the presence of endoleaks, which are defined as persistent perigraft flow within the aortic aneurysm sac. Diagnosis of endoleaks can be performed with various imaging modalities, and indications for treatment are based on further subclassifications. Early detection and correct classification of endoleaks are crucial for planning patient management. The vast majority of endoleaks can be treated successfully by interventional means. Guidelines for Imaging Detection and Treatment of endoleaks are described in this article.

  15. Management of Immediate Post-Endovascular Aortic Aneurysm Repair Type Ia Endoleaks and Late Outcomes.

    PubMed

    AbuRahma, Ali F; Hass, Stephen M; AbuRahma, Zachary T; Yacoub, Michael; Mousa, Albeir Y; Abu-Halimah, Shadi; Dean, L Scott; Stone, Patrick A

    2017-04-01

    Post-endovascular aortic aneurysm repair (EVAR) endoleaks and the need for reintervention are challenging. Additional endovascular treatment is advised for type Ia endoleaks detected on post-EVAR completion angiogram. This study analyzed management and late outcomes of these endoleaks. This was a retrospective review of prospectively collected data from EVAR patients during a 10-year period. All post-EVAR type Ia endoleaks on completion angiogram were identified (group A) and their early (30-day) and late outcomes were compared with outcomes of patients without endoleaks (group B). Kaplan-Meier analysis was used for survival analysis, sac expansion, late type Ia endoleak, and reintervention. Seventy-one of 565 (12.6%) patients had immediate post-EVAR type Ia endoleak. Early intervention (proximal aortic cuffs and/or stenting) was used in 56 of 71 (79%) in group A vs 31 of 494 (6%) in group B (p < 0.0001). Late type Ia endoleak was noted in 9 patients (13%) in group A at a mean follow-up of 28 months vs 10 patients (2%) in group B at a mean follow-up of 32 months (p < 0.0001). Late sac expansion and reintervention rates were 9% and 10% for group A vs 5% and 3% for group B (p = 0.2698 and p = 0.0198), respectively. Freedom rates from late type Ia endoleaks at 1, 3, and 5 years for group A were 88%, 85%, and 80% vs 98%, 98%, and 96% for group B (p < 0.001); and for late intervention, were 94%, 92%, and 77% for group A, and 99%, 97%, and 95% for group B (p = 0.007), respectively. Survival rates were similar. Immediate post-EVAR type Ia endoleaks are associated with higher rates of early interventions, late endoleaks and reintervention, which will necessitate strict post-EVAR surveillance. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Aortic curvature as a predictor of intraoperative type Ia endoleak.

    PubMed

    Schuurmann, Richte C L; Ouriel, Kenneth; Muhs, Bart E; Jordan, William D; Ouriel, Richard L; Boersen, Johannes T; de Vries, Jean-Paul P M

    2016-03-01

    Hostile infrarenal neck characteristics are associated with complications such as type Ia endoleak after endovascular aneurysm repair. Aortic neck angulation has been identified as one such characteristic, but its association with complications has not been uniform between studies. Neck angulation assumes triangular oversimplification of the aortic trajectory, which may explain conflicting findings. By contrast, aortic curvature is a measurement that includes the bending rate and tortuosity and may provide better predictive value for neck complications. Data were retrieved from the Heli-FX (Aptus Endosystems, Inc, Sunnyvale, Calif) Aortic Securement System Global Registry (ANCHOR). One cohort included patients who presented with intraoperative endoleak type Ia at the completion angiogram as the indication for EndoAnchors (Aptus Endosystems), and a second cohort comprised those without intraoperative or late type Ia endoleak (controls). The aortic trajectory was divided into six segments with potentially different influence on the stent graft performance: suprarenal, juxtarenal, and infrarenal aortic neck (-30 to -10 mm, -10 to 10 mm, and 10-30 mm from the lowest renal artery, respectively), the entire aortic neck, aneurysm sac, and terminal aorta (20 mm above the bifurcation to the bifurcation). Maximum and average curvature were automatically calculated over the six segments by proprietary custom software. Aortic curvature was compared with other standard neck characteristics, including neck length, neck diameter, maximum aneurysm sac diameter, neck thrombus and calcium thickness and circumference, suprarenal angulation, infrarenal angulation, and the neck tortuosity index. Independent risk factors for intraoperative type Ia endoleak were identified using backwards stepwise logistic regression. For the variables in the final regression model, suitable cutoff values in relation to the prediction of acute type Ia endoleak were defined with the area under the

  17. Transcatheter Embolization of Type I Endoleaks Associated With Endovascular Abdominal Aortic Aneurysm Repair Using Ethylene Vinyl Alcohol Copolymer.

    PubMed

    Graif, Assaf; Vance, Ansar Z; Garcia, Mark J; Lie, Kevin T; McGarry, Michael K; Leung, Daniel A

    2017-01-01

    To evaluate the feasibility, safety, and outcome of transcatheter embolization using ethylene vinyl alcohol copolymer (EVOH) of type I endoleaks associated with endovascular abdominal aortic aneurysm repair. Retrospective chart review was performed to identify 8 consecutive patients who had undergone EVOH embolization for type I endoleaks between 2012 and 2015. The primary approach used to access the endoleak was the perigraft technique, where the endoleak itself is catheterized at the anastomotic site. Six type Ia and 2 type Ib endoleaks were treated. In 2 patients, a direct transabdominal approach was used to access the endoleak because it was inaccessible via the perigraft approach. Coils were used in addition to EVOH in 5 cases. Residual endoleak was noted in 1 case, whereas 2 patients developed a recurrent type I endoleak during follow-up. No EVOH complications were observed. The 5 remaining patients demonstrated freedom from endoleak and reintervention at a mean follow-up of 6.9 months. Type I endoleaks can be safely and effectively treated by embolotherapy with EVOH. Larger endoleaks resulting from grossly undersized endografts appear to be unsuitable for EVOH embolization.

  18. Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair.

    PubMed

    Schuurmann, Richte C L; van Noort, Kim; Overeem, Simon P; van Veen, Ruben; Ouriel, Kenneth; Jordan, William D; Muhs, Bart E; 't Mannetje, Yannick W; Reijnen, Michel M P J; Fioole, Bram; Ünlü, Çağdaş; Brummel, Peter; de Vries, Jean-Paul P M

    2018-06-01

    To describe the added value of determining changes in position and apposition on computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR) to detect early caudal displacement of the device and to prevent type Ia endoleak. Four groups of elective EVAR patients were selected from a dataset purposely enriched with type Ia endoleak and migration (>10 mm) cases. The groups included cases of late type Ia endoleak (n=36), migration (n=9), a type II endoleak (n=16), and controls without post-EVAR complications (n=37). Apposition of the endograft fabric with the aortic neck, shortest distance between the fabric and the renal arteries, expansion of the main body (or dilatation of the aorta in the infrarenal sealing zone), and tilt of the endograft toward the aortic axis were determined on the first postoperative and the last available CTA scan without type Ia endoleak or migration. Differences in these endograft dimensions were compared between the first vs last scan and among the 4 groups. No significant differences in endograft configurations were observed among the groups on the first postoperative CTA scan. On the last CTA scan before a complication arose, the position of the fabric relative to the renal arteries, expansion of the main body, and apposition of the fabric with the aortic neck were significantly different between the type Ia endoleak (median follow-up 15 months) and migration groups (median follow-up 23 months) compared with the control group (median follow-up 19 months). Most endograft dimensions had changed significantly compared with the first postoperative CTA scan for all groups. Apposition had increased in the control group but had decreased significantly in the type Ia endoleak and migration groups. Progressive changes in dimensions of the endograft within the infrarenal neck could be detected on regular CTA scans before the complication became urgent in many patients.

  19. Natural history of gutter-related type Ia endoleaks after snorkel/chimney endovascular aneurysm repair.

    PubMed

    Ullery, Brant W; Tran, Kenneth; Itoga, Nathan K; Dalman, Ronald L; Lee, Jason T

    2017-04-01

    Alternative endovascular strategies using parallel or snorkel/chimney (chimney endovascular aneurysm repair [ch-EVAR]) techniques have been developed to address the lack of widespread availability and manufacturing limitations with branched/fenestrated aortic devices for the treatment of complex abdominal aortic aneurysms. Despite high technical success and midterm patency of snorkel stent configurations, concerns remain regarding the perceived increased incidence of early gutter-related type Ia endoleaks. We aimed to evaluate the incidence and natural history of gutter-related type Ia endoleaks following ch-EVAR. Review of medical records and available imaging studies, including completion angiography and serial computed tomographic angiography, was performed for all patients undergoing ch-EVAR at our institution between September 2009 and January 2015. Only procedures involving ≥1 renal artery with or without visceral snorkel stents were included. Primary outcomes of the study were presence and persistence or resolution of early gutter-related type Ia endoleak. Secondary outcomes included aneurysm sac shrinkage and need for secondary intervention related to the presence of type Ia gutter endoleak. Sixty patients (mean age, 75.8 ± 7.6 years; male, 70.0%) underwent ch-EVAR with a total of 111 snorkel stents (97 renal [33 bilateral renal], 12 superior mesenteric artery, 2 celiac). A mean of 1.9 ± 0.6 snorkel stents were placed per patient. Early gutter-related type Ia endoleaks were noted on 30.0% (n = 18) of initial postoperative imaging studies. Follow-up imaging revealed spontaneous resolution of these gutter endoleaks in 44.3%, 65.2%, and 88.4% of patients at 6, 12, and 18 months postprocedure, respectively. Long-term anticoagulation, degree of oversizing, stent type and diameter, and other clinical/anatomic variables were not significantly associated with presence of gutter endoleaks. Two patients (3.3%) required secondary intervention related to

  20. Predictors and outcomes of endoleaks in the Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms.

    PubMed

    Lal, Brajesh K; Zhou, Wei; Li, Ziyi; Kyriakides, Tassos; Matsumura, Jon; Lederle, Frank A; Freischlag, Julie

    2015-12-01

    The Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms study was a randomized controlled trial comparing open vs endovascular repair (EVAR) in standard-risk patients with infrarenal aortic aneurysms. The analysis reported here identifies characteristics, risk factors, and long-term outcome of endoleaks in patients treated with EVAR in the OVER cohort. The OVER trial enrolled 881 patients, of whom 439 received successful EVAR. Logistic regression analysis was used to identify predictors for endoleaks and secondary interventions. Kaplan-Meier survival analysis, longitudinal plots, and generalized linear mixed models methods were used to describe time to endoleak detection, resolution, or death. During a mean follow-up of 6.2 ± 2.4 years, 135 patients (30.5%) developed 187 endoleaks. Four patients with EVAR went on to rupture; these four patients did not all have an endoleak. Mortality between patients who did and did not develop endoleaks was not significantly different. The 187 endoleaks included 12% type I, 76% type II, 3% type III, 3% type IV, and 6% indeterminate. Patient demographics and vascular risk factors were not associated with endoleak development. The presence of endoleaks resulted in an increase in aneurysm diameter over time (P < .0001). Fifty-three percent of endoleaks resolved spontaneously, and 31.9% received secondary interventions. The initial aneurysm size independently predicted a need for secondary interventions (P < .0003). Delayed type II endoleaks (detected >1 year after EVAR) were associated with aneurysm enlargement compared with the early counterpart. There was no difference in aneurysm size or length of survival between type II and other types of endoleak. We present one of the most comprehensive and longest follow-up analyses of patients treated with aortic endografts. Endoleaks were common and negatively affected aneurysm diameter reduction. Delayed type II endoleaks were associated with late

  1. EndoAnchors to Resolve Persistent Type Ia Endoleak Secondary to Proximal Cuff With Parallel Graft Placement.

    PubMed

    Donselaar, Esmé J; van der Vijver-Coppen, Rozemarijn J; van den Ham, Leo H; Lardenoye, Jan Willem H P; Reijnen, Michel M P J

    2016-02-01

    To describe 2 patients with a distally migrated endograft causing a type Ia endoleak and treatment with a proximal cuff and chimney grafts that required EndoAnchors to finally seal the leak. Two men, ages 86 and 72 years, presented with stent-graft migration and type Ia endoleak at 5 and 15 years after endovascular repair, respectively. Both were treated with a proximal cuff in combination with a chimney graft to the left renal artery. In both cases, the type Ia endoleak persisted, likely due to gutter formation. Both patients were treated in the same setting with EndoAnchors that instantly resolved the endoleak. At 1-year follow-up, there was no recurrent endoleak or migration, with patent chimney grafts and renal arteries and stable renal function. EndoAnchors may effectively resolve a persistent type Ia endoleak arising from gutter formation after placement of a proximal cuff and chimney grafts. © The Author(s) 2015.

  2. Type 1a endoleak following Zone 1 and Zone 2 thoracic endovascular aortic repair: effect of bird-beak configuration.

    PubMed

    Kudo, Tomoaki; Kuratani, Toru; Shimamura, Kazuo; Sakamoto, Tomohiko; Kin, Keiwa; Masada, Kenta; Shijo, Takayuki; Torikai, Kei; Maeda, Koichi; Sawa, Yoshiki

    2017-10-01

    Type 1a endoleak is one of the most severe complications after thoracic endovascular aortic repair (TEVAR), because it carries the risk of aortic rupture. The association between bird-beak configuration and Type 1a endoleak remains unclear. The purpose of this study was to analyse the predictors of Type 1a endoleak following Zone 1 and Zone 2 TEVAR, with a particular focus on the effect of bird-beak configuration. From April 2008 to July 2015, 105 patients (mean age 68.6 years) who underwent Zone 1 and 2 landing TEVAR were enrolled, with a mean follow-up period of 4.3 years. The patients were categorized into 2 groups, according to the presence (Group B, n = 32) or the absence (Group N, n = 73) of bird-beak configuration on the first postoperative multidetector computed tomography. The Kaplan-Meier event-free rate curve showed that Type 1a endoleak and bird-beak progression occurred less frequently in Group N than in Group B. Five-year freedom from Type 1a endoleak rates were 79.7% and 100% for Groups B and N, respectively (P = 0.007). Multivariable logistic regression analysis showed that dissecting aortic aneurysm (odds ratio 3.72, 95% confidence interval 1.30-11.0; P = 0.014) and shorter radius of inner curvature (odds ratio 1.09, 95% confidence interval 0.85-0.99; P = 0.025) were significant risk factors for bird-beak configuration. Multivariable Cox proportional hazard regression showed that Z-type stent graft (hazard ratio 2.69, 95% confidence interval 1.11-6.51; P = 0.030) was a significant risk factor for bird-beak progression. Appropriate stent grafts need to be chosen carefully to prevent Type 1a endoleak and bird-beak configuration after landing Zone 1 and 2 TEVAR. Patients with bird-beak configuration on early postoperative multidetector computed tomography require closer follow-up to screen for Type 1a endoleak. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio

  3. Treatment of type II endoleak using Onyx with long-term imaging follow-up.

    PubMed

    Khaja, Minhaj S; Park, Auh Whan; Swee, Warren; Evans, Avery J; Fritz Angle, J; Turba, Ulku C; Sabri, Saher S; Matsumoto, Alan H

    2014-06-01

    The purpose of our study is to report our experience with the use of an ethylene vinyl alcohol copolymer (Onyx) in an off-label fashion for the treatment of type II endoleak after endovascular repair of the thoracic (TEVAR) and abdominal (EVAR) aorta. A retrospective review of patients with type I and/or II endoleak treated with Onyx was performed. Data regarding the technical, clinical, and imaging outcomes were collected. Technical success was defined as decreased or eliminated endoleak on the first imaging follow-up. Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up. Eighteen patients (15 male, 3 female) with a mean age of 79 years (range 69-92) met inclusion criteria (16 abdominal aortic aneurysm, 2 thoracic aortic aneurysm). Sixteen patients had type II endoleak, and 2 had complex type II endoleak with a type I component. The interval between endograft placement and treatment was a mean of 30 months. Direct sac treatment approach was used in 13 patients; transarterial approach was used in 3 patients. Seven patients required the use of coils, N-butyl cyanoacrylate glue, or Amplatzer vascular plugs. The average volume of Onyx used per treatment was 5.6 mL (range 2.5-13). Duration of imaging follow-up was 0.75-72.5 months (mean 32.8). Sixteen of 18 (88.9 %) patients had initial technical and clinical success. Two of 18 patients (11.1 %) were initial technical failures, and 1 remained a failure despite a second treatment and attempted surgical ligation. Eight of 18 (44.4 %) of patients eventually required a second intervention, 5 (27.8 %) of them due to delayed clinical failure. Complications included 1 psoas hematoma, 1 transient L2 nerve paresis, and 1 intraperitoneal Onyx leak; all of these were without clinical sequelae. Onyx with or without coil/glue/Amplatzer plug embolization is safe and useful in the treatment of type II endoleak after TEVAR and EVAR. However, long-term clinical and imaging follow-up is needed

  4. In vitro analysis of type II endoleaks and aneurysm sac pressurization on longitudinal stent-graft displacement.

    PubMed

    Knowles, Martyn; Pellisar, Tiago; Murphy, Erin H; Stanley, Gregory A; Hashmi, Abraham F; Arko, M Zachary; Arko, Frank R

    2011-08-01

    To evaluate the effects of type II endoleaks and sac pressurization on stent-graft displacement following endovascular aneurysm repair (EVAR). Experimental silicone infrarenal aneurysm (6-cm) models were "treated" with a Talent stent-graft deployed with 20-mm proximal and distal landing zones. Inflow and outflow vessels were created as part of the silicone model to control flow into the aneurysm sac. All aneurysm models were uniform, with a diameter neck of 31 mm, a neck length of 20 mm, and iliac artery diameters of 16 mm. The aortic model was secured in a water bath to a pulsatile pump under physiological conditions; the output phase ratio (%systole/%diastole) was set at 65/35 with a pump rate of 80 beats per minute. Commercially available bifurcated stent-grafts were then displaced in vitro utilizing a linear motion apparatus attached to a force gauge. The mean arterial pressure (MAP) and pulse pressure (PP) at the aortic inflow were 60.1 ± 3.1 and 38.3 ± 7.8 mmHg, respectively. Peak force to cause initial stent-graft migration with and without a type II endoleak was recorded and compared. In aneurysm sacs with no endoleak, the MAP and sac PP were 32 ± 6.4 and 6 ± 1.3 mmHg, respectively (p<0.01). In aneurysm sacs with a type II endoleak, the MAP and sac PP were 54.1 ± 9.7 and 16.1 ± 4.1 mmHg, respectively (p<0.02). Peak force to initiate migration was 16.0 ± 1.41 N (range 15-18) with no endoleak vs. 23.2 ± 2.2 N (range 20-25) in those with a type IIa endoleak and 23.5 ± 2.5 N (range 20-26) in those with a type IIb endoleak (p<0.001). Type II endoleaks are associated with a significantly increased sac pressure. Increased sac pressurization from type II endoleaks results in a significantly greater force to displace a stent-graft longitudinally. Type II endoleaks may therefore inhibit migration and offer a benefit following EVAR; however, clinical correlation of these results is required.

  5. Long-term results of intra-arterial onyx injection for type II endoleaks following endovascular aneurysm repair.

    PubMed

    Ribé, L; Bicknell, C D; Gibbs, R G; Burfitt, N; Jenkins, M P; Cheshire, N; Hamady, M

    2017-06-01

    Purpose The aim of this paper is to report our experience of type II endoleak treatment after endovascular aneurysm repair with intra-arterial injection of the embolizing liquid material, Onyx liquid embolic system. Methods From 2005 to 2012, we performed a retrospective review of 600 patients, who underwent endovascular repair of an abdominal aortic aneurysm. During this period, 18 patients were treated with Onyx for type II endoleaks. Principal findings The source of the endoleak was the internal iliac artery in seven cases, inferior mesenteric artery in seven cases and lumbar arteries in four cases. Immediate technical success was achieved in all patients and no endoleak from the treated vessel recurred. During a mean follow-up of 19 months, no major morbidity or mortality occurred, and one-year survival was 100%. Conclusions Treatment of type II endoleaks with Onyx is safe and effective over a significant time period.

  6. Spontaneous delayed sealing in selected patients with a primary type-Ia endoleak after endovascular aneurysm repair.

    PubMed

    Bastos Gonçalves, F; Verhagen, H J M; Vasanthananthan, K; Zandvoort, H J A; Moll, F L; van Herwaarden, J A

    2014-07-01

    Direct additional therapy is advised for type-Ia endoleaks detected on completion angiography after endovascular aneurysm repair (EVAR). Additional intraoperative endovascular procedures are, however, often challenging or not possible, and direct open conversion is unattractive. The results of a selective, conservative strategy for patients with primary type-Ia endoleak has been analysed. This was a retrospective, single-centre study (UMC, Utrecht, NL). From 2004 to 2008, all patients with a primary type-Ia endoleak and suitable anatomy for EVAR, stentgraft oversizing ≥15%, and optimal deployment were included. Complications during follow-up were studied and all sequential CTA scans were reviewed. These were compared with the remaining patients, treated during the same period. Fifteen patients were included (14 male, median age 77, range 67-85) with a median aneurysm diameter of 60 mm (48-80), an aneurysm neck diameter of 26 mm (21-32), a neck length of 29 mm (11-39), and infrarenal angulation of 49° (31-90). One patient suffered rupture 2 days after EVAR - leading to the only AAA-related death. Eight of the 15 type-Ia endoleaks disappeared spontaneously on the first postoperative CTA, obtained within 1 week of EVAR. On the second postoperative CTA, obtained a median of 5 months (1-12) after EVAR, all remaining endoleaks had sealed. One recurrence occurred at 4.85 years. During a median follow-up of 3.3 years, there were five secondary interventions. Compared with controls, there were more secondary (or recurrent) type-1a endoleaks (13% vs. 4%), endograft migrations (13% vs. 3%), sac growths (33% vs. 16%), and secondary interventions (33% vs. 23%). None of these differences however, were statistically significant. All but one of the primary type-Ia endoleaks sealed spontaneously. Until sealing, the risk of rupture persisted, but subsequently only one recurrence of type-Ia endoleak was seen. In selected patients, a conservative approach for primary type

  7. Type II endoleak after endovascular abdominal aortic aneurysm repair: a conservative approach with selective intervention is safe and cost-effective.

    PubMed

    Steinmetz, Eric; Rubin, Brian G; Sanchez, Luis A; Choi, Eric T; Geraghty, Patrick J; Baty, Jack; Thompson, Robert W; Flye, M Wayne; Hovsepian, David M; Picus, Daniel; Sicard, Gregorio A

    2004-02-01

    The conservative versus therapeutic approach to type II endoleak after endovascular repair of abdominal aortic aneurysm (EVAR) has been controversial. The purpose of this study was to evaluate the safety and cost-effectiveness of the conservative approach of embolizing type II endoleak only when persistent for more than 6 months and associated with aneurysm sac growth of 5 mm or more. Data for 486 consecutive patients who underwent EVAR were analyzed for incidence and outcome of type II endoleaks. Spiral computed tomography (CT) scans were reviewed, and patient outcome was evaluated at either office visit or telephone contact. Patients with new or late-appearing type II endoleak were evaluated with spiral CT at 6-month intervals to evaluate both persistence of the endoleak and size of the aneurysm sac. Persistent (>or=6 months) type II endoleak and aneurysm sac growth of 5 mm or greater were treated with either translumbar glue or coil embolization of the lumbar source, or transarterial coil embolization of the inferior mesenteric artery. Type II endoleaks were detected in 90 (18.5%) patients. With a mean follow-up of 21.7 +/- 16 months, only 35 (7.2%) patients had type II endoleak that persisted for 6 months or longer. Aneurysm sac enlargement was noted in 5 patients, representing 1% of the total series. All 5 patients underwent successful translumbar sac embolization (n = 4) or transarterial inferior mesenteric artery embolization (n = 4) at a mean follow-up of 18.2 +/- 8.0 months, with no recurrence or aneurysm sac growth. No patient with treated or untreated type II endoleak has had rupture of the aneurysm. The mean global cost for treatment of persistent type II endoleak associated with aneurysm sac growth was US dollars 6695.50 (hospital cost plus physician reimbursement). Treatment in the 30 patients with persistent type II endoleak but no aneurysm sac growth would have represented an additional cost of US dollars 200000 or more. The presence or absence of a

  8. Transarterial Embolization of Type II Endoleaks after EVAR: The Role of Ethylene Vinyl Alcohol Copolymer (Onyx)

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

    Mueller-Wille, Rene, E-mail: rene.mueller-wille@ukr.de; Wohlgemuth, Walter A., E-mail: walter.wohlgemuth@ukr.de; Heiss, Peter, E-mail: peter.heiss@ukr.de

    2013-10-15

    Purpose: To determine the feasibility and efficacy of transarterial endoleak embolization using the liquid embolic agent ethylene vinyl alcohol copolymer (Onyx). Methods: Over a 7-year period eleven patients (6 women, 5 men; mean age 68 years, range 37-83 years) underwent transarterial embolization of a type II endoleak after endovascular aortic aneurysm repair using the liquid embolic agent Onyx. Two patients (18 %) had a simple type II endoleak with only one artery in communication with the aneurysm sac, whereas 9 patients (82 %) had a complex type II endoleak with multiple communicating vessels. We retrospectively analyzed the technical and clinicalmore » success of transarterial type II endoleak embolization with Onyx. Complete embolization of the nidus was defined as technical success. Embolization was considered clinically successful when volume of the aneurysm sac was stable or decreased on follow-up CT scans. Result: Mean follow-up time was 26.0 (range 6-50) months. Clinical success was achieved in 8 of 11 patients (73 %). Transarterial nidus embolization with Onyx was technically successful in 6 of 11 patients (55 %). In three cases the nidus was embolized without direct catheterization from a more distal access through the network of collateral vessels. Conclusion: Onyx is a favorable embolic agent for transarterial endoleak embolization. To achieve the best clinical results, complete occlusion of the nidus is mandatory.« less

  9. Redo thoracic endovascular aortic repair due to endoleak with celiac artery snorkeling.

    PubMed

    Planer, David; Bliagos, Dimitrios; Gray, William A

    2011-10-01

    Reintervention due to endoleak of aortic endograft repair is often challenging. Herein, we report endovascular endoleak repair in a patient with previous thoracic and abdominal endovascular grafts with extensive coverage of the aorta. The present technique included snorkeling of the celiac trunk to preserve antegrade flow in the celiac artery and to maintain future options for reintervention. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  10. Advantages of contrast-enhanced ultrasonography over computed tomography for the detection of persistent type II endoleak after embolization: A case report.

    PubMed

    Cury, Maysa Heineck; Cury, Marcus Vinícius Martins; Godoy, Marcos Roberto; Matielo, Marcelo Fernando

    2016-10-01

    The aim of this case report is to describe the use of contrast-enhanced ultrasonography in the detection of a type II endoleak after prior embolization with Onyx. A 74-year-old male patient with hypertension previously underwent endovascular repair of a 7.1-cm infrarenal aortic aneurysm. CT angiography surveillance revealed a type II endoleak associated with aneurysm sac expansion. Selective transarterial embolization of the endoleak was performed, but it was not possible to detect the persistent endoleak using CT angiography because of image artifacts caused by Onyx. Contrast-enhanced ultrasonography enabled us to detect the persistent endoleak in this patient. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:522-526, 2016. © 2016 Wiley Periodicals, Inc.

  11. Successful Aortic Banding for Type IA Endoleak Due to Neck Dilatation after Endovascular Abdominal Aortic Aneurysm Repair: Case Report.

    PubMed

    Tashima, Yasushi; Tamai, Koichi; Shirasugi, Takehiro; Sato, Kenichiro; Yamamoto, Takahiro; Imamura, Yusuke; Yamaguchi, Atsushi; Adachi, Hideo; Kobinata, Toshiyuki

    2017-09-25

    A 69-year-old man with a type IA endoleak that developed approximately 21 months after endovascular abdominal aortic aneurysm repair (EVAR) of a 46 mm diameter aneurysm was referred to our department. He had impaired renal function, Parkinson's disease, and previous cerebral infarction. Computed tomography angiography showed a type IA endoleak with neck dilatation and that the aneurysm had grown to 60 mm in diameter. We decided to perform aortic banding. The type IA endoleak disappeared after banding and the patient was discharged on postoperative day 10. Aortic banding may be effective for type IA endoleak after EVAR and less invasive for high-risk patients in particular.

  12. Type 2 Endoleaks Post-EVAR: Current Evidence for Rupture Risk, Intervention and Outcomes of Treatment

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

    Chung, Raymond, E-mail: rchung@doctors.org.uk; Morgan, Robert A., E-mail: Robert.Morgan@stgeorges.nhs.uk

    Type 2 endoleaks (EL2) are the most commonly encountered endoleaks following EVAR. Despite two decades of experience, there remains considerable variation in the management of EL2 with controversies ranging from if to treat, when to treat and how to treat. Here, we summarise the available evidence, describe the treatment techniques available and offer guidelines for management.

  13. Outcomes and morphologic changes of immediate type Ia endoleak following endovascular repair of acute type B aortic dissection.

    PubMed

    Huang, Wenhui; Yang, Fan; Luo, Jianfang; Xie, NianJin; He, Pengcheng; Luo, Songyuan; Liu, Yuan; Zhou, Yingling; Fan, Ruixin; Huang, Meiping; Chen, Jiyan

    2015-02-01

    The clinical significance of immediate type Ia endoleaks after thoracic endovascular aortic repair (TEVAR) for aneurysms has been described in detail. However, this phenomenon is still controversial in TEVAR patients treated for acute type B aortic dissection. A single-institution study was conducted in 81 prospectively evaluated patients treated between January 2012 and June 2012 for acute type B aortic dissection. Preoperative and postoperative computed tomography angiography (CTA) images were analyzed using 3-dimensional reconstruction to measure the areas and indices of the true lumen, false lumen, and total aorta in the proximal, middle, and distal descending thoracic aorta. Data were analyzed and compared between the 2 groups of patients, with and without immediate type Ia endoleaks. The average follow-up period was 12 months (range 10-13 months) after the procedure. TEVAR was successfully performed in all patients (mean age 53 years; 86% men). Thirty-six of the 81 patients were diagnosed with complicated type B dissection, including persistent pain (19/36, 52.7%), refractory hypertension (4/36, 11.1%), and end-organ ischemia (13/36, 36.1%). Of all the patients, 37 (45.7%) were diagnosed with immediate type Ia endoleaks. The differences between the 30-day and 1-year all-cause mortality rates between the 2 groups were nonsignificant (13.5% vs. 2.2%, P = 0.08; 16.2% vs. 4.5%, P = 0.13). No stroke or paraplegia occurred during the follow-up. Reintervention was performed in 2 patients for delayed type I endoleaks in the group without immediate type Ia endoleaks. Pre- and postoperative CTA images were available for analysis in 54 patients. Among them, 24 patients had type Ia endoleaks. Patients with immediate type Ia endoleaks had a significantly larger preoperative distal false lumen area (498 ± 274 vs. 284 ± 213 mm(2), P = 0.02) and a larger distal aortic area (759 ± 275 vs. 624 ± 185 mm(2), P = 0.03). The 1-year follow-up CTA demonstrated significantly

  14. Type IIIb Endoleak and Relining: A Mathematical Model of Distraction Forces.

    PubMed

    Swaelens, Charles; Poole, Robert J; Torella, Francesco; McWilliams, Richard G; England, Andrew; Fisher, Robert K

    2016-04-01

    To examine the changes in distraction force following relining of a conventional abdominal aortic stent-graft with a type IIIb endoleak using the Nellix endovascular sealing device compared to a unilateral stent-graft. Relining is often used to repair type IIIb endoleaks, but the consequences to graft stability are unknown. A mathematical model was constructed based on pressure and volume flow through the stent-grafts, incorporating recognized distraction force equations. Steady flow was presumed at peak systolic pressures to calculate the maximum distraction force, with gravity ignored. Distraction forces for 28- to 36-mm-diameter stent-graft bodies with 16-mm limbs were calculated and compared to forces following relining with single and double Nellix devices or the Renu unilateral device. Distraction forces for the 28-, 32-, and 36-mm stent-grafts prior to relining were 5.99, 10.21, and 14.99 N, respectively. Similar forces were reported after relining with bilateral Nellix devices (5.86, 10.08, and 14.86 N, respectively). However, use of a unilateral Nellix increased the distraction forces to 9.92, 14.14, and 18.92 N, respectively. These were comparable to the increase observed after relining with a Renu unilateral stent-graft (9.87, 14.09, and 18.86 N, respectively). The proportional increase in distraction force for a unilateral relining ranged from 26% to 66%, with the greatest increase noted in the smaller diameter main bodies. Relining a stent-graft with a type IIIb endoleak using bilateral Nellix devices does not increase the distraction force. However, a unilateral Nellix device or the Renu system could theoretically increase the distraction force by up to 66%, potentially risking migration and type Ia endoleak. In clinical practice, these results suggest that a relining with bilateral Nellix may have benefits over the Renu unilateral stent-graft. © The Author(s) 2016.

  15. Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes

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

    Ameli-Renani, S., E-mail: seyedameli@doctors.org.uk; Morgan, R. A., E-mail: Robert.morgan@stgeorges.nhs.uk

    2015-10-15

    AimTo evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).Materials and MethodsSeven patients (5 men; mean age 83; range 79–90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6–301) and from endoleak diagnosis to embolisation was 20 days (range 2–50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up.more » Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103–471 days).ResultsAll cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.ConclusionIf a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.« less

  16. Utility of ⁹⁹mTc-human serum albumin diethylenetriamine pentaacetic acid SPECT for evaluating endoleak after endovascular abdominal aortic aneurysm repair.

    PubMed

    Nakai, Motoki; Sato, Hirotatsu; Sato, Morio; Ikoma, Akira; Sonomura, Tetsuo; Nishimura, Yoshiharu; Okamura, Yoshitaka

    2015-01-01

    The purpose of this study was to assess the utility of (99m)Tc-human serum albumin diethylenetriamine pentaacetic acid ((99m)Tc-HSAD) SPECT in the detection of endoleaks after endovascular abdominal aortic aneurysm repair. Fifteen patients (11 men, four women) with aneurysm sac expansion of 5 mm or greater after endovascular abdominal aortic aneurysm repair underwent three-phase CT, (99m)Tc-HSAD SPECT, and CT during aortography. Sensitivity calculations for three-phase CT and (99m)Tc-HSAD SPECT were performed with CT during aortography as the reference standard. The volume of each endoleak was measured with CT during aortography. Seven subjects underwent embolization with N-butyl cyanoacrylate (NBCA)-Lipiodol (ethiodized oil, Guerbet and metallic coils. Three-phase CT and (99m)Tc-HSAD SPECT were repeated after embolization to assess their efficacy. Endoleaks were interpreted as perigraft radioisotope accumulation in 12 patients (80.0%) on (99m)Tc-HSAD SPECT images, in 13 patients (86.7%) on three-phase CT images, and in 15 patients (100%) on CT during aortography. The mean endoleak volume visualized with (99m)Tc-HSAD SPECT was 8.37 cm(3) (range, 5.2-15.1 cm(3)), and the volume not visualized was 3.47 cm(3) (2.5-4.6 cm(3)), a statistically significant difference (p = 0.019). In two patients, (99m)Tc-HSAD SPECT depicted endoleaks evident at delayed phase CT during aortography but not at three-phase CT, suggesting they were slow-filling endoleaks. Accumulation of (99m)Tc-HSAD corresponding to endoleaks disappeared after embolization, but CT evaluation of embolization was impeded by artifacts of NBCA-Lipiodol and metallic coils. Technetium-99m-labeled HSAD SPECT proved less sensitive than three-phase CT but depicted endoleaks with volumes 5.2 cm(3) or greater as perigraft radioisotope accumulation. Slow-filling endoleaks can be visualized with (99m)Tc-HSAD SPECT, which can be used to evaluate the efficacy of embolization.

  17. Chitosan–Sodium Tetradecyl Sulfate Hydrogel: Characterization and Preclinical Evaluation of a Novel Sclerosing Embolizing Agent for the Treatment of Endoleaks

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

    Zehtabi, Fatemeh; Dumont-Mackay, Vincent; Fatimi, Ahmed

    PurposeTo compare the efficacy of an embolization agent with sclerosing properties (made of chitosan and sodium tetradecyl sulfate, CH–STS) with a similar embolization agent but without sclerosing properties (made of chitosan, CH) in treating endoleaks in a canine endovascular aneurysm repair model.MethodsTwo chitosan-based radiopaque hydrogels were prepared, one with STS and one without STS. Their rheological, injectability, and embolizing properties were assessed in vitro; afterwards, their efficacy in occluding endoleaks was compared in a canine bilateral aneurysm model reproducing type I endoleaks (n = 9 each). The primary endpoint was endoleak persistence at 3 or 6 months, assessed on a CT scan andmore » macroscopic examination. Secondary endpoints were the occurrence of stent-graft (SG) thrombosis, the evolution of the aneurysm mean diameter, as well as aneurysm healing and inflammation scores in pathology examinations.ResultsIn vitro experiments showed that both products gelled rapidly and presented initial storage moduli greater than 800 Pa, which increased with time. Both gels were compatible with microcatheter injection and occlude flow up to physiological pressure in vitro. In a type I endoleak model, the injection of CH–STS sclerosing gel tended to reduce the risk of occurrence of endoleaks, compared to CH non-sclerosing agent (2/9 vs. 6/9, p = 0.069). No case of SG thrombosis was observed. Moderate inflammation was found around both gels, with a comparable intensity score in both CH and CH–STS groups (2.6 ± 0.9 and 2.7 ± 0.9, respectively; p = 0.789).ConclusionsFlow occlusion combined with chemical endothelial denudation appears promising for the treatment of endoleaks.Level of EvidenceN/A.« less

  18. The Burden of Hard Atherosclerotic Plaques Does Not Promote Endoleak Development After Endovascular Aortic Aneurysm Repair: A Risk Stratification

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

    Petersen, Johannes, E-mail: johannes.petersen@i-med.ac.at; Glodny, Bernhard, E-mail: bernhard.glodny@i-med.ac.at

    Purpose: To objectify the influence of the atherosclerotic burden in the proximal landing zone on the development of endoleaks after endovascular abdominal aortic aneurysm repair (EVAR) or thoracic endovascular aneurysm repair (TEVAR) using objective aortic calcium scoring (ACS). Materials and Methods: This retrospective observation study included 267 patients who received an aortic endograft between 1997 and 2010 and for whom preoperative computed tomography (CT) was available to perform ACS using the CT-based V600 method. The mean follow-up period was 2 {+-} 2.3 years. Results: Type I endoleaks persisted in 45 patients (16.9%), type II in 34 (12.7%), type III inmore » 8 (3%), and type IV or V in 3 patients, respectively (1.1% each). ACS in patients with type I endoleaks was not increased: 0.029 {+-} 0.061 ml compared with 0.075 {+-} 0.1349 ml in the rest of the patients, (p > 0.05; Whitney-Mann U-Test). There were significantly better results for the indication 'traumatic aortic rupture' than for the other indications (p < 0.05). In multivariate logistic regression analyses, age was an independent risk factor for the development of type I endoleaks in the thoracic aorta (Wald 9.5; p = 0.002), whereas ACS score was an independent protective factor (Wald 6.9; p = 0.009). In the abdominal aorta, neither age nor ACS influenced the development of endoleaks. Conclusion: Contrary to previous assumptions, TEVAR and EVAR can be carried out without increasing the risk of an endoleak of any type, even if there is a high atherosclerotic 'hard-plaque' burden of the aorta. The results are significantly better for traumatic aortic.« less

  19. Towards an entirely endovascular aortic world: an update of techniques and outcomes for endovascular and open treatment of type I, II, and III endoleaks.

    PubMed

    Mangialardi, Nicola; Orrico, Matteo; Ronchey, Sonia; Praquin, Barbara; Alberti, Vittorio; Setacci, Carlo

    2016-10-01

    Endovascular aneurysm repair (EVAR) is largely the most adopted strategy for aneurysmal disease of the aorta. Nevertheless, the high incidence of reintervention makes it difficult to identify EVAR as a definitive solution; in particular, the most frequent indication of reintervention is endoleak, which is defined as persistent flow into the aneurysmal sac from different sources. Several treatment strategies are described. A contemporary literature search was performed with the intent of describing techniques and outcomes of endovascular and open strategies to type I, II, and III endoleak. Described techniques and outcomes were organized by indication (type I, II, and III endoleak) and by type of approach (endovascular, open, and laparoscopic) to give an overview of the current status of the treatment for the three most frequent types of endoleak. Several endovascular means are described in the literature for the treatment of endoleak.

  20. Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx.

    PubMed

    Wojtaszek, Mikolaj; Wnuk, Emilia; Maciag, Rafal; Solonynko, Bohdan; Korzeniowski, Krzysztof; Lamparski, Krzysztof; Rowinski, Olgierd

    2016-01-01

    Type 2 endoleaks (T2E) occur in 10 to 20% of patients after endovascular abdominal aortic aneurysm repair (EVAR) and remain a significant clinical issue. To evaluate the efficacy and clinical outcomes of transarterial treatment of persistent type II endoleaks after EVAR using the liquid embolic Onyx. From February 2012 to August 2015 transarterial T2E embolization was attempted in 22 patients (21 men, median age: 73, range: 62-88 years). Indications for treatment included an increase in the diameter of the aneurysm sac above 5 mm and a persistent endoleak observed for more than 6 months. Mean time from EVAR to endoleak treatment was 43 months (range: 2-125 months). Primary technical success was achieved in 17 (77.3%) patients and secondary technical success in 81.8%, with 0% in-hospital mortality. The mean procedure time was 95 ±48 min, with an average fluoroscopy time of 54 ±25 min. The mean amount of Onyx used was 7.5 ±6.6 ml. Clinical success was seen in 17/21 patients with follow-up imaging (80.9%). Mean follow-up time was 17 months (range: 3-38 months). Onyx has been shown to effectively stabilize previous aneurysm growth as a result of the T2E in the majority of our patients. Transarterial embolization of T2E can be significantly improved as compared to previously reported results by using liquid embolic polymers such as Onyx.

  1. Angiossarcoma mimetizando endoleak tardio pós-reparo endovascular de aneurisma de aorta infrarrenal: relato de caso

    PubMed Central

    de Almeida, Bruno Lorenção; Caria, Vinicius Pena; Cavalcante, Sthefanie Fauve Andrade; Ventin, Felipe Carvalho; Vieira, Eduardo Augusto Moreira; Darold, Eduardo Mulinari; de Souza, Rodrigo Américo Cunha; Araújo, Edmur Carlos

    2017-01-01

    Resumo Em todo paciente submetido a reparo endovascular do aneurisma de aorta abdominal (REVA) que se apresente subitamente com quadro de dor abdominal ou sinais de choque, a hipótese de endoleak ou vazamento, com expansão do aneurisma e ruptura deve ser aventada. Apresentamos o caso de um paciente em pós-operatório de REVA que apresentou uma neoplasia de duodeno mimetizando um endoleak. PMID:29930672

  2. An Uncommon Case of Type III Endoleak Treated with a Custom-made Thoracic Stent Graft.

    PubMed

    Massara, Mafalda; Barillà, David; Franco, Gaetana; Volpe, Alberto; Serra, Raffaele; De Caridi, Giovanni; Alberti, Antonino; Volpe, Pietro

    2016-08-01

    Endovascular aortic repair (EVAR) has been shown to be a valid and minimally invasive alternative to open abdominal aortic aneurysm repair. A major shortcoming for EVAR is the need to submit patients to regular follow-up to detect potential complications such as endoleak, limb occlusion, aneurysm expansion, aneurysm rupture, infection, structural failure, and migration. In this case report, we describe an uncommon case of late type III endoleak due to complete detachment of the stent-graft main body segment from its suprarenal uncovered fixation stent. It was treated with a custom-made Relay(®) NBS Plus (Bolton Medical, Barcelona, Spain) thoracic stent graft which also provided extra suprarenal fixation of the thoracic stent graft in the proximal neck. The postoperative period was uneventful and a computed tomography scan 1 year later revealed proper positioning of the stent graft and no signs of endoleak. The successful strategy chosen to correct this complication was at the same time original and infrequent, and also avoided potential complications related to open surgical repair and general anesthesia. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx

    PubMed Central

    Wnuk, Emilia; Maciag, Rafal; Solonynko, Bohdan; Korzeniowski, Krzysztof; Lamparski, Krzysztof; Rowinski, Olgierd

    2016-01-01

    Introduction Type 2 endoleaks (T2E) occur in 10 to 20% of patients after endovascular abdominal aortic aneurysm repair (EVAR) and remain a significant clinical issue. Aim To evaluate the efficacy and clinical outcomes of transarterial treatment of persistent type II endoleaks after EVAR using the liquid embolic Onyx. Material and methods From February 2012 to August 2015 transarterial T2E embolization was attempted in 22 patients (21 men, median age: 73, range: 62–88 years). Indications for treatment included an increase in the diameter of the aneurysm sac above 5 mm and a persistent endoleak observed for more than 6 months. Mean time from EVAR to endoleak treatment was 43 months (range: 2–125 months). Results Primary technical success was achieved in 17 (77.3%) patients and secondary technical success in 81.8%, with 0% in-hospital mortality. The mean procedure time was 95 ±48 min, with an average fluoroscopy time of 54 ±25 min. The mean amount of Onyx used was 7.5 ±6.6 ml. Clinical success was seen in 17/21 patients with follow-up imaging (80.9%). Mean follow-up time was 17 months (range: 3–38 months). Conclusions Onyx has been shown to effectively stabilize previous aneurysm growth as a result of the T2E in the majority of our patients. Transarterial embolization of T2E can be significantly improved as compared to previously reported results by using liquid embolic polymers such as Onyx. PMID:28194246

  4. Aortic Curvature Is a Predictor of Late Type Ia Endoleak and Migration After Endovascular Aneurysm Repair.

    PubMed

    Schuurmann, Richte C L; van Noort, Kim; Overeem, Simon P; Ouriel, Kenneth; Jordan, William D; Muhs, Bart E; 't Mannetje, Yannick; Reijnen, Michel; Fioole, Bram; Ünlü, Çağdaş; Brummel, Peter; de Vries, Jean-Paul P M

    2017-06-01

    To evaluate the association between aortic curvature and other preoperative anatomical characteristics and late (>1 year) type Ia endoleak and endograft migration in endovascular aneurysm repair (EVAR) patients. Eight high-volume EVAR centers contributed 116 EVAR patients (mean age 81±7 years; 103 men) to the study: 36 patients (mean age 82±7 years; 31 men) with endograft migration and/or type Ia endoleak diagnosed >1 year after the initial EVAR and 80 controls without early or late complications. Aortic curvature was calculated from the preoperative computed tomography scan as the maximum and average curvature over 5 predefined aortic segments: the entire infrarenal aortic neck, aneurysm sac, and the suprarenal, juxtarenal, and infrarenal aorta. Other morphological characteristics included neck length, neck diameter, mural neck calcification and thrombus, suprarenal and infrarenal angulation, and largest aneurysm sac diameter. Independent risk factors were identified using backward stepwise logistic regression. Relevant cutoff values for each of the variables in the final regression model were determined with the receiver operator characteristic curve. Logistic regression identified maximum curvature over the length of the aneurysm sac (>47 m -1 ; p=0.023), largest aneurysm sac diameter (>56 mm; p=0.028), and mural neck thrombus (>11° circumference; p<0.001) as independent predictors of late migration and type Ia endoleak. Aortic curvature is a predictor for late type Ia endoleak and endograft migration after EVAR. These findings suggest that aortic curvature is a better parameter than angulation to predict post-EVAR failure and should be included as a hostile neck parameter.

  5. Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair.

    PubMed

    Abraha, Iosief; Luchetta, Maria Laura; De Florio, Rita; Cozzolino, Francesco; Casazza, Giovanni; Duca, Piergiorgio; Parente, Basso; Orso, Massimiliano; Germani, Antonella; Eusebi, Paolo; Montedori, Alessandro

    2017-06-09

    People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR). We searched MEDLINE, Embase, LILACS, ISI Conference Proceedings, Zetoc, and trial registries in June 2016 without language restrictions and without use of filters to maximize sensitivity. Any cross-sectional diagnostic study evaluating participants who received EVAR by both ultrasound (with or without contrast) and CT scan assessed at regular intervals. Two pairs of review authors independently extracted data and assessed quality of included studies using the QUADAS 1 tool. A third review author resolved discrepancies. The unit of analysis was number of participants for the primary analysis and number of scans performed for the secondary analysis. We carried out a meta-analysis to estimate sensitivity and specificity of CDUS or CE-CDUS using a bivariate model. We analysed each index test separately. As potential sources of heterogeneity, we explored year of publication, characteristics of included participants (age and gender), direction of the study (retrospective, prospective), country of origin, number of CDUS operators, and ultrasound manufacturer. We identified 42 primary studies with 4220 participants. Twenty studies provided accuracy data based on the number of individual participants (seven of which provided data with and without the use of contrast). Sixteen of

  6. Influence of warfarin therapy on the occurrence of postoperative endoleaks and aneurysm sac enlargement after endovascular abdominal aortic aneurysm repair.

    PubMed

    Seike, Yoshimasa; Tanaka, Hiroshi; Fukuda, Tetsuya; Itonaga, Tatsuya; Morita, Yoshiaki; Oda, Tatsuya; Inoue, Yosuke; Sasaki, Hiroaki; Minatoya, Kenji; Kobayashi, Junjiro

    2017-04-01

    This study aims to determine whether warfarin therapy influences the occurrence of endoleaks or aneurysm sac enlargement after endovascular aortic repair (EVAR). A total of 367 patients who underwent EVAR for abdominal aortic aneurysm between 2007 and 2013 were recruited for this study. Satisfactory follow-up data including completed computed tomography scan follow-up for more than 2 years were available for 209 patients, and the mean follow-up time was 37 ± 12 months. Twenty-nine (16%) patients were on warfarin therapy (warfarin group), whereas 180 (84%) patients were not on warfarin therapy (control group). Two- and four-year freedom rates for persistent type II endoleaks were significantly lower in patients of the warfarin group compared with the control group (85 and 49% vs 93 and 91%, respectively; P = 0.0001). Similarly, 2- and 4-year freedom rates for sac enlargement (>5 mm) were significantly lower in patients of the warfarin group compared with the control group (83 and 61% vs 92 and 82%, respectively; P = 0.0036). Using Cox regression analysis, the warfarin therapy was identified to be an independent positive predictor of sac enlargement after EVAR [hazard ratio (HR): 2.4; 95% confidence interval (CI): 1.08-5.40; P = 0.032], together with persistent type II endoleak. Warfarin therapy was also an independent predictor for persistent type II endoleak (HR: 3.7; 95% CI: 1.81-7.41; P < 0.0001) together with the number of patent lumbar arteries. Results suggested that warfarin therapy was significantly associated with an increased risk for persistent II endoleak and sac enlargement after EVAR. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. A Technique of "Chimney Nellix" for the Management of Type 1a Endoleak After EVAR.

    PubMed

    Joseph, Simon Z; Kwok, C H Ricky; Hockley, Joseph A; Garbowski, Marek W; Ferguson, John; Samuelson, Shaun; Jansen, Shirley J

    2018-05-01

    This report presents 3 procedures with visceral "chimney stenting" in conjunction with an endovascular aneurysm sealing (EVAS) device, known as chEVAS, for treatment of type 1a endoleak. It includes the first published chEVAS in a patient with previous fenestrated endovascular aneurysm repair (FEVAR). Cases include an 80-year-old man 8 years after FEVAR for a juxtarenal abdominal aortic aneurysm (AAA); an 85-year-old woman 9 months after endovascular aneurysm repair (EVAR) for a ruptured infrarenal AAA; and an 84-year-old woman 3 months after EVAR for a symptomatic infrarenal AAA. Technical success was achieved in all cases, with 1 postoperative death. The remaining 2 patients had no residual type 1a endoleak at 10 and 14 months respectively. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  8. Preliminary results of endovascular aneurysm sealing from the multicenter Italian Research on Nellix Endoprosthesis (IRENE) study.

    PubMed

    Gossetti, Bruno; Martinelli, Ombretta; Ferri, Michelangelo; Silingardi, Roberto; Verzini, Fabio

    2018-05-01

    underwent reinterventions. At 1-year follow-up, complications included 3 (1.1%) type II endoleaks, 4 (1.4%) type IA endoleaks, 1 (0.3%) type IB endoleak, 2 (0.7%) distal stent migrations, 5 (1.8%) distal embolizations, and 1 (0.3%) stent occlusion. Twelve patients (3.7%) underwent reinterventions, including four (1.4%) surgical conversions due to aortoduodenal fistula (1), endograft infection (1), and type IA endoleak that was unsuccessfully treated percutaneously (2). Two AAA-related deaths occurred. Freedom from aneurysm-related reintervention was 98.3% at 1-month and 94.7% at 12-month follow-up. The preliminary results of this real-world multicenter study showed that EVAS with Nellix for the management of AAAs appears feasible. This device platform is associated with acceptable procedure-related mortality and low overall complication and reintervention rates. Definitive conclusions on the value of this novel device await long-term follow-up data. Published by Elsevier Inc.

  9. Definition of Type II Endoleak Risk Based on Preoperative Anatomical Characteristics.

    PubMed

    Piazza, Michele; Squizzato, Francesco; Miccoli, Tommaso; Lepidi, Sandro; Menegolo, Mirko; Grego, Franco; Antonello, Michele

    2017-08-01

    To define the risk for type II endoleak (EII) after endovascular aneurysm repair (EVAR) based on preoperative anatomical characteristics. Between January 2008 and December 2015, 189 patients (mean age 78.4±7.6 years; 165 men) underwent standard EVAR. Mean aneurysm diameter was 5.7±0.7 cm and mean volume 125.2±45.8 cm 3 . Patients were assigned to the "at-risk" group (n=123, 65%) when at least one of the following criteria was present: patency of a >3-mm inferior mesenteric artery (IMA), patency of at least 3 pairs of lumbar arteries, or patency of 2 pairs of lumbar arteries and a sacral artery or accessory renal artery or any diameter patent IMA; otherwise, patients were entered in the "low-risk" group (n=66, 35%). EII rates and freedom from EII reintervention were compared using Kaplan-Meier curves. Preoperative clinical and anatomical characteristics were evaluated for their association with EII and EII reinterventions using multiple logistic regression analysis; results are presented as the odds ratio (OR) and 95% confidence interval (CI). Freedom from endoleak was lower in the at-risk group compared with the low-risk group at 36 months after EVAR (p=0.04). Freedom from EII-related reinterventions was significantly lower in the at-risk group (80% vs 100%, p=0.001) at 48 months. Based on the multiple regression analysis, the at-risk group had a higher likelihood of both EII (OR 9.91, 95% CI 2.92 to 33.72, p<0.001) and EII-related reinterventions (OR 9.11, 95% CI 1.06 to 78.44, p=0.04). These criteria had 89.4% (95% CI 83.9% to 93.2%) sensitivity and 48.0% (95% CI 40.7% to 55.3%) specificity for EII; sensitivity and specificity for EII reintervention were 100% (95% CI 93.8% to 100%) and 38.8% (95% CI 31.9% to 46.2%). Within the at-risk group, a sac thrombus volume <35% was an additional predictor for both EII (OR 5.21, 95% CI 1.75 to 15.47, p=0.003) and EII-related reinterventions (OR 8.33, 95% CI 2.20 to 31.51, p<0.002). The selection criteria effectively

  10. The use of technetium-99m-labeled human serum albumin diethylenetriamine pentaacetic acid single-photon emission CT scan in the follow-up of type II endoleak treatment.

    PubMed

    Nakai, Motoki; Sato, Hirotatsu; Ikoma, Akira; Sonomura, Tetsuo; Sato, Morio

    2014-03-01

    An 84-year-old woman presented with persistent type II endoleak with sac expansion from 57 mm to 75 mm during 4-year follow-up after endovascular abdominal aortic aneurysm repair. The patient underwent transabdominal embolization with coils and N-butyl cyanoacrylate/ethiodized oil (Lipiodol; Guerbet, Villepinte, France) mixture (2.5 mL). Because of the anticipated embolization artifacts on follow-up computed tomography (CT), technetium-99m-labeled human serum albumin diethylenetriamine pentaacetic acid single-photon emission computed tomography ((99m)Tc-HSAD SPECT) was performed before and after the intervention. Perigraft accumulation on (99m)Tc-HSAD SPECT corresponding to the endoleak disappeared after embolization. CT scan performed 12 months after embolization showed no signs of sac expansion. (99m)Tc-HSAD SPECT may be useful for evaluating therapeutic effect after embolization for endoleak. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  11. Polar orientation of renal grafts within the proximal seal zone affects risk of early type IA endoleaks after chimney endovascular aneurysm repair.

    PubMed

    Tran, Kenneth; Ullery, Brant W; Itoga, Nathan; Lee, Jason T

    2018-04-01

    The objective of this study was to describe the polar orientation of renal chimney grafts within the proximal seal zone and to determine whether graft orientation is associated with early type IA endoleak or renal graft compression after chimney endovascular aneurysm repair (ch-EVAR). Patients who underwent ch-EVAR with at least one renal chimney graft from 2009 to 2015 were included in this analysis. Centerline three-dimensional reconstructions were used to analyze postoperative computed tomography scans. The 12-o'clock polar position was set at the takeoff of the superior mesenteric artery. Relative polar positions of chimney grafts were recorded at the level of the renal artery ostium, at the mid-seal zone, and at the proximal edge of the graft fabric. Early type IA endoleaks were defined as evidence of a perigraft flow channel within the proximal seal zone. There were 62 consecutive patients who underwent ch-EVAR (35 double renal, 27 single renal) for juxtarenal abdominal aortic aneurysms with a mean follow-up of 31.2 months; 18 (29%) early type IA "gutter" endoleaks were identified. During follow-up, the majority of these (n = 13; 72%) resolved without intervention, whereas two patients required reintervention (3.3%). Estimated renal graft patency was 88.9% at 60 months. Left renal chimney grafts were most commonly at the 3-o'clock position (51.1%) at the ostium, traversing posteriorly to the 5- to 7-o'clock positions (55.5%) at the fabric edge. Right renal chimney grafts started most commonly at the 9-o'clock position (n = 17; 33.3%) and tended to traverse both anteriorly (11 to 1 o'clock; 39.2%) and posteriorly (5 to 7 o'clock; 29.4%) at the fabric edge. In the polar plane, the majority of renal chimney grafts (n = 83; 85.6%) traversed <90 degrees before reaching the proximal fabric edge. Grafts that traversed >90 degrees were independently associated with early type IA endoleaks (odds ratio, 11.5; 95% confidence interval, 2.1-64.8) even after

  12. The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm.

    PubMed

    Abdulrasak, M; Resch, T; Sonesson, B; Holst, J; Kristmundsson, T; Dias, N V

    2017-01-01

    The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months' follow-up. In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15-72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to

  13. The Influence of Preoperative Aneurysmal Thrombus Quantity and Distribution on the Development of Type II Endoleaks with Aneurysm Sac Enlargement After EVAR of AAA

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

    Müller-Wille, R., E-mail: rene.mueller-wille@ukr.de; Güntner, O., E-mail: oliverguentner@yahoo.de; Zeman, F., E-mail: florian.zeman@ukr.de

    PurposeTo determine the influence of preoperative aneurysmal thrombus quantity and distribution on the development of type II endoleak with aneurysm sac enlargement after endovascular aneurysm repair (EVAR).Materials and MethodsWe retrospectively analyzed the pre- and postoperatively performed CT scans of 118 patients who had follow-up imaging for at least 1 year after EVAR available. We assessed preoperative thrombus perimeter (T{sub Peri}), diameter (T{sub Dia}), cross-sectional area (T{sub CSA}), and volume (T{sub Vol}). The preoperative thrombus distribution was classified into no thrombus, semilunar-shaped (anterior, right side, left side, posterior) thrombus, and circumferential type thrombus. The number of preoperative patent aortic side branches (ASB)more » was identified. Endpoint was type II endoleak with aneurysm volume (A{sub Vol}) increase of ≥5 % during follow-up.ResultsDuring follow-up (2 years, range 1–9 years), 17 patients with type II endoleak had significant A{sub Vol} increase. Less preoperative T{sub Peri}, T{sub Dia}, T{sub CSA}, and T{sub Vol} were associated with A{sub Vol} increase. A circumferential thrombus distribution significantly protected against aneurysm enlargement (p = 0.028). The variables with the strongest significance for A{sub Vol} increase were preoperative T{sub Vol}/A{sub Vol} ratio (OR 0.95; p = 0.037) and number of patent ASB (OR 3.52; p < 0.001).ConclusionA low preoperative T{sub Vol}/A{sub Vol} ratio and a high number of patent ASB were associated with aneurysm sac enlargement after EVAR.« less

  14. Detection and visualization of endoleaks in CT data for monitoring of thoracic and abdominal aortic aneurysm stents

    NASA Astrophysics Data System (ADS)

    Lu, J.; Egger, J.; Wimmer, A.; Großkopf, S.; Freisleben, B.

    2008-03-01

    In this paper we present an efficient algorithm for the segmentation of the inner and outer boundary of thoratic and abdominal aortic aneurysms (TAA & AAA) in computed tomography angiography (CTA) acquisitions. The aneurysm segmentation includes two steps: first, the inner boundary is segmented based on a grey level model with two thresholds; then, an adapted active contour model approach is applied to the more complicated outer boundary segmentation, with its initialization based on the available inner boundary segmentation. An opacity image, which aims at enhancing important features while reducing spurious structures, is calculated from the CTA images and employed to guide the deformation of the model. In addition, the active contour model is extended by a constraint force that prevents intersections of the inner and outer boundary and keeps the outer boundary at a distance, given by the thrombus thickness, to the inner boundary. Based upon the segmentation results, we can measure the aneurysm size at each centerline point on the centerline orthogonal multiplanar reformatting (MPR) plane. Furthermore, a 3D TAA or AAA model is reconstructed from the set of segmented contours, and the presence of endoleaks is detected and highlighted. The implemented method has been evaluated on nine clinical CTA data sets with variations in anatomy and location of the pathology and has shown promising results.

  15. Examining the Preliminary Efficacy of a Dating Violence Prevention Program for Hispanic Adolescents

    ERIC Educational Resources Information Center

    Gonzalez-Guarda, Rosa Maria; Guerra, Jessica E.; Cummings, Amanda A.; Pino, Karen; Becerra, Maria M.

    2015-01-01

    The purpose of this study is to evaluate the preliminary efficacy of a dating violence (DV) prevention program for Cuban American adolescents ("JOVEN"/YOUTH: "Juntos Opuestos a la Violence Entre Novios"/Together Against Dating Violence). A randomized-controlled experimental design with a delayed condition was used to evaluate…

  16. Preliminary experience with the use of ultra-low profile endografts

    PubMed Central

    Mazzaccaro, Daniela; Malacrida, Giovanni; Amato, Bruno; Angileri, Salvatore Alessio; Ierardi, Anna Maria; Nano, Giovanni

    2017-01-01

    PURPOSE We aimed to report a preliminary single-center experience of elective endovascular aortic repair (EVAR) using ultra-low profile (ULP) endografts of 14 F outer diameter. METHODS Data of 67 consecutive patients who underwent EVAR using either Ovation (group A, n=30) or Incraft (group B, n=37) endografts were retrospectively analyzed. RESULTS Aorto-iliac anatomy was significantly different between the two groups, as patients of group A had a greater thrombotic apposition on proximal aortic neck (thrombus thickness: 7.2±1 mm vs. 3.3±1.6 mm, P = 0.042; percentage of the circumference covered by thrombus: 45.2%±10.4% vs. 18.7%±10.6%, P = 0.0003), while patients of group B had a more angulated proximal neck in the coronal axis (35.9°±6.4° vs. 16.7°±5°, P = 0.012). Procedural success was 93.3% and 97.3%, respectively, in groups A and B. One patient in group A required an immediate conversion to open surgery for persistent occlusion of both iliac limbs. Another patient required implantation of a conical endograft with a femoro-femoral right-to-left bypass for occlusion of the contralateral gate during the cannulation. In group B, one intraoperative type Ia endoleak was immediately corrected. Neither deaths nor major adverse events were recorded within 30-days. During a median follow-up of 15.2 months (range, 1–56.7 months) two type Ia endoleaks in group A required open conversion after 12.1 and 40.5 months, respectively. Three patients in group B required a reintervention after 30 days. Neither deaths nor aortic ruptures were recorded during follow-up. CONCLUSION Both ULP endografts showed satisfying early and mid-term results. PMID:29097346

  17. Preliminary investigation of a videogame prototype for cigarette and marijuana prevention in adolescents.

    PubMed

    Duncan, Lindsay R; Hieftje, Kimberly D; Pendergrass, Tyra M; Sawyer, Benjamin G; Fiellin, Lynn E

    2018-02-09

    Videogames are becoming increasingly popular to deliver health interventions; however, their role in the primary prevention of cigarette and marijuana use has not yet been evaluated. The purpose of this study was to conduct a preliminary test of the efficacy of a role-playing videogame prototype, smokeSCREEN, aimed at developing knowledge and behavioral skills associated with primary prevention of cigarette and marijuana use. The authors also explored participants' gameplay experience. This study employed a 1-group pretest-posttest design with 25 adolescent boys and girls aged 11 to 14 years (M age = 11.56, SD = 0.77) who had never tried cigarettes or marijuana. Participants played four 1-hour gameplay sessions over a 2-week period. Assessments of knowledge, self-efficacy, attitudes, perceived norms, and intentions related to cigarette and marijuana prevention were collected at baseline and 2-week and 12-week follow-ups. Ratings of gameplay experience were collected after the 2 weeks of gameplay. One-way repeated-measures analyses of variance (ANOVAs) were conducted. Findings are (1) improvements in knowledge for both cigarette (Wilks' λ = 0.62, F(2, 23) = 7.21, P = .004) and marijuana (Wilks' λ = 0.67, F(2, 23) = 5.75, P = .009) use from pre- to post-gameplay that were characterized by large effects; and (2) nonsignificant trends in the expected direction emerged for changes in self-efficacy and perceived norms related to both cigarettes and marijuana that were characterized by medium-large effects. Overall, the players provided positive reports of their experience with the smokeSCREEN videogame prototype. These findings provide preliminary evidence that a videogame has the potential to influence key cognitive and motivational variables and can be an engaging means to deliver a cigarette and marijuana prevention intervention.

  18. Early-Dynamic Positron Emission Tomography (PET)/Computed Tomography and PET Angiography for Endoleak Detection After Endovascular Aneurysm Repair.

    PubMed

    Drescher, Robert; Gühne, Falk; Freesmeyer, Martin

    2017-06-01

    To propose a positron emission tomography (PET)/computed tomography (CT) protocol including early-dynamic and late-phase acquisitions to evaluate graft patency and aneurysm diameter, detect endoleaks, and rule out graft or vessel wall inflammation after endovascular aneurysm repair (EVAR) in one examination without intravenous contrast medium. Early-dynamic PET/CT of the endovascular prosthesis is performed for 180 seconds immediately after intravenous injection of F-18-fluorodeoxyglucose. Data are reconstructed in variable time frames (time periods after tracer injection) to visualize the arterial anatomy and are displayed as PET angiography or fused with CT images. Images are evaluated in view of vascular abnormalities, graft configuration, and tracer accumulation in the aneurysm sac. Whole-body PET/CT is performed 90 to 120 minutes after tracer injection. This protocol for early-dynamic PET/CT and PET angiography has the potential to evaluate vascular diseases, including the diagnosis of complications after endovascular procedures.

  19. Preliminary Testing of a Program to Prevent Type 2 Diabetes among High-Risk Youth.(research Papers)

    ERIC Educational Resources Information Center

    Grey, Margaret; Berry, Diane; Davidson, Maryanne; Galasso, Pam; Gustafson, Elaine; Melkus, Gail

    2004-01-01

    Type 2 diabetes is increasing among youth, with minority youth at highest risk. This preliminary study tested the feasibility of a school-based program to prevent type 2 diabetes in youth at risk. Forty-one participants (age 12.6 [+ or -] 1.1 years; 63% female, 51% African American, 44% Hispanic, and 5% Caucasian) were randomly assigned to one of…

  20. Preliminary Results of a Comprehensive Approach to Prevent Antisocial Behaviour in Preschool and Primary School Pupils in Luxembourg

    ERIC Educational Resources Information Center

    Petermann, Franz; Natzke, Heike

    2008-01-01

    This pilot study evaluated the preliminary short- and middle-term impact of a nation-wide, school-based prevention initiative on antisocial behaviour of preschool and primary school pupils in Luxembourg. Seventeen preschool and reception classes (n = 183) were assigned to intervention and comparison conditions. The intervention included…

  1. Persistent type II endoleak after EVAR: the predictive value of the AAA thrombus volume.

    PubMed

    Gallitto, Enrico; Gargiulo, Mauro; Mascoli, Chiara; Freyrie, Antonio; DE Matteis, Massimo; Serra, Carla; Bianchini Massoni, Claudio; Faggioli, Gianluca; Stella, Andrea

    2018-02-01

    Persistent type II endoleaks (ELIIp, ≥6 months) after an endovascular aneurysm repair (EVAR) can be associated with adverse outcomes. The aims of this study are the evaluation of the incidence of ELIIp, their preoperative morphological predictive features (PMF) and the post-EVAR abdominal aortic aneurysm (AAA) evolution in the presence of ELIIp. Patients underwent EVAR between 2008 and 2010 were prospectively collected. Cases with ELIIp (group A: AG) were identified. A control group without ELIIp (group B: BG), homogeneous for clinical characteristics, follow-up timing and methods (CTA and/or CEUS at 6.12 months and yearly thereafter) was retrospectively selected. The PMF evaluated by computed-tomography-angiography (CTA) were: AAA-diameter, number and diameter of AAA efferent patent vessels (EPV), AAA-total volume (TV), AAA-thrombus volume (THV) and TV/THV rate (%VR). Volumes were calculated by the dedicated vessels analysis software. AG and BG were compared. The primary endpoint was to evaluate the incidence of ELIIp. Secondary endpoints were to analyze the relation between PMF and ELIIp and to assess the post-EVAR AAA-evolution in the presence of ELIIp. Between 2008 and 2010, 200 patients underwent EVAR to treat AAA electively. An ELIIp was detected in 35cases (17.5%) (AG). Twenty-seven patients (13.5%) were included in BG. An overall of 62 patients (GA+GB) were analyzed. The mean pre-operative AAA diameter and EPV were 58±11.6 mm and 5.5±1.8 mm, respectively. The mean TV and THV were 187±111.5 cc and 82±75 cc, respectively. The median %VR was 42.3%. ELIIp was correlated to EPV≥6 (χ2, p=.015) and %VR <40% (logistic regression, P=0.032). The mean follow-up was 22±9 months. Seven (20%) ELIIp spontaneously sealed and 6 (17%) required reinterventions (2 conversions to OR). There were not PMF associated to ELIIp evolution and AAA growth post-EVAR. ELIIp is a not rare complication and it could require re-interventions. Our data suggest that VEP≥6 or %VT<40

  2. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm

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

    Goltz, Jan Peter, E-mail: janpeter.goltz@uksh.de; Loesaus, Julia; Frydrychowicz, Alex

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft.more » The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel’s orifice despite the stentgraft being in place.« less

  3. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm.

    PubMed

    Goltz, Jan Peter; Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg; Wiedner, Marcus

    2016-02-01

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel's orifice despite the stentgraft being in place.

  4. Multilevel analysis of women's empowerment and HIV prevention: quantitative survey Results from a preliminary study in Botswana.

    PubMed

    Greig, Fiona E; Koopman, Cheryl

    2003-06-01

    This preliminary study explored relationships between women's empowerment and HIV prevention on the national and individual level with a focus on Botswana. Among sub-Saharan Africa countries, HIV prevalence was positively correlated with indirect indicators of women's empowerment relating to their education (female enrollment in secondary education and ratio of female to male secondary school enrollment), but not to their economic status (female share of paid employment in industry and services) or political status (women's share of seats in national parliament), while controlling for gross national income, percentage of births attended, and percentage of roads paved. Condom use at last sexual encounter was positively and significantly correlated with both indicators of women's educational empowerment, but was not significantly related to the other two indices. Empowerment at the individual level was explored through a preliminary quantitative survey of 71 sexually active women in Gaborone, Botswana, that was conducted in February 2001. Regression analyses showed that women's negotiating power and economic independence were the factors most strongly related to condom use, and did not show that education was a crucial factor. Economic independence was the factor most strongly related to negotiating power. These results suggest that in Botswana, HIV prevention efforts may need to improve women's negotiating skills and access to income-generating activities.

  5. TRI Preliminary Dataset

    EPA Pesticide Factsheets

    The TRI preliminary dataset includes the most current TRI data available and reflects toxic chemical releases and pollution prevention activities that occurred at TRI facilities during the each calendar year.

  6. Preventative Vaccines for Zika Virus Outbreak: Preliminary Evaluation.

    PubMed

    Kim, Eun; Erdos, Geza; Huang, Shaohua; Kenniston, Thomas; Falo, Louis D; Gambotto, Andrea

    2016-11-01

    Since it emerged in Brazil in May 2015, the mosquito-borne Zika virus (ZIKV) has raised global concern due to its association with a significant rise in the number of infants born with microcephaly and neurological disorders such as Guillain-Barré syndrome. We developed prototype subunit and adenoviral-based Zika vaccines encoding the extracellular portion of the ZIKV envelope gene (E) fused to the T4 fibritin foldon trimerization domain (Efl). The subunit vaccine was delivered intradermally through carboxymethyl cellulose microneedle array (MNA). The immunogenicity of these two vaccines, named Ad5.ZIKV-Efl and ZIKV-rEfl, was tested in C57BL/6 mice. Prime/boost immunization regimen was associated with induction of a ZIKV-specific antibody response, which provided neutralizing immunity. Moreover, protection was evaluated in seven-day-old pups after virulent ZIKV intraperitoneal challenge. Pups born to mice immunized with Ad5.ZIKV-Efl were all protected against lethal challenge infection without weight loss or neurological signs, while pups born to dams immunized with MNA-ZIKV-rEfl were partially protected (50%). No protection was seen in pups born to phosphate buffered saline-immunized mice. This study illustrates the preliminary efficacy of the E ZIKV antigen vaccination in controlling ZIKV infectivity, providing a promising candidate vaccine and antigen format for the prevention of Zika virus disease. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Development and preliminary evaluation of a behavioural HIV prevention program for teenage girls of Latino descent in the USA

    PubMed Central

    Davidson, Tatiana M.; Lopez, Cristina M.; Saulson, Raelle; Borkman, April L.; Soltis, Kathryn; Ruggiero, Kenneth J.; de Arellano, Michael; Wingood, Gina M.; DiClemente, Ralph J.; Danielson, Carla Kmett

    2014-01-01

    National data suggests that teenage girls of Latino descent in the USA are disproportionately affected by HIV with the rate of new infections being approximately 4 times higher compared to White women of comparable age (Centers for Disease Control and Prevention 2013). This paper highlights the need for an effective single-sex HIV prevention program for teenage girls of Latino descent and describes the development and preliminary evaluation of Chicas Healing, Informing, Living and Empowering (CHILE), a culturally-tailored, HIV prevention programme exclusively for teenage girls of Latino descent that was adapted from Sisters Informing, Healing, Living, and Empowering (SiHLE), an evidence-based HIV prevention program that is culturally tailored for African American young women. Theatre testing, a pre-testing methodology to assess consumer response to a demonstration of a product, was utilised to evaluate the relevance and utility of the HIV program as well as opportunities for the integration of cultural constructs. Future directions for the evaluation of CHILE are discussed. PMID:24697607

  8. Development and preliminary evaluation of a behavioural HIV-prevention programme for teenage girls of Latino descent in the USA.

    PubMed

    Davidson, Tatiana M; Lopez, Cristina M; Saulson, Raelle; Borkman, April L; Soltis, Kathryn; Ruggiero, Kenneth J; de Arellano, Michael; Wingood, Gina M; Diclemente, Ralph J; Danielson, Carla Kmett

    2014-01-01

    National data suggests that teenage girls of Latino descent in the USA are disproportionately affected by HIV, with the US Centers for Disease Control and Prevention reporting the rate of new infections being approximately four times higher compared to White women of comparable age . This paper highlights the need for an effective single-sex HIV-prevention programme for teenage girls of Latino descent and describes the development and preliminary evaluation of Chicas Healing, Informing, Living and Empowering (CHILE), a culturally-tailored, HIV-prevention programme exclusively for teenage girls of Latino descent that was adapted from Sisters Informing, Healing, Living and Empowering (SiHLE), an evidence-based HIV- prevention program that is culturally tailored for African American young women. Theatre testing, a pre-testing methodology to assess consumer response to a demonstration of a product, was utilised to evaluate the relevance and utility of the HIV programme as well as opportunities for the integration of cultural constructs. Future directions for the evaluation of CHILE are discussed.

  9. Acceptability and Preliminary Outcomes of a Peer-Led Depression Prevention Intervention for African American Adolescents and Young Adults in Employment Training Programs

    ERIC Educational Resources Information Center

    Tandon, Darius; Mendelson, Tamar; Mance, GiShawn

    2011-01-01

    This study examines the acceptability and preliminary outcomes from an open trial of a depression prevention intervention for low-income African American adolescents and young adults in employment training programs. The sample (N=42) consisted of predominately African American adolescents and young adults (mean age=19.1) exhibiting subclinical…

  10. Prevention of post-rape psychopathology: preliminary findings of a controlled acute rape treatment study.

    PubMed

    Resnick, H; Acierno, R; Holmes, M; Kilpatrick, D G; Jager, N

    1999-01-01

    Violent sexual assault such as rape typically results in extremely high levels of acute distress. The intensity of these acute psychological reactions may play a role in later recovery, with higher levels of immediate distress associated with poorer outcome. Unfortunately, post-rape forensic evidence collection procedures may serve to increase, rather than reduce initial distress, potentially exacerbating future psychopathology. To address these concerns, an acute time-frame hospital-based video intervention was developed to: (a) minimize anxiety during forensic rape exams, and (b) prevent post-rape posttraumatic stress disorder (PTSD), panic, and anxiety. Preliminary data indicated that (1) psychological distress at the time of the exam was strongly related to PTSD symptomatology 6 weeks post-rape, and (2) the video intervention successfully reduced distress during forensic exams.

  11. Selective Intra-procedural AAA sac Embolization During EVAR Reduces the Rate of Type II Endoleak.

    PubMed

    Mascoli, C; Freyrie, A; Gargiulo, M; Gallitto, E; Pini, R; Faggioli, G; Serra, C; De Molo, C; Stella, A

    2016-05-01

    The pre-treatment presence of at least six efferent patent vessels (EPV) from the AAA sac and/or AAA thrombus volume ratio (VR%) <40% are considered to be positive predictive factors for persistent type II endoleak (ELIIp). The aim of the present study was to evaluate the effectiveness of sac embolization during EVAR in patients with pre-operative morphological risk factors (p-MRF) for ELIIp. Patients undergoing EVAR and intra-procedural AAA sac embolization (Group A, 2012-2013) were retrospectively selected and compared with a control group of patients with the same p-MRF, who underwent EVAR without intra-procedural sac embolization (Group B, 2008-2010). The presence of ELIIp was evaluated by duplex ultrasound at 0 and 6 months, and by contrast enhanced ultrasound at 12 months. The association between AAA diameter, age, COPD, smoking, anticoagulant therapy, and AAA sac embolization with ELIIp was evaluated using multiple logistic regression. The primary endpoint was the effectiveness of the intra-procedural AAA sac embolization for ELIIp prevention. Secondary endpoints were AAA sac evolution and freedom from ELIIp and embolization related re-interventions at 6-12 months. Seventy patients were analyzed: 26 Group A and 44 Group B; the groups were homogeneous for clinical/morphological characteristics. In Group A the median number of coils positioned in AAA sac was 4.1 (IQR 1). There were no complications related to the embolization procedures. A significantly lower number of ELIIp was detected in Group A than in Group B (8/26 vs. 33/44, respectively, p < .001) at discharge, and this was confirmed at 6-12 months (7/26 vs. 30/44 respectively, p = .001, and 5/25 vs. 32/44, respectively, p < .001). On multivariate analysis, intra-procedural AAA sac embolization was the only factor independently associated with freedom from ELIIp at 6 (OR 0.196, 95% CI 0.06-0.63; p = .007) and 12 months (OR 0.098, 95% CI 0.02-0.35; p < .001). No differences in median AAA sac

  12. An Alternative Approach for Treating a Type Ia Endoleak after Conventional EVAR Using the Nellix Endovascular Aneurysm Sealing.

    PubMed

    Martinelli, Ombretta; Fresilli, Mauro; Irace, Luigi; Venosi, Salvatore; Jabbour, Jihad; Picone, Veronica; Maruca, Debora; Di Girolamo, Alessia; Gossetti, Bruno

    2018-05-01

    To report the use of a Nellix endovascular aneurysm sealing (EVAS) device, to successfully treat a type Ia endoleak (EL) after an endovascular aortic repair (EVAR). A 70-year-old man was diagnosed with a 90-mm aortic aneurysm, suspicious for being inflammatory. It was initially treated successfully, with a Medtronic Endurant (Medtronic, Minneapolis, MN, USA). Five years after the index endovascular repair, an asymptomatic type Ia EL was detected on duplex ultrasound and computed tomographic angiogram. Other endovascular solutions in the form of proximal cuff, chimney was considered difficult to execute due to challenges in planning, manipulation, and renal cannulation caused by the short proximal sealing zone above the existing stent graft and the constraints of the previous endograft. Thus, a relining of the previous endoprothesis was performed using the Nellix system (Endologix, Inc., Irvine, CA, USA). One-year follow-up imaging demonstrated successful resolution of the EL and persistent sealing of the Nellix device. Nellix EVAS system can be an alternative and safe option for relining a stent graft with a type Ia EL. Nellix platform can be added to the clinician's armamentarium for treating type Ia EL after conventional EVAR of infrarenal abdominal aortic aneurysm (AAA). Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Development of a monitoring platform for slope instability and sliding prevention : preliminary results

    NASA Astrophysics Data System (ADS)

    Drakatos, G.; Paradissis, D.; Anastasiou, D.; Elias, P.; Marinou, A.; Chousianitis, K.; Papanikolaou, X.; Zacharis, V.; Argyrakis, P.; Papazisi, K.; Makropoulos, K.

    2012-04-01

    Land sliding, as a consequence of slope instability, constitutes a natural catastrophe resulting mainly from geological cause often followed by disastrous impact on both the natural and man-made environment. The reasons causing land slides can vary from purely geological factors, to other relevant or not natural catastrophes, urban or residential expansion, tourist growth in areas under inappropriate geological background, or even a combination of the aforementioned causes The respective consequences, also span a wide range of negative impacts, both for the man-made (e.g. destruction of transportation infrastructure, constructions and urban or sub-urban areas) and the natural environment. Unfortunately, prevention of land slides is still largely ineffective adding to an inefficient and inadequate addressing of the problem, mainly due to the lack of systematic monitoring of such regions and due to the fact that "treatment" overwhelms "prevention". Recent developments in Global Navigation Satellite Systems (GNSS), Satellite Geodesy and satellite differential interferometry (DinSAR), have established these fields as fully equipped, from a scientific and engineering perspective, to act --either as autonomous techniques or in conjunction-- as prevention and/or early warning systems. Such state-of-the-art technology was implemented, in a project undertaken by the Institute of Geodynamics Dionysos Satellite Observatory/Higher Geodesy Laboratory and the Institute for Space Applications and Remote Sensing, in order to evaluate the potential of monitoring slide stability and the assessment of hazard evaluation. Therefore, for the first time in Greece, an attempt was made to develop a monitoring platform for slope instability and sliding prevention at two of the most hazardous, regarding soil instabilities, regions of Peloponnese, namely Sellas and Chalkio (in Messinia and Korinthia respectively). GPS campaigns were carried through, cGPS stations were installed and a network

  14. Triple In Situ Antegrade Laser Fenestration of Aortic Stent-Graft Extension Using Fusion Imaging for Urgent Treatment of Symptomatic Abdominal Aneurysm with Type 1 Endoleak.

    PubMed

    Touma, Joseph; Kobeiter, Hicham; Majewski, Marek; Tacher, Vania; Desgranges, Pascal

    2018-03-01

    The present report describes the management of massive proximal type 1 endoleak with an enlarged symptomatic aneurysmal sac. Urgent treatment was performed using in situ laser fenestration of an aortic proximal extension facing renovisceral ostia. Image fusion was obtained intraoperatively. For each target vessel (superior mesenteric and two renal arteries), an Aptus HeliFX steerable sheath (Medtronic) inserted through femoral access was curved to face the vessel's ostium marker. A laser catheter (Spectranetics) was used to traverse the stent-graft and insert a 0.014" guidewire in the vessel. The fenestration was enlarged using a 2.5-mm-diameter cutting balloon, followed by a 4-mm-diameter balloon angioplasty and a V12 I Cast/Advanta covered stent implantation. Final angiogram demonstrated aneurysm exclusion and patent target vessels. The postoperative course and 7 months follow-up were uneventful. Level of evidence Level 4.

  15. A Preliminary Study of a Spanish Graphic Novella Targeting Hearing Loss Prevention.

    PubMed

    Guiberson, Mark; Wakefield, Emily

    2017-09-18

    This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest-posttest interview surveys to establish if the novella had an immediate influence on the participants' beliefs about noise-induced hearing loss and usage of hearing protection devices. Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific questions on noise-induced hearing loss, myths, and hearing protection device usage. A pretest-posttest design was applied to measure the graphic novella's immediate influence on workers. The posttest scores on Hearing Protection Beliefs statements were significantly better than pretest scores, with a large effect size observed. Digital media may be an effective way to overcome language and literacy barriers with Spanish-speaking workers when providing health education and prevention efforts.

  16. A Preliminary Study of a Spanish Graphic Novella Targeting Hearing Loss Prevention

    PubMed Central

    Wakefield, Emily

    2017-01-01

    Purpose This preliminary study developed a digital graphic novella targeting hearing protection beliefs of Spanish-speaking agricultural workers. Researchers used pretest–posttest interview surveys to establish if the novella had an immediate influence on the participants' beliefs about noise-induced hearing loss and usage of hearing protection devices. Method Researchers developed a digital graphic novella directed to increase knowledge about noise-induced hearing loss and increase the proper use of hearing protection devices. The novella was tailored to meet the specific linguistic and literacy needs of Spanish-speaking agricultural workers. Thirty-one Spanish-speaking farmworkers of Mexican nationality participated. This study included an interview survey with specific questions on noise-induced hearing loss, myths, and hearing protection device usage. A pretest–posttest design was applied to measure the graphic novella's immediate influence on workers. Results The posttest scores on Hearing Protection Beliefs statements were significantly better than pretest scores, with a large effect size observed. Conclusion Digital media may be an effective way to overcome language and literacy barriers with Spanish-speaking workers when providing health education and prevention efforts. PMID:28651254

  17. Middle-term results of endovascular aneurysm repair in Japan: does intraoperative endovascular management against the hostile aneurysmal neck prevent the proximal type I endoleak?

    PubMed

    Hoshina, K; Kato, M; Hosaka, A; Miyahara, T; Mikuriya, A; Ohkubo, N; Miyata, T

    2011-10-01

    Endovascular aneurysm repair (EVAR) was first approved in Japan in 2007. In order to avoid the learning curve generally seen in the initial stages of implementation, we have aimed for procedural perfection. As the proximal type I endoleak (EL) is associated with a higher risk of late conversion and rupture, so we have treated the intraoperative type I EL scrupulously. The hostile neck, which is known to be a risk for perigraft leakage, is the focus of this study. We showed both the middle-term results of EVAR in our country and the possible necessity of intraoperative management for the hostile neck. From a consecutive series of 134 patients who underwent EVAR of abdominal aortic aneurysms, 129 cases in which contrast agent was used intraoperatively were selected. All cases had at least 12-month follow-up postoperatively (12-40 months). Of the 129 selected cases, 49 cases (37%) that did not fulfill the commercially recommended criteria of the aneurysmal neck (length <15 mm and angle >60° of the aneurysm or >45° of the suprarenal aorta) were assigned to the off-label group. The other 80 cases were assigned to the on-label group. We carefully observed the completion angiography and when we found or suspected a type I EL, we performed a re-touch up, changed to a non-compliant balloon, and used a supportive device, such as a PalmazTM stent or aortic cuffs, in sequence. No postoperative type I ELs were detected within the follow-up period. Intraoperative type I ELs were detected more frequently in the off-label group (51%) than the on-label group (20%) (P<0.01). The rate of type I EL in the off-label group in terms of the neck length criteria (11/14 cases) was higher than that in the on-label group (30/115 cases) (P<0.01). In terms of the neck angle, patients in the off-label group had a greater tendency to develop the type I EL than those in the on-label group (18/42 vs. 23/87 cases) (P=0.06). Off-label usage regarding aneurysmal neck length and angle tends to be

  18. INTEGRATION OF POLLUTION PREVENTION TOOLS

    EPA Science Inventory

    A prototype computer-based decision support system was designed to provide small businesses with an integrated pollution prevention methodology. Preliminary research involved compilation of an inventory of existing pollution prevention tools (i.e., methodologies, software, etc.),...

  19. Preventing Mania: A Preliminary Examination of the GOALS Program

    PubMed Central

    Johnson, Sheri L.; Fulford, Daniel

    2010-01-01

    There is strong evidence of a relationship between goal dysregulation and mania. Building on these findings, we examined the feasibility of developing a mania prevention treatment program designed to improve goal regulation skills for those with bipolar disorder. Here, we describe the process of developing a manual, delivering the intervention to a series of cases, and then conducting a small open uncontrolled trial. All participants met diagnostic criteria for bipolar I disorder based on the Structured Clinical Interview for DSM-IV and were not currently experiencing episodes of depression or mania. Ten participants (8 female, mean age = 46.7 years) were enrolled in the GOALS program and completed an average of 13.2 weekly sessions. Participants were administered the Bech-Rafaelson Mania Scale (BRMS) and the Modified Hamilton Rating Scale for Depression at baseline and termination. Some participants completed self-report scales including the Altman Self-Rating Mania Scale, the Beck Depression Inventory, and the Willingly Approached Set of Statistically Unrealistic Pursuits at baseline and termination. In addition, participants were administered a consumer satisfaction questionnaire at termination. At termination, all 10 participants found the program highly relevant and helpful. Most importantly, even though levels of mania were low initially, mean levels of manic symptoms on the BRMS decreased significantly from baseline to termination, and all 10 participants were within a healthy range (BRMS <7) at termination. Although the lack of control group or follow-up data limits this study, preliminary evidence suggests that it is feasible to identify treatment targets by drawing from the basic research literature in bipolar disorder. Findings await replication and more careful testing within a randomized controlled trial. PMID:19433142

  20. Evaluation of a decision support system for pressure ulcer prevention and management: preliminary findings.

    PubMed

    Zielstorff, R D; Estey, G; Vickery, A; Hamilton, G; Fitzmaurice, J B; Barnett, G O

    1997-01-01

    A decision support system for prevention and management of pressure ulcers was developed based on AHCPR guidelines and other sources. The system was implemented for 21 weeks on a 20-bed clinical care unit. Fifteen nurses on that unit volunteered as subjects of the intervention to see whether use of the system would have a positive effect on their knowledge about pressure ulcers and on their decision-making skills related to this topic. A similar care unit was used as a control. In addition, the system was evaluated by experts for its instructional adequacy, and by end users for their satisfaction with the system. Preliminary results show no effect on knowledge about pressure ulcers and no effect on clinical decision making skills. The system was rated positively for instructional adequacy, and positively for user satisfaction. User interviews related to satisfaction supplemented the quantitative findings. A discussion of the issues of conducting experiments like this in today's clinical environment is included.

  1. [RADAR: a program for the prevention of suicide in adolescents in the region of Aysen, Chile, preliminary results].

    PubMed

    Bustamante, Francisco; Urquidi, Cinthya; Florenzano, Ramón; Barrueto, Carolina; de Los Hoyos, Jaime; Ampuero, Karla; Terán, Laura; Figueroa, María Inés; Farías, Magdalena; Rueda, María Livia; Giacaman, Eduardo

    2018-02-01

    We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

  2. Preliminary program evaluation of emergency department HIV prevention counseling.

    PubMed

    Sitlinger, Andrea P; Lindsell, Christopher J; Ruffner, Andrew H; Wayne, D Beth; Hart, Kimberly W; Trott, Alexander T; Fichtenbaum, Carl J; Lyons, Michael S

    2011-07-01

    Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit

  3. Characteristics and Risk Factors for Type 2 Endoleak in an East Asian Population From a Japanese Multicenter Database.

    PubMed

    Fujimura, Naoki; Obara, Hideaki; Matsubara, Kentaro; Watada, Susumu; Shibutani, Shintaro; Akiyoshi, Takurin; Harada, Hirohisa; Kitagawa, Yuko

    2016-01-01

    Clinically distinct differences exist between East Asian and Caucasian subjects, but data for type 2 endoleak (T2EL) are limited in the East Asian population. The aim of this study was to analyze the characteristics of East Asian T2EL using a Japanese multicenter database. Retrospective analysis of 832 endovascular aneurysm repairs performed from 2008 to 2014 were conducted. T2EL was observed in 234 cases (28.1%), and in 32 cases (3.8%) it led to sac expansion >5 mm caused by isolated T2EL (median follow-up, 35.6 months). On univariate and multivariate analysis, non-smoker status (odds ratio [OR], 2.216; P<0.001), Excluder stent graft (OR, 2.027; P<0.001), and T2EL at final angiogram (OR, 2.080; P<0.001) were risk factors for T2EL. On multivariate analysis for isolated T2EL with sac expansion, only non-smoker status remained (OR, 2.671; P<0.001). Other than T1EL, isolated T2EL was the most significant risk factor for sac expansion (OR, 18.486; P<0.001). Furthermore, out of 11 transarterial embolization procedures initiated, 4 led to rupture during follow-up. East Asian T2EL had a strong relationship with non-smoker status. Also, T2EL was a significant risk factor for sac expansion, which sometimes led to rupture even after intervention. Along with the high prevalence of T2EL observed, East Asian T2EL may not always be benign.

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

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

    Pitton, Michael B., E-mail: pitton@radiologie.klinik.uni-mainz.de; Scheschkowski, Tobias; Ring, Markus

    2009-09-15

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 {+-} 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need formore » primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 {+-} 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 {+-} 4.7 months. Mean survival and freedom from any event was 66.7 {+-} 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks ({Delta} at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion

  5. Refinement and Preliminary Testing of an Imagery-Based Program to Improve Coping and Performance and Prevent Trauma among Urban Police Officers

    PubMed Central

    Arble, Eamonn; Lumley, Mark A.; Pole, Nnamdi; Blessman, James; Arnetz, Bengt B.

    2016-01-01

    Police officers are regularly exposed to traumatic critical incidents. The substantial mental, behavioral, and social costs of police trauma indicate a substantial need for prevention. We have refined and enhanced a previously tested Swedish program to the harsh conditions of U.S. inner cities. The program was designed to strengthen resilience during stressful encounters and teach methods of coping after exposure, thereby preventing the emergence of maladaptive symptoms and behaviors with adverse effects on professionalism. In an uncontrolled demonstration project, junior officers were trained by senior officers to engage in imaginal rehearsal of specific dangerous situations while incorporating optimal police tactics and healthy emotional reactions. A class of 32 officers in the police academy engaged in the program, and they and the trainers reported high satisfaction with it. After their first year of field work, 22 officers were reassessed. Compared to pre-training, these officers showed significant increases in the use of positive reframing and humor and significant reductions in anxiety and alcohol use over the year. Trauma symptoms did not increase. These results offer preliminary evidence for the feasibility and effectiveness of this trauma prevention program for new police officers. PMID:28439149

  6. Refinement and Preliminary Testing of an Imagery-Based Program to Improve Coping and Performance and Prevent Trauma among Urban Police Officers.

    PubMed

    Arble, Eamonn; Lumley, Mark A; Pole, Nnamdi; Blessman, James; Arnetz, Bengt B

    2017-03-01

    Police officers are regularly exposed to traumatic critical incidents. The substantial mental, behavioral, and social costs of police trauma indicate a substantial need for prevention. We have refined and enhanced a previously tested Swedish program to the harsh conditions of U.S. inner cities. The program was designed to strengthen resilience during stressful encounters and teach methods of coping after exposure, thereby preventing the emergence of maladaptive symptoms and behaviors with adverse effects on professionalism. In an uncontrolled demonstration project, junior officers were trained by senior officers to engage in imaginal rehearsal of specific dangerous situations while incorporating optimal police tactics and healthy emotional reactions. A class of 32 officers in the police academy engaged in the program, and they and the trainers reported high satisfaction with it. After their first year of field work, 22 officers were reassessed. Compared to pre-training, these officers showed significant increases in the use of positive reframing and humor and significant reductions in anxiety and alcohol use over the year. Trauma symptoms did not increase. These results offer preliminary evidence for the feasibility and effectiveness of this trauma prevention program for new police officers.

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

    Wieners, Gero, E-mail: gero.wieners@med.ovgu.d; Meyer, Frank; Halloul, Zuhir

    PurposeThis prospective study was designed to assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR).MethodsThirty-two patients with aortic aneurysms who had undergone EVAR were included in this study. All patients were examined by dual-phase computed tomography angiography (CTA) as well as MRA with gadofosveset in the first-pass and steady-state phases. Two independent readers evaluated the images of CTA and MRA in terms of endoleak type II, feeding vessel, and image quality.ResultsMedian follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type IImore » was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations.ConclusionMRA with gadofosveset appeared superior to CTA, and has higher diagnostic accuracy, in the detection of endoleak after EVAR.« less

  8. Transcutaneous supraorbital neurostimulation for the prevention of chronic migraine: a prospective, open-label preliminary trial.

    PubMed

    Di Fiore, Paola; Bussone, Gennaro; Galli, Alberto; Didier, Henri; Peccarisi, Cesare; D'Amico, Domenico; Frediani, Fabio

    2017-05-01

    Since chronic migraine is difficult to treat and often associated with medication overuse, non-invasive neurostimulation approaches are worth investigating. Transcutaneous supraorbital neurostimulation using the Cefaly ® device is promising as a non-invasive preventive treatment for episodic migraine, but no data are available for chronic migraine. Our aim was to perform a preliminary evaluation of the efficacy of the Cefaly ® device for the prophylaxis of chronic migraine with or without medication overuse. Primary endpoints were 50% reduction in monthly migraine days and 50% reduction in monthly medication use over 4 months. In an open-label study, twenty-three consecutive headache center patients with chronic migraine, diagnosed according to International Headache Society criteria, were recruited prospectively. After informed consent, patients were trained to use Cefaly ® and instructed to use it for 20 min daily over 4 months. All patients received active neurostimulation. Thirty-five percent of the patients enrolled in the study achieved the study endpoints. Over half the patients had a greater than 50% reduction in acute medication consumption.

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

    Ikoma, Akira, E-mail: yfb04322@nifty.com; Nakai, Motoki, E-mail: momonga@wakayama-med.ac.jp; Sato, Morio, E-mail: morisato@wakayama-med.ac.jp

    PurposeTo assess the relationship between the systolic sac pressure index (SPI) and the presence of endoleaks 12 months after endovascular abdominal aortic aneurysm repair (EVAR).Materials and MethodsWe performed a single-center prospective trial of consecutively treated patients. SPI (calculated as systolic sac pressure/systolic aortic pressure) was measured by catheterization immediately after EVAR. Contrast-enhanced computed tomography was scheduled 12 months after EVAR to detect possible endoleaks.ResultsData were available for 34 patients who underwent EVAR for an AAA. Persisting type II endoleak was found in 8 patients (endoleak-positive group) but not in the other 26 patients (endoleak-negative group). The mean ± standard deviation SPI was significantly greatermore » in the endoleak-positive group than in the endoleak-negative group (0.692 ± 0.048 vs. 0.505 ± 0.081, respectively; P = .001). Receiver-operating characteristic curve analysis revealed that an SPI of 0.638 was the optimum cutoff value for predicting a persistent endoleak at 12 months with high accuracy (0.971; 33/34), sensitivity (1.00), and specificity (0.962) values. The mean change in AAA diameter was −4.28 ± 5.03 mm and 2.22 ± 4.54 mm in patients with SPI of <0.638 or ≥0.638, respectively (P = .002).ConclusionPatients with an SPI of ≥0.638 immediately after EVAR were more likely to have a persistent type II endoleak at 12 months with an accuracy of 0.971, and showed increases in aneurysm sac diameter compared with patients with an SPI of <0.638.« less

  10. Preliminary results of antiscarring therapy in the prevention of postendoscopic esophageal mucosectomy strictures

    PubMed Central

    Wu, Yuhsin; Schomisch, Steve J.; Cipriano, Cassandra; Chak, Amitabh; Lash, Richard H.; Ponsky, Jeffrey L.

    2015-01-01

    Background Esophageal endoscopic submucosal dissection (ESD) is an effective minimally invasive therapy for early esophageal cancer and high-grade Barrett dysplasia. However, esophageal stricture formation after circumferential or large ESD has limited its wide adoption. Mitomycin C (MMC), halofuginone (Hal), and transforming growth factor β3 (TGF-β3) exhibits antiscarring effects that may prevent post-ESD stricture formation. Methods Using endoscopic mucosectomy (EEM) technique, an 8- to 10-cm-long circumferential esophageal mucosal segment was excised in a porcine model. The site was either untreated (control, n = 6) or received 40 evenly distributed injections of antiscarring agent immediately and at weeks 1 and 2. High and low doses were used: MMC 5 mg (n = 2), 0.5 mg (n = 2); Hal 5 mg (n = 2), 1.5 mg (n = 2), 0.5 mg (n = 2); TGF-β3 2 μg (n = 2), 0.5 μg (n = 2). The degree of stricture formation was determined by the percentage reduction of the esophageal lumen on weekly fluoroscopic examination. Animals were euthanized when strictures exceeded 80 % or the animals were unable to maintain weight. Results The control group had a luminal diameter reduction of 78.2 ± 10.9 % by 2 weeks and were euthanized by week 3. Compared at 2 weeks, the Hal group showed a decrease in mean stricture formation (68.4 % low dose, 57.7 % high dose), while both TGF-β3 dosage groups showed no significant change (65.3 % low dose, 76.2 % high dose). MMC was most effective in stricture prevention (53.6 % low dose, 35 % high dose). Of concern, the esophageal wall treated with high-dose MMC appeared to be necrotic and eventually led to perforation. In contrast, low dose MMC, TGF-β3 and Hal treated areas appeared re-epithelialized and healthy. Conclusions Preliminary data on MMC and Hal demonstrated promise in reducing esophageal stricture formation after EEM. More animal data are needed to perform adequate statistical analysis in order to determine overall efficacy of antiscarring

  11. 29 CFR 1601.23 - Preliminary or temporary relief.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Preliminary or temporary relief. 1601.23 Section 1601.23 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURAL REGULATIONS Procedure for the Prevention of Unlawful Employment Practices Procedure to Rectify Unlawful...

  12. Facility Pollution Prevention Guide

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

    Not Available

    The U.S. Environmental Protection Agency (U.S. EPA) has developed the Facility Pollution Prevention Guide for those who are interested in and responsible for pollution prevention in industrial or service facilities. It summarizes the benefits of a company-wide pollution prevention program and suggests ways to incorporate pollution prevention in company policies and practices. The Guide describes how to establish a company-wide pollution prevention program. It outlines procedures for conducting a preliminary assessment to identify opportunities for waste reduction or elimination. Then, it describes how to use the results of the preassessment to prioritize areas for detailed assessment, how to use themore » detailed assessment to develop pollution prevention options, and how to implement those options that withstand feasibility analysis. Methods of evaluating, adjusting, and maintaining the program are described. Later chapters deal with cost analysis for pollution prevention projects and with the roles of product design and energy conservation in pollution prevention. Appendices consist of materials that will support the pollution prevention effort: assessment worksheets, sources of additional information, examples of evaluative methods, and a glossary.« less

  13. Collecting costs of community prevention programs: communities putting prevention to work initiative.

    PubMed

    Khavjou, Olga A; Honeycutt, Amanda A; Hoerger, Thomas J; Trogdon, Justin G; Cash, Amanda J

    2014-08-01

    Community-based programs require substantial investments of resources; however, evaluations of these programs usually lack analyses of program costs. Costs of community-based programs reported in previous literature are limited and have been estimated retrospectively. To describe a prospective cost data collection approach developed for the Communities Putting Prevention to Work (CPPW) program capturing costs for community-based tobacco use and obesity prevention strategies. A web-based cost data collection instrument was developed using an activity-based costing approach. Respondents reported quarterly expenditures on labor; consultants; materials, travel, and services; overhead; partner efforts; and in-kind contributions. Costs were allocated across CPPW objectives and strategies organized around five categories: media, access, point of decision/promotion, price, and social support and services. The instrument was developed in 2010, quarterly data collections took place in 2011-2013, and preliminary analysis was conducted in 2013. Preliminary descriptive statistics are presented for the cost data collected from 51 respondents. More than 50% of program costs were for partner organizations, and over 20% of costs were for labor hours. Tobacco communities devoted the majority of their efforts to media strategies. Obesity communities spent more than half of their resources on access strategies. Collecting accurate cost information on health promotion and disease prevention programs presents many challenges. The approach presented in this paper is one of the first efforts successfully collecting these types of data and can be replicated for collecting costs from other programs. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

  14. Preliminary Evidence Supports Modification of Retraction Technique to Prevent Needlestick Injuries

    PubMed Central

    Fa, Bernadette Alvear; Cuny, Eve

    2016-01-01

    A modified retraction technique was introduced into the DDS degree preclinical anesthesia course in 2011 with the goal of reducing needlestick exposure incidents. In numerous studies of dental exposures, injuries from dental anesthetic needles account for the highest proportion of all exposures. The purpose of this study was to assess the preliminary impact of a modified retraction technique on the incidence of blood and body fluids (BBF) exposure incidents associated with needles during injection. Data from evaluations of students from 2014 and 2015 were obtained and tracked to determine whether the modified retraction technique was “excellent,” “clinically acceptable,” or “clinically unacceptable.” Data were collected to determine if the patient perceived the modified retraction technique as “comfortable” or “correctable when addressed” to help improve student technique for future injections. Likewise, data from the blood-borne exposure database where all information related to BBF exposures is recorded were reviewed and the information separated by year and class. This study presents preliminary data only and because of the small sample size does not lend itself to validation by statistical analysis. However, the technique effectively removes the operator's hand from the field during injection, reducing the risk of accidental intraoral needlestick to the nondominant hand of the operator. PMID:27973940

  15. Unenhanced Cone Beam Computed Tomography and Fusion Imaging in Direct Percutaneous Sac Injection for Treatment of Type II Endoleak: Technical Note

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

    Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com; Ierardi, Anna Maria; Radaelli, Alessandro

    AimTo evaluate safety, feasibility, technical success, and clinical success of direct percutaneous sac injection (DPSI) for the treatment of type II endoleaks (T2EL) using anatomical landmarks on cone beam computed tomography (CBCT) and fusion imaging (FI).Materials and MethodsEight patients with T2EL were treated with DPSI using CBCT as imaging guidance. Anatomical landmarks on unenhanced CBCT were used for referencing T2EL location in the first five patients, while FI between unenhanced CBCT and pre-procedural computed tomography angiography (CTA) was used in the remaining three patients. Embolization was performed with thrombin, glue, and ethylene–vinyl alcohol copolymer. Technical and clinical success, iodinated contrastmore » utilization, procedural time, fluoroscopy time, and mean radiation dose were registered.ResultsDPSI was technically successful in all patients: the needle was correctly positioned at the first attempt in six patients, while in two of the first five patients the needle was repositioned once. Neither minor nor major complications were registered. Average procedural time was 45 min and the average administered iodinated contrast was 13 ml. Mean radiation dose of the procedure was 60.43 Gy cm{sup 2} and mean fluoroscopy time was 18 min. Clinical success was achieved in all patients (mean follow-up of 36 months): no sign of T2EL was reported in seven patients until last CT follow-up, while it persisted in one patient with stability of sac diameter.ConclusionsDPSI using unenhanced CBCT and FI is feasible and provides the interventional radiologist with an accurate and safe alternative to endovascular treatment with limited iodinated contrast utilization.« less

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

    Dudeck, O., E-mail: oliver.dudeck@med.ovgu.de; Schnapauff, D.; Herzog, L.

    PurposeThis study was designed to identify parameters on CT angiography (CTA) of type II endoleaks following endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), which can be used to predict the subsequent need for reinterventions.MethodsWe retrospectively identified 62 patients with type II endoleak who underwent early CTA in mean 3.7 ± 1.9 days after EVAR. On the basis of follow-up examinations (mean follow-up period 911 days; range, 373–1,987 days), patients were stratified into two groups: those who did (n = 18) and those who did not (n = 44) require reintervention. CTA characteristics, such as AAA, endoleak, as well as nidus dimensions, patency of the inferior mesentericmore » artery, number of aortic branch vessels, and the pattern of endoleak appearance, were recorded and correlated with the clinical outcome.ResultsUnivariate and receiver operating characteristic curve regression analyses revealed significant differences between the two groups for the endoleak volume (surveillance group: 1391.6 ± 1427.9 mm{sup 3}; reintervention group: 3227.7 ± 2693.8 mm{sup 3}; cutoff value of 2,386 mm{sup 3}; p = 0.002), the endoleak diameter (13.6 ± 4.3 mm compared with 25.9 ± 9.6 mm; cutoff value of 19 mm; p < 0.0001), the number of aortic branch vessels (2.9 ± 1.2 compared with 4.2 ± 1.4 vessels; p = 0.001), as well as a “complex type” endoleak pattern (13.6 %, n = 6 compared with 44.4 %, n = 8; p = 0.02).ConclusionsEarly CTA can predict the future need for reintervention in patients with type II endoleak. Therefore, treatment decision should be based not only on aneurysm enlargement alone but also on other imaging characteristics.« less

  17. Violence Prevention in Middle School: A Preliminary Study

    ERIC Educational Resources Information Center

    KIllam, Wendy K.; Roland, Catherine B.; Weber, Bill

    2014-01-01

    Violence in schools continues reflecting violence within society. There is a growing need for violence prevention programs within the schools that provide students with the skills needed to cope with interpersonal and relationship is-sues effectively. This study was conducted at a middle school and there were 345 middle school students (6th to 8th…

  18. Using media to promote suicide prevention hotlines to Veteran households.

    PubMed

    Karras, Elizabeth; Stephens, Brady; Kemp, Janet E; Bossarte, Robert M

    2014-02-01

    This article presents preliminary evidence that media campaigns are valuable in promoting suicide prevention hotlines to Veteran households by reporting data from 2526 telephone surveys. Findings from this study underscore the need for further investigation of the use of media campaigns to support suicide prevention initiatives aimed at Veteran populations.

  19. Developing a preliminary 'never event' list for general practice using consensus-building methods.

    PubMed

    de Wet, Carl; O'Donnell, Catherine; Bowie, Paul

    2014-03-01

    The 'never event' concept has been implemented in many acute hospital settings to help prevent serious patient safety incidents. Benefits include increasing awareness of highly important patient safety risks among the healthcare workforce, promoting proactive implementation of preventive measures, and facilitating incident reporting. To develop a preliminary list of never events for general practice. Application of a range of consensus-building methods in Scottish and UK general practices. A total of 345 general practice team members suggested potential never events. Next, 'informed' staff (n =15) developed criteria for defining never events and applied the criteria to create a list of candidate never events. Finally, UK primary care patient safety 'experts' (n = 17) reviewed, refined, and validated a preliminary list via a modified Delphi group and by completing a content validity index exercise. There were 721 written suggestions received as potential never events. Thematic categorisation reduced this to 38. Five criteria specific to general practice were developed and applied to produce 11 candidate never events. The expert group endorsed a preliminary list of 10 items with a content validity index (CVI) score of >80%. A preliminary list of never events was developed for general practice through practitioner experience and consensus-building methods. This is an important first step to determine the potential value of the never event concept in this setting. It is now intended to undertake further testing of this preliminary list to assess its acceptability, feasibility, and potential usefulness as a safety improvement intervention.

  20. Feasibility, Acceptability, and Preliminary Efficacy of an Online HIV Prevention Program for Diverse Young Men who have Sex with Men: The Keep It Up! Intervention

    PubMed Central

    Mustanski, Brian; Garofalo, Robert; Monahan, Colleen; Gratzer, Beau; Andrews, Rebecca

    2013-01-01

    Young men who have sex with men (YMSM) are disproportionately infected with HIV/AIDS and there are few prevention programs with published efficacy for this population. This study evaluated the feasibility, acceptability, and preliminary efficacy of an online, interactive, and highly engaging HIV prevention program called Keep It Up! The intervention was designed to be delivered to diverse YMSM upon receiving an HIV negative text result, with the goal for them to “Keep It Up” and stay negative. In a randomized clinical trial, the intervention was compared to an online didactic HIV knowledge condition. The study sample included 102 sexually active YMSM. Participants reported completing online modules in settings that were private and not distracting. Mixed methods data showed intervention participants felt the program was valuable and acceptable. Compared to the control condition, participants in the intervention arm had a 44 % lower rate of unprotected anal sex acts at the 12-week follow-up (p < 0.05). PMID:23673793

  1. Primary prevention research: a preliminary review of program outcome studies.

    PubMed

    Schaps, E; Churgin, S; Palley, C S; Takata, B; Cohen, A Y

    1980-07-01

    This article reviews 35 drug abuse prevention program evaluations employing drug-specific outcome measures. Many of these evaluations assessed the effects of "new generation" prevention strategies: affective, peer-oriented, and multidimensional approaches. Only 14 studies evaluated purely informational programs. Evaluations were analyzed to ascertain (1) characteristics of the programs under study, (2) characteristics of the research designs, and (3) patterns among findings. This review provides some evidence that the newer prevention strategies may produce more positive and fewer negative outcomes than did older drug information approaches. Over 70% of the programs using the newer strategies produced some positive effects; only 29% showed negative effects. In contrast, 46% of informational programs showed positive effects; 46% showed negative effects. These findings must be approached with great caution, since the research was frequently scientifically inadequate, and since rigor of research was negatively correlated with intensity and duration of program services.

  2. Implementation of School Policies to Prevent Youth Tobacco Use in Alabama

    ERIC Educational Resources Information Center

    Geiger, Brian F.; Vaid, Isam; Beeson, Diane; Riddle, Barry

    2012-01-01

    Background: Public health professionals must monitor the effectiveness of school policies and programs to prevent youth initiation, promote quitting, and eliminate secondhand smoke. This analysis of school tobacco policies was preliminary to release of a state tobacco prevention and control plan for 2010-2015. Methods: University health educators…

  3. A cross-validation trial of an Internet-based prevention program for alcohol and cannabis: Preliminary results from a cluster randomised controlled trial.

    PubMed

    Champion, Katrina E; Newton, Nicola C; Stapinski, Lexine; Slade, Tim; Barrett, Emma L; Teesson, Maree

    2016-01-01

    Replication is an important step in evaluating evidence-based preventive interventions and is crucial for establishing the generalizability and wider impact of a program. Despite this, few replications have occurred in the prevention science field. This study aims to fill this gap by conducting a cross-validation trial of the Climate Schools: Alcohol and Cannabis course, an Internet-based prevention program, among a new cohort of Australian students. A cluster randomized controlled trial was conducted among 1103 students (Mage: 13.25 years) from 13 schools in Australia in 2012. Six schools received the Climate Schools course and 7 schools were randomized to a control group (health education as usual). All students completed a self-report survey at baseline and immediately post-intervention. Mixed-effects regressions were conducted for all outcome variables. Outcomes assessed included alcohol and cannabis use, knowledge and intentions to use these substances. Compared to the control group, immediately post-intervention the intervention group reported significantly greater alcohol (d = 0.67) and cannabis knowledge (d = 0.72), were less likely to have consumed any alcohol (even a sip or taste) in the past 6 months (odds ratio = 0.69) and were less likely to intend on using alcohol in the future (odds ratio = 0.62). However, there were no effects for binge drinking, cannabis use or intentions to use cannabis. These preliminary results provide some support for the Internet-based Climate Schools: Alcohol and Cannabis course as a feasible way of delivering alcohol and cannabis prevention. Intervention effects for alcohol and cannabis knowledge were consistent with results from the original trial; however, analyses of longer-term follow-up data are needed to provide a clearer indication of the efficacy of the intervention, particularly in relation to behavioral changes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  4. Notification: Preliminary Research to Evaluate Hazardous Waste Passing Through Publicly Owned Treatment Works

    EPA Pesticide Factsheets

    March 13, 2013. The EPA's OIG plans to start preliminary research to evaluate the effectiveness of the EPA’s programs in preventing and addressing contamination of surface water from hazardous wastes passing through publicly owned treatment works.

  5. Pilot testing an internet-based STI and HIV prevention intervention with Chilean women.

    PubMed

    Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

    2015-03-01

    The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. © 2014 Sigma Theta Tau International.

  6. Pilot Testing an Internet-Based STI and HIV Prevention Intervention With Chilean Women

    PubMed Central

    Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

    2015-01-01

    Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132

  7. Developing a preliminary ‘never event’ list for general practice using consensus-building methods

    PubMed Central

    de Wet, Carl; O’Donnell, Catherine; Bowie, Paul

    2014-01-01

    Background The ‘never event’ concept has been implemented in many acute hospital settings to help prevent serious patient safety incidents. Benefits include increasing awareness of highly important patient safety risks among the healthcare workforce, promoting proactive implementation of preventive measures, and facilitating incident reporting. Aim To develop a preliminary list of never events for general practice. Design and setting Application of a range of consensus-building methods in Scottish and UK general practices. Method A total of 345 general practice team members suggested potential never events. Next, ‘informed’ staff (n =15) developed criteria for defining never events and applied the criteria to create a list of candidate never events. Finally, UK primary care patient safety ‘experts’ (n = 17) reviewed, refined, and validated a preliminary list via a modified Delphi group and by completing a content validity index exercise. Results There were 721 written suggestions received as potential never events. Thematic categorisation reduced this to 38. Five criteria specific to general practice were developed and applied to produce 11 candidate never events. The expert group endorsed a preliminary list of 10 items with a content validity index (CVI) score of >80%. Conclusion A preliminary list of never events was developed for general practice through practitioner experience and consensus-building methods. This is an important first step to determine the potential value of the never event concept in this setting. It is now intended to undertake further testing of this preliminary list to assess its acceptability, feasibility, and potential usefulness as a safety improvement intervention. PMID:24567655

  8. Management of Endovascular Aortic Aneurysm Complications via Retrograde Catheterization Through the Distal Stent-Graft Landing Zone.

    PubMed

    Zhang, Xicheng; Sun, Yuan; Chen, Zhaolei; Jing, Yuanhu; Xu, Miao

    2017-08-01

    A retrograde technique through the gap between the distal stent landing zone and the iliac artery wall has been applied to treat type II endoleak after endovascular aortic aneurysm repair (EVAR). In this study, we tried to investigate its efficacy in the management of type III endoleak and intraoperative accidental events. We reported 2 complications of EVAR that were difficult to treat with conventional methods. One patient had a sustained type III endoleak after EVAR, and the right renal artery was accidentally sealed by a graft stent in the other patient during the operation. Both complications were managed by the retrograde technique from the distal stent landing zone. In the first case, the endoleak was easily embolized by the retrograde catheterization technique, and in the second case, a stent was implanted in the right renal artery using the retrograde technique to restore blood flow. In some EVAR cases, the technique of retrograde catheterization through the distal stent-graft landing zone is feasible, safe, and easy to perform.

  9. Intra-operative cone beam computed tomography can help avoid reinterventions and reduce CT follow up after infrarenal EVAR.

    PubMed

    Törnqvist, P; Dias, N; Sonesson, B; Kristmundsson, T; Resch, T

    2015-04-01

    Re-interventions after endovascular abdominal aortic aneurysm repair (EVAR) are common and therefore a strict imaging follow up protocol is required. The purpose of this study was to evaluate whether cone beam computed tomography (CBCT) can detect intra-operative complications and to compare this with angiography and the 1 month CT follow up (computed tomography angiography [CTA]). Fifty-one patients (44 men) were enrolled in a prospective trial. Patients underwent completion angiography and CBCT during infrarenal EVAR. Contrast was used except when pre-operative renal insufficiency was present or if the maximum contrast dose threshold was reached. CBCT reconstruction included the top of the stent graft to the iliac bifurcation. Endoleaks, kinks, or compressions were recorded. CBCT was technically successful in all patients. Twelve endoleaks were detected on completion digital subtraction angiography (CA). CBCT detected 4/5 type 1 endoleaks, but only one type 2 endoleak. CTA identified eight type 2 endoleaks and one residual type I endoleak. Two cases of stent compression were seen on CA. CBCT revealed five stent compressions and one kink, which resulted in four intra-operative adjunctive manoeuvres. CTA identified all cases of kinks or compressions that were left untreated. Two of them were corrected later. No additional kinks/compressions were found on CTA. Groin closure consisted of 78 fascia sutures, nine cut downs, and 11 percutaneous sutures. Seven femoral artery pseudoaneurysms (<1 cm) were detected on CTA, but no intervention was needed. CA is better than CBCT in detecting and categorizing endoleaks but CBCT (with or without contrast) is better than CA for detection of kinks or stentgraft compression. CTA plus CBCT identified all significant complications noted on the 1 month follow up CTA. The use of intra-operative CA and CBCT could replace early CTA after standard EVAR thus reducing overall radiation and contrast use. Technical development might further

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

    Pitton, Michael Bernhard, E-mail: pitton@radiologie.klinik.uni-mainz.de; Schmenger, Patrick; Dueber, Christoph

    Purpose: To investigate pressure and maximum rate of rise of systolic pressure (peak dP/dt) in completely excluded aneurysms and endoleaks to determine the hemodynamic impact of endoleaks. Methods: In mongrel dogs (n =36) experimental aneurysms were created by insertion of a patch (portion of rectus abdomen is muscle sheath) into the infrarenalaorta. In group I (n 18), all aortic branches of the aneurysm were ligated and all aneurysms were completely excluded by stent grafts. Group II (n = 18) consisted of aneurysms with patent aortic side branches that represented sources of endoleaks.One week (n = 12), six weeks (n =more » 12),and six months (n = 12) after stent grafting,hemodynamic measurements were obtained in thrombosed aneurysms and proved endoleaks. Systemic blood pressure and intraaneurysmal pressure were simultaneously measured and the respective peak dP/dt were computed. Results: At the six-month follow-up, the systolic-pressure ratio (intraaneurysmatic pressure: systemic pressure)was significantly increased in endoleaks compared to non-perfused areas(0.879 {+-} 0.042 versus 0.438 {+-} 0.176, p <0.01, group II) or completely excluded aneurysms (0.385 {+-}0.221, group I). Peak dP/dt ratio (intraaneurysmal peak dP/dt: systemic peak dP/dt) was 0.922 {+-} 0.154 in endoleaks, compared to 0.084 {+-} 0.080 in non-perfused areas (group II, p <0.01), and was 0.146 {+-} 0.121 in completely excluded aneurysms (group I). The diastolic-pressure ratio was also increased inendoleaks compared to non-perfused areas (0.929 {+-} 0.088 versus 0.655 {+-} 0.231, p < 0.01, group II) or completely excluded aneurysms (0.641 {+-} 0.278, group I). In excluded aneurysms, pressure exposure declined as the length of the follow-up period increased. Conclusion: Type II endoleaks transmit pulsatile pressure of near systemic level and indicate insufficient treatment result. In contrast, complete endovascular exclusion of aneurysms results in significantly reduced pressure exposure.« less

  11. Applying Computer Technology to Substance Abuse Prevention Science Results of a Preliminary Examination

    ERIC Educational Resources Information Center

    Marsch, Lisa A.; Bickel, Warren K.; Badger, Gary J.

    2007-01-01

    This manuscript reports on the development and evaluation of a computer-based substance abuse prevention program for middle school-aged adolescents, called "HeadOn: Substance Abuse Prevention for Grades 6-8TM". This self-guided program was designed to deliver effective drug abuse prevention science to youth via computer-based educational…

  12. [Prevention of schizophrenia: a review].

    PubMed

    Balhara, Yatan Pal Singh

    2013-01-01

    Research over the years has introduced multiple interventions for schizophrenia. Notwithstanding the nature of intervention pharmacological or psychological a complete cure for the condition remains a much-desired, yet unachieved goal. What is required is an exploration of alternative intervention strategies for treating schizophrenia a preventive approach is such an option. The chronic nature of schizophrenia and its associated disabilities have a tremendously negative affect the quality of life of patients, their families, and communities. Among the preferred approaches to reducing the negative consequences associated with the disorder is the prevention of its emergence. This review aimed to present the available data on the prevention of schizophrenia data that suggest some pharmacological and non-pharmacological interventions have a potential role in the prevention of schizophrenia. Nonetheless, the findings are restricted to a few sites and are at best preliminary; as such, the findings must be replicated in new studies that include large samples and different settings.

  13. Pressure injection of solubilized benomyl for prevention and cure of oak wilt

    Treesearch

    Thomas W. Jones; Garold F. Gregory; Percy McWain

    1973-01-01

    A preliminary evaluation of the effectiveness of injecting solubilized benomyl into oaks for prevention or cure of oak wilt disease is presented. Symptom development was greatly reduced or prevented in trees injected with fungicide before inoculation. Symptom development was markedly arrested in diseased trees by fungicide injected before more than 10 percent of the...

  14. Pharmacists' and prescribers' neonatal abstinence syndrome (NAS) prevention behaviors: a preliminary analysis.

    PubMed

    Hagemeier, Nicholas E; Click, Ivy A; Flippin, Heather; Gilliam, Holly; Ross, Alexandra; Basden, Jeri Ann; Carico, Ronald

    2018-02-01

    Background Maternal opioid use and neonatal abstinence syndrome (NAS) incidence have increased markedly in the US in recent years. Objectives (1) To assess prescribers' and community pharmacists' guideline-based NAS prevention behaviors; (2) to describe providers' perceptions of contraceptive appropriateness in female patients of childbearing age. Method Cross-sectional study of 100 randomly selected primary care physicians, 100 prescribers authorized to engage in in-office treatment of opioid use disorders with buprenorphine, 100 pain management clinic directors, and 100 community pharmacists in Tennessee (N = 400 providers total) to evaluate self-reported engagement in 15 NAS prevention behaviors and perceived appropriateness of 8 contraceptive methods in opioid using women of childbearing age. Results An overall response rate of 17.5% was obtained. Pain clinic directors reported the most engagement in NAS prevention, engaging 80% or more of female patients of childbearing age prescribed an opioid in 11 prevention behaviors, followed by buprenorphine prescribers (8 behaviors), primary care physicians (5 behaviors), and community pharmacists (2 behaviors). Pain clinic directors, primary care physicians, and community pharmacists perceived oral contraceptive pills and patches to be as appropriate as long-acting, reversible forms of contraception (e.g., implants, injectable depots, intrauterine devices). Conclusion Provider engagement in behaviors that could prevent NAS is variable. Interventions should be implemented that equip providers to engage patients in conversations about long-acting, reversible contraception.

  15. Tailored Prevention of Inpatient Falls

    PubMed Central

    ZUYEV, LYUBOV; BENOIT, ANGELA N.; CHANG, FRANK Y.; DYKES, PATRICIA C.

    2011-01-01

    Patient falls and fall-related injuries are serious problems in hospitals. The Fall TIPS application aims to prevent patient falls by translating routine nursing fall risk assessment into a decision support intervention that communicates fall risk status and creates a tailored evidence-based plan of care that is accessible to the care team, patients, and family members. In our design and implementation of the Fall TIPS toolkit, we used the Spiral Software Development Life Cycle model. Three output tools available to be generated from the toolkit are bed poster, plan of care, and patient education handout. A preliminary design of the application was based on initial requirements defined by project leaders and informed by focus groups with end users. Preliminary design partially simulated the paper version of the Morse Fall Scale currently used in hospitals involved in the research study. Strengths and weaknesses of the first prototype were identified by heuristic evaluation. Usability testing was performed at sites where research study is implemented. Suggestions mentioned by end users participating in usability studies were either directly incorporated into the toolkit and output tools, were slightly modified, or will be addressed during training. The next step is implementation of the fall prevention toolkit on the pilot testing units. PMID:20975543

  16. Outcome-based anatomic criteria for defining the hostile aortic neck.

    PubMed

    Jordan, William D; Ouriel, Kenneth; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; de Vries, Jean-Paul P M

    2015-06-01

    There is abundant evidence linking hostile proximal aortic neck anatomy to poor outcome after endovascular aortic aneurysm repair (EVAR), yet the definition of hostile anatomy varies from study to study. This current analysis was undertaken to identify anatomic criteria that are most predictive of success or failure at the aortic neck after EVAR. The study group comprised 221 patients in the Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry (ANCHOR) clinical trial, a population enriched with patients with challenging aortic neck anatomy and failure of sealing. Imaging protocols were not protocol specified but were performed according to the institution's standard of care. Core laboratory analysis assessed the three-dimensional centerline-reformatted computed tomography scans. Failure at the aortic neck was defined by type Ia endoleak occurring at the time of the initial endograft implantation or during follow-up. Receiver operating characteristic curve analysis was used to assess the value of each anatomic measure in the classification of aortic neck success and failure and to identify optimal thresholds of discrimination. Binary logistic regression was performed after excluding highly intercorrelated variables, creating a final model with significant predictors of outcome after EVAR. Among the 221 patients, 121 (54.8%) remained free of type Ia endoleak and 100 (45.2%) did not. Type Ia endoleaks presented immediately after endograft deployment in 58 (58.0%) or during follow-up in 42 (42.0%). Receiver operating characteristic curve analysis identified 12 variables where the classification of patients with type Ia endoleak was significantly more accurate than chance alone. Increased aortic neck diameter at the lowest renal artery (P = .013) and at 5 mm (P = .008), 10 mm (P = .008), and 15 mm (P = .010) distally; aneurysm sac diameter (P = .001), common iliac artery diameters (right, P = .012; left, P = .032), and a conical (P = .049) neck

  17. External aortic wrap for repair of type 1 endoleak☆

    PubMed Central

    Dean, Anastasia; Yap, Swee Leong; Bhamidipaty, Venu; Pond, Franklin

    2014-01-01

    INTRODUCTION Type 1 endoleak is a rare complication after endovascular abdominal aortic aneurysm repair (EVAR) with a reported frequency up to 2.88%. It is a major risk factor for aneurysmal enlargement and rupture. PRESENTATION OF CASE We present a case of a 68 year old gentleman who was found to have a proximal type 1 endoleak with loss of graft wall apposition on routine surveillance imaging post-EVAR. An initial attempt at endovascular repair was unsuccessful. Given the patient's multiple medical co-morbidities, which precluded the possibility of conventional graft explantation and open repair, we performed a novel surgical technique which did not require aortic cross-clamping. A double-layered Dacron wrap was secured around the infra-renal aorta with Prolene sutures, effectively hoisting the posterior bulge to allow wall to graft apposition and excluding the endoleak. Post-operative CT angiogram showed resolution of the endoleak and a stable sac size. DISCUSSION Several anatomical factors need to be considered when this technique is proposed including aortic neck angulation, position of lumbar arteries and peri-aortic venous anatomy. While an external wrap technique has been investigated sporadically for vascular aneurysms, to our knowledge there is only one similar case in the literature. CONCLUSION Provided certain anatomical features are present, an external aortic wrap is a useful and successful option to manage type 1 endoleak in high-risk patients who are unsuitable for aortic clamping. PMID:25217878

  18. Influence of aortic neck characteristics on successful aortic wall penetration of EndoAnchors in therapeutic use during endovascular aneurysm repair.

    PubMed

    Goudeketting, Seline R; van Noort, Kim; Ouriel, Kenneth; Jordan, William D; Panneton, Jean M; Slump, Cornelis H; de Vries, Jean-Paul P M

    2018-04-21

    This study sought to quantify EndoAnchor (Medtronic Vascular, Santa Rosa, Calif) penetration into the aortic wall in patients undergoing endovascular abdominal aortic aneurysm repair and to assess predictors of successful penetration and its relationship to postprocedural type IA endoleak. A subset of patients from the Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) were included if they met the following criteria: the indication for EndoAnchor use was to treat a type IA endoleak, and postprocedure contrast-enhanced computed tomography (CT) scans of sufficient quality were available for core laboratory review. Patients undergoing implantation of cuffs or stents during the EndoAnchor implantation procedure were excluded. Baseline anatomic characteristics were recorded. The cohort was divided into patients with and without persistent type IA endoleaks at the first postoperative CT scan. Penetration of each EndoAnchor measured on this CT scan was defined as good penetration when the EndoAnchor penetrated ≥2 mm into the aortic wall, borderline penetration when EndoAnchor penetration was <2 mm or a gap remained between the endograft and aortic wall, or no penetration when the EndoAnchor did not penetrate into the aortic wall. Differences between the groups were analyzed with the Mann-Whitney U test or Fisher exact test. Multivariate analyses were performed to identify independent predictors of EndoAnchor penetration, and procedural success was defined by absence of type IA endoleak. Eighty-six patients of the primary (n = 61 [71%]) and revision (n = 25 [29%]) arms of the ANCHOR registry were included. There were 53 (62%) without and 33 (38%) with persistent type IA endoleaks on the first postprocedural CT scan. The median number of EndoAnchors with good penetration was significantly greater in the cohort without endoleaks, 4 (interquartile range, 3-5) vs 3 (interquartile range, 1.5-4), respectively (P = .002). A

  19. Online gaming dependency: a preliminary study in China.

    PubMed

    Peng, Wei; Liu, Ming

    2010-06-01

    Based on theories and previous studies on problematic Internet use, we propose a model to better understand the contributors to and consequences of online gaming dependency. A preliminary study was conducted through a survey of online gamers in China. The results of path analysis found that maladaptive cognitions, shyness, and depression are positively related to online gaming dependency. Online gaming dependency was also positively related to different types of negative life outcomes. The findings of this study have implications for the prevention and treatment of addictive online gaming.

  20. A new method for precise determination of endograft position and apposition in the aortic neck after endovascular aortic aneurysm repair.

    PubMed

    VAN Noort, Kim; Schuurmann, Richte C; Slump, Cornelis H; Vos, Jan A; Devries, Jean P

    2016-10-01

    Follow-up imaging after endovascular aortic aneurysm repair (EVAR) focuses on detection of gross abnormalities: endoleaks and significant (>10 mm) migration. Precise determination of endograft position and wall apposition may predict late complications. We present a new measurement method to determine precise position and apposition of endografts in the aortic neck. Four patients were selected from our EVAR database. These patients had late (>1 year) type IA endoleak or >1 cm endograft migration. Twenty patients with uneventful follow-up were measured as controls. The new software adds six parameters to define endograft position and neck apposition: fabric distance to renal arteries, tilt, endograft expansion (% of the maximum original diameter), neck surface, apposition surface, and shortest apposition length. These parameters were determined on preoperative and all available postoperative CT-scans, to detect subtle changes during follow-up. All patients with endoleak or migration had increases in fabric distance, tilt, or endograft expansion or decrease of apposition surface. Changes occurred at least one CT scan before the endoleak or migration was noted in the CT reports. The patient without complications showed no changes in position or apposition during follow-up. The new measurement method detected subtle changes in endograft position and apposition during CT follow-up, not recognized initially. It can potentially determine endograft movements and decrease of apposition surface before they lead to complications like type IA endoleaks or uncorrectable migration. A larger follow-up study comparing complicated and non-complicated EVAR patients is needed to corroborate these results.

  1. Using communities that care for community child maltreatment prevention.

    PubMed

    Salazar, Amy M; Haggerty, Kevin P; de Haan, Benjamin; Catalano, Richard F; Vann, Terri; Vinson, Jean; Lansing, Michaele

    2016-03-01

    The prevention of mental, emotional, and behavioral (MEB) disorders among children and adolescents is a national priority. One mode of implementing community-wide MEB prevention efforts is through evidence-based community mobilization approaches such as Communities That Care (CTC). This article provides an overview of the CTC framework and discusses the adaptation process of CTC to prevent development of MEBs through preventing child abuse and neglect and bolstering child well-being in children aged 0 to 10. Adaptations include those to the intervention itself as well as those to the evaluation approach. Preliminary findings from the Keeping Families Together pilot study of this evolving approach suggest that the implementation was manageable for sites, and community board functioning and community adoption of a science-based approach to prevention in pilot sites looks promising. Implications and next steps are outlined. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Thoracic Endovascular Aortic Repair With Single/Double Chimney Technique for Aortic Arch Pathologies.

    PubMed

    Wang, Tun; Shu, Chang; Li, Ming; Li, Quan-Ming; Li, Xin; Qiu, Jian; Fang, Kun; Dardik, Alan; Yang, Chen-Zi

    2017-06-01

    To summarize a single-center experience using the single/double chimney technique in association with thoracic endovascular aortic repairs (TEVAR) for aortic arch pathologies. From November 2007 to March 2016, 122 patients (mean age 50.4±12.7 years, range 29-80; 92 men) with aortic arch pathologies underwent TEVAR combined with single (n=101) or double (n=21) chimney grafts to reconstruct the supra-aortic branches: 21 innominate arteries, 114 left common carotid arteries, and 8 left subclavian arteries (LSA). Pathologies included type B aortic dissection (n=47), aortic arch dissection (n=49), retrograde type A aortic dissection (n=8), thoracic aortic aneurysm (n=7), penetrating aortic arch ulcer (n=9), and post-TEVAR type I endoleak (n=2). Follow-up examinations included computed tomography at 0.5, 3, 6, and 12 months and yearly thereafter. The aortic stent-grafts were deployed in zone 0 (n=21), zone 1 (n=93), and zone 2 (n=8). One (0.8%) of the 122 patients died at 4 days due to a perforated peptic ulcer. Type Ia endoleaks were found intraoperatively in 13 (10.7%) patients, including 3 with the double chimney technique. Type II endoleaks occurred in 6 (4.9%) patients; 3 were treated with duct occluders in the LSA. Postoperative chimney graft migration occurred in 1 (0.8%) patient with double chimneys; additional stent-grafts were deployed in both chimneys. Median follow-up was 32.3 months, during which 1 (0.8%) patient died after a stroke at 3 months. Chimney stent-graft patency was observed in the remaining 120 patients. Two (1.7%) secondary TEVARs were performed for distal aortic dissection. Nine asymptomatic type Ia endoleaks and 1 type II endoleak persisted in follow-up; a type II endoleak in 1 patient with Marfan syndrome sealed in 52 months. TEVAR with the chimney technique provides a safe, minimally invasive alternative with good chimney graft patency and low postoperative mortality during midterm follow-up. The double chimney technique should be used

  3. Endovascular stent-graft repair of failed endovascular abdominal aortic aneurysm repair.

    PubMed

    Baril, Donald T; Silverberg, Daniel; Ellozy, Sharif H; Carroccio, Alfio; Jacobs, Tikva S; Sachdev, Ulka; Teodorescu, Victoria J; Lookstein, Robert A; Marin, Michael L

    2008-01-01

    Despite high initial technical success, the long-term durability of endovascular abdominal aortic aneurysm repair (EVAR) continues to be a concern. Following EVAR, patients can experience endoleaks, device migration, device fractures, or aneurysm growth that may require intervention. The purpose of this study was to review all patients treated with secondary endovascular devices at our institution for failed EVAR procedures. Over an 8-year period, 988 patients underwent EVAR, of whom 42 (4.3%) required secondary interventions involving placement of additional endovascular devices. Data regarding patient characteristics, aneurysm size, initial device type, time until failure, failure etiology, secondary interventions, and outcomes were reviewed. The mean time from initial operation until second operation was 34.1 months. Failures included type I endoleaks in 38 patients (90.5%), type III endoleaks in two patients (4.8%), and enlarging aneurysms without definite endoleaks in two patients (4.8%). The overall technical success rate for secondary repair was 92.9% (39/42). Perioperative complications occurred in nine patients (21.4%), including wound complications (n = 6), cerebrovascular accident (CVA) (n = 1), foot drop (n = 1), and death (n = 1). Mean follow-up following secondary repair was 16.4 months (range 1-50). Eighty-six percent of patients treated with aortouni-iliac devices had successful repairs compared to 45% of patients treated with proximal cuffs. Ten patients (23.8%) had persistent or recurrent type I or type III endoleaks following revision. Of these, four had tertiary interventions, including two patients who had additional devices placed. Failures following EVAR occur in a small but significant number of patients. When anatomically possible, endovascular revision offers a safe means of treating these failures. Aortouni-iliac devices appear to offer a more durable repair than the proximal cuff for treatment of proximal type I endoleaks. Midterm

  4. Early Enlargement of Aneurysmal Sac and Separation of EndoBags of Nellix Endovascular Aneurysm Sealing System as Signs of Increased Risk of Later Aneurysm Rupture.

    PubMed

    Cheng, Lik Fai; Cheung, Kwok Fai; Chan, Kwong Man; Ma, Johnny Ka Fai; Luk, Wing Hang; Chan, Micah Chi King; Ng, Carol Wing Kei; Mahboobani, Neeraj Ramesh; Ng, Wai Kin; Wong, Ting

    2016-11-01

    Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture. To the best of the authors' knowledge, this was the first reported case of aortic rupture after EVAS without detectable endoleak during and after the procedure.

  5. Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes.

    PubMed

    Donovan, Dennis M; Thomas, Lisa Rey; Sigo, Robin Little Wing; Price, Laura; Lonczak, Heather; Lawrence, Nigel; Ahvakana, Katie; Austin, Lisette; Lawrence, Albie; Price, Joseph; Purser, Abby; Bagley, Lenora

    2015-01-01

    Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.

  6. HEALING OF THE CANOE: PRELIMINARY RESULTS OF A CULTURALLY GROUNDED INTERVENTION TO PREVENT SUBSTANCE ABUSE AND PROMOTE TRIBAL IDENTITY FOR NATIVE YOUTH IN TWO PACIFIC NORTHWEST TRIBE

    PubMed Central

    Donovan, Dennis M.; Thomas, Lisa Rey; Sigo, Robin Little Wing; Price, Laura; Lonczak, Heather; Lawrence, Nigel; Ahvakana, Katie; Austin, Lisette; Lawrence, Albie; Price, Joseph; Purser, Abby; Bagley, Lenora

    2015-01-01

    Using Community-Based and tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S’Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth. PMID:25768390

  7. [Preliminary results of a community fall prevention programme: Precan study (falls prevention in La Ribera)].

    PubMed

    Pérez-Ros, Pilar; Martínez-Arnau, Francisco; Tormos Miñana, Immaculada; López Aracil, Aranzazu; Oltra Sanchis, M Carmen; Pechene Mera, Leidy E; Tarazona-Santabalbina, Francisco José

    2014-01-01

    To evaluate the results of a fall prevention programme designed to be applied to the elderly living in the community. The sample consisted of 249 participants ≥70 years of age, who were randomly assigned to one of three groups. The monthly intervention group (GIM): instructions on fall prevention and healthy exercises to improve physical function and balance at beginning of the study, and a monthly theoretical and practical refresher session. The quarterly intervention group (GIT), with the same beginning intervention and a refresher session every three months. The control group (GC), the same beginning intervention but no refresher sessions. The mean age of the sample was 74.47 years (SD 5.33), with 64% women. The incidence of falls was reduced from 0.64 per patient year in the previous year to 0.39 in the post-intervention year in GIM, from 0.49 to 0.47 in GIT, and in the GC it remained at 0.47 before and twelve months after, but with no significant differences in the reduction between groups (P=.062). At the end of the study there was a decrease in Rizzo scale of 0.72 points (95% CI: 0.57-0.88, P<.001). An interdisciplinary community intervention programme can contribute to reducing the incidence of falls. Further studies are required to continue research into the incidence of falls in the elderly living in the community. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  8. Prevention of Coronary Atherosclerosis: The Role of a College Health Service.

    ERIC Educational Resources Information Center

    Manchester, Ralph A.; Greenland, Philip

    1987-01-01

    This paper reviews the concept of behavioral risk factors for atherosclerosis which become entrenched in adolescence or young adulthood. Evidence favoring intervention in the adolescent years and a screening program at the University of Rochester Health Service are described. A preliminary strategy for prevention of atherosclerosis on campus is…

  9. Stress Prevention and Mindfulness: A Psychoeducational and Support Group for Teachers

    ERIC Educational Resources Information Center

    Reiser, Jenson E.; Murphy, Susan L.; McCarthy, Christopher J.

    2016-01-01

    A stress prevention and mindfulness (SPAM) group is described, which is a 6-week psychoeducational and support group for teachers. The group incorporated psychoeducation about stress and utilized elements of Mindfulness-Based Stress Reduction (MBSR). The group was implemented in a public charter school in the Southwest. Preliminary evaluation…

  10. Preliminary Investigation of a Stress Prevention and Mindfulness Group for Teachers

    ERIC Educational Resources Information Center

    Reiser, Jenson E.; McCarthy, Christopher J.

    2018-01-01

    This exploratory study evaluated a short-term (6-8 weeks) psychoeducation and support group for teachers focused on stress prevention and mindfulness (labeled SPAM group). A total of 4 groups were implemented in different schools, and evaluation was conducted with quantitative (pre- and post-measures of teacher vulnerability to stress, job…

  11. Technical and clinical outcome of Talent versus Endurant endografts for endovascular aortic aneurysm repair.

    PubMed

    Mensel, Birger; Kühn, Jens-Peter; Träger, Tobias; Dührkoop, Martin; von Bernstorff, Wolfram; Rosenberg, Christian; Hoene, Andreas; Puls, Ralf

    2012-01-01

    The technical evolution of endografts for the interventional management of infrarenal abdominal aortic aneurysms (AAA) has allowed a continuous expansion of indications. This study compares the established Talent endograft with its successor, the Endurant endograft, taking individual aortoiliac anatomy into account. From June 2007 to December 2010, 35 patients with AAA were treated with a Talent endograft (33 men) and 36 patients with an Endurant endograft (34 men). Aortoiliac anatomy was evaluated in detail using preinterventional computed tomography angiography. The 30-day outcome of both groups were compared regarding technical and clinical success as well as complications including endoleaks. The Endurant group included more patients with unfavorable anatomy (kinking of pelvic arteries, p = 0.017; shorter proximal neck, p = 0.084). Primary technical success was 91.4% in the Talent group and 100% in the Endurant group (p = 0.115). Type 1 endoleaks occurred in 5.7% of patients in the Talent group and in 2.8% of those in the Endurant group (p = 0.614). Type 3 endoleaks only occurred in the Talent group (2.9% of patients; p = 0.493). Type 2 endoleaks were significantly less common in the Endurant group than in the Talent group (8.3% versus 28.6%; p = 0.035). Rates of major and minor complications were not significantly different between both groups. Primary clinical success was significantly better in the Endurant group (97.2%) than in the Talent group (80.0%) (p = 0.028). Endurant endografts appear to have better technical and clinical outcome in patients with difficult aortoiliac anatomy, significantly reducing the occurrence of type 2 endoleaks.

  12. Impact of 3-dimensional-computed tomography workstation for precise planning of endovascular aneurysm repair.

    PubMed

    Higashiura, Wataru; Sakaguchi, Shoji; Tabayashi, Nobuoki; Taniguchi, Shigeki; Kichikawa, Kimihiko

    2008-12-01

    Compared with open surgery, imaging is considered to be important for planning and device selection of endovascular aneurysm repair (EVAR). The present study evaluated the usefulness of a 3-dimensional (3D)-computed tomography (CT) workstation in planning EVAR. A prospective study was conducted in 8 patients who underwent EVAR using Zenith endograft between February and August 2007. Endograft size and optimized deployment projection were decided using a 3D-CT workstation. The primary endpoint was defined as successful deployment of a same size endograft as preoperatively selected without type I or III endoleak or inadvertent arterial occlusion. The following parameters were investigated: (a) incidence of use of an alternative endograft; (b) prevalence of type I or III endoleak; and (c) distance from lowest renal artery to tip of graft. Successful deployment of endograft was achieved in all 8 patients. Use of alternative endograft or type I or III endoleak was not detected in 8 patients. Distance from the lowest renal artery to the tip of the graft was 2.8mm. Assessment using a 3D-CT workstation appears to allow accurate endograft selection and precise deployment of the Zenith endograft without type I or III endoleak, even in institutes with a small number of patients.

  13. Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation.

    PubMed

    Nezlek, J B; Galano, J

    1993-09-01

    This paper presents the results of a study of state-wide adolescent pregnancy prevention coalitions. Key informants in five states throughout the southern United States were given semi-structured interviews regarding the adolescent pregnancy prevention coalitions in their states. From these interviews and other documents, conclusions were drawn regarding the nature and importance of the environments within which these coalitions operate, the universe of activities in which coalitions engage, and the stages of development of these coalitions. Katz and Kahn's model of social organizations served as the basis for understanding coalitions in terms of these three considerations. Future research should consider the utility of organizational models that can explain more fully the organization--committee hybrid structure that tends to characterize these coalitions.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    Cheng, Lik Fai, E-mail: rickieclf@yahoo.com.hk; Cheung, Kwok Fai; Chan, Kwong Man

    Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture. To themore » best of the authors’ knowledge, this was the first reported case of aortic rupture after EVAS without detectable endoleak during and after the procedure.« less

  16. A comparative analysis of the outcomes of aortic cuffs and converters for endovascular graft migration.

    PubMed

    Thomas, Bradley G; Sanchez, Luis A; Geraghty, Patrick J; Rubin, Brian G; Money, Samuel R; Sicard, Gregorio A

    2010-06-01

    Proximal attachment failure, often leading to graft migration, is a severe complication of endovascular aneurysm repair (EVAR). Aortic cuffs have been used to treat proximal attachment failure with mixed results. The Zenith Renu AAA Ancillary Graft (Cook Inc, Bloomington, Ind) is available in two configurations: converter and main body extension. Both provide proximal extension with active fixation for the treatment of pre-existing endovascular grafts with failed or failing proximal fixation or seal in patients who are not surgical candidates. We prospectively compared the outcomes of patient treatment with these two device configurations. From September 2005 to May 2008, a prospective, nonrandomized, postmarket registry was conducted to collect data from 151 patients treated at 95 institutions for proximal aortic endovascular graft failure using the Renu graft. Treatment indications included inadequate proximal fixation or seal, for example, migration, and type I and III endoleak. A total of 136 patients (90%) had migration, 111 (74%) had endoleak, and 94 (62%) had endoleaks and graft migration. AneuRx grafts were present in 126 patients (83%), of which 89 (59%) were treated with a converter and 62 (41%) with a main body extension. Outcomes using converters vs main body extensions for endoleak rates, changes in aneurysm size, and ruptures were compared. Preprocedural demographics between the two groups did not differ significantly. Procedural success rates were 98% for the converter group and 100% for the main body extension group. At a mean follow-up of 12.8 +/- 7.5 months, no type III endoleaks (0%)were identified in the converter group, and five (8%) were identified in the main body extension group. There were no aneurysm ruptures in patients treated with converters (0%) and three ruptures (5%) in patients treated with main body extensions. Each patient with aneurysm rupture had been treated with a Renu main body extension, developed a type III endoleak, and

  17. Functional requirements regarding medical registries--preliminary results.

    PubMed

    Oberbichler, Stefan; Hörbst, Alexander

    2013-01-01

    The term medical registry is used to reference tools and processes to support clinical or epidemiologic research or provide a data basis for decisions regarding health care policies. In spite of this wide range of applications the term registry and the functional requirements which a registry should support are not clearly defined. This work presents preliminary results of a literature review to discover functional requirements which form a registry. To extract these requirements a set of peer reviewed articles was collected. These set of articles was screened by using methods from qualitative research. Up to now most discovered functional requirements focus on data quality (e. g. prevent transcription error by conducting automatic domain checks).

  18. Efficacy and durability of the chimney graft technique in urgent and complex thoracic endovascular aortic repair.

    PubMed

    Bin Jabr, Adel; Lindblad, Bengt; Dias, Nuno; Resch, Timothy; Malina, Martin

    2015-04-01

    This study reports the early and midterm to long-term experience of chimney grafts (CGs) in urgent endovascular repair of complex lesions in the thoracic aorta. Twenty-nine high-risk patients (20 men) who were unfit for open repair were treated using CG technique for ruptured (n = 14) or symptomatic (n = 15) aortic lesions engaging the aortic arch itself (n = 9), the descending aorta (n = 10), or the thoracoabdominal aorta (n = 10). Twenty-two patients (76%) were treated urgently (≤24 hours) and seven were semiurgent (≤3 days). Of 41 chimneys used, 24 were placed in supra-aortic branches and 17 in visceral branches. Median follow-up (interquartile range) for the entire cohort was 2 years (0.6-3.8 years), 2.5 years (1-4 years) for 30-day survivors, and 3.5 years (1.9-6.4 years) for those who were still alive. Four patients (14%) died ≤30 days of cerebral infarction (n = 1), visceral ischemia secondary to the initial rupture (n = 1), multiple organ failure (n = 1), or heart failure (n = 1). There were 11 late deaths (38%); however, only two deaths were related to the CG technique. The primary and secondary technical success rates were 86% (25 of 29) and 97% (28 of 29), respectively. The secondary patency rate of CGs was 98%. Seventeen (68%) of the aortic lesions shrank significantly. Three patients (10%) had primary type I endoleak and another three (10%) had secondary type I endoleak. The endoleaks were managed with Onyx (ev3 Endovascular, Inc, Plymouth, Minn) or coil embolization (n = 2), restenting (n = 1), and conversion to open repair (n = 2). One secondary endoleak is still under observation after >20 months. All primary endoleaks and one secondary endoleak originated from CGs in the brachiocephalic trunk (4 of 6 [67%]). The midterm to long-term results of the CG technique for urgent and complex lesions of the thoracic aorta in high-risk patients are promising, with low early mortality and long durability of the CGs. More patients with longer follow

  19. The costs of HIV prevention strategies in developing countries.

    PubMed Central

    Söderlund, N.; Lavis, J.; Broomberg, J.; Mills, A.

    1993-01-01

    Since many evaluations of HIV (human immunodeficiency virus) prevention programmes do not include data on costs, a preliminary analysis of the costs and outputs of a sample of HIV prevention projects was attempted. Case studies, representing six broad HIV prevention strategies in developing countries with differing levels of per capita gross domestic product, were sought on the basis of availability of data and potential generalizability. The six prevention strategies studied were mass media campaigns, peer education programmes, sexually transmitted disease treatment, condom social marketing, safe blood provision, and needle exchange/bleach provision programmes. Financial cost data were abstracted from published studies or were obtained directly from project coordinators. Although estimates of cost-effectiveness were not made, calculations of the relative cost per common process measure of output were compared. Condom distribution costs ranged from US$ 0.02 to 0.70 per condom distributed, and costs of strategies involving personal educational input ranged from US$ 0.15 to 12.59 per contact. PMID:8261563

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

    Choke, Edward; Munneke, Graham; Morgan, Robert

    Purpose. The principal anatomic contraindication to endovascular aneurysm repair (EVR) is an unfavorable proximal aortic neck. With increasing experience, a greater proportion of patients with unfavorable neck anatomy are being offered EVR. This study aimed to evaluate outcomes in patients with challenging proximal aortic neck anatomy. Methods. Prospectively collected data from 147 consecutive patients who underwent EVR between December 1997 and April 2005 were supplemented with a retrospective review of medical records and radiological images. Unfavorable anatomic features were defined as neck diameter >28 mm, angulation >60 deg., circumferential thrombus >50%, and length <10 mm. Eighty-seven patients with 0 adversemore » features (good necks) were compared with 60 patients with one or more adverse features (hostile necks). Results. Comparing the good neck with the hostile neck group, there were no significant differences in the incidence of primary technical success (p = 0.15), intraoperative adjunctive procedures (p = 0.22), early proximal type I endoleak (<30 days) (p = 1.0), late proximal type I endoleak (>30 days) (p = 0.57), distal type I endoleak (p = 0.40), type III endoleak (p 0.51), secondary interventions (p = 1.0), aneurysm sac expansion (p = 0.44), or 30 day mortality (p = 0.70). The good neck group had a significantly increased incidence of type II endoleak (p = 0.023). By multivariate analysis, the incidence of intraoperative adjunctive procedures was significantly increased in the presence of severe angulation (p = 0.041, OR 3.08, 95% CI 1.05-9.04). Conclusion. Patients with severely hostile proximal aortic neck anatomy may be treated with EVR, although severely angulated necks require additional intraoperative procedures. Early outcomes are encouraging and suggest that indications for EVR may be expanded to include patients with hostile neck anatomy.« less

  1. Clinical and experimental study of TMJ distraction: preliminary results.

    PubMed

    Festa, F; Galluccio, G

    1998-01-01

    A physiotherapeutic approach, with manual maneuvers and/or distraction appliances, is indicated in the treatment of temporomandibular joint disorders (TMDs) to prevent the progressive fibrosis of the muscle fibers. In this article, the authors report preliminary results of experimental and clinical studies conducted to assess the real effect of distraction in temporomandibular joint disorders. The experimental invivo studies confirmed the structural alteration due to compression and distraction on the capsular and condylar tissues. Clinical cases are reported to show the increase of the intraarticular vertical dimension, with a forward and downward movement of the condyles in a more physiologic condition.

  2. Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

    PubMed

    O'Connell, Timothy; Chang, Debra

    2012-01-01

    While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

  3. Preliminary results of a novel hay-hole fall prevention initiative.

    PubMed

    Batra, Erich K; Gross, Brian W; Jammula, Shreya; Bradburn, Eric H; Baier, Ronald D; Reihart, Michael J; Murphy, Dennis; Moyer, Kay; Hess, Joseph; Lackmann, Susan; Miller, Jo Ann; Rogers, Frederick B

    2018-02-01

    Hay-hole falls are a prevalent source of trauma among Anabaptists-particularly Anabaptist youth. We sought to decrease hay-hole falls in South Central Pennsylvania through the development and distribution of all-weather hay-hole covers to members of the at-risk Anabaptist community. Following the creation of a rural trauma prevention syndicate, hay-hole cover prototypes co-designed and endorsed by the Pennsylvania Amish Safety Committee were developed and distributed throughout South Central Pennsylvania. Preintervention and postintervention surveys were distributed to recipients to gain an understanding of the hay-hole fall problem in this population, to provide insight into the acceptance of the cover within the community, and to determine the efficacy of the cover in preventing falls. A total of 231 hay-hole covers were distributed throughout eight rural trauma-prone counties in Pennsylvania. According to preintervention survey data, 52% of cover recipients reported at least one hay-hole fall on their property, with 46% reporting multiple falls (median fall rate, 1.00 [1.00-2.00] hay-hole falls per respondent). The median self-reported distance from hay-hole to ground floor was 10.0 (8.00-12.0) feet, and the median number of hay-holes present on-property was 3.00 (2.00-4.00) per respondent. Postintervention survey data found 98% compliance with hay-hole cover installation and no subsequent reported hay-hole falls. With the support of the Pennsylvania Amish Safety Committee, we developed a well-received hay-hole cover which could effectively reduce fall trauma across other rural communities in the United States. Epidemiological study, Level III.

  4. Empowering bystanders to prevent campus violence against women: a preliminary evaluation of a poster campaign.

    PubMed

    Potter, Sharyn J; Moynihan, Mary M; Stapleton, Jane G; Banyard, Victoria L

    2009-01-01

    Researchers at a midsized public northeastern university evaluated the efficacy of a poster campaign to determine if students increase their knowledge of prosocial bystander behaviors and willingness to intervene in instances of sexual violence after viewing a series of campaign posters where student actors model appropriate bystander behaviors. During the last week of the campaign, undergraduates were invited to participate in a Web survey. The results of this preliminary evaluation indicate promising variation in the awareness of students who reported seeing the campaign compared to those who did not.

  5. Design of a Vehicle Based Intervention System to Prevent Ozone Loss

    NASA Technical Reports Server (NTRS)

    Cole, Robin; Fisher, Daniel; Meade, Matt; Neel, James; Olson, Kristin; Pittman, Andrew; Valdivia, Anne; Wibisono, Aria; Mason, William H.; Kirschbaum, Nathan

    1995-01-01

    This project was designed to be completed over a period of three years. Overall project goals were: (1) To understand the processes that contribute to stratospheric ozone loss; (2) To determine the best prevention scheme for loss; (3) To design a delivery vehicle to accomplish the prevention scheme. The 1994-1995 design objectives included: (1) To review the results of the 1993-1994 design team, including a reevaluation of the major assumptions and criteria selected to choose a vehicle; (2) To evaluate preliminary vehicle concepts and perform quantitative trade studies to select the optimal vehicle concept.

  6. The Role of Duplex Ultrasound In Detecting Graft Thrombosis And Endoleak After Endovascular Aortic Repair For Abdominal Aneurysm.

    PubMed

    Mazzaccaro, Daniela; Farina, Augusto; Petsos, Kostantinos; Nano, Giovanni

    2018-05-19

    to assess the role of DUS in detecting endoleaks (EL) and graft thrombosis (GT) in a cohort of patients submitted to EVAR for elective infrarenal AAA in two centers. Data of all consecutive patients treated in two Operative Unit of Vascular Surgery, from 01/01/2000 to 31/12/2016, were retrospectively collected and evaluated. Follow-up data were analyzed to evaluate survival and device-related complications, both at thirty-day and in the mid-term. The results of CTA and DUS that were performed yearly, with a time interval between the two exams lower than 30 days, were paired in terms of maximum transverse diameters of the aneurysmal sac, identification of EL and of GT. Sensibility (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of the DUS were calculated with respect to data of each paired CTA and to data of the real clinical diagnosis of either EL or GT. A Student's t test was performed to compare the aneurysmal sac diameters measured with DUS to those of CTA. "Kappa" coefficient of agreement was also calculated. A P value <0.05 was the level reference for statistical significance. A total of 920 patients (104 female, 11.3%) underwent EVAR for elective infrarenal AAA. Technical success was achieved in 910 cases (98.9%). At 30 days, there were 5 deaths (0.5%), no GT and 3 small type II EL which didn't require any adjunctive procedure. Mean follow-up was 64.8 months (range 1-120.3 months). Survival and freedom from complications were estimated to be 78.4%+1.9% and 48.3%+1.7% respectively at 10 years. Seventy-six more EL and 8 GT were recorded. Considering the CTA as the gold standard, SE, SP, and ACC of DUS in the detection of the EL were 93.2%+5.8%, 98.8%+1.1% and 97.8%, respectively, with a PPV of 94.5%+5.2% and a NPV of 98.3%+1.4%. Considering however the real diagnosis of the EL, SE, SP and ACC of DUS were slightly lower (89.4%+6.9%, 98.5%+1.3% and 96.9%, respectively), as well as PPV and NPV (93

  7. Preliminary Evaluation of the "Playing the Game" Sexual Assault Prevention Theatre Program

    ERIC Educational Resources Information Center

    Thatcher, W. Gregory

    2011-01-01

    Purpose: To compare the effectiveness of a one-time sexual assault prevention theatre performance against a similar content video performance and a non-intervention control group. Methods: Using the College Date Rape Attitudes and Behaviors Survey, four-hundred ninety-seven students provided matched pairs data for analysis. Results: At a…

  8. Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes.

    PubMed

    Nawaz, Haq; Petraro, Paul V; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M

    2016-01-01

    The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

  9. Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

    PubMed Central

    Nawaz, Haq; Petraro, Paul V.; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M.

    2016-01-01

    Background The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. Results A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Conclusion Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits. PMID:27507540

  10. Surgical internal iliac artery preservation associated with endovascular repair of infrarenal aortoiliac aneurysms to avoid buttock claudication and distal type I endoleaks.

    PubMed

    Gaudric, Julien; Tresson, Philippe; Derycke, Lucie; Tezenas Du Montcel, Sophie; Couture, Thibault; Davaine, Jean-Michel; Kashi, Mahine; Lawton, James; Chiche, Laurent; Koskas, Fabien

    2018-06-21

    The objective of this study was to assess outcomes of a hybrid technique for treatment of abdominal aortic aneurysm (AAA) associated with iliac aneurysm without distal neck by combining an AAA endovascular repair approach with open surgery for preservation of the internal iliac artery (IIA). The files of 51 patients operated on between 1998 and 2017 in a single vascular surgery department were retrospectively analyzed. Inclusion criteria were patients with AAA associated with uni-iliac or bi-iliac aneurysm without suitable distal sealing zone. Surgery consisted of deployment of an aortouni-iliac stent graft combined with an extra-anatomic crossover prosthetic bypass. With use of a limited retroperitoneal approach, the contralateral proximal common iliac aneurysm was surgically excluded and the IIA revascularized by direct ilioiliac anastomosis or terminal common iliac suture, preserving the iliac bifurcation. The patients' mean age was 74 years (58-88 years), and 92% were men. The mean follow-up was 5.8 years (0.1-18 years). Twenty-nine patients (57%) had one or more high-risk criteria for open surgery. Nineteen patients (37.3%) had aortouni-iliac aneurysms, 19 (37.3%) aortobi-iliac aneurysms, 5 (10%) isolated iliac aneurysms, and 8 (15.7%) bi-iliac aneurysms without aortic location. Four patients (7.8%) also had IIA aneurysms. Surgery was successful in all cases. Two patients (4%) died during the 30 days after surgery. One surgically preserved IIA occluded within the first month, resulting in buttock claudication. The 5-year IIA primary patency rate was 96%. Type I proximal endoleaks occurred in two patients, requiring additional surgery 3 years and 13 years after the initial surgery, respectively. This hybrid technique, consisting of AAA endovascular exclusion combined with open IIA revascularization, is safe and effective for preservation of pelvic vascularization. It is associated with long-term patency and low morbidity rates. We have been using this

  11. Graphene Nanolayers as a New Method for Bacterial Biofilm Prevention: Preliminary Results.

    PubMed

    Dybowska-Sarapuk, Łucja; Kotela, Andrzej; Krzemiński, Jakub; Wróblewska, Marta; Marchel, Halina; Romaniec, Magdalena; Łęgosz, Paweł; Jakubowska, Małgorzata

    2017-07-01

    Biofilms are microbial communities of surface-attached cells embedded in a self-produced extracellular matrix. They have been found to play a role in a wide variety of infections, including catheter-related urinary tract and bloodstream infections, and, therefore remain a significant source of morbidity and mortality among the world's population. Recently, much attention has been devoted to the prevention of biofilm formation on implant surfaces. Nanomaterials such as graphene, characterized by antibacterial activity and low toxicity to human cells, are promising candidates for biomedical applications. This study investigates the antibacterial efficiency of graphene and specially produced graphene decorated with silver nanoparticles, obtained by one of the methods of printed electronics (spray-coating system). These methods are not only economical, but also enable the printing of layers of various thicknesses on different types of materials, including flexible and nonplanar substrates. The aim of the study was to reveal the ability of graphene and graphene-nanosilver layers to prevent the formation of Staphylococcus epidermidis biofilm on the surface of a Foley catheter.

  12. A Smart Web Aid for Preventing Diabetes in Rural China: Preliminary Findings and Lessons

    PubMed Central

    Cheng, Jing; Li, Kaichun; Xie, Shaoyu; Liang, Han; Shen, Xingrong; Feng, Rui

    2014-01-01

    Background Increasing cases of diabetes, a general lack of routinely operational prevention, and a long history of separating disease prevention and treatment call for immediate engagement of frontier clinicians. This applies especially to village doctors who work in rural China where the majority of the nation’s vast population lives. Objective This study aims to develop and test an online Smart Web Aid for Preventing Type 2 Diabetes (SWAP-DM2) capable of addressing major barriers to applying proven interventions and integrating diabetes prevention into routine medical care. Methods Development of SWAP-DM2 used evolutionary prototyping. The design of the initial system was followed by refinement cycles featuring dynamic interaction between development of practical and effective standardized operation procedures (SOPs) for diabetes prevention and Web-based assistance for implementing the SOPs. The resulting SOPs incorporated proven diabetes prevention practices in a synergetic way. SWAP-DM2 provided support to village doctors ranging from simple educational webpages and record maintenance to relatively sophisticated risk scoring and personalized counseling. Evaluation of SWAP-DM2 used data collected at baseline and 6-month follow-up assessment: (1) audio recordings of service encounters; (2) structured exit surveys of patients’ knowledge, self-efficacy, and satisfaction; (3) measurement of fasting glucose, body mass index, and blood pressure; and (4) qualitative interviews with doctors and patients. Data analysis included (1) descriptive statistics of patients who received SWAP-DM2–assisted prevention and those newly diagnosed with prediabetes and diabetes; (2) comparison of the variables assessed between baseline and follow-up assessment; and (3) narratives of qualitative data. Results The 17 participating village doctors identified 2219 patients with elevated diabetes risk. Of these, 84.85% (1885/2219) consented to a fasting glucose test with 1022 new

  13. Culturally Grounded Stress Reduction and Suicide Prevention for African American Adolescents

    PubMed Central

    Robinson, W. LaVome; Case, Mary H.; Whipple, Christopher R.; Gooden, Adia S.; Lopez-Tamayo, Roberto; Lambert, Sharon F.; Jason, Leonard A.

    2016-01-01

    Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9th, 10th and 11th grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed. PMID:27517094

  14. Preliminary national rail plan.

    DOT National Transportation Integrated Search

    2009-10-15

    The Passenger Rail Investment and Improvement Act of 2008 (PRIIA) directed the Administrator of the Federal Railroad Administration (FRA) to develop a Preliminary National Rail Plan (PNRP or Preliminary Plan) to address the rail needs of the Nation. ...

  15. Gamification strategy on prevention of STDs for youth.

    PubMed

    Gabarron, Elia; Schopf, Thomas; Serrano, J Artur; Fernandez-Luque, Luis; Dorronzoro, Enrique

    2013-01-01

    Sexually transmitted diseases (STDs) and especially chlamydia is a worrying problem among North-Norwegian youngsters. Gamified web applications should be valued for sexual health education, and thus STDs prevention, for their potential to get users engaged and involved with their healthcare. Aiming to achieve that youngsters become more aware of STDs we have developed "sjekkdeg.no", a gamified web application focused on sexual health targeting North-Norwegian youngsters. Gamification techniques like avatars, achievement-based gifts and social network sharing buttons have been implemented in the site that includes educational content on sexual health and a STDs symptom checker. Preliminary results show that the game-style web app could be useful to encourage users to learn more on sexual health and STDs and thus changing their risky behaviors and preventing sexually transmitted diseases.

  16. Adaptation and Implementation of a Science-Based Prevention System in Colombia: Challenges and Achievements

    PubMed Central

    Pérez-Gómez, Augusto; Mejía-Trujillo, Juliana; Brown, Eric C.; Eisenberg, Nicole

    2016-01-01

    During the last 2 years, the Colombian government and the Nuevos Rumbos Corporation have been implementing an adapted version of the Communities That Care (CTC) prevention system, called Comunidades Que se Cuidan (CQC) in Spanish, for use in Colombia. This brief report presents the process of implementing CQC and identifies some of the main challenges and achievements of implementing the system in eight communities in Colombia. Preliminary results of a pilot study of CQC implementation in Colombia show that prevention system development, including a focus on measuring community risk and protection, can be established successfully in Latin American communities despite a lack of rigorously tested prevention programs and strategies. Moreover, mobilizing community coalitions toward science-based prevention, with a focus on examining local risk and protective factor data, can spur development and evaluation of prevention efforts in Latin America. PMID:28154437

  17. 7 CFR 614.7 - Preliminary technical determinations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Preliminary technical determinations. 614.7 Section... Preliminary technical determinations. (a) A preliminary technical determination becomes final 30 days after... purpose of gathering additional information and discussing the facts relating to the preliminary technical...

  18. Project Lazarus: community-based overdose prevention in rural North Carolina.

    PubMed

    Albert, Su; Brason, Fred W; Sanford, Catherine K; Dasgupta, Nabarun; Graham, Jim; Lovette, Beth

    2011-06-01

    In response to some of the highest drug overdose death rates in the country, Project Lazarus developed a community-based overdose prevention program in Western North Carolina. The Wilkes County unintentional poisoning mortality rate was quadruple that of the state's in 2009 and due almost exclusively to prescription opioid pain relievers, including fentanyl, hydrocodone, methadone, and oxycodone. The program is ongoing. The overdose prevention program involves five components: community activation and coalition building; monitoring and surveillance data; prevention of overdoses; use of rescue medication for reversing overdoses by community members; and evaluating project components. Principal efforts include education of primary care providers in managing chronic pain and safe opioid prescribing, largely through the creation of a tool kit and face-to-face meetings. Preliminary unadjusted data for Wilkes County revealed that the overdose death rate dropped from 46.6 per 100,000 in 2009 to 29.0 per 100,000 in 2010. There was a decrease in the number of victims who received prescriptions for the substance implicated in their fatal overdose from a Wilkes County physician; in 2008, 82% of overdose decedents received a prescription for an opioid analgesic from a Wilkes prescriber compared with 10% in 2010. While the results from this community-based program are preliminary, the number and nature of prescription opioid overdose deaths in Wilkes County changed during the intervention. Further evaluation is required to understand the localized effect of the intervention and its potential for replication in other areas. Wiley Periodicals, Inc.

  19. Development of pre-consultation prevention summary and reminder sheets for patients: preliminary study of acceptability and sustainability.

    PubMed

    Frank, Oliver; Aylward, Paul; Stocks, Nigel

    2014-05-01

    Patients attending general practices receive about 60% of indicated preventive services. Patients do not know which preventive services are indicated for them and want their GPs to offer those services. Patients arriving for consultations in three general practices received individualised prevention summary sheets. Acceptability was assessed by patient survey. Sustainability was assessed by the number of sheets printed over time. Seventy-two percent of patients discussed the advice on their sheet in the consultation, and 89% wanted to receive the sheets in the future. Practices printed 8882 sheets in the 52 weeks from the start of the trial. This new intervention seems to be acceptable and sustainable in the Australian setting. It has the potential, therefore, to increase the delivery of preventive care in general practice. A larger trial is needed to demonstrate its effect on performance of preventive activities and on patient outcomes.

  20. Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm.

    PubMed

    Drury, D; Michaels, J A; Jones, L; Ayiku, L

    2005-08-01

    Conventional management of abdominal aortic aneurysm (AAA) is by open repair and is associated with a mortality rate of 2-6 per cent. Endovascular aneurysm repair (EVAR) is an alternative technique first introduced in 1991. A systematic review was undertaken of the evidence for the safety and efficacy of elective EVAR in the management of asymptomatic infrarenal AAA. Thirteen electronic bibliographical databases were searched, covering biomedical, health-related, science and social science literature. Outcomes were assessed with respect to efficacy (successful deployment, technical success, conversion rates and secondary intervention rates) and safety (30-day mortality rate, procedure morbidity rates and technical issues-endoleaks, graft thrombosis, stenosis and migration). Of 606 reports identified, 61 met the inclusion criteria (three randomized and 15 non-randomized controlled trials, and 43 uncontrolled studies). There were 29 059 participants in total; 19,804 underwent EVAR. Deployment was successful in 97.6 per cent of cases. Technical success (complete aneurysm exclusion) was 81.9 per cent at discharge and 88.8 per cent at 30 days. Secondary intervention to treat endoleak or maintain graft patency was required in 16.2 per cent of patients. Mean stay in the intensive care unit and mean hospital stay were significantly shorter following EVAR. The 30-day mortality rate for EVAR was 1.6 per cent (randomized controlled trials) and 2.0 per cent in nonrandomized trials and case series. Technical complications comprised stent migration (4.0 per cent), graft limb thrombosis (3.9 per cent), endoleak (type I, 6.8 per cent; type II, 10.3 per cent; type III, 4.2 per cent) and access artery injury (4.8 per cent). EVAR is technically effective and safe, with lower short-term morbidity and mortality rates than open surgery. However, there is a need for extended follow-up as the long-term success of EVAR in preventing aneurysm-related deaths is not yet known.

  1. [Postpartum depression: we know the risks, can it be prevented?].

    PubMed

    Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

    2005-10-01

    In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

  2. 25 CFR 11.1105 - Preliminary inquiry.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... shelter care, the children's court shall conduct a preliminary inquiry with 24 hours for the purpose of... to the parents, guardian or custodian, the children's court shall conduct a preliminary inquiry... custodian is not present at the preliminary inquiry, the children's court shall determine what efforts have...

  3. 25 CFR 11.1105 - Preliminary inquiry.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... shelter care, the children's court shall conduct a preliminary inquiry with 24 hours for the purpose of... to the parents, guardian or custodian, the children's court shall conduct a preliminary inquiry... custodian is not present at the preliminary inquiry, the children's court shall determine what efforts have...

  4. 25 CFR 11.1105 - Preliminary inquiry.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... shelter care, the children's court shall conduct a preliminary inquiry with 24 hours for the purpose of... to the parents, guardian or custodian, the children's court shall conduct a preliminary inquiry... custodian is not present at the preliminary inquiry, the children's court shall determine what efforts have...

  5. 25 CFR 11.1105 - Preliminary inquiry.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... shelter care, the children's court shall conduct a preliminary inquiry with 24 hours for the purpose of... to the parents, guardian or custodian, the children's court shall conduct a preliminary inquiry... custodian is not present at the preliminary inquiry, the children's court shall determine what efforts have...

  6. 25 CFR 11.1105 - Preliminary inquiry.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... shelter care, the children's court shall conduct a preliminary inquiry with 24 hours for the purpose of... to the parents, guardian or custodian, the children's court shall conduct a preliminary inquiry... custodian is not present at the preliminary inquiry, the children's court shall determine what efforts have...

  7. Foodstuffs for Preventing Cancer: The Preclinical and Clinical Development of Berries

    PubMed Central

    Stoner, Gary D.

    2009-01-01

    Laboratory research involving berries is a promising example of food-based cancer prevention. Berries contain many known chemopreventive agents, such as anthocyanins and ellagitannins, that can be greatly concentrated in freeze-dried berry powders. Based on our program of berry research, this commentary presents the first reported stepwise scheme for the preclinical and clinical development of foodstuffs for cancer prevention. Our preclinical work within this scheme includes promising approaches for assessing the chemopreventive potential of berry powder and berry extracts in preclinical model systems; for determining these compounds’ mechanisms of action; and for identifying the active constituents in berries. The commentary also presents preliminary results of clinical trials in the oral cavity, esophagus and colon using various formulations of freeze-dried berries. The relative merits of berry powders, extracts or individual constituents (anthocyanins) for cancer prevention are also discussed. PMID:19258544

  8. Foodstuffs for preventing cancer: the preclinical and clinical development of berries.

    PubMed

    Stoner, Gary D

    2009-03-01

    Laboratory research involving berries is a promising example of food-based cancer prevention. Berries contain many known chemopreventive agents such as anthocyanins and ellagitannins that can be greatly concentrated in freeze-dried berry powders. Based on our program of berry research, this commentary presents the first reported stepwise scheme for the preclinical and clinical development of foodstuffs for cancer prevention. Our preclinical work within this scheme includes promising approaches for assessing the chemopreventive potential of berry powder and berry extracts in preclinical model systems, for determining the mechanisms of action of these agents, and for identifying the active constituents in berries. The commentary also presents preliminary results of clinical trials in the oral cavity, esophagus, and colon using various formulations of freeze-dried berries. The relative merits of berry powders, extracts, or individual constituents (anthocyanins) for cancer prevention are also discussed.

  9. Hip-hop to prevent substance use and HIV among African-American youth: a preliminary investigation.

    PubMed

    Turner-Musa, Jocelyn O; Rhodes, Warren A; Harper, P Thandi Hicks; Quinton, Sylvia L

    2008-01-01

    Substance use and HIV risk behaviors are increasing among African-American youth. Interventions that incorporate youth values and beliefs are needed to reduce this trajectory. Hip-hop plays an important role in the lives of many African-American youth and provides a context within which to prevent risky behaviors. The current study examines the efficacy of a hip-hop based substance use and HIV preventive intervention that targets African-American middle-school youth. The sample consists of 68 middle-school students who completed baseline and 6-month follow-up assessments. Findings suggest that students in the intervention group were significantly more likely to have higher knowledge of perception of drug risk and more knowledge about HIV/AIDS compared to students in the comparison group at the 6-month post-intervention assessment. Discussion is centered on implications of hip-hop as a viable approach for preventing substance use and HIV within a high-risk group.

  10. Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.

    PubMed

    Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole

    2017-10-01

    An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The prevention of injuries in contact flag football.

    PubMed

    Kaplan, Yonatan; Myklebust, Grethe; Nyska, Meir; Palmanovich, Ezequiel; Victor, Jan; Witvrouw, Erik

    2014-01-01

    American flag football is a non-tackle, contact sport with many moderate to severe contact-type injuries reported. A previous prospective injury surveillance study by the authors revealed a high incidence of injuries to the fingers, face, knee, shoulder and ankle. The objectives of the study were to conduct a pilot-prospective injury prevention study in an attempt to significantly reduce the incidence and the severity of injuries as compared to a historical cohort, as well as to provide recommendations for a future prospective injury prevention study. A prospective injury prevention study was conducted involving 724 amateur male (mean age: 20.0 ± 3.1 years) and 114 female (mean age: 21.2 ± 7.2 years) players. Four prevention measures were implemented: the no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure. An injury surveillance questionnaire was administered to record all time-loss injuries sustained in game sessions. There was a statistically significant reduction in the number of injured players, the number of finger/hand injuries, the incidence rate and the incidence proportion between the two cohorts (p < 0.05). This one-season pilot prevention study has provided preliminary evidence that finger/hand injuries can be significantly reduced in flag football. Prevention strategies for a longer, prospective, randomised-controlled injury prevention study should include the strict enforcement of the no-pocket rule, appropriate head gear, the use of comfortable-fitting ankle braces and mouth guards, and changing the blocking rules of the game.

  12. Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement

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

    Juszkat, Robert, E-mail: radiologiamim@wp.p; Pukacki, Fryderyk; Zarzecka, Anna

    We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The proceduremore » was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.« less

  13. Preventing and Responding to Sexual Misconduct: Preliminary Efficacy of a Peer-Led Bystander Training Program for Preventing Sexual Misconduct and Reducing Heavy Drinking Among Collegiate Athletes.

    PubMed

    Morean, Meghan E; Darling, Nancy; Smit, Jessie; DeFeis, Jolie; Wergeles, Maya; Kurzer-Yashin, Dana; Custer, Kaitlyn

    2018-06-01

    Sexual misconduct occurs with disproportionate frequency on college campuses, and alcohol is involved in most sexual assaults. Importantly, collegiate athletes are at risk for both heavy drinking and sexual misconduct. Thus, the current study evaluated the efficacy of a novel, 2.5-hr, peer-facilitated, interactive, group-based bystander intervention program for student athletes that integrated information on sexual misconduct and risky drinking (Preventing and Responding to Sexual Misconduct [PRSM]). In all, 205 athletes completed 25-min surveys immediately before and after the training, and 76 (of 94 invited) completed a 3-month follow-up. Participating in the workshop was associated with significant increases in acknowledgment that sexual misconduct is a problem on campus, knowledge of where to get help if sexual misconduct occurs, knowledge about the college's procedures for addressing sexual misconduct, confidence that the college's procedures for addressing sexual misconduct are fair, bystander confidence, and engagement in a range of bystander activities. A significant decrease in rape myths also was observed. Participating in the workshop also produced changes in alcohol-related beliefs and behaviors. After participating in PRSM, athletes reported increased expectations that drinking alcohol can produce negative effects including aggression and acute intoxication. Participating in the workshop also was associated with significant reductions in drinking frequency, the total number of drinks consumed per month, the maximum drinks consumed in 24 hours, the frequency of binge-drinking episodes, and the experience of alcohol-related problems. In sum, the PRSM program evidenced preliminary efficacy as a program designed to increase prosocial bystander behavior and decrease high-risk drinking among collegiate athletes; changes in beliefs and behaviors consistent with reducing risk for sexual misconduct and problem drinking were observed after workshop participation

  14. 40 CFR 161.170 - Preliminary analysis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Preliminary analysis. (a) If the product is produced by an integrated system, the applicant must provide a preliminary analysis of each technical grade of active ingredient contained in the product to identify all... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Preliminary analysis. 161.170 Section...

  15. Evaluating the benefits of risk prevention initiatives

    NASA Astrophysics Data System (ADS)

    Di Baldassarre, G.

    2012-04-01

    The likelihood and adverse impacts of water-related disasters, such as floods and landslides, are increasing in many countries because of changes in climate and land-use. This presentation illustrates some preliminary results of a comprehensive demonstration of the benefits of risk prevention measures, carried out within the European FP7 KULTURisk project. The study is performed by using a variety of case studies characterised by diverse socio-economic contexts, different types of water-related hazards (floods, debris flows and landslides, storm surges) and space-time scales. In particular, the benefits of state-of-the-art prevention initiatives, such as early warning systems, non-structural options (e.g. mapping and planning), risk transfer strategies (e.g. insurance policy), and structural measures, are showed. Lastly, the importance of homogenising criteria to create hazard inventories and build memory, efficient risk communication and warning methods as well as active dialogue with and between public and private stakeholders, is highlighted.

  16. Review of Interventions in the Field of Prevention of Adolescent Pregnancy. Preliminary Report.

    ERIC Educational Resources Information Center

    Dryfoos, Joy G.

    This report presents an overview of programs that may have a potential for prevention of teenage pregnancy. The report starts with a summary of expert opinions on the dimensions of and solutions to the problem and then describes several relatively successful programs. Following this is an overview of interventions with an analysis of program…

  17. Preliminary hazards analysis -- vitrification process

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

    Coordes, D.; Ruggieri, M.; Russell, J.

    1994-06-01

    This paper presents a Preliminary Hazards Analysis (PHA) for mixed waste vitrification by joule heating. The purpose of performing a PHA is to establish an initial hazard categorization for a DOE nuclear facility and to identify those processes and structures which may have an impact on or be important to safety. The PHA is typically performed during and provides input to project conceptual design. The PHA is then followed by a Preliminary Safety Analysis Report (PSAR) performed during Title 1 and 2 design. The PSAR then leads to performance of the Final Safety Analysis Report performed during the facility`s constructionmore » and testing. It should be completed before routine operation of the facility commences. This PHA addresses the first four chapters of the safety analysis process, in accordance with the requirements of DOE Safety Guidelines in SG 830.110. The hazards associated with vitrification processes are evaluated using standard safety analysis methods which include: identification of credible potential hazardous energy sources; identification of preventative features of the facility or system; identification of mitigative features; and analyses of credible hazards. Maximal facility inventories of radioactive and hazardous materials are postulated to evaluate worst case accident consequences. These inventories were based on DOE-STD-1027-92 guidance and the surrogate waste streams defined by Mayberry, et al. Radiological assessments indicate that a facility, depending on the radioactive material inventory, may be an exempt, Category 3, or Category 2 facility. The calculated impacts would result in no significant impact to offsite personnel or the environment. Hazardous materials assessment indicates that a Mixed Waste Vitrification facility will be a Low Hazard facility having minimal impacts to offsite personnel and the environment.« less

  18. The Results of Teaching Middle School Students Two Relaxation Techniques as Part of a Conflict Prevention Program.

    ERIC Educational Resources Information Center

    Dacey, John S.; And Others

    1997-01-01

    Boston College Conflict Prevention Program techniques for relaxation and self-control were taught to middle-school students in two Boston schools. Preliminary results from teacher interviews revealed that students spontaneously used these methods to calm their "fight-or-flight" reactions in real conflicts. Results also indicated that…

  19. A Preliminary Evaluation of Two Behavioral Skills Training Procedures for Teaching Abduction-Prevention Skills to Schoolchildren

    PubMed Central

    Johnson, Brigitte M; Miltenberger, Raymond G; Knudson, Peter; Egemo-Helm, Kristin; Kelso, Pamela; Jostad, Candice; Langley, Linda

    2006-01-01

    Although child abduction is a low-rate event, it presents a serious threat to the safety of children. The victims of child abduction face the threat of physical and emotional injury, sexual abuse, and death. Previous research has shown that behavioral skills training (BST) is effective in teaching children abduction-prevention skills, although not all children learn the skills. This study compared BST only to BST with an added in situ training component to teach abduction-prevention skills in a small-group format to schoolchildren. Results showed that both programs were effective in teaching abduction-prevention skills. In addition, the scores for the group that received in situ training were significantly higher than scores for the group that received BST alone at the 3-month follow-up assessment. PMID:16602383

  20. Attitudes and Perceptions of Suicide and Suicide Prevention Messages for Asian Americans

    PubMed Central

    Thapa, Priyata; Sung, Yoonhee; Klingbeil, David A.; Lee, Chih-Yuan Steven; Klimes-Dougan, Bonnie

    2015-01-01

    Understanding the context of suicidal behaviors is critical for effective suicide prevention strategies. Although suicide is an important topic for Asian Americans, there is limited information about what Asian Americans’ attitudes are towards suicide and their perceptions about the effectiveness of prevention efforts. These questions are critical to examine to provide foundational knowledge for determining how best to intervene. In this study, Asian American (n = 87) and White (n = 87) participants completed self-report indexes on their knowledge of depression and suicide (e.g., estimates of suicide rates), coping attitudes (e.g., help-seeking) and suicide prevention attitudes (e.g., usefulness of PSAs). The results indicate that in comparison to Whites, Asian Americans perceived suicidal behavior to be more common, perceived a stronger link between depression and suicide, less frequently endorsed help-seeking strategies, and reported more concern or distress after viewing a suicide prevention PSA. These preliminary results also suggest the possibility of cultural differences in perceptions of suicide prevention messages. The implications of these findings are discussed with a focus on providing recommendations for exploring suicide prevention efforts for Asian Americans. PMID:26690227

  1. Use of an audit in violence prevention research.

    PubMed

    Erwin, Elizabeth Hite; Meyer, Aleta; McClain, Natalie

    2005-05-01

    Auditing is an effective tool for articulating the trustworthiness and credibility of qualitative research. However, little information exists on how to conduct an audit. In this article, the authors illustrate their use of an audit team to explore the methods and preliminary findings of a study aimed at identifying the relevant and challenging problems experienced by urban teenagers. This study was the first in a series of studies to improve the ecological validity of violence prevention programs for high-risk urban teenagers, titled Identifying Essential Skills for Violence Prevention. The five phases of this audit were engaging the auditor, becoming familiar with the study, discussing methods and determining strengths and limitations, articulating audit findings, and planning subsequent research. Positioning the audit before producing final results allows researchers to address many study limitations, uncover potential sources of bias in the thematic structure, and systematically plan subsequent steps in an emerging design.

  2. Validation of Safety-Critical Systems for Aircraft Loss-of-Control Prevention and Recovery

    NASA Technical Reports Server (NTRS)

    Belcastro, Christine M.

    2012-01-01

    Validation of technologies developed for loss of control (LOC) prevention and recovery poses significant challenges. Aircraft LOC can result from a wide spectrum of hazards, often occurring in combination, which cannot be fully replicated during evaluation. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of hazardous and uncertain conditions, and the validation framework must provide some measure of assurance that the new vehicle safety technologies do no harm (i.e., that they themselves do not introduce new safety risks). This paper summarizes a proposed validation framework for safety-critical systems, provides an overview of validation methods and tools developed by NASA to date within the Vehicle Systems Safety Project, and develops a preliminary set of test scenarios for the validation of technologies for LOC prevention and recovery

  3. Preliminary evidence of HIV seroconversion among HIV-negative men who have sex with men taking non-prescribed antiretroviral medication for HIV prevention in Miami, Florida, USA.

    PubMed

    Buttram, Mance E; Kurtz, Steven P

    2017-04-01

    Background Limited information suggests that men who have sex with men (MSM) are informally obtaining antiretroviral medication (ARVs) and using them for HIV pre-exposure prophylaxis (PrEP). Data are drawn from an on-going study examining the use of non-prescribed ARVs for PrEP. To date, 24 qualitative interviews have been conducted with HIV-negative, substance-using MSM living in Miami, Florida, USA. Data are presented from two participants who reported HIV seroconversion while using non-prescribed ARVs for PrEP. Preliminary data indicate that some young MSM: (i) lack awareness of and accurate information about the efficacious use of PrEP; (ii) obtain non-prescribed ARVs from HIV-positive sex partners and use these medications for PrEP in a way that does not provide adequate protection against HIV infection or cohere with established guidelines; and (iii) engage in multiple HIV transmission risk behaviours, including condomless anal sex and injection drug use. The informal, non-prescribed and non-medically supervised use of ARVs for HIV prevention has the potential to undermine the protective benefits of PrEP and leave men unprotected against HIV transmission and at risk for ARV resistance.

  4. [Preventing dependency in the elderly].

    PubMed

    Gómez Pavón, J; Martín Lesende, I; Baztán Cortés, J J; Regato Pajares, P; Formiga Pérez, F; Segura Benedito, A; Abizanda Soler, P; de Pedro Cuesta, J

    2008-01-01

    Dependency, i.e. the need to depend on another person to perform activities of daily living, is the main concern and cause of suffering and poor quality of life in the elderly. The prevalence of dependency increases with age and is related to the presence of prior disease and fragility. Dependency is associated with increased morbidity, mortality and institutionalization, as well as with greater health and social resource utilization, all of which increases health costs. To create a consensus document on the main health recommendations for the prevention of dependency in the elderly, based on the scientific evidence available to date, with the collaboration of scientific societies and public health administrations (the Spanish Ministry of Health, Autonomous Communities and Cities). a) a preliminary consensus document was drafted by an expert group composed of representatives of various scientific societies and health administrations. This document was based on a review of the recommendations and guidelines published by the main organizations involved in health promotion and the prevention of disease, functional deterioration and dependency in the elderly; b) the consensus document was reviewed by the remaining experts assigned by the scientific societies and central and autonomous administrations; c) the final document was approved after a session in which the text was discussed and reviewed by all the experts participating in the working group (including the academic committee); d) the document was presented and discussed in the First National Conference on Prevention and Health Promotion in Clinical Practice in Spain. All participating experts signed a conflicts of interest statement. The document provides recommendations, with their grades of evidence, grouped in the following three categories: a) health promotion and disease prevention, with specific preventive activities for the elderly, including prevention of geriatric syndromes; b) prevention of functional

  5. [Primary Prevention of Mental Disorders in Children of Mentally Ill Parents. The Kanu Programme "Canoe--Moving Jointly Forward"].

    PubMed

    Linthorst, K; Bauer, U; Osipov, I; Pinheiro, P; Rehder, M

    2015-09-01

    Children of parents who suffer from mental health disorders are more likely to develop mental disorders than children of parents not suffering from mental disorders. For children at risk, preventive strategies are hardly available and, if available, rarely supported by a scientific evaluation. "Kanu - Gemeinsam weiterkommen (canoe - moving jointly forward)" is a preventive strategy that was developed within a research project focusing on primary prevention in children who live in families with parents affected by mental disorders. The intervention is characterised by a multi-modular concept and was tested in the adult psychiatric setting. Preliminary results indicate a preventive impact of the intervention programme. © Georg Thieme Verlag KG Stuttgart · New York.

  6. [Defining an ethics for preventive trials].

    PubMed

    Chippaux, J-P

    2008-04-01

    Preventive trials (to prevent from infection) or prophylaxis trials (to avoid consequences of the disease) differ from other clinical trials as they apply to healthy subjects or subjects considering themselves as such: the latter do not ask for intervention even less for trial. Moreover, it is generally an experiment which aims at validating a public health intervention, the individual character of which could appear as secondary regarding the collective interest. It concerns many tools or methods: preventive or prophylactic vaccines and drugs, condoms, impregnated bed nets, etc. The field of implementation of preventive trials is large and covers routine immunization (EPI), large-scale control or eradication of endemic diseases or epidemics, for which the concept of individual risk is generally better understood. Preventive trials imply ethical obligations (high individual or collective benefits and absence of risks as there is no immediate therapeutic compensation), methodological adaptations (because the number of subjects is considerably larger than for therapeutic trials) and a sensitive valorization towards a large population who is not asking for the recommended intervention. As regard the benefits, it is also necessary to consider the costs in comparison with the expected efficacy The methodological constraints are important because the demonstration of both safety and efficacy requires a very large number of subjects to validate the product. It is often necessary to use indirect or substitutive markers and indicators (title of protective antibodies rather than definite clinical protection) which need a preliminary validation. Before carrying out a preventive or prophylactic trial, it is advisable to specify the objectives in order to assess the real profits and absence of risks during the trial and after the implementation of the tested product. Preventive trials require a phase of technological transfer to guarantee the application of the validated tools

  7. Assessing the Efficiency of HIV Prevention around the World: Methods of the PANCEA Project

    PubMed Central

    Marseille, Elliot; Dandona, Lalit; Saba, Joseph; McConnel, Coline; Rollins, Brandi; Gaist, Paul; Lundberg, Mattias; Over, Mead; Bertozzi, Stefano; Kahn, James G

    2004-01-01

    Objective To develop data collection methods suitable to obtain data to assess the costs, cost-efficiency, and cost-effectiveness of eight types of HIV prevention programs in five countries. Data Sources/Study Setting Primary data collection from prevention programs for 2002–2003 and prior years, in Uganda, South Africa, India, Mexico, and Russia. Study Design This study consisted of a retrospective review of HIV prevention programs covering one to several years of data. Key variables include services delivered (outputs), quality indicators, and costs. Data Collection/Extraction Methods Data were collected by trained in-country teams during week-long site visits, by reviewing service and financial records and interviewing program managers and clients. Principal Findings Preliminary data suggest that the unit cost of HIV prevention programs may be both higher and more variable than previous studies suggest. Conclusions A mix of standard data collection methods can be successfully implemented across different HIV prevention program types and countries. These methods can provide comprehensive services and cost data, which may carry valuable information for the allocation of HIV prevention resources. PMID:15544641

  8. 25 CFR 700.115 - Preliminary acquisition notice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Acquisition and Disposal of Habitations and/or Improvements § 700.115 Preliminary acquisition notice. As soon as feasible in the acquisition process, the Commission shall issue a preliminary acquisition notice.../her habitations and/or improvements. (b) Explain that such preliminary acquisition notice is not a...

  9. 75 FR 72831 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)-Ethics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)--Ethics Subcommittee (ES... counsel to the ACD, CDC, regarding a broad range of public health ethics questions and issues arising from... strategy for addressing its charge to provide a preliminary overview to the ACD on ethical issues related...

  10. 28 CFR 2.48 - Revocation: Preliminary interview.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Revocation: Preliminary interview. 2.48....48 Revocation: Preliminary interview. (a) Interviewing officer. A parolee who is retaken on a warrant issued by a Commissioner shall be given a preliminary interview by an official designated by the Regional...

  11. 43 CFR 3425.1-7 - Preliminary data.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... used is other than underground mining techniques, the authorized officer shall obtain documents... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Preliminary data. 3425.1-7 Section 3425.1... Preliminary data. (a) Any application for a lease shall contain preliminary data to assist the authorized...

  12. 43 CFR 3425.1-7 - Preliminary data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... used is other than underground mining techniques, the authorized officer shall obtain documents... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Preliminary data. 3425.1-7 Section 3425.1... Preliminary data. (a) Any application for a lease shall contain preliminary data to assist the authorized...

  13. 43 CFR 3425.1-7 - Preliminary data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... used is other than underground mining techniques, the authorized officer shall obtain documents... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Preliminary data. 3425.1-7 Section 3425.1... Preliminary data. (a) Any application for a lease shall contain preliminary data to assist the authorized...

  14. [Smoking and young people; effectiveness of smoking prevention and cessation programmes].

    PubMed

    Monshouwer, K; Onrust, S; Rikkers-Mutsaerts, E; Lammers, J

    2017-01-01

    - In this article, we discuss the scientific knowledge on the effects of interventions that help young people to quit smoking and interventions that should prevent young people from starting to smoke.- We also describe the interventions in the Netherlands that, after a quality assessment, have been included in the database of the National Institute for Public Health and the Environment (RIVM) Centre for Healthy Living.- Interventions have varying degrees of success in helping young people to quit smoking. There are only indications of a modest effect of behavioural interventions.- Preventive interventions mostly occur in a school setting and are making a modest contribution to the reduction of the number of young people that start smoking.- There are preliminary indications of the effectiveness of interventions in a medical setting. However, research into this is rare and there is no insight in long-term effects.- The database of the RIVM Centre for Healthy Living includes mainly preventive interventions in a school setting and only one smoking cessation intervention.

  15. Anithrombotic prevention in vascular disease: bases for a new strategy in antithrombotic therapy

    PubMed Central

    Altman, Raul

    2007-01-01

    A tendency toward bleeding often undercuts the beneficial preventive effect of higher doses of a single antithrombotic drug or combined antithrombotic therapy. Although high doses of antithrombotic drugs may be necessary for optimal prevention, such therapy can also elicit more frequent bleeding. Although major bleeding could be a reversible event is likely to lead clinicians to discontinue antithrombotic therapy which in turn could increase the risk of myocardial infarction, stroke, and cardiovascular death. Thus, to prevent thrombotic events without frequent bleeding complications, the preferred approach might be to use anti-inflammatory drugs in addition to the first-line antithrombotic drugs to reduce inflammation and thrombin formation in atheroma. Although some preliminary data have been already published, to confirm the potential benefit of anti-inflammatory drugs in acute coronary syndromes large prospective double-bind randomized trials are necessary. PMID:17727726

  16. Aneurysm Sac Pressure Measurement with Minimally Invasive Implantable Pressure Sensors: An Alternative to Current Surveillance Regimes after EVAR?

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

    Springer, Fabian; Guenther, Rolf W.; Schmitz-Rode, Thomas

    Current protocols for surveillance after endovascular repair (EVAR) of abdominal aortic aneurysms are mostly based on costly and time-consuming imaging procedures and aim to detect adverse events such as graft migration, endoleaks or aneurysm sac enlargement. These imaging procedures are either associated with radiation exposure to the patients or may be harmful to the patient due to the use of iodine- or gadolinium-containing contrast agents. Furthermore the advantages of EVAR in the short term might be negated by the necessity for endograft surveillance over years. Thus, alternative modalities for follow-up are being investigated. One of these technologies provides pressure informationmore » directly from the aneurysm sac. This noninvasive, telemetric pressure sensing was tested in vitro as well as in first clinical trials and was able to identify successful aneurysm exclusion after EVAR. The telemetric pressure sensors showed a promising efficacy and accuracy in detecting type I and type III endoleaks and will help to clarify the clinical relevance of type II endoleaks. This article provides an overview of the in vitro sensors investigated as well as the first clinical trials and the sensors' potential to change the current endograft surveillance regimes.« less

  17. Rupture of abdominal aortic aneurysm: concurrent comparison of outcome of those occurring after endovascular repair versus those occurring without previous treatment in an 11-year single-center experience.

    PubMed

    May, James; White, Geoffrey H; Stephen, Michael S; Harris, John P

    2004-11-01

    repair complicated by endoleak does not prevent rupture. The data suggest, however, that rupture, when it occurs in these circumstances, may not be accompanied by such major hemodynamic changes and high mortality as rupture of an untreated AAA. Further long-term follow-up and analysis in a larger group of patients are required to confirm the apparent intermediate level of protection afforded by failed endovascular repair, which does not prevent rupture but enhances survival after operation to treat rupture, possibly by ameliorating the hemodynamic changes associated with the rupture process.

  18. Prevention Practice Differences Among Persons With Spinal Cord Injuries Who Rarely Versus Frequently Sustain Pressure Ulcers

    ERIC Educational Resources Information Center

    Jones, Michael L.; Marini, Irmo; Slate, John R.

    2005-01-01

    Pressure ulcers are common among people with spinal cord injury (SCI) and not only are costly to treat but also affect the quality of life of those affected by them. Despite a plethora of literature on prevention, there are few wellness studies focusing on the practices of people who do not develop pressure ulcers. This preliminary study sought to…

  19. [Evaluation of the efficiency of preventive medical examinations of railway transport workers].

    PubMed

    Pankova, V B; Golysheva, G V; Khvastunov, R M; Makarov, A A

    2006-01-01

    The paper reflects the priority role of preliminary and periodic medical examinations in the system of measures implemented by therapeutic-and-prophylactic institutions of the Ministry of Railway of Russia. It gives a comprehensive assessment of the medical, social, and economic aspects of the efficiency of preventive medical examinations. Emphasis is laid on the necessity of elaborating methods to evaluate the economic efficiency of medical measures under the conditions of market economy. At the same time, light is shed on the difficulties available when a full-scale, within the whole industry, economic evaluation of periodic medical examinations is made. The role of a cost-effect analysis is shown as the most flexible existing principle in the evaluation of the efficiency of medical preventive measures.

  20. [Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey].

    PubMed

    Sziller, István; Szabó, Miklós; Valek, Andrea; Rigó, Barbara; Ács, Nándor

    2014-07-20

    At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

  1. The Viking biological investigation - Preliminary results

    NASA Technical Reports Server (NTRS)

    Klein, H. P.; Oyama, V. I.; Berdahl, B. J.; Horowitz, N. H.; Hobby, G. L.; Levin, G. V.; Straat, P. A.; Lederberg, J.; Rich, A.; Hubbard, J. S.

    1976-01-01

    A preliminary progress report is presented for the Viking biological investigation through its first month. The carbon assimilation, gas exchange, and labeled release experiments are described in detail, and the chronology of the experiments is outlined. For the first experiment, it is found that a small amount of gas was converted into organic material in one sample and that heat treatment of a duplicate sample prevented such conversion. In the second experiment, a substantial amount of O2 was detected along with significant increases in CO2 and small changes in N2. In the third experiment, a significant amount of radioactive gas was evolved from one sample, but not from a duplicate heat-treated sample. Possible biological and nonbiological interpretations are considered for these results. It is concluded that while the experiments provide clear evidence for the occurrence of chemical reactions and while the results do not violate any prima facie criteria for biological processes, a definitive answer cannot yet be given to the question of whether life exists on Mars.

  2. ADCS Prevention Instrument Project: assessment of instrumental activities of daily living for community-dwelling elderly individuals in dementia prevention clinical trials.

    PubMed

    Galasko, Douglas; Bennett, David A; Sano, Mary; Marson, Daniel; Kaye, Jeff; Edland, Steven D

    2006-01-01

    In primary prevention trials for Alzheimer disease, the inception cohort typically has normal or minimally impaired complex activities of daily living (ADL). ADL change during a trial could trigger detailed evaluation or serve as an outcome measure. A brief, easily administered, and reliable ADL rating scale would assist prevention studies. To develop an ADL scale for prevention trials that allows self-rating or completion by informants. The Activities of Daily Living-Prevention Instrument (ADL-PI) was developed, comprising 15 ADL and 5 physical function questions. Six hundred forty-four elderly subjects participating in the Prevention Instrument Project completed a self-rated version of the ADL-PI, and informants for 632 subjects completed an informant version. Informants also completed a Mild Cognitive Impairment (MCI) ADL questionnaire to allow comparisons. Subjects performed well on all ADL scales at baseline. Completion of the ADL-PI questionnaires at home or in-clinic yielded comparable information. Scores from baseline to 3 months had good reliability. The ADL-PI, obtained from either self-report or informants, discriminated between subjects rated as CDR 0 and CDR 0.5. Subjects with worse baseline cognitive performance also had slightly worse ADL-PI scores. Preliminary analysis indicates that subjects who triggered cognitive evaluations had slightly lower baseline ADL-PI scores by both self and informant reports. The ADL-PI can be completed at home or in clinic, and has adequate reliability. The utility of self-administered and informant versions and predictive value of reported deficits requires further follow-up.

  3. A Preliminary Study of the Prevention of Ice on Aircraft by the Use of Engine-exhaust Heat

    NASA Technical Reports Server (NTRS)

    Rodert, Lewis A

    1939-01-01

    An investigation was made in the N.A.C.A. ice tunnel at air temperatures from 20 degrees to 28 degrees Fahrenheit and at a velocity of 80 miles per hour to determine whether ice formations on a model wing could be prevented by the use of the heat from the engine-exhaust gas. Various spanwise duct systems were tested in a 6-foot-chord N.A.C.A. 23012 wing model. The formation of ice over the entire wing chord was prevented by the direct heating of the forward 10 percent of the wing by hot air, which was passed through leading-edge ducts. Under dry conditions, enough heat to maintain the temperature of the forward 10 percent of the wing at about 200 degrees Fahrenheit above that of the ambient air was required for the prevention of ice formation. The air temperature in the ducts that was necessary to produce these skin temperatures varied from 360 degrees to 834 degrees Fahrenheit; the corresponding air velocities in the duct were 152 and 45 feet per second. Ice formations at the leading edge were locally prevented by air that passed over the interior of the wing surface at a velocity of 30 feet per second and a temperature of 122 degrees Fahrenheit.

  4. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

    PubMed Central

    La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

    2016-01-01

    Background Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization. We modified Interpersonal Psychotherapy-Adolescent Skills Training for depression, incorporating strategies for dealing with social anxiety and peer victimization. Objective Our open trial assessed the feasibility, acceptability, and preliminary benefit of the modified program (called UTalk) for adolescents at risk for SAD or depression and who also reported peer victimization. Method Adolescents (N=14; 13–18 years; 79% girls; 86% Hispanic) were recruited and completed measures of peer victimization, social anxiety, and depression both pre- and post-intervention and provided ratings of treatment satisfaction. Independent evaluators (IEs) rated youths’ clinical severity. The intervention (3 individual and 10 group sessions) was conducted weekly during school. Results Regarding feasibility, 86% of the adolescents completed the intervention (M attendance=11.58 sessions). Satisfaction ratings were uniformly positive. Intention-to-treat analyses revealed significant declines in adolescent- and IE-rated social anxiety and depression and in reports of peer victimization. Additional secondary benefits were observed. Conclusions Although further evaluation is needed, the UTalk intervention appears feasible to administer in schools, with high satisfaction and preliminary benefit. Implications for research on the prevention of adolescent SAD and depression are discussed. PMID:27857509

  5. Loss of Control Prevention and Recovery: Onboard Guidance, Control, and Systems Technologies

    NASA Technical Reports Server (NTRS)

    Belcastro, Christine M.

    2012-01-01

    Loss of control (LOC) is one of the largest contributors to fatal aircraft accidents worldwide. LOC accidents are complex in that they can result from numerous causal and contributing factors acting alone or (more often) in combination. These LOC hazards include vehicle impairment conditions, external disturbances; vehicle upset conditions, and inappropriate crew actions or responses. Hence, there is no single intervention strategy to prevent these accidents. NASA previously defined a comprehensive research and technology development approach for reducing LOC accidents and an associated integrated system concept. Onboard technologies for improved situation awareness, guidance, and control for LOC prevention and recovery are needed as part of this approach. Such systems should include: LOC hazards effects detection and mitigation; upset detection, prevention and recovery; and mitigation of combined hazards. NASA is conducting research in each of these areas. This paper provides an overview of this research, including the near-term LOC focus and associated analysis, as well as preliminary flight system architecture.

  6. 23 CFR 645.109 - Preliminary engineering.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  7. 23 CFR 645.109 - Preliminary engineering.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  8. 23 CFR 645.109 - Preliminary engineering.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  9. 23 CFR 645.109 - Preliminary engineering.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  10. 23 CFR 645.109 - Preliminary engineering.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  11. Preliminary evidence for the integration of music into HIV prevention for severely mentally ill Latinas.

    PubMed

    Loue, Sana; Mendez, Nancy; Sajatovic, Martha

    2008-12-01

    Individuals with severe mental illness (SMI) may be at increased risk of HIV infection. Prevention programs designed specifically for SMI have relied primarily on principles of cognitive-behavior change theories delivered in a small group format and in venues and services utilized by SMI. Most intervention effects have not been shown to be sustainable over time. We report on our findings relating to the importance of music to Puerto Rican women with SMI and the implications for HIV prevention interventions with this population. We interviewed and shadowed over a 2-year period 53 women of Puerto Rican ethnicity between the ages of 18 and 50, residing in northeastern Ohio, who had been diagnosed with schizophrenia, bipolar disorder, or major depression. Nearly one-half of the participants listened to music regularly. Some reported that music was essential to their lives. Participants reported that music improved their mental and social well-being by facilitating expression and reflection of their emotions and increasing their energy levels. Music may affect the core negative symptoms and compensate for neuropsychological deficits in women with schizophrenia and related conditions by facilitating the articulation of emotion and allowing individuals to better attend to and potentially incorporate external activities into their lives. The use of music in HIV prevention efforts with SMI Latinas may facilitate their emotional expression and assist them in integrating the educative efforts into their life style choices.

  12. Follow-up after endovascular aortic aneurysm repair can be stratified based on first postoperative imaging.

    PubMed

    Baderkhan, H; Haller, O; Wanhainen, A; Björck, M; Mani, K

    2018-05-01

    Lifelong postoperative surveillance is recommended following endovascular aneurysm repair (EVAR). Although the purpose is to prevent and/or identify complications early, it also results in increased cost and workload. This study was designed to examine whether it may be possible to identify patients at low risk of complications based on their first postoperative CT angiogram (CTA). All patients undergoing EVAR in two Swedish centres between 2001 and 2012 were identified retrospectively and categorized based on the first postoperative CTA as at low risk (proximal and distal sealing zone at least 10 mm and no endoleak) or high risk (sealing zone less than 10 mm and/or presence of any endoleak) of complications. Some 326 patients (273 men) with a CTA performed less than 1 year after EVAR were included (low risk 212, 65·0 per cent; high risk 114, 35·0 per cent). There was no difference between the groups in terms of sex, age, co-morbidities, abdominal aortic aneurysm (AAA) diameter, preoperative AAA neck anatomy, stent-graft type or duration of follow-up (mean(s.d.) 4·8(3·2) years). Five-year freedom from AAA-related adverse events was 97·1 and 47·7 per cent in the low- and high-risk groups respectively (P < 0·001). The corresponding freedom from AAA-related reintervention was 96·2 and 54·1 per cent (P < 0·001). The method had a sensitivity of 88·3 per cent, specificity of 77·0 per cent and negative predictive value of 96·6 per cent to detect AAA-related adverse events. The number of surveillance imaging per AAA-related adverse event was 168 versus 11 for the low-risk versus high-risk group. Two-thirds of patients undergoing EVAR have an adequate seal and no endoleak on the first postoperative CTA, and a very low risk of AAA-related events up to 5 years. Less vigilant follow-up after EVAR may be considered for these patients. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  13. Integrating HIV Prevention and Relationship Education for Young Same-Sex Male Couples: A Pilot Trial of the 2GETHER Intervention.

    PubMed

    Newcomb, Michael E; Macapagal, Kathryn R; Feinstein, Brian A; Bettin, Emily; Swann, Gregory; Whitton, Sarah W

    2017-08-01

    Young men who have sex with men are at high risk for HIV, and most new HIV infections occur in serious relationships. This pilot study assessed the feasibility, acceptability and preliminary efficacy of the 2GETHER couples-based HIV prevention and relationship education intervention for young same-sex male couples. We enrolled 57 young male couples (N = 114) into a four-session hybrid group and individual intervention. We assessed acceptability via post-session surveys and exit interviews, and we examined preliminary efficacy at a two week posttest. The vast majority of participants (93%) reported exclusively positive impressions of 2GETHER, and all components received high mean ratings. We observed decreases in HIV risk behavior, increases in information, motivation and behavioral skills related to HIV prevention, and improvement in relationship investment between pretest and posttest. Integrating relationship education and sexual health programming may be an effective way to reduce HIV transmissions in young male couples.

  14. Proposed national strategies for the prevention of leading work-related diseases and injuries. Part 1

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

    Not Available

    1986-01-01

    Preliminary strategies developed at the National Symposium on the Prevention of Leading Work Related Diseases and Injuries, held in Atlanta, Georgia on May 1 to 3, 1985 were revised, elaborated, and further developed. Strategies were developed for the prevention of occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. Lung diseases considered included silicosis, asbestosis, lung cancer mesothelioma, coal workers' pneumoconiosis, byssinosis, occupational asthma, hypersensitivity pneumonitis, asphyxiation, irritation, pulmonary edema, brucellosis, psitticosis, anthrax, mycobacterioses, histoplasmosis, aspergillosis, and coccidioidomycosis. Occupational cancers were discussed as they occur in the lung, pleura, peritoneum, bladder, kidneys, blood, nasalmore » cavity, skin, nasal sinuses, and liver.« less

  15. 7 CFR 3430.32 - Preliminary application review.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE COMPETITIVE AND NONCOMPETITIVE NON-FORMULA... Evaluation § 3430.32 Preliminary application review. Prior to technical examination, a preliminary review...

  16. Evaluation methodology for flood damage reduction by preliminary water release from hydroelectric dams

    NASA Astrophysics Data System (ADS)

    Ando, T.; Kawasaki, A.; Koike, T.

    2017-12-01

    IPCC AR5 (2014) reported that rainfall in the middle latitudes of the Northern Hemisphere has been increasing since 1901, and it is claimed that warmer climate will increase the risk of floods. In contrast, world water demand is forecasted to exceed a sustainable supply by 40 percent by 2030. In order to avoid this expectable water shortage, securing new water resources has become an utmost challenge. However, flood risk prevention and the secure of water resources are contradictory. To solve this problem, we can use existing hydroelectric dams not only as energy resources but also for flood control. However, in case of Japan, hydroelectric dams take no responsibility for it, and benefits have not been discussed accrued by controlling flood by hydroelectric dams, namely by using preliminary water release from them. Therefore, our paper proposes methodology for assessing those benefits. This methodology has three stages as shown in Fig. 1. First, RRI model is used to model flood events, taking account of the probability of rainfall. Second, flood damage is calculated using assets in inundation areas multiplied by the inundation depths generated by that RRI model. Third, the losses stemming from preliminary water release are calculated, and adding them to flood damage, overall losses are calculated. We can evaluate the benefits by changing the volume of preliminary release. As a result, shown in Fig. 2, the use of hydroelectric dams to control flooding creates 20 billion Yen benefits, in the probability of three-day-ahead rainfall prediction of the assumed maximum rainfall in Oi River, in the Shizuoka Pref. of Japan. As the third priority in the Sendai Framework for Disaster Risk Reduction 2015-2030, `investing in disaster risk reduction for resilience - public and private investment in disaster risk prevention and reduction through structural and non-structural measures' was adopted. The accuracy of rainfall prediction is the key factor in maximizing the benefits

  17. 33 CFR 116.10 - Preliminary review.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... on a bridge's accident history or other criteria, to conduct a Preliminary Investigation. (c) The... Section 116.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES ALTERATION OF UNREASONABLY OBSTRUCTIVE BRIDGES § 116.10 Preliminary review. (a) Upon receipt of a written...

  18. 33 CFR 116.10 - Preliminary review.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... on a bridge's accident history or other criteria, to conduct a Preliminary Investigation. (c) The... Section 116.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES ALTERATION OF UNREASONABLY OBSTRUCTIVE BRIDGES § 116.10 Preliminary review. (a) Upon receipt of a written...

  19. 33 CFR 116.10 - Preliminary review.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... on a bridge's accident history or other criteria, to conduct a Preliminary Investigation. (c) The... Section 116.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES ALTERATION OF UNREASONABLY OBSTRUCTIVE BRIDGES § 116.10 Preliminary review. (a) Upon receipt of a written...

  20. 33 CFR 116.10 - Preliminary review.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... on a bridge's accident history or other criteria, to conduct a Preliminary Investigation. (c) The... Section 116.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES ALTERATION OF UNREASONABLY OBSTRUCTIVE BRIDGES § 116.10 Preliminary review. (a) Upon receipt of a written...

  1. 33 CFR 116.10 - Preliminary review.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... on a bridge's accident history or other criteria, to conduct a Preliminary Investigation. (c) The... Section 116.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES ALTERATION OF UNREASONABLY OBSTRUCTIVE BRIDGES § 116.10 Preliminary review. (a) Upon receipt of a written...

  2. Computational Analysis of Stresses Acting on Intermodular Junctions in Thoracic Aortic Endografts

    PubMed Central

    Prasad, Anamika; To, Lillian K.; Gorrepati, Madhu L.; Zarins, Christopher K.; Figueroa, C. Alberto

    2011-01-01

    Purpose: To evaluate the biomechanical and hemodynamic forces acting on the intermodular junctions of a multi-component thoracic endograft and elucidate their influence on the development of type III endoleak due to disconnection of stent-graft segments. Methods: Three-dimensional computer models of the thoracic aorta and a 4-component thoracic endograft were constructed using postoperative (baseline) and follow-up computed tomography (CT) data from a 69-year-old patient who developed type III endoleak 4 years after stent-graft placement. Computational fluid dynamics (CFD) techniques were used to quantitate the displacement forces acting on the device. The contact stresses between the different modules of the graft were then quantified using computational solid mechanics (CSM) techniques. Lastly, the intermodular junction frictional stability was evaluated using a Coulomb model. Results: The CFD analysis revealed that curvature and length are key determinants of the displacement forces experienced by each endograft and that the first 2 modules were exposed to displacement forces acting in opposite directions in both the lateral and longitudinal axes. The CSM analysis revealed that the highest concentration of stresses occurred at the junction between the first and second modules of the device. Furthermore, the frictional analysis demonstrated that most of the surface area (53%) of this junction had unstable contact. The predicted critical zone of intermodular stress concentration and frictional instability matched the location of the type III endoleak observed in the 4-year follow-up CT image. Conclusion: The region of larger intermodular stresses and highest frictional instability correlated with the zone where a type III endoleak developed 4 years after thoracic stent-graft placement. Computational techniques can be helpful in evaluating the risk of endograft migration and potential for modular disconnection and may be useful in improving device placement

  3. Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair

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

    Ishibashi, Hiroyuki, E-mail: ishibash@aichi-med-u.ac.j; Ishiguchi, Tsuneo; Ohta, Takashi

    2010-10-15

    PurposeIntraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement.MethodsA microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery.ResultsThe systolic sac pressure index (SPI) was 0.87 {+-} 0.10 after main-body deployment, 0.63 {+-} 0.12 after leg deployment (P < 0.01), and 0.56 {+-} 0.12 after completion of the procedure (P < 0.01). Pulse pressure was 55 {+-} 21 mmHg,more » 23 {+-} 15 mmHg (P < 0.01), and 16 {+-} 12 mmHg (P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 {+-} 0.13 vs. 0.54 {+-} 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 {+-} 0.10 to 0.55 {+-} 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 {+-} 0.12 vs. 0.55 {+-} 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 {+-} 0.12 vs. 0.57 {+-} 0.12, NS).ConclusionsSac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.« less

  4. The Endurant Stent Graft System: 15-month follow-up report in patients with challenging abdominal aortic anatomies.

    PubMed

    Hyhlik-Dürr, Alexander; Weber, Tim F; Kotelis, Drossos; Rengier, Fabian; Gahlen, Johannes; Böck, Stefanie; Köhler, Jürgen; Ratusinski, Christoph-M; Böckler, Dittmar

    2011-08-01

    The objective of this study is to report a 15-month follow-up with the Endurant Stent Graft System in patients with challenging aortic anatomies. At three German clinics, a consecutive series of 50 patients underwent endovascular abdominal aortic repair (EVAR) for challenging abdominal aortic aneurysm with the Endurant stent graft between November 2008 and May 2009. EVAR was elective in 48 cases and emergent in two. Patients had short (≤15 mm) aortic necks, severe suprarenal/infrarenal angulation, and/or small (<8 mm), calcified, severely angulated, or tortuous iliac or femoral access vessels. Additionally, a cohort of 40 patients without challenging anatomies were retrospectively analysed to clarify differences concerning technical success, mortality, and morbidity between these groups. The primary technical success rate was 92% (46/50). The 30-day mortality rate was 2% (1/50), the death due to multiorgan failure. Intraoperative angiograms revealed three type I endoleaks (2 proximal and 1 distal), and one of those was persisting at 30 days (30-day rate, 2%). Postoperative imaging discovered no further type I or type III endoleaks. The 30-day rate of the type II endoleak was 6% (3/50). There were two cases of graft limb occlusion, both requiring reintervention within 30 days. Follow-up was available in all of the 50 patients (100%) over a median of 15 months (1-25). During this time, seven patients died (overall mortality, 16%; 8/50), besides the above-described patient, all of them unrelated to the procedure. Compared to the 30-day results with the Endurant stent graft in non-challenging anatomies (no type I endoleak; no graft limb occlusion; all-cause mortality, 0%), procedure-related complications in challenging anatomies are increasing. Early and 15-month results with the Endurant stent graft in patients with challenging aortic anatomies are encouraging.

  5. Tailored prevention of inpatient falls: development and usability testing of the fall TIPS toolkit.

    PubMed

    Zuyev, Lyubov; Benoit, Angela N; Chang, Frank Y; Dykes, Patricia C

    2011-02-01

    Patient falls and fall-related injuries are serious problems in hospitals. The Fall TIPS application aims to prevent patient falls by translating routine nursing fall risk assessment into a decision support intervention that communicates fall risk status and creates a tailored evidence-based plan of care that is accessible to the care team, patients, and family members. In our design and implementation of the Fall TIPS toolkit, we used the Spiral Software Development Life Cycle model. Three output tools available to be generated from the toolkit are bed poster, plan of care, and patient education handout. A preliminary design of the application was based on initial requirements defined by project leaders and informed by focus groups with end users. Preliminary design partially simulated the paper version of the Morse Fall Scale currently used in hospitals involved in the research study. Strengths and weaknesses of the first prototype were identified by heuristic evaluation. Usability testing was performed at sites where research study is implemented. Suggestions mentioned by end users participating in usability studies were either directly incorporated into the toolkit and output tools, were slightly modified, or will be addressed during training. The next step is implementation of the fall prevention toolkit on the pilot testing units.

  6. 19 CFR 202.3 - Preliminary inquiry.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Preliminary inquiry. 202.3 Section 202.3 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF COSTS OF PRODUCTION § 202.3 Preliminary inquiry. Upon the receipt of an application properly filed, the...

  7. 19 CFR 202.3 - Preliminary inquiry.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Preliminary inquiry. 202.3 Section 202.3 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF COSTS OF PRODUCTION § 202.3 Preliminary inquiry. Upon the receipt of an application properly filed, the...

  8. 19 CFR 202.3 - Preliminary inquiry.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Preliminary inquiry. 202.3 Section 202.3 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF COSTS OF PRODUCTION § 202.3 Preliminary inquiry. Upon the receipt of an application properly filed, the...

  9. 19 CFR 202.3 - Preliminary inquiry.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Preliminary inquiry. 202.3 Section 202.3 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF COSTS OF PRODUCTION § 202.3 Preliminary inquiry. Upon the receipt of an application properly filed, the...

  10. 19 CFR 202.3 - Preliminary inquiry.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Preliminary inquiry. 202.3 Section 202.3 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF COSTS OF PRODUCTION § 202.3 Preliminary inquiry. Upon the receipt of an application properly filed, the...

  11. 18 CFR 154.105 - Preliminary statement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF ENERGY REGULATIONS UNDER NATURAL GAS ACT RATE SCHEDULES AND TARIFFS Form and Composition of Tariff § 154.105 Preliminary statement. The preliminary statement must contain a brief general description of the company's operations and may also contain a general explanation of its policies and...

  12. 40 CFR 158.345 - Preliminary analysis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Preliminary analysis. 158.345 Section 158.345 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.345 Preliminary analysis. (a) If the product is produced by...

  13. 40 CFR 158.345 - Preliminary analysis.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Preliminary analysis. 158.345 Section 158.345 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.345 Preliminary analysis. (a) If the product is produced by...

  14. 40 CFR 158.345 - Preliminary analysis.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Preliminary analysis. 158.345 Section 158.345 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.345 Preliminary analysis. (a) If the product is produced by...

  15. 40 CFR 158.345 - Preliminary analysis.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Preliminary analysis. 158.345 Section 158.345 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.345 Preliminary analysis. (a) If the product is produced by...

  16. 40 CFR 158.345 - Preliminary analysis.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Preliminary analysis. 158.345 Section 158.345 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.345 Preliminary analysis. (a) If the product is produced by...

  17. Concentrating solar collector subsystem: Preliminary design package

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Preliminary design data are presented for a concentrating solar collector including an attitude controller. Provided are schedules, technical status, all documents required for preliminary design, and other program activities.

  18. Endovascular stenting of a chronic ruptured type B thoracic aortic dissection, a second chance: a case report.

    PubMed

    Arshad, Ali; Khan, Sumaira L; Whitaker, Simon C; Macsweeney, Shane T

    2008-02-07

    We aim to highlight the need for awareness of late complications of endovascular thoracic aortic stenting and the need for close follow-up of patients treated by this method. We report the first case in the English literature of an endovascular repair of a previously stented, ruptured chronic Stanford type B thoracic aortic dissection re-presenting with a type III endoleak of the original repair. Endovascular thoracic stenting is now a widely accepted technique for the treatment of thoracic aortic dissection and its complications. Long term follow up is necessary to ensure that late complications are identified and treated appropriately. In this case of type III endoleak, although technically challenging, endovascular repair was feasible and effective.

  19. 32 CFR 644.30 - Preliminary real estate work.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

  20. 32 CFR 644.30 - Preliminary real estate work.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

  1. 32 CFR 644.30 - Preliminary real estate work.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

  2. 32 CFR 644.30 - Preliminary real estate work.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

  3. 32 CFR 644.30 - Preliminary real estate work.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

  4. 32 CFR 1901.11 - Preliminary information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Preliminary information. 1901.11 Section 1901.11 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 Filing of Privacy Act Requests § 1901.11 Preliminary information. Members...

  5. 32 CFR 1901.11 - Preliminary information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Preliminary information. 1901.11 Section 1901.11 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 Filing of Privacy Act Requests § 1901.11 Preliminary information. Members...

  6. [Preliminary evaluation on seroma prevention and treatment with transposition of tissue flaps and arista hemostatic powder].

    PubMed

    Zhang, Ruming; Tan, Yiwen; Wang, Heqi

    2006-12-01

    To investigate and evaluate prevention and treatment of seroma by transposition of tissue flaps and Arista hemostatic powder after regional lymph node resection in patients with malignant tumors. Twelve patients (6 males, 6 females; aged 31-81 years, with metastatic tumors underwent prevention and treatment of seroma with the tissue flaps and Arista hemostatic powder spray after regional lymph node resection. The metastatic tumors involved the axilla in 1 patient with breast carcinoma, the iliac and inguinal regions in 2 patients with carcinomas of the uterine cervix and the rectum, and the inguinal region in 9 patients, including 4 patients with malignant fibrous histiocytoma(3 in the thigh, 1 in the leg), 2 patients with squamous carcinomas in the leg, 1 patient with synovial sarcoma in the knee, 1 patient with epithelioid sarcoma in the leg, and 1 patient with malignant melanoma in the foot. As for the lymph node removal therapy. 1 patient underwent axillary lymph node removal, 2 patients underwent lymph node removal in theiliac and inguinal regions, and 9 patients underwent lymph node removal in the inguinal region. Meanwhile, of the 12 patients, 6 patients underwent transposition of sartorius flaps with Arista hemostatic powder, 3 patients underwent transposition of the rectus abdominis myocutaneous flaps (including 2 patients treated with Arista spray befor the wound closure and 1 patient treated by transposition of local skin flaps with Arista spray used again),and 3 patients underwent only the suturing of the wounds combined with Arista. At the same time, of the 12 patients,only 4 patient underwent the transplantation of artificial blood vessels. The follow-up for 2-10 months after operation revealed that 10 patients, who had received the transposition of tissue flaps and the spray of Arista hemostatic powder, had the first intention of the incision heal with seroma cured. Nine patients were given a preventive use of Arista hemostatic powder and therefore

  7. Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy

    PubMed Central

    Williams, M. L.; Daniel, C. M.; Clayton, S.

    2008-01-01

    Internet delivered primary prevention interventions for HIV risk reduction present significant challenges. Changing lifestyle behaviors, such as beginning to use condoms, is difficult and men seeking dates on line may want to avoid thinking about HIV risk which may lead to low initiation and high dropout rates. Many Internet delivered HIV risk reduction programs have mimicked face-to-face outreach programs, failing to take advantage of the Internet’s capabilities or did not conduct evaluation. This study focuses on examining the feasibility, acceptability, and efficacy of an Internet delivered HIV risk reduction program for rural men who have sex with men (MSM). The program included online recruiting, three intervention modules, each with two sessions, online questionnaires. The intervention was developed based on iterative research and the Information-Motivation-Behavioral skills model. Participants (N = 475) were randomly assigned to one of six module orders and data were collected automatically at pre-test and after each module. Data supports the feasibility and acceptability of the program as demonstrated by good retention and rapid program completion. Knowledge, self-efficacy, outcome expectancies and motivation increase in a dose response fashion. Post-intervention behavior changes included reduced anal sex and significant increases in condom use. Limitations include a short follow-up period, a predominantly young white rural sample, and the lack of an attention control. Overall the results of the study provide support for the efficacy of Internet-based interventions to reduce risk of HIV infection. Results also support traditional research methods to evaluate HIV prevention programs delivered exclusively through the Internet. PMID:18770021

  8. Sensing Senses: Tactile Feedback for the Prevention of Decubitus Ulcers

    PubMed Central

    Verbunt, Marcel

    2009-01-01

    Decubitus ulcers, also known as pressure sores, is a major problem in health care, in particular for patients with spinal cord injuries. These patients cannot feel the discomfort that would urge healthy people to change their posture. We describe a system that uses a sensor mat to detect problematic postures and provides tactile feedback to the user. The results of our preliminary study with healthy subjects show that the tactile feedback is a viable option to spoken feedback. We envision the system being used for rehabilitation games, but also for everyday Decubitus ulcers prevention. PMID:19949852

  9. Hybrid treatment of aortic arch disease

    PubMed Central

    Metzger, Patrick Bastos; Rossi, Fabio Henrique; Moreira, Samuel Martins; Issa, Mario; Izukawa, Nilo Mitsuru; Dinkhuysen, Jarbas J.; Spina Neto, Domingos; Kambara, Antônio Massamitsu

    2014-01-01

    Introduction The management of thoracic aortic disease involving the ascending aorta, aortic arch and descending thoracic aorta are technically challenging and is an area in constant development and innovation. Objective To analyze early and midterm results of hybrid treatment of arch aortic disease. Methods Retrospective study of procedures performed from January 2010 to December 2012. The end points were the technical success, therapeutic success, morbidity and mortality, neurologic outcomes, the rate of endoleaks and reinterventions. Results A total of 95 patients treated for thoracic aortic diseases in this period, 18 underwent hybrid treatment and entered in this study. The average ages were 62.3 years. The male was present in 66.7%. The technical and therapeutic success was 94.5% e 83.3%. The perioperative mortality rate of 11.1%. There is any death during one-year follow- up. The reoperation rates were 16.6% due 2 cases of endoleak Ia and one case of endoleak II. There is any occlusion of anatomic or extra anatomic bypass during follow up. Conclusion In our study, the hybrid treatment of aortic arch disease proved to be a feasible alternative of conventional surgery. The therapeutic success rates and re- interventions obtained demonstrate the necessity of thorough clinical follow-up of these patients in a long time. PMID:25714205

  10. Uncertainty Modeling for Robustness Analysis of Control Upset Prevention and Recovery Systems

    NASA Technical Reports Server (NTRS)

    Belcastro, Christine M.; Khong, Thuan H.; Shin, Jong-Yeob; Kwatny, Harry; Chang, Bor-Chin; Balas, Gary J.

    2005-01-01

    Formal robustness analysis of aircraft control upset prevention and recovery systems could play an important role in their validation and ultimate certification. Such systems (developed for failure detection, identification, and reconfiguration, as well as upset recovery) need to be evaluated over broad regions of the flight envelope and under extreme flight conditions, and should include various sources of uncertainty. However, formulation of linear fractional transformation (LFT) models for representing system uncertainty can be very difficult for complex parameter-dependent systems. This paper describes a preliminary LFT modeling software tool which uses a matrix-based computational approach that can be directly applied to parametric uncertainty problems involving multivariate matrix polynomial dependencies. Several examples are presented (including an F-16 at an extreme flight condition, a missile model, and a generic example with numerous crossproduct terms), and comparisons are given with other LFT modeling tools that are currently available. The LFT modeling method and preliminary software tool presented in this paper are shown to compare favorably with these methods.

  11. 32 CFR 1800.11 - Preliminary information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Preliminary information. 1800.11 Section 1800.11... ACCESS TO NACIC RECORDS UNDER THE FREEDOM OF INFORMATION ACT (FOIA) Filing of FOIA Requests § 1800.11 Preliminary information. Members of the public shall address all communications to the NACIC Coordinator as...

  12. Preliminary Drill Sites

    DOE Data Explorer

    Lane, Michael

    2013-06-28

    Preliminary locations for intermediate depth temperature gradient holes and/or resource confirmation wells based on compilation of geological, geophysical and geochemical data prior to carrying out the DOE-funded reflection seismic survey.

  13. 37 CFR 1.115 - Preliminary amendments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... amendment unduly interferes with the preparation of a first Office action in an application. Factors that... first Office action as of the date of receipt (§ 1.6) of the preliminary amendment by the Office; and... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Preliminary amendments. 1.115...

  14. 37 CFR 1.115 - Preliminary amendments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... amendment unduly interferes with the preparation of a first Office action in an application. Factors that... first Office action as of the date of receipt (§ 1.6) of the preliminary amendment by the Office; and... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Preliminary amendments. 1.115...

  15. 37 CFR 1.115 - Preliminary amendments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... amendment unduly interferes with the preparation of a first Office action in an application. Factors that... first Office action as of the date of receipt (§ 1.6) of the preliminary amendment by the Office; and... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Preliminary amendments. 1.115...

  16. 32 CFR 1801.11 - Preliminary information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Preliminary information. 1801.11 Section 1801.11... RIGHTS UNDER THE PRIVACY ACT OF 1974 Filing Of Privacy Act Requests § 1801.11 Preliminary information... outstanding fees for information services at this or other federal agencies will not be accepted and action on...

  17. A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan.

    PubMed

    Ogawa, Yukihisa; Nishimaki, Hiroshi; Osuga, Keigo; Ikeda, Osamu; Hongo, Norio; Iwakoshi, Shinichi; Kawasaki, Ryota; Woodhams, Reiko; Yamaguchi, Masato; Kamiya, Mika; Kanematsu, Masayuki; Honda, Masanori; Kaminou, Toshio; Koizumi, Jun; Kichikawa, Kimihiko

    2016-08-01

    To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results. A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups. A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups. This is the first report of a multi-institutional questionnaire survey of IR procedures

  18. Adverse events in British hospitals: preliminary retrospective record review

    PubMed Central

    Vincent, Charles; Neale, Graham; Woloshynowych, Maria

    2001-01-01

    Objectives To examine the feasibility of detecting adverse events through record review in British hospitals and to make preliminary estimates of the incidence and costs of adverse events. Design Retrospective review of 1014 medical and nursing records. Setting Two acute hospitals in Greater London area. Main outcome measure Number of adverse events. Results 110 (10.8%) patients experienced an adverse event, with an overall rate of adverse events of 11.7% when multiple adverse events were included. About half of these events were judged preventable with ordinary standards of care. A third of adverse events led to moderate or greater disability or death. Conclusions These results suggest that adverse events are a serious source of harm to patients and a large drain on NHS resources. Some are major events; others are frequent, minor events that go unnoticed in routine clinical care but together have massive economic consequences. PMID:11230064

  19. Hip-Hop to Prevent Substance Use and HIV among African-American Youth: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Turner-Musa, Jocelyn O.; Rhodes, Warren A.; Harper, P. Thandi Hicks; Quinton, Sylvia L.

    2008-01-01

    Substance use and HIV risk behaviors are increasing among African-American youth. Interventions that incorporate youth values and beliefs are needed to reduce this trajectory. Hip-hop plays an important role in the lives of many African-American youth and provides a context within which to prevent risky behaviors. The current study examines the…

  20. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China.

    PubMed

    Xiao, Zhiwen; Li, Xiaoming; Lin, Danhua; Tam, Cheuk Chi

    2015-01-01

    The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.

  1. Prevention and early intervention for behaviour problems in children with developmental disabilities.

    PubMed

    Einfeld, Stewart L; Tonge, Bruce J; Clarke, Kristina S

    2013-05-01

    To review the recent evidence regarding early intervention and prevention studies for children with developmental disabilities and behaviour problems from 2011 to 2013. Recent advances in the field are discussed and important areas for future research are highlighted. Recent reviews and studies highlight the utility of antecedent interventions and skills training interventions for reducing behaviour problems. There is preliminary evidence for the effectiveness of parent training interventions when delivered in minimally sufficient formats or in clinical settings. Two recent studies have demonstrated the utility of behavioural interventions for children with genetic causes of disability. Various forms of behavioural and parent training interventions are effective at reducing the behaviour problems in children with developmental disabilities. However, research on prevention and early intervention continues to be relatively scarce. Further large-scale dissemination studies and effectiveness studies in clinical or applied settings are needed.

  2. A Comparative Study of Different Hypothermic Circulatory Arrest Strategies on Aortic Surgery.

    ClinicalTrials.gov

    2018-03-22

    Morality; Hypothermic Circulatory Arrest Time; Aortic-cross Clamping Time; Cardiopulmonary Bypass Time; Operation Time; Re-Thoracotomy; ICU Stay; Mechanical Ventilation Time; Blood Transfusion; Neurological Disorder; Dialysis; Aneurysm; Endoleak; Hospital Stay

  3. [Preventable drug-related morbidity: determining valid indicators for primary care in Portugal].

    PubMed

    Guerreiro, Mara Pereira; Cantrill, Judith A; Martins, Ana Paula

    2007-01-01

    Preventable drug-related morbidity (PDRM) indicators are operational measures of therapeutic risk management. These clinical indicators, which cover a wide range of drugs, combine process and outcome in the same instrument. They were developed in the US and have been validated for primary care settings in the US, UK and Canada. This study is part of a research programme; it aimed to determine a valid set of PDRM indicators for adult patients in primary care in Portugal. Face validity of 61 US and UK-derived indicators translated to Portuguese was preliminarily determined by means of a postal questionnaire using a purposive sample of four Portuguese pharmacists with different backgrounds. Preliminary content validity of indicators approved in the previous stage was determined by cross-checking each definition of PDRM with standard drug information sources in Portugal. Face and content validity of indicators yielded by preliminary work were then established by a 37 expert panel (20 community pharmacists and 17 general practitioners) using a two-round Delphi survey. Data were analysed using SPSS release 11.5. Nineteen indicators were ruled out in preliminary validation. Changes were made in the content of eight of the remaining 42 indicators; these were related to differences in the drugs being marketed and patterns of drug monitoring between countries. Thirty-five indicators were consensus approved as PDRM for adult patients in Portuguese primary care by the Delphi panel.

  4. Parent-Child Interaction, Self-Regulation, and Obesity Prevention in Early Childhood.

    PubMed

    Anderson, Sarah E; Keim, Sarah A

    2016-06-01

    This paper describes the epidemiologic evidence linking parent-child relationships, self-regulation, and weight status with a focus on early childhood. The emotional quality of parent-child interactions may influence children's risk for obesity through multiple pathways. Prospective studies linking observer ratings of young children's self-regulation, particularly inhibitory control, to future weight status are discussed. Although findings are preliminary, promoting positive relationships between parents/caregivers and young children holds promise as a component of efforts to prevent childhood obesity. Multi-disciplinary collaborations between researchers with training in developmental science and child health should be encouraged.

  5. Apparent prevention of neural tube defects by periconceptional vitamin supplementation.

    PubMed Central

    Smithells, R W; Sheppard, S; Schorah, C J; Seller, M J; Nevin, N C; Harris, R; Read, A P; Fielding, D W

    1981-01-01

    An earlier preliminary paper is expanded. Women who had given birth to one or more infants with a neural tube defect were recruited into a trial of per conceptional vitamin supplementation. Two hundred mothers attending five centres were fully supplemented (FS), 50 were partially supplemented (PS), and 300 were unsupplemented (US). Neural tube defect recurrences in the study pregnancies were 1 (0.5%), in FS, none in PS, and 13 (4%) in US mothers. The difference in outcome between FS and US mothers is significant. The most likely explanation is that supplementation has prevented some neural tube defects, but further studies are needed. PMID:7332338

  6. A complex systems approach to evaluate HIV prevention in metropolitan areas: preliminary implications for combination intervention strategies.

    PubMed

    Marshall, Brandon D L; Paczkowski, Magdalena M; Seemann, Lars; Tempalski, Barbara; Pouget, Enrique R; Galea, Sandro; Friedman, Samuel R

    2012-01-01

    HIV transmission among injecting and non-injecting drug users (IDU, NIDU) is a significant public health problem. Continuing propagation in endemic settings and emerging regional outbreaks have indicated the need for comprehensive and coordinated HIV prevention. We describe the development of a conceptual framework and calibration of an agent-based model (ABM) to examine how combinations of interventions may reduce and potentially eliminate HIV transmission among drug-using populations. A multidisciplinary team of researchers from epidemiology, sociology, geography, and mathematics developed a conceptual framework based on prior ethnographic and epidemiologic research. An ABM was constructed and calibrated through an iterative design and verification process. In the model, "agents" represent IDU, NIDU, and non-drug users who interact with each other and within risk networks, engaging in sexual and, for IDUs, injection-related risk behavior over time. Agents also interact with simulated HIV prevention interventions (e.g., syringe exchange programs, substance abuse treatment, HIV testing) and initiate antiretroviral treatment (ART) in a stochastic manner. The model was constructed to represent the New York metropolitan statistical area (MSA) population, and calibrated by comparing output trajectories for various outcomes (e.g., IDU/NIDU prevalence, HIV prevalence and incidence) against previously validated MSA-level data. The model closely approximated HIV trajectories in IDU and NIDU observed in New York City between 1992 and 2002, including a linear decrease in HIV prevalence among IDUs. Exploratory results are consistent with empirical studies demonstrating that the effectiveness of a combination of interventions, including syringe exchange expansion and ART provision, dramatically reduced HIV prevalence among IDUs during this time period. Complex systems models of adaptive HIV transmission dynamics can be used to identify potential collective benefits of

  7. Mapping an HIV/STD prevention curriculum for Zambian in-school settings.

    PubMed

    Mpofu, Elias; Lawrence, Frank; Ngoma, Mary Shilalukey; Siziya, Seter; Malungo, Jacob R S

    2008-04-01

    HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.

  8. 46 CFR 71.50-21 - Preliminary examination requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... exclusively use divers to examine the underwater hull plating, you must arrange to have a preliminary... the predominant means to examine your vessel's hull plating, a preliminary examination and the...

  9. 46 CFR 176.635 - Preliminary examination requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Preliminary examination requirements. 176.635 Section... (UNDER 100 GROSS TONS) INSPECTION AND CERTIFICATION Hull and Tailshaft Examinations § 176.635 Preliminary examination requirements. (a) If you exclusively use divers to examine the underwater hull plating, you must...

  10. The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up.

    PubMed

    Skeffington, Petra M; Rees, Clare S; Mazzucchelli, Trevor G; Kane, Robert T

    2016-01-01

    To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The "control" group received "Training as Usual" (TAU). Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583.

  11. 14 CFR 150.31 - Preliminary review: Acknowledgments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... program submitted under § 150.23, the Regional Airports Division Manager acknowledges to the airport... preliminary review, the Regional Airports Division Manager finds that the submission does not conform to the... reconsideration and development of a program in accordance with this part. (c) If, based on the preliminary review...

  12. 33 CFR 1.07-25 - Preliminary matters.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Preliminary matters. 1.07-25 Section 1.07-25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL GENERAL PROVISIONS Enforcement; Civil and Criminal Penalty Proceedings § 1.07-25 Preliminary matters. (a...

  13. 33 CFR 1.07-25 - Preliminary matters.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Preliminary matters. 1.07-25 Section 1.07-25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL GENERAL PROVISIONS Enforcement; Civil and Criminal Penalty Proceedings § 1.07-25 Preliminary matters. (a...

  14. 33 CFR 1.07-25 - Preliminary matters.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Preliminary matters. 1.07-25 Section 1.07-25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL GENERAL PROVISIONS Enforcement; Civil and Criminal Penalty Proceedings § 1.07-25 Preliminary matters. (a...

  15. 33 CFR 1.07-25 - Preliminary matters.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Preliminary matters. 1.07-25 Section 1.07-25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL GENERAL PROVISIONS Enforcement; Civil and Criminal Penalty Proceedings § 1.07-25 Preliminary matters. (a...

  16. 33 CFR 1.07-25 - Preliminary matters.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Preliminary matters. 1.07-25 Section 1.07-25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL GENERAL PROVISIONS Enforcement; Civil and Criminal Penalty Proceedings § 1.07-25 Preliminary matters. (a...

  17. Getting the Incentives Right: Improving Oral Health Equity With Universal School-Based Caries Prevention

    PubMed Central

    Niederman, Richard; Trescher, Anna-Lena; Listl, Stefan

    2017-01-01

    Despite significant financial, training, and program investments, US children’s caries experience and inequities continued to increase over the last 20 years. We posit that (1) dental insurance payment systems are not aligned with the current best evidence, exacerbating inequities, and (2) system redesign could meet health care’s triple aim and reduce children’s caries by 80%. On the basis of 2013 to 2016 Medicaid and private payment rates and the caries prevention literature, we find that effective preventive interventions are either (1) consistently compensated less than ineffective interventions or (2) not compensated at all. This economic and clinical misalignment may account for underuse of effective caries prevention and subsequent overuse of restorative care. We propose universal school-based comprehensive caries prevention to address this misalignment. Preliminary modeling suggests that universal caries prevention could eliminate 80% of children’s caries and cost less than one fifth of current Medicaid children’s oral health spending. If implemented with bundled payments based on cycle of care and measurable outcomes, there would be an alignment of incentives, best evidence, care, and outcomes. Such a program would meet the Healthy People Oral Health goals for children, as well as health care’s triple aim. PMID:28661798

  18. Gaining perspective: the effects of message frame on viewer attention to and recall of osteoporosis prevention print advertisements.

    PubMed

    O'Malley, Deborah A; Latimer-Cheung, Amy E

    2013-11-01

    This study examined how framed messages affect viewer attention to and cognitive processing of osteoporosis prevention print ads. Attention was measured with eye tracking technology. Cognitive processing was assessed through masked recall. A total of 60 college-aged women viewed 12 gain-framed, 12 loss-framed, and 12 neutral-framed ads. Number of fixations, dwell time, and recall of gain-framed osteoporosis prevention ads were higher than loss-framed or neutral-framed ads, p < .01. Message recall was positively correlated with the number of fixations and dwell time for the gain-framed and neutral-framed messages, p < .01. These findings provide preliminary insight into potential mechanisms underlying message framing effects.

  19. Peer-support suicide prevention in a non-metropolitan U.S. community.

    PubMed

    Walker, Rheeda L; Ashby, Judy; Hoskins, Olivia D; Greene, Farrah N

    2009-01-01

    Though suicide is a leading cause of death for high school age youth, the overall base rates for suicide deaths are relatively low. Consequently, very few evidence-based suicide prevention programs that address suicide death have emerged. Relative to urban areas, non-metropolitan and rural communities in particular tend to report higher suicide rates that are compounded by poor access to mental health care. In the current study, 63 high school youth participated in the three-day, LifeSavers peer-support suicide prevention training program. The goals of the program are to teach youth to engage in teamwork and listen to others without judgment in addition to recognizing the signs for youth who may be at risk for suicide. The overall aim of LifeSavers is to create a culture whereby primary prevention is active and crisis situations are preempted. Each participant in the current study completed pre-test and posttraining measures of suicide attitudes and knowledge, self-esteem, and also self-acceptance. Findings demonstrated a significant increase in knowledge and positive attitudes toward suicide prevention and also self-esteem, but not self-acceptance. Though more work is needed, these preliminary data reveal that youth in rural communities may benefit from programming such as LifeSavers that commit to advancing peer support and peer-gatekeeping efforts.

  20. 7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

  1. 7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

  2. 7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

  3. 7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

  4. 7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

  5. 17 CFR 242.100 - Preliminary note; definitions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) REGULATIONS M, SHO, ATS, AC, AND NMS AND CUSTOMER MARGIN REQUIREMENTS FOR SECURITY FUTURES Regulation M § 242.100 Preliminary note; definitions. (a) Preliminary note: Any transaction or series of transactions, whether or not effected pursuant to the provisions of Regulation M (§§ 242.100-242.105 of this...

  6. 18 CFR 1b.6 - Preliminary investigations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Preliminary investigations. 1b.6 Section 1b.6 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.6 Preliminary investigations. The...

  7. 18 CFR 1b.6 - Preliminary investigations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Preliminary investigations. 1b.6 Section 1b.6 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.6 Preliminary investigations. The...

  8. 18 CFR 1b.6 - Preliminary investigations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Preliminary investigations. 1b.6 Section 1b.6 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.6 Preliminary investigations. The...

  9. 18 CFR 1b.6 - Preliminary investigations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Preliminary investigations. 1b.6 Section 1b.6 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.6 Preliminary investigations. The...

  10. Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

    PubMed Central

    Choi, Jae-Sung; Oh, Se Jin; Sung, Yong Won; Moon, Hyun Jong; Lee, Jung Sang

    2016-01-01

    Background The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results The mean age was 72.4±5.1 years, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was 269.8±72.3 minutes. The mean total length of aortic coverage was 186.0±49.2 mm. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of 16.8±14.8 months, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs. PMID:27064672

  11. Development of a smoking prevention mass media program using diagnostic and formative research.

    PubMed

    Worden, J K; Flynn, B S; Geller, B M; Chen, M; Shelton, L G; Secker-Walker, R H; Solomon, D S; Solomon, L J; Couchey, S; Costanza, M C

    1988-09-01

    The process of developing a mass media campaign to prevent smoking among adolescents is described in detail. This campaign supplements a school smoking prevention program and shares educational objectives with the school program but is otherwise independent. It comprises various television and radio 30- and 60-sec "spot" messages. The campaign development process includes identifying educational objectives and strategies for appealing to young people; conducting diagnostic surveys and focus groups to determine target audience interests and perceptions about smoking and media content; suggesting approaches to producers to create preliminary television and radio messages for testing; conducting formative pretests with target groups to select optimal messages and suggest improvements to those messages; producing final messages for media presentation; and developing a media exposure plan to place messages in local media at optimal times for reception by target audiences. The media campaign is being evaluated in a 5-year project with 5,500 adolescents in four communities to determine the additional effect of mass media over a school program alone in preventing smoking.

  12. Preventing violence against children in schools: Contributions from the Be Safe program in Sri Lanka.

    PubMed

    Lam, Steven; Zwart, Christine; Chahal, Inem; Lane, David; Cummings, Harry

    2018-02-01

    Violence against children is a global public health issue with serious social, economic, physical, and emotional impacts. This study evaluates the effectiveness of a school-based program aimed to prevent and respond to physical, sexual, and psychological violence against children in Sri Lanka from the perspective of parents. A cross-sectional retrospective study design was used. A total of 835 parents of children who participated in the program were surveyed across seven districts in Sri Lanka. Dose-response analyses were conducted to assess for correlations between program exposure and perceived prevention of violence against children. Low to moderate correlations were found between exposure to the program and perceived child safety in schools, school policies, and in the community. The findings provide preliminary evidence of program effectiveness; however, more efforts are needed to validate and sustain outcomes. Implications for future violence prevention programming, along with the use of dose-response evaluations, are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.

    PubMed

    Kennedy, Stephen B; Johnson, Knowlton; Harris, Albert O; Lincoln, Adams; Neace, William; Collins, David

    2004-03-01

    The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberia's HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.

  14. The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up

    PubMed Central

    Rees, Clare S.; Mazzucchelli, Trevor G.; Kane, Robert T.

    2016-01-01

    Aim To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). Design A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The “control” group received “Training as Usual” (TAU). Method Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. Results We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. Conclusion While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583 PMID:27382968

  15. Mobile text messaging solutions for obesity prevention

    NASA Astrophysics Data System (ADS)

    Akopian, David; Jayaram, Varun; Aaleswara, Lakshmipathi; Esfahanian, Moosa; Mojica, Cynthia; Parra-Medina, Deborah; Kaghyan, Sahak

    2011-02-01

    Cellular telephony has become a bright example of co-evolution of human society and information technology. This trend has also been reflected in health care and health promotion projects which included cell phones in data collection and communication chain. While many successful projects have been realized, the review of phone-based data collection techniques reveals that the existing technologies do not completely address health promotion research needs. The paper presents approaches which close this gap by extending existing versatile platforms. The messaging systems are designed for a health-promotion research to prevent obesity and obesity-related health disparities among low-income Latino adolescent girls. Messaging and polling mechanisms are used to communicate and automatically process response data for the target constituency. Preliminary survey data provide an insight on phone availability and technology perception for the study group.

  16. Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials.

    PubMed

    Raskin, Jeffrey B; Kamm, Michael A; Jamal, M Mazen; Márquez, Juan; Melzer, Ehud; Schoen, Robert E; Szalóki, Tibor; Barrett, Karen; Streck, Paul

    2014-10-01

    No therapy has been proven to prevent the recurrence of diverticulitis. Mesalamine has shown efficacy in preventing relapse in inflammatory bowel disease, and there is preliminary evidence that it might be effective for diverticular disease. We investigated the efficacy of mesalamine in preventing recurrence of diverticulitis in 2 identical but separate phase 3, randomized, double-blind, placebo-controlled, multicenter trials (identical confirmatory trials were conducted for regulatory reasons). We evaluated the efficacy and safety of multimatrix mesalamine vs placebo in the prevention of recurrent diverticulitis in 590 (PREVENT1) and 592 (PREVENT2) adult patients with ≥1 episodes of acute diverticulitis in the previous 24 months that resolved without surgery. Patients received mesalamine (1.2 g, 2.4 g, or 4.8 g) or placebo once daily for 104 weeks. The primary end point was the proportion of recurrence-free patients at week 104. Diverticulitis recurrence was defined as surgical intervention at any time for diverticular disease or presence of computed tomography scan results demonstrating bowel wall thickening (>5 mm) and/or fat stranding consistent with diverticulitis. For a portion of the study, recurrence also required the presence of abdominal pain and an increase in white blood cells. Mesalamine did not reduce the rate of diverticulitis recurrence at week 104. Among patients in PREVENT1, 53%-63% did not have disease recurrence, compared with 65% of those given placebo. Among patients in PREVENT2, 59%-69% of patients did not have disease recurrence, compared with 68% of those given placebo. Mesalamine did not reduce time to recurrence, and the proportions of patients requiring surgery were comparable among treatment groups. No new adverse events were identified with mesalamine administration. Mesalamine was not superior to placebo in preventing recurrent diverticulitis. Mesalamine is not recommended for this indication. ClinicalTrials.gov ID: NCT00545740 and

  17. The viking biological investigation: preliminary results.

    PubMed

    Klein, H P; Horowitz, N H; Levin, G V; Oyama, V I; Lederberg, J; Rich, A; Hubbard, J S; Hobby, G L; Straat, P A; Berdahl, B J; Carle, G C; Brown, F S; Johnson, R D

    1976-10-01

    Three different types of biological experiments on samples of martian surface material ("soil") were conducted inside the Viking lander. In the carbon assimilation or pyrolytic release experiment, (14)CO(2) and (14)CO were exposed to soil in the presence of light. A small amount of gas was found to be converted into organic material. Heat treatment of a duplicate sample prevented such conversion. In the gas exchange experiment, soil was first humidified (exposed to water vapor) for 6 sols and then wet with a complex aqueous solution of metabolites. The gas above the soil was monitored by gas chromatography. A substantial amount of O(2) was detected in the first chromatogram taken 2.8 hours after humidification. Subsequent analyses revealed that significant increases in CO(2) and only small changes in N(2) had also occurred. In the labeled release experiment, soil was moistened with a solution containing several (14)C-labeled organic compounds. A substantial evolution of radioactive gas was registered but did not occur with a duplicate heat-treated sample. Alternative chemical and biological interpretations are possible for these preliminary data. The experiments are still in process, and these results so far do not allow a decision regarding the existence of life on the plonet Mars.

  18. "Extreme" or tariff sports: their injuries and their prevention (with particular reference to diving, cheerleading, gymnastics, and figure skating).

    PubMed

    Foley, E C; Bird, H A

    2013-04-01

    The interface between sports medicine and performing arts medicine is closest for "tariff" sports, where the sportsperson can select their own programme of varying difficulty with the more complex skills carrying potential for higher marks. Inevitably, some performers over-reach themselves. Examples of injuries and prevention strategies to avoid such injuries are discussed in a preliminary analysis of four sports: diving, cheerleading, gymnastics, and figure skating.

  19. Preliminary Predictors of within-Session Adherence to Exposure and Response Prevention in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Morgan, Jessica; Caporino, Nicole E.; De Nadai, Alessandro S.; Truax, Tatyana; Lewin, Adam B.; Jung, Leah; Park, Jennifer M.; Khan, Yasmeen Ali; Murphy, Tanya K.; Storch, Eric A.

    2013-01-01

    Background: Cognitive-behavioral therapy with exposure and response prevention (ERP) is an effective treatment for pediatric OCD; however, up to 30 % of children are treatment non-responders and as many as 40% are partial responders. Although poor treatment adherence has been linked to attenuated response in adults with OCD, little research has…

  20. 32 CFR 644.392 - Air Force-preliminary report of excess.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Air Force-preliminary report of excess. 644.392... PROPERTY REAL ESTATE HANDBOOK Disposal Predisposal Action § 644.392 Air Force—preliminary report of excess... Armed Services Committees of the Congress.) When the preliminary real estate disposal directive is...

  1. Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair.

    PubMed

    Donayre, Carlos E; Zarins, Christopher K; Krievins, Dainis K; Holden, Andrew; Hill, Andrew; Calderas, Carlos; Velez, Jaime; White, Rodney A

    2011-03-01

    All current aortic endografts depend on proximal and distal fixation to prevent migration. However, migration and rupture can occur, particularly in patients with aortic necks that are short or angulated, or both. We present our initial clinical experience with a new sac-anchoring endoprosthesis designed to anchor and seal the device within the aneurysm sac. The initial worldwide experience using a new endoprosthesis for the treatment of aortic aneurysms (Nellix Endovascular, Palo Alto, Calif) was reviewed. The endoprosthesis consists of dual balloon-expandable endoframes surrounded by polymer-filled endobags designed to obliterate the aneurysm sac and maintain endograft position. Clinical results and follow-up contrast computed tomography (CT) scans at 30 days and 6 and 12 months were reviewed. The endograft was successfully deployed in 21 patients with infrarenal aortic aneurysms measuring 5.7 ± 0.7 cm (range, 4.3-7.4 cm). Two patients with common iliac aneurysms were treated with sac-anchoring extenders that maintained patency of the internal iliac artery. Infusion of 71 ± 37 mL of polymer (range, 19-158 mL) into the aortic endobags resulted in complete aneurysm exclusion in all patients. Mean implant time was 76 ± 35 minutes, with 33 ± 17 minutes of fluoroscopy time and 180 ± 81 mL of contrast; estimated blood loss was 174 ± 116 mL. One patient died during the postoperative period (30-day mortality, 4.8%), and one died at 10 months from non-device-related causes. During a mean follow-up of 8.7 ± 3.1 months and a median of 6.3 months, there were no late aneurysm- or device-related adverse events and no secondary procedures. CT imaging studies at 6 months and 1 year revealed no increase in aneurysm size, no device migration, and no new endoleaks. One patient had a limited proximal type I endoleak at 30 days that resolved at 60 days and remained sealed. One patient has an ongoing distal type I endoleak near the iliac bifurcation, with no change in aneurysm

  2. Coming to the new D.A.R.E.: A preliminary test of the officer-taught elementary keepin' it REAL curriculum.

    PubMed

    Day, L Edward; Miller-Day, Michelle; Hecht, Michael L; Fehmie, Desiree

    2017-11-01

    The present study reports a preliminary evaluation of D.A.R.E.'s new elementary school keepin' it REAL substance abuse prevention program. Given the widespread dissemination of D.A.R.E., this evaluation, even though of short term effects, has important implications for national prevention efforts. The new prevention curriculum teaches social and emotional competencies such as decision making and resistance skills. Social and emotional competencies and other risk factors were examined among students (N=943) in 26 classrooms, 13 classrooms in the treatment condition (n=359) and 13 classrooms in the control condition (n=584) using a quasi-experimental matched group design. Pretest comparisons of treatment and control groups were completed, along with attrition analyses, and hierarchical logistic and linear regressions were computed to assess the intervention. The results revealed that the intervention produced significant effects on preventative factors such as the likelihood of resisting peer pressure, increased responsible decision making knowledge and decision-making skills, and confidence in being able to explain why they would refuse offers of cigarettes. The results of this study suggest that D.A.R.E.'s elementary keepin' it REAL program has promise as a social and emotional learning (SEL) based prevention program. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 10 CFR 830.206 - Preliminary documented safety analysis.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Preliminary documented safety analysis. 830.206 Section 830.206 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT Safety Basis Requirements § 830.206 Preliminary documented safety analysis. If construction begins after December 11, 2000, the contractor...

  4. Best practice principles for community-based obesity prevention: development, content and application.

    PubMed

    King, L; Gill, T; Allender, S; Swinburn, B

    2011-05-01

    Best practice in obesity prevention has generally been defined in terms of 'what' needs to be done while neglecting 'how'. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

  5. Daily Life Experience and Somatic Symptoms: A Preliminary Report.

    DTIC Science & Technology

    1981-03-01

    AAO7 9 859 STATE UNIV OF NEW YORK AT STONY BROOK FG 5/10 DAILY LIFE EXPERIENCE AND SOMATIC SYMPTOMS: A PRELIMINARY REPOR--ETC(U) MAR 8I A A STONE. J...Experience and Somatic Symptoms: A Preliminary Report Arthur A. Stone Long Island Research Institute and Department of Psychiatry arnd Behavioral...TITLE (and S..,til.) s. ALF - , rlA9OQ COVERED Daily Life Experience and Somatic Symptoms: A Technical p " Preliminary Report, EL..... S. PERFORMING

  6. 40 CFR 154.31 - Notices of Preliminary Determination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., retail food prices, and otherwise on the agricultural economy. (3) Send the proposed notices and analysis... PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.31 Notices of Preliminary Determination. The Administrator shall prepare a Notice of Preliminary Determination after the close of the comment period on a...

  7. Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control.

    PubMed

    Magiorakos, A P; Burns, K; Rodríguez Baño, J; Borg, M; Daikos, G; Dumpis, U; Lucet, J C; Moro, M L; Tacconelli, E; Simonsen, G Skov; Szilágyi, E; Voss, A; Weber, J T

    2017-01-01

    Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE. The guidance was created by a group of experts who were functioning independently of their organisations, during two meetings hosted by the European Centre for Disease Prevention and Control. A list of epidemiological risk factors placing patients "at-risk" for carriage with CRE was created by the experts. The conclusions of a systematic review on the prevention of spread of CRE, with the addition of expert opinion, were used to construct lists of core and supplemental infection prevention and control measures to be implemented for "at-risk" patients upon admission to healthcare settings. Individuals with the following profile are "at-risk" for carriage of CRE: a) a history of an overnight stay in a healthcare setting in the last 12 months, b) dialysis-dependent or cancer chemotherapy in the last 12 months, c) known previous carriage of CRE in the last 12 months and d) epidemiological linkage to a known carrier of a CRE.Core infection prevention and control measures that should be considered for all patients in healthcare settings were compiled. Preliminary supplemental measures to be implemented for "at-risk" patients on admission are: pre-emptive isolation, active screening for CRE , and contact precautions. Patients who are confirmed positive for CRE will need additional supplemental measures. Strengthening the microbiological capacity, surveillance and reporting of new cases of CRE in healthcare settings and countries

  8. Using PANDA (Preventing the Abuse of Tobacco, Narcotics, Drugs, and Alcohol) in a Baltimore City Head Start Setting: A Preliminary Study.

    ERIC Educational Resources Information Center

    Belcher, Harolyn M. E.; Lockhart, Paula J.; Perkins-Parks, Susan; McNally, Margaret

    2000-01-01

    Describes an evaluation of a substance abuse prevention curriculum, Preventing the Abuse of Tobacco, Narcotics, Drugs, and Alcohol (PANDA), taught to African American Head Start preschool students, examining changes in children's self-concept following participation. Overall, students demonstrated significantly improved self-concept, and PANDA…

  9. [The preliminary assessment in the B-BS protocol as a tool for the discovery of job stress symptoms and contingencies: a method under experimentation by INAIL].

    PubMed

    Clerici, P; Guercio, A

    2010-01-01

    The proposed model is aimed at assessing work-related stress and consists of a preliminary phase during which the Organization is monitored, Indexes and stressors are defined, characterized and then weighted; existing symptoms (if any) are also identified. A 'Probability vs. Severity' Matrix is then built up as a result: these tasks can profitably be performed by a technical professional, typically the Responsible of the Safety and Health Committee. According to found evidences, a second phase, strictly based upon the application of psychosocial research tools, might be needed to investigate group of workers that resulted troublesome during the preliminary phase. The preliminary phase of investigation on organizational stressors and indexes can be easily and successfully integrated with the 'Safety Assessment' steps provided for the B-BS protocol, also aimed at monitoring the organizational wellbeing and consequently acting on the workers' behavior. The model has been specifically designed for Small and Medium Enterprises, with the global objective of preventing accidents at work due to misbehavior and distraction, by correctly and safely applying operational procedures and mutual relationships.

  10. 10 CFR 824.6 - Preliminary notice of violation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Preliminary notice of violation. 824.6 Section 824.6 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR THE ASSESSMENT OF CIVIL PENALTIES FOR CLASSIFIED INFORMATION SECURITY VIOLATIONS § 824.6 Preliminary notice of violation. (a) In order to begin a proceeding to...

  11. 10 CFR 824.6 - Preliminary notice of violation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Preliminary notice of violation. 824.6 Section 824.6 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR THE ASSESSMENT OF CIVIL PENALTIES FOR CLASSIFIED INFORMATION SECURITY VIOLATIONS § 824.6 Preliminary notice of violation. (a) In order to begin a proceeding to...

  12. Bully Prevention in Positive Behavior Support: Preliminary Evaluation of Third-, Fourth-, and Fifth-Grade Attitudes toward Bullying

    ERIC Educational Resources Information Center

    Ross, Scott W.; Horner, Robert H.

    2014-01-01

    The current pilot study demonstrates the potential of adding simple and efficient bully prevention strategies to already established School-Wide Positive Behavior Interventions and Supports. The self-report surveys of third-, fourth-, and fifth-grade students from three elementary schools evaluated the relationship between the implementation of…

  13. Preliminary burn and impact tests of hybrid polymeric composites. [preventing graphite fiber release

    NASA Technical Reports Server (NTRS)

    Tompkins, S. S.; Brewer, W. D.

    1978-01-01

    Free graphite fibers released into the environment from resin matrix composite components, as a result of fire and/or explosion, pose a potential hazard to electrical equipment. An approach to prevent the fibers from becoming airborne is to use hybrid composite materials which retain the fibers at the burn site. Test results are presented for three hybrid composites that were exposed to a simulation of an aircraft fire and explosion. The hybrid systems consisted of 16 plies of graphite-epoxy with two plies of Kevlar-, S-glass-, or boron-epoxy on each face. Two different test environments were used. In one environment, specimens were heated by convection only, and then impacted by a falling mass. In the other environment, specimens were heated by convection and by radiation, but were not impacted. The convective heat flux was about 100-120 kW/m in both environments and the radiative flux was about 110 kW/sq m.

  14. Are labour-intensive efforts to prevent pressure ulcers cost-effective?

    PubMed

    Mathiesen, Anne Sofie Mølbak; Nørgaard, Kamilla; Andersen, Marie Frederikke Bruun; Møller, Klaus Meyer; Ehlers, Lars Holger

    2013-10-01

    Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement. To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care. A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty. Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB. This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care. The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.

  15. Caught in the Web: A Review of Web-Based Suicide Prevention

    PubMed Central

    Lai, Mee Huong; Maniam, Thambu; Ravindran, Arun V

    2014-01-01

    Background Suicide is a serious and increasing problem worldwide. The emergence of the digital world has had a tremendous impact on people’s lives, both negative and positive, including an impact on suicidal behaviors. Objective Our aim was to perform a review of the published literature on Web-based suicide prevention strategies, focusing on their efficacy, benefits, and challenges. Methods The EBSCOhost (Medline, PsycINFO, CINAHL), OvidSP, the Cochrane Library, and ScienceDirect databases were searched for literature regarding Web-based suicide prevention strategies from 1997 to 2013 according to the modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The selected articles were subjected to quality rating and data extraction. Results Good quality literature was surprisingly sparse, with only 15 fulfilling criteria for inclusion in the review, and most were rated as being medium to low quality. Internet-based cognitive behavior therapy (iCBT) reduced suicidal ideation in the general population in two randomized controlled trial (effect sizes, d=0.04-0.45) and in a clinical audit of depressed primary care patients. Descriptive studies reported improved accessibility and reduced barriers to treatment with Internet among students. Besides automated iCBT, preventive strategies were mainly interactive (email communication, online individual or supervised group support) or information-based (website postings). The benefits and potential challenges of accessibility, anonymity, and text-based communication as key components for Web-based suicide prevention strategies were emphasized. Conclusions There is preliminary evidence that suggests the probable benefit of Web-based strategies in suicide prevention. Future larger systematic research is needed to confirm the effectiveness and risk benefit ratio of such strategies. PMID:24472876

  16. Development of a Targeted Smoking Relapse-Prevention Intervention for Cancer Patients.

    PubMed

    Meltzer, Lauren R; Meade, Cathy D; Diaz, Diana B; Carrington, Monica S; Brandon, Thomas H; Jacobsen, Paul B; McCaffrey, Judith C; Haura, Eric B; Simmons, Vani N

    2018-04-01

    We describe the series of iterative steps used to develop a smoking relapse-prevention intervention customized to the needs of cancer patients. Informed by relevant literature and a series of preliminary studies, an educational tool (DVD) was developed to target the unique smoking relapse risk factors among cancer patients. Learner verification interviews were conducted with 10 cancer patients who recently quit smoking to elicit feedback and inform the development of the DVD. The DVD was then refined using iterative processes and feedback from the learner verification interviews. Major changes focused on visual appeal, and the inclusion of additional testimonials and graphics to increase comprehension of key points and further emphasize the message that the patient is in control of their ability to maintain their smoking abstinence. Together, these steps resulted in the creation of a DVD titled Surviving Smokefree®, which represents the first smoking relapse-prevention intervention for cancer patients. If found effective, the Surviving Smokefree® DVD is an easily disseminable and low-cost portable intervention which can assist cancer patients in maintaining smoking abstinence.

  17. Preliminary AirMSPI Datasets

    Atmospheric Science Data Center

    2018-02-26

    ... Datasets   The data files available through this web page and ftp links are preliminary AIrMSPI datasets from recent campaigns. ... and geometric corrections. Caution should be used for science analysis. At a later date, more qualified versions will be made public. ...

  18. Preliminary design package for Sunair SEC-601 solar collector

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The preliminary design of the Owens-Illinois model Sunair SEC-601 tubular air solar collector is presented. Information in this package includes the subsystem design and development approaches, hazard analysis, and detailed drawings available as the preliminary design review.

  19. The Soviet Military Views Operation Desert Storm: A Preliminary Assessment

    DTIC Science & Technology

    1991-09-23

    NO. IACCESSION NO. 11. TITLE (Include Security Classification) The Soviet Military Views Operation Desert Storm: .A Preliminary Assessment UNCLASSIFIED...VIEWS OPERATION DESERT STORM: A PRELIMINARY ASSESSMENT Stephen J. Blank Av~qoxa 10 a r I~ )~ I.RA&I .1 . a .. _ . . .. J l tia.o.. .. ._ ’Vflstribitleu...preliminary assessments , largely through the spring of 1991, suggest lines of argument that will surely appear later in greater depth, detail, and

  20. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

    PubMed

    Aragon, Daleen; Sole, Mary Lou; Brown, Scott

    2005-01-01

    Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

  1. App-guided exposure and response prevention for obsessive compulsive disorder: an open pilot trial.

    PubMed

    Boisseau, Christina L; Schwartzman, Carly M; Lawton, Jessica; Mancebo, Maria C

    2017-11-01

    Although effective treatments for obsessive-compulsive disorder (OCD) exist, there are significant barriers to receiving evidence-based care. Mobile health applications (Apps) offer a promising way of overcoming these barriers by increasing access to treatment. The current study investigated the feasibility, acceptability, and preliminary efficacy of LiveOCDFree, an App designed to help OCD patients conduct exposure and response prevention (ERP). Twenty-one participants with mild to moderate symptoms of OCD were enrolled in a 12-week open trial of App-guided self-help ERP. Self-report assessments of OCD, depression, anxiety, and quality of life were completed at baseline, mid-treatment, and post-treatment. App-guided ERP was a feasible and acceptable self-help intervention for individuals with OCD, with high rates of retention and satisfaction. Participants reported significant improvement in OCD and anxiety symptoms pre- to post-treatment. Findings suggest that LiveOCDFree is a feasible and acceptable self-help intervention for OCD. Preliminary efficacy results are encouraging and point to the potential utility of mobile Apps in expanding the reach of existing empirically supported treatments.

  2. Preliminary design study for an atomospheric science facility

    NASA Technical Reports Server (NTRS)

    Hutchison, R.

    1972-01-01

    The activities and results of the Atmospheric Science Facility preliminary design study are reported. The objectives of the study were to define the scientific goals, to determine the range of experiment types, and to develop the preliminary instrument design requirements for a reusable, general purpose, optical research facility for investigating the earth's atmosphere from a space shuttle orbital vehicle.

  3. Preliminary Advanced Colloids Experiment

    NASA Image and Video Library

    2011-09-29

    ISS029-E-011867 (29 Sept. 2011) --- NASA astronaut Mike Fossum, Expedition 29 commander, works with the Light Microscopy Module (LMM) control box in the Destiny laboratory of the International Space Station in preparation for another session with the Preliminary Advanced Colloids Experiment (PACE) hardware.

  4. The health farm concept in the primary prevention of coronary artery disease.

    PubMed

    Ahmad, A M

    1995-12-01

    The purpose of the study is as a preliminary outline of the effectiveness of initiating high-risk individuals into the Health Farm concept in the primary prevention of coronary artery disease (CAD). Thirty-five (35) Army personnel, all male, with risk-factors for CAD were brought together on a Health Farm concept to go through a predesigned ten-day Farm programme comprising CAD risk-assessment, comprehensive medical examination, relevant blood chemistry analysis, physical fitness evaluation, individualised weekly exercise routine, physical fitness workouts, individualised diet, lectures, group discussion and individual counselling. Description of the participants (as measurements of various relevant parameters) are made at the start and as participant-achievement. The results show general participant-compliance to the programme which was reflected by significant changes in weight (p < 0.005), percentile VO2Max (p < 0.005), percentile push-ups (p < 0.005) and girth-difference (p < 0.005). The study showed that the Health Farm concept is effective in initiating high-risk individuals into lifestyles conducive to the primary prevention of CAD. Sustained results towards primary prevention of CAD can be expected with compliance to a long-term follow-up that has been identified and to which participants have been made aware of. Other previous intervention studies are briefly discussed.

  5. 28 CFR 36.605 - Procedure following preliminary determination of equivalency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... State Laws or Local Building Codes § 36.605 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite...

  6. [Prevention and Treatment of Eating Disorders: The Health Care Network Anorexia and Bulimia nervosa].

    PubMed

    Weigel, Angelika; Gumz, Antje; Kästner, Denise; Romer, Georg; Wegscheider, Karl; Löwe, Bernd

    2015-07-01

    The "Health care network anorexia and bulimia nervosa", a subproject of psychenet - the Hamburg network for mental health - aims to decrease the incidence of eating disorders as well as the risk for chronic illness courses. One focal project, therefore, evaluates a school-based prevention manual in a randomized controlled trial. The other one examines the impact of a systemic public health intervention on early treatment initiation in anorexia nervosa. The present article provides an overview about study design and interventions in both focal projects as well as preliminary results. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Inositol for prevention of neural tube defects: a pilot randomised controlled trial - CORRIGENDUM

    PubMed Central

    Greene, Nicholas D. E.; Leung, Kit-Yi; Gay, Victoria; Burren, Katie; Mills, Kevin; Chitty, Lyn S.; Copp, Andrew J.

    2016-01-01

    Although peri-conceptional folic acid (FA) supplementation can prevent a proportion of neural tube defects (NTDs), there is increasing evidence that many NTDs are FA non-responsive. The vitamin-like molecule inositol may offer a novel approach to preventing FA-non-responsive NTDs. Inositol prevented NTDs in a genetic mouse model, and was well tolerated by women in a small study of NTD recurrence. In the present study, we report the Prevention of Neural Tube Defects by Inositol (PONTI) pilot study designed to gain further experience of inositol usage in human pregnancy as a preliminary trial to a future large-scale controlled trial to evaluate efficacy of inositol in NTD prevention. Study subjects were UK women with a previous NTD pregnancy who planned to become pregnant again. Of 117 women who made contact, ninety-nine proved eligible and forty-seven agreed to be randomised (double-blind) to peri-conceptional supplementation with inositol plus FA or placebo plus FA. In total, thirty-three randomised pregnancies produced one NTD recurrence in the placebo plus FA group (n 19) and no recurrences in the inositol plus FA group (n 14). Of fifty-two women who declined randomisation, the peri-conceptional supplementation regimen and outcomes of twenty-four further pregnancies were documented. Two NTDs recurred, both in women who took only FA in their next pregnancy. No adverse pregnancy events were associated with inositol supplementation. The findings of the PONTI pilot study encourage a large-scale controlled trial of inositol for NTD prevention, but indicate the need for a careful study design in view of the unwillingness of many high-risk women to be randomised. PMID:26917444

  8. Inositol for the prevention of neural tube defects: a pilot randomised controlled trial.

    PubMed

    Greene, Nicholas D E; Leung, Kit-Yi; Gay, Victoria; Burren, Katie; Mills, Kevin; Chitty, Lyn S; Copp, Andrew J

    2016-03-28

    Although peri-conceptional folic acid (FA) supplementation can prevent a proportion of neural tube defects (NTD), there is increasing evidence that many NTD are FA non-responsive. The vitamin-like molecule inositol may offer a novel approach to preventing FA-non-responsive NTD. Inositol prevented NTD in a genetic mouse model, and was well tolerated by women in a small study of NTD recurrence. In the present study, we report the Prevention of Neural Tube Defects by Inositol (PONTI) pilot study designed to gain further experience of inositol usage in human pregnancy as a preliminary trial to a future large-scale controlled trial to evaluate efficacy of inositol in NTD prevention. Study subjects were UK women with a previous NTD pregnancy who planned to become pregnant again. Of 117 women who made contact, ninety-nine proved eligible and forty-seven agreed to be randomised (double-blind) to peri-conceptional supplementation with inositol plus FA or placebo plus FA. In total, thirty-three randomised pregnancies produced one NTD recurrence in the placebo plus FA group (n 19) and no recurrences in the inositol plus FA group (n 14). Of fifty-two women who declined randomisation, the peri-conceptional supplementation regimen and outcomes of twenty-two further pregnancies were documented. Two NTD recurred, both in women who took only FA in their next pregnancy. No adverse pregnancy events were associated with inositol supplementation. The findings of the PONTI pilot study encourage a large-scale controlled trial of inositol for NTD prevention, but indicate the need for a careful study design in view of the unwillingness of many high-risk women to be randomised.

  9. Photobiomodulation in the Prevention of Tooth Sensitivity Caused by In-Office Dental Bleaching. A Randomized Placebo Preliminary Study.

    PubMed

    Calheiros, Andrea Paiva Corsetti; Moreira, Maria Stella; Gonçalves, Flávia; Aranha, Ana Cecília Correa; Cunha, Sandra Ribeiro; Steiner-Oliveira, Carolina; Eduardo, Carlos de Paula; Ramalho, Karen Müller

    2017-08-01

    Analyze the effect of photobiomodulation in the prevention of tooth sensitivity after in-office dental bleaching. Tooth sensitivity is a common clinical consequence of dental bleaching. Therapies for prevention of sensitivity have been investigated in literature. This study was developed as a randomized, placebo blind clinical trial. Fifty patients were selected (n = 10) and randomly divided into five groups: (1) control, (2) placebo, (3) laser before bleaching, (4) laser after bleaching, and (5) laser before and after bleaching. Irradiation was performed perpendicularly, in contact, on each tooth during 10 sec per point in two points. The first point was positioned in the middle of the tooth crown and the second in the periapical region. Photobiomodulation was applied using the following parameters: 780 nm, 40 mW, 10 J/cm 2 , 0.4 J per point. Pain was analyzed before, immediately after, and seven subsequent days after bleaching. Patients were instructed to report pain using the scale: 0 = no tooth sensitivity, 1 = gentle sensitivity, 2 = moderate sensitivity, 3 = severe sensitivity. There were no statistical differences between groups at any time (p > 0.05). More studies, with others parameters and different methods of tooth sensitivity analysis, should be performed to complement the results found. Within the limitation of the present study, the laser parameters of photobiomodulation tested in the present study were not efficient in preventing tooth sensitivity after in-office bleaching.

  10. NEEMA: a school-based diabetes risk prevention program designed for African-American children.

    PubMed Central

    Shaw-Perry, Mary; Horner, Charlotte; Treviño, Roberto P.; Sosa, Erica T.; Hernandez, Irene; Bhardwaj, Abhishek

    2007-01-01

    OBJECTIVE: To conduct formative assessment and preliminary biological impact of a school-based diabetes risk prevention program for African-American children during a 14-week study. METHODS: NEEMA is a school-based diabetes prevention program tailored for African-American children. The NEEMA is implemented via four social networks-classroom (Health and Physical Education Class), after school (Health Club), home (Family Fun Fair) and school cafeteria (Food Service Program). Formative assessment data were collected through semistructured interviews with physical education (PE) teachers and a pre-to-post design was used to measure biological impact. Fasting capillary glucose, height, weight, body mass index, percent body fat and fitness data were collected from a sample of 58 fourth-grade students. The six elementary schools had > 40% African-American enrollment and were located in low-income neighborhoods. RESULTS: Face-to-face interview data revealed diabetes, obesity and food insufficiency as major health concerns among PE teachers. Teachers also cited large classes and short PE periods as major challenges for implementing the program. From baseline to follow-up, fitness laps increased from 16.40 (SD = 9.98) to 23.72 (SD = 14.79) (p < 0.000), fasting capillary glucose decreased from 89.17 mg/dl (SD = 10.05) to 83.50 mg/dl (SD = 11.26) (p < 0.000), and percent body fat decreased from 27.26 (SD=12.89) to 26.68 (SD = 11.67) (p < 0.537). CONCLUSION: The NEEMA pilot study provided teacher feedback useful for revising the NEEMA health curricula and positive preliminary impact of the NEEMA PE class on children's fitness and blood glucose levels. PMID:17444425

  11. 9.4T Human MRI: Preliminary Results

    PubMed Central

    Vaughan, Thomas; DelaBarre, Lance; Snyder, Carl; Tian, Jinfeng; Akgun, Can; Shrivastava, Devashish; Liu, Wanzahn; Olson, Chris; Adriany, Gregor; Strupp, John; Andersen, Peter; Gopinath, Anand; van de Moortele, Pierre-Francois; Garwood, Michael; Ugurbil, Kamil

    2014-01-01

    This work reports the preliminary results of the first human images at the new high-field benchmark of 9.4T. A 65-cm-diameter bore magnet was used together with an asymmetric 40-cm-diameter head gradient and shim set. A multichannel transmission line (transverse electromagnetic (TEM)) head coil was driven by a programmable parallel transceiver to control the relative phase and magnitude of each channel independently. These new RF field control methods facilitated compensation for RF artifacts attributed to destructive interference patterns, in order to achieve homogeneous 9.4T head images or localize anatomic targets. Prior to FDA investigational device exemptions (IDEs) and internal review board (IRB)-approved human studies, preliminary RF safety studies were performed on porcine models. These data are reported together with exit interview results from the first 44 human volunteers. Although several points for improvement are discussed, the preliminary results demonstrate the feasibility of safe and successful human imaging at 9.4T. PMID:17075852

  12. Configuration affects parallel stent grafting results.

    PubMed

    Tanious, Adam; Wooster, Mathew; Armstrong, Paul A; Zwiebel, Bruce; Grundy, Shane; Back, Martin R; Shames, Murray L

    2018-05-01

    A number of adjunctive "off-the-shelf" procedures have been described to treat complex aortic diseases. Our goal was to evaluate parallel stent graft configurations and to determine an optimal formula for these procedures. This is a retrospective review of all patients at a single medical center treated with parallel stent grafts from January 2010 to September 2015. Outcomes were evaluated on the basis of parallel graft orientation, type, and main body device. Primary end points included parallel stent graft compromise and overall endovascular aneurysm repair (EVAR) compromise. There were 78 patients treated with a total of 144 parallel stents for a variety of pathologic processes. There was a significant correlation between main body oversizing and snorkel compromise (P = .0195) and overall procedural complication (P = .0019) but not with endoleak rates. Patients were organized into the following oversizing groups for further analysis: 0% to 10%, 10% to 20%, and >20%. Those oversized into the 0% to 10% group had the highest rate of overall EVAR complication (73%; P = .0003). There were no significant correlations between any one particular configuration and overall procedural complication. There was also no significant correlation between total number of parallel stents employed and overall complication. Composite EVAR configuration had no significant correlation with individual snorkel compromise, endoleak, or overall EVAR or procedural complication. The configuration most prone to individual snorkel compromise and overall EVAR complication was a four-stent configuration with two stents in an antegrade position and two stents in a retrograde position (60% complication rate). The configuration most prone to endoleak was one or two stents in retrograde position (33% endoleak rate), followed by three stents in an all-antegrade position (25%). There was a significant correlation between individual stent configuration and stent compromise (P = .0385), with 31

  13. The INNOVATION Trial: four-year safety and effectiveness of the INCRAFT® AAA Stent-Graft System for endovascular repair.

    PubMed

    Pratesi, Giovanni; Pratesi, Carlo; Chiesa, Roberto; Coppi, Gioacchino; Scheinert, Dierk; Brunkwall, Jan S; van der Meulen, Stefaan; Torsello, Giovanni

    2017-10-01

    This paper reports the 4-year safety and effectiveness of the INCRAFT® AAA Stent-Graft System (Cordis Corp., Milpitas, CA, USA), an ultra-low-profile device for the treatment of abdominal aortic aneurysms. The INNOVATION Trial is the prospective, first-in-human, multicenter trial to evaluate the safety and effectiveness of the INCRAFT® System. Patients underwent annual clinical and computed tomography angiography examination as part of the study protocol. The INCRAFT® AAA Stent-Graft System is a customizable tri-modular design, with an ultra-low profile (14-Fr) delivery system. Patient were treated under approved protocol, the prescribed clinical and imaging follow-up at annually through 5 years. Results analyzed and adjudicated by a clinical events committee, independent core laboratory, and a data safety and monitoring board. This manuscript reports results through 4 years of follow-up. A total of 60 patients were enrolled in the trial, all of whom were successfully treated. Follow-up rates at 1 and 4 years were 93% (56/60) and 85% (51/60), respectively. All-cause mortality at 4 years was 17.6% and no death was AAA-, device-, or procedure-related. The secondary reintervention rate at 1 year was 4.6%, primarily the result of stent thrombosis. In total, 10 patients required 13 post-procedure interventions within 4-years of follow-up (2 to repair a type I endoleak, 4 to repair a type II endoleak, 1 for stent thrombosis, 1 for renal stenosis, 1 for aneurysm enlargement, 2 for limb migration and 2 for prosthesis stenosis or occlusion). There were 4 cases (10%) of aneurysm enlargement reported at the 4 year follow-up. At 4 years, 38 out of 39 patients were free from type I and III endoleaks. There were no proximal type I or type III endoleaks at 4-year follow-up. Core laboratory evaluation of the postoperative imaging studies indicated absence of endograft migration while a single fracture was demonstrated without any clinical sequelae. The INCRAFT® AAA Stent

  14. Reorganization of equivalence classes: effects of preliminary training and meaningful stimuli.

    PubMed

    Arntzen, Erik; Nartey, Richard K; Fields, Lanny

    2018-05-01

    In Condition 1, adults learned the baseline relations for the three equivalence classes A1-B1-C1-D1-E1, A2-B2-C2-D2-E2, and A3-B3-C3-D3-E3. Classes contained abstract shapes in the ABS and four preliminary training groups. Each class in the PIC group contained one picture and four abstract shapes. Before class formation for four other groups, preliminary training involved establishing identity (CC) or arbitrary (CX) relations either with or without a delay. Without preliminary training, classes formed with low and high likelihoods in the ABS and PIC groups, respectively. Preliminary training with no delay produced modest increases in class formation, while preliminary training with delay produced large increases in class formation. Condition 2 replicated Condition 1 but with training of reassigned BC and CD relations that linked C from one class to B and D from another class: B1-C2, B2-C3, B3-C1, C2-D1, C3-D2, and C1-D3. Subsequent tests assessed the emergence of the reorganized classes A1-B1-C2-D1-E1, A2-B2-C3-D2-E2, and A3-B3-C1-D3-E3. All preliminary training procedures increased likelihood of forming the reorganized classes to the level seen in the PIC group. Greater gains were produced by preliminary training with no delays than with delays. Test performances also showed how preliminary training influenced baseline acquisition speed and participant-defined relations. © 2018 Society for the Experimental Analysis of Behavior.

  15. Cell emulation and preliminary results.

    DOT National Transportation Integrated Search

    2016-07-01

    This report details preliminary results of the testing plan implemented by the Hawaii Natural Energy Institute to evaluate Electric Vehicle (EV) battery durability and reliability under electric utility grid operations. Commercial EV battery cells ar...

  16. Adapted Physical Activity for the Promotion of Health and the Prevention of Multifactorial Chronic Diseases: the Erice Charter.

    PubMed

    Romano-Spica, Vincenzo; Macini, Pierluigi; Fara, Gaetano Maria; Giammanco, Giuseppe

    2015-01-01

    The Erice Charter was unanimously approved at the conclusion of the 47th Residential Course "Adapted Physical Activity in Sport, Wellness and Fitness: New Challenges for Prevention and Health Promotion", held on 20-24 April 2015 in Erice, Italy, at the "Ettore Majorana" Foundation and Centre for Scientific Culture, and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health. After an intense discussion the participants identified the main points associated with the relevance of physical activity for Public Health, claiming the pivotal role of the Department of Prevention in coordinating and managing preventive actions. The participants underlined the importance of the physicians specialized in Hygiene, Preventive Medicine and Public Health. The contribution of other operators such as physicians specialized in Sport Medicine was stressed. Further, the holders of the new degree in Human Movement and Sport Sciences were considered fundamental contributors for the performance of physical activity and their presence was seen as a promising opportunity for the Departments of Prevention. Primary prevention based on recreational physical activities should become easily accessible for the population, avoiding obstacles such as certification steps or complex bureaucracy. The Sport Doctor is recognized as the principal referent for preliminary physical evaluation and clinical monitoring in secondary and tertiary prevention actions based on adapted physical activities. Developing research in the field is essential as well as implementing higher education on physical activity management in Schools of Public Health.

  17. [Prevention of post-operative pain and haemorrhage in PPH (Procedure for Prolapse and Hemorrhoids) and STARR (Stapled Trans-Anal Rectal Resection). Preliminary results in 261 cases].

    PubMed

    Mongardini, M; Custureri, F; Schillaci, F; Cola, A; Maturo, A; Fanello, G; Corelli, S; Pappalardo, G

    2005-04-01

    Intra- and early (first week) post-operative haemorrhages are the most common complications in stapled hemorrhoidectomy PPH (Procedure for Prolapse and Hemorrhoids) and in circumferential resection of the rectal prolapse STARR (Stapled Trans Anal Rectal Resection). Performing PPH and STARR we employed a gelatin based haemostatic sealant with thrombin component (FloSeal) to control intra-operative bleeding and to reduce post-operative bleeding avoiding haemostatic stitches on suture line. We report the preliminary results on 197 PPH and 64 STARR; 44 PPH (22.4%) and 27 STARR (42.2%) were treated by FloSeal. No major post-operative bleeding was observed in all patients treated by FloSeal, compared to 1.3% and 2.7% of hemorrhage respectively in PPH and STARR patients treated without sealant. Post-operative pain was less severe in patients treated by FloSeal, without a difference statistically significant. The data are preliminary and must be confirmed in prospective randomized trials in larger series.

  18. Academic physicians' opinions on preliminary reporting of echocardiographic data.

    PubMed

    McDonald, R W; Rice, M J; Reller, M D; Silberbach, G M; Imus, R L; Marcella, C P; Brazee, R B; Pantely, G A

    1993-01-01

    Preliminary reporting of echocardiographic data by cardiac sonographers has become a key issue in the echocardiography community. A survey on this issue was sent to 248 academic physicians and 89 (35.8%) were returned. In response to a question in the survey, 76 physicians stated that they had at least a limited amount of knowledge in echocardiography. For the group, 62% wanted a written or verbal preliminary report and 52% concluded that this report should be a part of the cardiac sonographer's position. If cardiac abnormalities are suspected, 65% wanted the results before the cardiologist reviewed the study, but only 42% of the physicians wanted a diagnostic versus a descriptive type of report. About 49% stated that if necessary they would attempt to influence the cardiac sonographer to give them a preliminary report, whereas 67% of the physicians would possibly use this information to medically manage the patient. Fifty percent believed that it was legal for a cardiac sonographer to give a preliminary report. Another 70% said that the cardiac sonographer would NOT be "practicing medicine without a license" and 66% concluded that they would NOT be "aiding and abetting the unauthorized practice of medicine" if given this information. These data have important potential ramifications for both cardiac sonographers as well as for the practice of cardiology regarding the issue of preliminary echocardiographic reports.

  19. Preliminary Reliability and Validity of an Exercise Benefits and Barriers for Stroke Prevention Scale in an African American Sample.

    PubMed

    Aycock, Dawn M; Clark, Patricia C

    2015-01-01

    African Americans are at heightened risk of first stroke, and regular exercise can reduce stroke risk. Benefits and barriers to exercise subscales from 2 instruments were combined to create the Exercise Benefits and Barriers for Stroke Prevention (EBBSP) scale. Reliability and validity of the EBBSP scale were examined in a nonrandom sample of 66 African Americans who were primarily female, average age 43.3 ± 9.4 years, and high school graduates. Both subscales had adequate internal consistency reliability. Factor analysis revealed two factors for each subscale. More benefits and fewer perceived barriers were significantly related to current exercise and future intentions to exercise. The EBBSP scale may be useful in research focused on understanding, predicting, and promoting exercise for stroke prevention in adults.

  20. Dissonance-based eating disorder program reduces cardiac risk: A preliminary trial.

    PubMed

    Green, Melinda A; Willis, Mary; Fernandez-Kong, Kristen; Reyes, Shuhan; Linkhart, Ruby; Johnson, Molly; Thorne, Tyler; Kroska, Emily; Woodward, Halley; Lindberg, Jessica

    2017-04-01

    We conducted a randomized, controlled preliminary trial to examine the effect of a dissonance-based eating disorder program on eating disorder symptoms and cardiac risk indices in a community sample of women with subclinical and clinical symptoms (N = 47), examining the efficacy of the program in both the indicated prevention and treatment realms. Eating disorder symptoms, body mass index, and biomarkers of cardiac risk were examined in dissonance and assessment-only control conditions at baseline, postintervention, and 2-month follow-up. Specifically, we assessed mean R wave amplitude, QT interval length, vagal tone (high frequency spectral power of heart rate variability), and sympathetic tone (low/high frequency spectral power ratio) via electocardiography (ECG) at each assessment period. We predicted a statistically significant 2 (condition: control, dissonance) × 3 (time: baseline, postintervention, 2-month follow-up) interaction in the mixed factorial MANOVA results. Results confirmed this hypothesis. Eating disorder symptoms and cardiac risk indices decreased significantly among participants in the dissonance condition at postintervention and 2-month follow-up compared with baseline. Results provide support for the efficacy of a dissonance-based program in the reduction of eating disorder symptoms and cardiac risk indices among women with subclinical and clinical eating disorder symptoms. Findings establish the efficaciousness of this dissonance-based approach in the indicated prevention and treatment realms and establish its efficacy in reducing cardiac risk indicators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Preliminary evaluation of synthetic speech

    DOT National Transportation Integrated Search

    1972-08-01

    The report briefly discusses the methods for storing and generating synthetic speech and a preliminary evaluation of the intelligibility of a speech synthesizer having a 75-word vocabulary selected for air traffic control messages. A program is sugge...

  2. Gender-Based Violence Prevention. Issues in Prevention

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This issue of "Issues in Prevention" focuses on gender-based violence prevention. This issue contains the following articles: (1) Preventing Gender-Based Violence: An Overview (Linda Langford); (2) Q&A With Amelia Cobb; (3) Denim Day at HBCUs; (4) Dear Colleague Letter; (5) ED Grants for Violence Prevention; and (6) Higher Education Center…

  3. 1986 traffic fatalities, preliminary report

    DOT National Transportation Integrated Search

    1987-04-01

    This report provides a number of preliminary estimate of traffic fatalities and fatal accidents for 1986. Trend data are presented for both the long and short term. Some summary statistics are provided at the State and Regional level. The national es...

  4. [External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: development of instruments for assessing structural quality].

    PubMed

    Saupe-Heide, M; Gerlich, C; Lukasczik, M; Musekamp, G; Neuderth, S; Vogel, H

    2013-12-01

    As required by German law, inpatient institutions offering prevention and rehabilitation measures for mothers, fathers and children are obliged to implement external quality assurance measures. In 2 pilot projects funded by the German federal association of health insurance funds, external quality assurance procedures for in-hospital prevention and rehabilitation of mothers and fathers were analyzed with the aim of developing a set of instruments for the description of structural characteristics in this area of health care and to evaluate its appropriateness. Concerning structure-related quality, the project included a) designing and evaluating a questionnaire, b) the definition of assessment criteria for subsequent comparative data analyses, and c) the description and documentation of the current state in the field of rehabilitation and prevention for mothers, fathers and children. To document structural quality comprehensively, a modular questionnaire was developed and tested in a survey of 115 inpatient prevention and rehabilitation institutions for mothers, fathers and children. Involving an expert panel, preliminary basic and selection criteria were defined in order to assure a conducive assessment with regard to structural attributes. The majority of institutions had provider agreements for both prevention and rehabilitation. Measures for mothers/fathers with children were predominant; only 7 institutions exclusively treated mothers and fathers. Institution sizes varied strongly. Major indications included psychosomatics, dermatology, and pneumology. Overall, structural conditions of the institutions showed a high standard. Potential for development was found with regard to some aspects of the conceptual framework of institutional practice and the implementation of the International Classification of Functioning, Disability and Health (ICF) in diagnostics. In this article, the degrees of fulfillment with relation to the structural dimensions are presented

  5. 28 CFR 36.604 - Procedure following preliminary determination of equivalency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

  6. 28 CFR 36.604 - Procedure following preliminary determination of equivalency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

  7. 28 CFR 36.604 - Procedure following preliminary determination of equivalency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

  8. 28 CFR 36.604 - Procedure following preliminary determination of equivalency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... State Laws or Local Building Codes § 36.604 Procedure following preliminary determination of equivalency... of the preliminary determination of equivalency with respect to the particular code, and invite... enforcement of the code, at which interested individuals, including individuals with disabilities, are...

  9. Comparison-Bot: an Automated Preliminary-Final Report Comparison System.

    PubMed

    Kalaria, Amit D; Filice, Ross W

    2016-06-01

    Regular comparison of preliminary to final reports is a critical part of radiology resident and fellow education as prior research has documented substantial preliminary to final discrepancies. Unfortunately, there are many barriers to this comparison: high study volume; overnight rotations without an attending; the ability to finalize reports remotely; the subtle nature of many changes; and lack of easy access to the preliminary report after finalization. We developed a system that automatically compiles and emails a weekly summary of report differences for all residents and fellows. Trainees can also create a custom report using a date range of their choice and can view this data on a resident dashboard. Differences between preliminary and final reports are clearly highlighted with links to the associated study in Picture Archiving and Communication Systems (PACS) for efficient review and learning. Reports with more changes, particularly changes made in the impression, are highlighted to focus attention on those exams with substantive edits. Our system provides an easy way for trainees to review changes to preliminary reports with immediate access to the associated images, thereby improving their educational experience. Departmental surveys showed that our report difference summary is easy to understand and improves the educational experience of our trainees. Additionally, interesting descriptive statistics help us understand how reports are changed by trainee level, by attending, and by exam type. Finally, this system can be easily ported to other departments who have access to their Health Level 7 (HL7) data.

  10. Chinese and South Asian Religious Institutions and HIV Prevention in New York City

    PubMed Central

    Chin, John J.; Mantell, Joanne; Weiss, Linda; Bhagavan, Mamatha; Luo, Xiaoting

    2012-01-01

    Religious institutions in Asian immigrant communities are in a unique position to confront the challenges of the HIV epidemic for the populations they serve. However, there has been little research on whether these institutions are willing or able to take a role in HIV prevention. This article reports on findings from a qualitative study of three Asian immigrant religious institutions in New York City (a Buddhist temple, a Hindu temple, an Islamic center/mosque) that are part of a larger study of Asian immigrant community institutions and their response to the HIV epidemic. Several prominent themes arose that formed the basis of a preliminary theoretical framework describing the way Asian immigrant religious institutions may evaluate their role in HIV prevention. The interview data indicate that the institutions take a stance of “conservative innovation,” weighing their role as keepers of morality and religious tradition against the changing needs of their communities and then adjusting their practices or positions incrementally (to varying degrees) to stay responsive and relevant. PMID:16255643

  11. Preliminary design package for prototype solar heating system

    NASA Technical Reports Server (NTRS)

    1978-01-01

    A summary is given of the preliminary analysis and design activity on solar heating systems. The analysis was made without site specific data other than weather; therefore, the results indicate performance expected under these special conditions. Major items include system candidates, design approaches, trade studies and other special data required to evaluate the preliminary analysis and design. The program calls for the development and delivery of eight prototype solar heating and cooling systems for installation and operational test.

  12. Preliminary Opto-Mechanical Design for the X2000 Transceiver

    NASA Technical Reports Server (NTRS)

    Hemmati, H.; Page, N. A.

    2000-01-01

    Preliminary optical design and mechanical conceptual design for a 30 cm aperture transceiver are described. A common aperture is used for both transmit and receive. Special attention was given to off-axis and scattered light rejection and isolation of the receive channel from the transmit channel. Requirements, details of the design and preliminary performance analysis of the transceiver are provided.

  13. A preliminary study of the population-adjusted effectiveness of substance abuse prevention programming: towards making IOM program types comparable.

    PubMed

    Shamblen, Stephen R; Derzon, James H

    2009-03-01

    The Institute of Medicine distinguishes between programs based on who is targeted: the entire population (universal), those at risk (selective), or persons exhibiting the early stages of use or related problem behavior (indicated). Evaluations suggest that although universal programs can be effective in reducing and preventing substance use, selective and indicated programs are both more effective and have greater cost-benefit ratios. This paper tests these assumptions by comparing the impact of these program types in reducing and preventing substance use at the individual level (i.e., those exposed to intervention services) and in the population (i.e., those exposed and not exposed to intervention services). A meta-analysis was performed on 43 studies of 25 programs to examine program comparability across IOM categories. When examining unadjusted effect sizes at the individual level, universal programs were modestly more successful in reducing tobacco use, but selective and indicated programs were modestly more successful in reducing alcohol and marijuana use. When adjusted to the population level, the average effect sizes for selective and indicated programs were reduced by approximately half. At the population level, universal programs were more successful in reducing tobacco and marijuana use and selective and indicated programs were more successful in reducing alcohol use. Editors' Strategic Implications: the authors' focus on the public health value of a prevention strategy is compelling and provides a model for analyses of other strategies and content areas.

  14. Why is quaternary prevention important in prevention?

    PubMed Central

    Tesser, Charles Dalcanale

    2017-01-01

    ABSTRACT Quaternary prevention consists in the identification of persons at risk of excessive medicalization and their protection against new unnecessary interventions, avoiding iatrogenic damages. Here, we argue about the importance of quaternary prevention in specific primary and secondary prevention. The recent great development of preventive medicine, biomedicalization of risks and their treatment as if they were diseases, and the powerful influence of the commercial interests of pharmaceutical industries on the production of medical-sanitary knowledge alter classifications, create diseases and pre-diseases, lower cutoff points, and erase the distinction between prevention and healing. This situation converts larger amounts of asymptomatic persons into sick individuals and diverts clinical attention and resources from sick persons to the healthy, from older adults to young persons, and from the poor to the rich. Quaternary prevention facilitates and induces the development and systematization of operational knowledge and guidelines to contain hypermedicalization and the damages of preventive actions in professional care, especially in primary health care. PMID:29211199

  15. 78 FR 34644 - Stainless Steel Plate in Coils From Belgium: Preliminary Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... Coils From Belgium: Preliminary Results of Antidumping Duty Administrative Review; 2011-2012 AGENCY... of the scope of the order, see the ``Decision Memorandum for the Preliminary Results of Antidumping... Preliminary Decision Memorandum are identical in content. Preliminary Results of the Review As a result of...

  16. Modification of an endovascular stent graft for abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Moloye, Olajompo Busola

    Endovascular surgery is currently used to treat abdominal aortic aneurysms (AAA). A stent graft is deployed to exclude blood flow from the aneurysm sac. It is an effective procedure used in preventing aneurysm rupture, with reduced patient morbidity and mortality compared to open surgical repair. Migration and leakage around the device ("endoleak") due to poor sealing of the stent graft to the aorta have raised concerns about the long-term durability of endovascular repair. A preliminary study of cell migration and proliferation is presented as a prelude to a more extensive in vivo testing. A method to enhance the biological seal between the stent graft and the aorta is proposed to eliminate this problem. This can be achieved by impregnating the stent graft with 50/50 poly (DL-lactide co glycolic acid) (PLGA) and growth factors such as basic fibroblast growth factor (bFGF) or connective tissue growth factor (CTGF), at the proximal and distal ends. It is hypothesized that as PLGA degrades it will release the growth factors that will promote proliferation and migration of aortic smooth muscle cells to the coated site, leading to a natural seal between the aorta and the stent graft. In addition, growth factor release should promote smooth muscle cell (SMC) contraction that will help keep the stent graft in place at the proximal and distal ends. It is shown that a statistically significant effect of increased cell proliferation and migration is observed for CTGF release. Less of an effect is noted for bFGF or just the PLGA. The effect is estimated to be large enough to be clinically significant in a future animal study. The long term goal of this study is to reduce migration encounter after graft deployment and to reduce secondary interventions of EVAR especially for older patients who are unfit for open surgical treatment.

  17. 19 CFR 351.205 - Preliminary determination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Introduction. A preliminary determination in an antidumping or countervailing duty investigation constitutes... short life cycle merchandise (see section 733(b)(1)(B) and section 739 of the Act). (c) Contents of...

  18. Internet-Delivered, Family-Based Treatment for Early-Onset OCD: A Preliminary Case Series

    PubMed Central

    Comer, Jonathan S.; Furr, Jami M.; Cooper-Vince, Christine E.; Kerns, Caroline E.; Chan, Priscilla T.; Edson, Aubrey L.; Khanna, Muniya; Franklin, Martin E.; Garcia, Abbe M.; Freeman, Jennifer B.

    2014-01-01

    Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (MAge = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as “excellent.” The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care. PMID:24295036

  19. Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial

    PubMed Central

    LoRusso, Amanda; Shin, Sunny H.; Khalsa, Sat Bir S.

    2016-01-01

    Adolescence is a key developmental period for preventing substance use initiation, however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors. Recent research suggests that mind–body practices such as yoga may have beneficial effects on several substance use risk factors, and that these practices may serve as promising interventions for preventing adolescent substance use. The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence. Seventh-grade students in a public school were randomly assigned by classroom to receive either a 32-session yoga intervention (n = 117) in place of their regular physical education classes or to continue with physical-education-as-usual (n = 94). Participants (63.2 % female; 53.6 % White) completed pre- and post-intervention questionnaires assessing emotional self-regulation, perceived stress, mood impairment, impulsivity, substance use willingness, and actual substance use. Participants also completed questionnaires at 6-months and 1-year post-intervention. Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition. Immediate pre- to post-intervention differences did not emerge for the remaining outcomes. However, long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition, and males in the control condition, demonstrated improvements in emotional self-control. The findings suggest that school-based yoga may have beneficial effects with regard to preventing males' and females' willingness to smoke cigarettes, as well as improving emotional self-control in females. However additional research is required, particularly with regard to the potential long-term effects of mind–body interventions in

  20. Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial.

    PubMed

    Butzer, Bethany; LoRusso, Amanda; Shin, Sunny H; Khalsa, Sat Bir S

    2017-03-01

    Adolescence is a key developmental period for preventing substance use initiation, however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors. Recent research suggests that mind-body practices such as yoga may have beneficial effects on several substance use risk factors, and that these practices may serve as promising interventions for preventing adolescent substance use. The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence. Seventh-grade students in a public school were randomly assigned by classroom to receive either a 32-session yoga intervention (n = 117) in place of their regular physical education classes or to continue with physical-education-as-usual (n = 94). Participants (63.2 % female; 53.6 % White) completed pre- and post-intervention questionnaires assessing emotional self-regulation, perceived stress, mood impairment, impulsivity, substance use willingness, and actual substance use. Participants also completed questionnaires at 6-months and 1-year post-intervention. Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition. Immediate pre- to post-intervention differences did not emerge for the remaining outcomes. However, long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition, and males in the control condition, demonstrated improvements in emotional self-control. The findings suggest that school-based yoga may have beneficial effects with regard to preventing males' and females' willingness to smoke cigarettes, as well as improving emotional self-control in females. However additional research is required, particularly with regard to the potential long-term effects of mind-body interventions

  1. 28 CFR 36.605 - Procedure following preliminary denial of certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

  2. 28 CFR 36.605 - Procedure following preliminary denial of certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

  3. 28 CFR 36.605 - Procedure following preliminary denial of certification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

  4. 28 CFR 36.605 - Procedure following preliminary denial of certification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Local Building Codes § 36.605 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a preliminary determination to deny certification of a code under § 36.603... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

  5. 32 CFR 644.392 - Air Force-preliminary report of excess.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Air Force-preliminary report of excess. 644.392 Section 644.392 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Predisposal Action § 644.392 Air Force—preliminary report of excess...

  6. 28 CFR 36.606 - Procedure following preliminary denial of certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Local Building Codes § 36.606 Procedure following preliminary denial of certification. (a) If the Assistant Attorney General makes a Preliminary determination to deny certification of a code under § 36.604... specification of the manner in which the code could be amended in order to qualify for certification. (b) The...

  7. Perspectives in Genetics and Sickle Cell Disease Prevention in Africa: Beyond the Preliminary Data from Cameroon.

    PubMed

    Wonkam, Ambroise; Ngo Bitoungui, Valentina Josiane; Ngogang, Jeanne

    2015-01-01

    Management of sickle cell disease (SCD) in Africa needs to be accompanied by various preventive strategies, including early detection via prenatal genetic diagnosis (PND). Contrary to Cameroonian doctors who considered termination of an affected pregnancy (TAP) for SCD in 36.1%, the majority of parents (62.5%) with affected children accepted TAP in principle. In practice, most women opted for TAP (90%), justified by a huge psycho-social burden. The ethical and legal challenges of PND prompted the need to explore the use of genetics for secondary prevention of SCD. In 610 Cameroonian SCD patients, the genomic variations in two principal foetal haemoglobin-promoting loci were significantly associated with foetal haemoglobin levels. In addition, the co-inheritance of a 3.7-kb α-globin gene deletion and SCD was associated with a late disease onset and possibly improved survival: there was a much higher allele frequency of the 3.7-kb α-globin gene deletion in SCD patients (∼ 40%) than in haemoglobin AA controls (∼ 10%). The data indicate the urgent need to develop and implement policy actions in sub-Saharan Africa on at least four levels: (1) the implementation of SCD screening practices and early neonatal follow-up; (2) the development and incorporating of socio-economic support to alleviate the burden of SCD on affected families; (3) the exploration of the appropriateness of the medical abortion laws for SCD, and (4) the development of national plans for genetic medicine, including research on genomic variants that affect the phenotypes of SCD, in order to potentially use them for anticipatory guidance. © 2015 S. Karger AG, Basel.

  8. Use of flow-diverting stents as salvage treatment following failed stent-assisted embolization of intracranial aneurysms.

    PubMed

    Heiferman, Daniel M; Billingsley, Joshua T; Kasliwal, Manish K; Johnson, Andrew K; Keigher, Kiffon M; Frudit, Michel E; Moftakhar, Roham; Lopes, Demetrius K

    2016-07-01

    Flow-diverting stents, including the Pipeline embolization device (PED) and Silk, have been beneficial in the treatment of aneurysms previously unable to be approached via endovascular techniques. Recurrent aneurysms for which stent-assisted embolization has failed are a therapeutic challenge, given the existing intraluminal construct with continued blood flow into the aneurysm. We report our experience using flow-diverting stents in the repair of 25 aneurysms for which stent-assisted embolization had failed. Nineteen (76%) of these aneurysms at the 12-month follow-up showed improved Raymond class occlusion, with 38% being completely occluded, and all aneurysms demonstrated decreased filling. One patient developed a moderate permanent neurologic deficit. Appropriate stent sizing, proximal and distal construct coverage, and preventing flow diverter deployment between the previously deployed stent struts are important considerations to ensure wall apposition and prevention of endoleak. Flow diverters are shown to be a reasonable option for treating previously stented recurrent cerebral aneurysms. 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/

  9. Preliminary design of a simple passive toe exercise apparatus with a flexible metal hydride actuator for pressure ulcer prevention.

    PubMed

    Ino, Shuichi; Sato, Mitsuru; Hosono, Minako; Nakajima, Sawako; Yamashita, Kazuhiko; Izumi, Takashi

    2010-01-01

    In an aging society, social demands for home-based rehabilitation and assistive technologies by healthcare and welfare services are globally increasing. The progress of quality-of-life technologies and rehabilitation science is a very important and urgent issue for elderly and disabled individuals as well as for their caregivers. Thus, there is a substantial need to develop simple bedside apparatuses for both continuous exercise of joints and for power assistance for standing to prevent and manage disuse syndromes (e.g., pressure ulcers, joint contractures and muscular atrophy). Unfortunately, there are currently no commercially-available actuators compatible with the human requirements of flexibility, quietness, lightness and a high power-to-weight ratio. To fulfill the above demands, we have developed a novel actuation device using a metal hydride (MH) alloy and a laminate film, called the flexible MH actuator, as a human-friendly force generator for healthcare and welfare services. In this paper, we show the basic structure and characteristics of the flexible MH actuator used to create a passive exercise system for preventing disuse syndromes. To evaluate the efficiency of passive exercise for bedsore prevention, subcutaneous blood flow during passive exercise at common pressure-ulcer sites is measured by a laser blood flow meter. The force and range-of-motion angle required for a passive exercise apparatus is also examined with the help of a professional physical therapist. Based on these findings, a prototype of a passive exercise apparatus is fabricated using the flexible MH actuator technology, and its operation characteristics are preliminarily verified using a thermoelectric control system.

  10. Hydrothermal Liquefaction Treatment Preliminary Hazard Analysis Report

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

    Lowry, Peter P.; Wagner, Katie A.

    A preliminary hazard assessment was completed during February 2015 to evaluate the conceptual design of the modular hydrothermal liquefaction treatment system. The hazard assessment was performed in 2 stages. An initial assessment utilizing Hazard Identification and Preliminary Hazards Analysis (PHA) techniques identified areas with significant or unique hazards (process safety-related hazards) that fall outside of the normal operating envelope of PNNL and warranted additional analysis. The subsequent assessment was based on a qualitative What-If analysis. This analysis was augmented, as necessary, by additional quantitative analysis for scenarios involving a release of hazardous material or energy with the potential for affectingmore » the public.« less

  11. 32 CFR 644.392 - Air Force-preliminary report of excess.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Air Force-preliminary report of excess. 644.392... PROPERTY REAL ESTATE HANDBOOK Disposal Predisposal Action § 644.392 Air Force—preliminary report of excess... Force screens its own properties for other defense requirements and clears the disposal with DOD and the...

  12. 76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... Review; Preliminary Human Health Risk Assessment; Extension of Comment Period AGENCY: Environmental... chlorpyrifos registration review; preliminary human health risk assessment. This document extends the comment... review, preliminary human health risk assessment, established in the Federal Register of Wednesday, July...

  13. Suicide prevention through online gatekeeping using search advertising techniques: a feasibility study.

    PubMed

    Sueki, Hajime; Ito, Jiro

    2015-01-01

    Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.

  14. Anatomy and histology as socially networked learning environments: some preliminary findings.

    PubMed

    Hafferty, Frederic W; Castellani, Brian; Hafferty, Philip K; Pawlina, Wojciech

    2013-09-01

    An exploratory study to better understand the "networked" life of the medical school as a learning environment. In a recent academic year, the authors gathered data during two six-week blocks of a sequential histology and anatomy course at a U.S. medical college. An eight-item questionnaire captured different dimensions of student interactions. The student cohort/network was 48 first-year medical students. Using social network analysis (SNA), the authors focused on (1) the initial structure and the evolution of informal class networks over time, (2) how informal class networks compare to formal in-class small-group assignments in influencing student information gathering, and (3) how peer assignment of professionalism role model status is shaped more by informal than formal ties. In examining these latter two issues, the authors explored not only how formal group assignment persisted over time but also how it functioned to prevent the tendency for groupings based on gender or ethnicity. The study revealed an evolving dynamic between the formal small-group learning structure of the course blocks and the emergence of informal student networks. For example, whereas formal group membership did influence in-class questions and did prevent formation of groups of like gender and ethnicity, outside-class questions and professionalism were influenced more by informal group ties where gender and, to a much lesser extent, ethnicity influence student information gathering. The richness of these preliminary findings suggests that SNA may be a useful tool in examining an array of medical student learning encounters.

  15. Environment effects from SRB exhaust effluents: Technique development and preliminary assessment

    NASA Technical Reports Server (NTRS)

    Goldford, A. I.; Adelfang, S. I.; Hickey, J. S.; Smith, S. R.; Welty, R. P.; White, G. L.

    1977-01-01

    Techniques to determine the environmental effects from the space shuttle SRB (Solid Rocket Booster) exhaust effluents are used to perform a preliminary climatological assessment. The exhaust effluent chemistry study was performed and the exhaust effluent species were determined. A reasonable exhaust particle size distribution is constructed for use in nozzle analyses and for the deposition model. The preliminary assessment is used to identify problems that are associated with the full-scale assessment; therefore, these preliminary air quality results are used with caution in drawing conclusion regarding the environmental effects of the space shuttle exhaust effluents.

  16. 76 FR 61695 - Gulf of Mexico Regional Ecosystem Restoration Strategy (Preliminary)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... through Executive Order 13554 for the purpose of coordinating the long-term conservation and restoration... Ecosystem Restoration Strategy (Preliminary) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... Ecosystem Restoration Strategy (Preliminary) for public review and feedback. The document is available at...

  17. 17 CFR 210.8-01 - Preliminary Notes to Article 8.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Preliminary Notes to Article 8... CONSERVATION ACT OF 1975 Article 8 Financial Statements of Smaller Reporting Companies § 210.8-01 Preliminary Notes to Article 8. Sections 210.8-01 to 210.8-08 shall be applicable to financial statements filed for...

  18. 78 FR 28192 - Polyethylene Retail Carrier Bags From Thailand: Preliminary Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... Bags From Thailand: Preliminary Results of Antidumping Duty Administrative Review; 2011-2012 AGENCY... Import Administration, ``Decision Memorandum for Preliminary Results of the 2011/12 Antidumping Duty... (August 12, 2010) (Section 129 Determination). Preliminary Results of Review As a result of our review, we...

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

    Lotfi, S., E-mail: shamim.lotfi@kcl.ac.uk; Clough, R. E.; Ali, T.

    Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997-2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18-90) years with mean follow-up of 15 (range, 0-61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 %more » (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.« less

  20. Hybrid endovascular repair in aortic arch pathologies: a retrospective study.

    PubMed

    Ma, Xiaohui; Guo, Wei; Liu, Xiaoping; Yin, Tai; Jia, Xin; Xiong, Jiang; Zhang, Hongpeng; Wang, Lijun

    2010-11-18

    The aortic arch presents specific challenges to endovascular repair. Hybrid repair is increasingly evolving as an alternative option for selected patients, and promising initial results have been reported. The aim of this study was to introduce our experiences and evaluate mid-term results of supra aortic transpositions for extended endovascular repair of aortic arch pathologies. From December 2002 to January 2008, 25 patients with thoracic aortic aneurysms and dissections involving the aortic arch were treated with hybrid endovascular treatment in our center. Of the 25 cases, 14 were atherosclerotic thoracic aortic aneurysms and 11 were thoracic aortic dissection. The hybrid repair method included total-arch transpositions (15 cases) or hemi-arch transpositions (10 cases), and endovascular procedures. All hybrid endovascular procedures were completed successfully. Three early residual type-I endoleaks and one type-II endoleak were observed. Stroke occurred in three patients (8%) during the in-hospital stage. The perioperative mortality rate was 4%; one patients died post-operatively from catheter related complications. The average follow-up period was 15 ± 5.8 months (range, 1-41 months). The overall crude survival rate at 15 months was 92% (23/25). During follow-up, new late endoleaks and stent-raft related complications were not observed. One case (4%) developed a unilateral lower limb deficit at 17 days and was readmitted to hospital. In conclusion, the results are encouraging for endovascular aortic arch repair in combination with supra-aortic transposition in high risk cases. Aortic endografting offers good mid-term results. Mid-term results of the hybrid approach in elderly patients with aortic arch pathologies are satisfying.

  1. Development and preliminary validation of the physician support of skin self-examination scale.

    PubMed

    Coroiu, Adina; Moran, Chelsea; Garland, Rosalind; Körner, Annett

    2018-05-01

    Skin self-examination (SSE) is a crucial preventive health behaviour in melanoma survivors, as it facilitates early detection. Physician endorsement of SSE is important for the initiation and maintenance of this behaviour. This study focussed on the preliminary validation of a new nine-item measure assessing physician support of SSE in melanoma patients. English and French versions of this measure were administered to 188 patients diagnosed with melanoma in the context of a longitudinal study investigating predictors and facilitators of SSE. Structural validity was investigated using exploratory factor analysis conducted in Mplus and convergent and divergent validity was assessed using bivariate correlations conducted in spss. Results suggest that the scale is a unidimensional and reliable measure of physician support for SSE. Given the uncertainty regarding the optimal frequency of SSE for at-risk individuals, we recommend that future psychometric evaluations of this scale consider tailoring items according to the most up-to-date research on SSE effectiveness.

  2. 17 CFR 210.8-01 - Preliminary Notes to Article 8.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Preliminary Notes to Article 8... ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8 Financial Statements of Smaller Reporting Companies § 210.8-01 Preliminary Notes to Article 8. Sections 210.8-01 to 210.8-08 shall...

  3. 17 CFR 210.8-01 - Preliminary Notes to Article 8.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Preliminary Notes to Article 8... ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Article 8 Financial Statements of Smaller Reporting Companies § 210.8-01 Preliminary Notes to Article 8. Sections 210.8-01 to 210.8-08 shall...

  4. Community Colleges--Prevention Challenges. Issues in Prevention

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This issue of "Issues in Prevention" focuses on prevention challenges facing community colleges. This issue contains the following articles: (1) Prevention at Community Colleges; (2) Q&A With William Auvenshine; (3) Chancellor's Initiative at the University of Wisconsin-Stout; (4) Alcohol Marketing in the Digital Age; and (5) Higher Education…

  5. A Preliminary Analysis of the Costs and Benefits of Older Age Accessions.

    DTIC Science & Technology

    1984-03-01

    8217AD-A143 160 A PRELIMINARY ANALYSIS OF THE COSTS AND BENEFITS OF I/ OLDER AGE ACCESSIONS(U) NAVAL POSTGRADUATE SCHOOL N A MONTEREY CA S D BARCLAY MAR...ELECTE JUL 1884d THESIS A PRELIMINARY ANALYSIS CF THE COSTS AND BENEFITS OF OLDER AGE ACCESSIONS CL by Susan D. Barclay March 1984 Thesis Advisor...for public release; distribution unlimited. A Preliminary Analysis of the Costs and Benefits of Older Age Accessions by Susan D. Barclay Lieutenant

  6. 24 CFR 570.461 - Post-preliminary approval requirements; lead-based paint.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... requirements; lead-based paint. 570.461 Section 570.461 Housing and Urban Development Regulations Relating to... GRANTS Urban Development Action Grants § 570.461 Post-preliminary approval requirements; lead-based paint. The recipient may receive preliminary approval prior to the accomplishment of lead-based paint...

  7. 24 CFR 570.461 - Post-preliminary approval requirements; lead-based paint.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... requirements; lead-based paint. 570.461 Section 570.461 Housing and Urban Development Regulations Relating to... GRANTS Urban Development Action Grants § 570.461 Post-preliminary approval requirements; lead-based paint. The recipient may receive preliminary approval prior to the accomplishment of lead-based paint...

  8. 24 CFR 570.461 - Post-preliminary approval requirements; lead-based paint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... requirements; lead-based paint. 570.461 Section 570.461 Housing and Urban Development Regulations Relating to... GRANTS Urban Development Action Grants § 570.461 Post-preliminary approval requirements; lead-based paint. The recipient may receive preliminary approval prior to the accomplishment of lead-based paint...

  9. 24 CFR 570.461 - Post-preliminary approval requirements; lead-based paint.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... requirements; lead-based paint. 570.461 Section 570.461 Housing and Urban Development Regulations Relating to... GRANTS Urban Development Action Grants § 570.461 Post-preliminary approval requirements; lead-based paint. The recipient may receive preliminary approval prior to the accomplishment of lead-based paint...

  10. 24 CFR 570.461 - Post-preliminary approval requirements; lead-based paint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... requirements; lead-based paint. 570.461 Section 570.461 Housing and Urban Development Regulations Relating to... GRANTS Urban Development Action Grants § 570.461 Post-preliminary approval requirements; lead-based paint. The recipient may receive preliminary approval prior to the accomplishment of lead-based paint...

  11. Standardized 2D ultrasound versus 3D/4D ultrasound and image fusion for measurement of aortic aneurysm diameter in follow-up after EVAR.

    PubMed

    Pfister, Karin; Schierling, Wilma; Jung, Ernst Michael; Apfelbeck, Hanna; Hennersperger, Christoph; Kasprzak, Piotr M

    2016-01-01

    To compare standardised 2D ultrasound (US) to the novel ultrasonographic imaging techniques 3D/4D US and image fusion (combined real-time display of B mode and CT scan) for routine measurement of aortic diameter in follow-up after endovascular aortic aneurysm repair (EVAR). 300 measurements were performed on 20 patients after EVAR by one experienced sonographer (3rd degree of the German society of ultrasound (DEGUM)) with a high-end ultrasound machine and a convex probe (1-5 MHz). An internally standardized scanning protocol of the aortic aneurysm diameter in B mode used a so called leading-edge method. In summary, five different US methods (2D, 3D free-hand, magnetic field tracked 3D - Curefab™, 4D volume sweep, image fusion), each including contrast-enhanced ultrasound (CEUS), were used for measurement of the maximum aortic aneurysm diameter. Standardized 2D sonography was the defined reference standard for statistical analysis. CEUS was used for endoleak detection. Technical success was 100%. In augmented transverse imaging the mean aortic anteroposterior (AP) diameter was 4.0±1.3 cm for 2D US, 4.0±1.2 cm for 3D Curefab™, and 3.9±1.3 cm for 4D US and 4.0±1.2 for image fusion. The mean differences were below 1 mm (0.2-0.9 mm). Concerning estimation of aneurysm growth, agreement was found between 2D, 3D and 4D US in 19 of the 20 patients (95%). Definitive decision could always be made by image fusion. CEUS was combined with all methods and detected two out of the 20 patients (10%) with an endoleak type II. In one case, endoleak feeding arteries remained unclear with 2D CEUS but could be clearly localized by 3D CEUS and image fusion. Standardized 2D US allows adequate routine follow-up of maximum aortic aneurysm diameter after EVAR. Image Fusion enables a definitive statement about aneurysm growth without the need for new CT imaging by combining the postoperative CT scan with real-time B mode in a dual image display. 3D/4D CEUS and image fusion

  12. Predictors of outcome after elective endovascular abdominal aortic aneurysm repair and external validation of a risk prediction model.

    PubMed

    Wisniowski, Brendan; Barnes, Mary; Jenkins, Jason; Boyne, Nicholas; Kruger, Allan; Walker, Philip J

    2011-09-01

    Endovascular abdominal aortic aneurysm (AAA) repair (EVAR) has been associated with lower operative mortality and morbidity than open surgery but comparable long-term mortality and higher delayed complication and reintervention rates. Attention has therefore been directed to identifying preoperative and operative variables that influence outcomes after EVAR. Risk-prediction models, such as the EVAR Risk Assessment (ERA) model, have also been developed to help surgeons plan EVAR procedures. The aims of this study were (1) to describe outcomes of elective EVAR at the Royal Brisbane and Women's Hospital (RBWH), (2) to identify preoperative and operative variables predictive of outcomes after EVAR, and (3) to externally validate the ERA model. All elective EVAR procedures at the RBWH before July 1, 2009, were reviewed. Descriptive analyses were performed to determine the outcomes. Univariate and multivariate analyses were performed to identify preoperative and operative variables predictive of outcomes after EVAR. Binomial logistic regression analyses were used to externally validate the ERA model. Before July 1, 2009, 197 patients (172 men), who were a mean age of 72.8 years, underwent elective EVAR at the RBWH. Operative mortality was 1.0%. Survival was 81.1% at 3 years and 63.2% at 5 years. Multivariate analysis showed predictors of survival were age (P = .0126), American Society of Anesthesiologists (ASA) score (P = .0180), and chronic obstructive pulmonary disease (P = .0348) at 3 years and age (P = .0103), ASA score (P = .0006), renal failure (P = .0048), and serum creatinine (P = .0022) at 5 years. Aortic branch vessel score was predictive of initial (30-day) type II endoleak (P = .0015). AAA tortuosity was predictive of midterm type I endoleak (P = .0251). Female sex was associated with lower rates of initial clinical success (P = .0406). The ERA model fitted RBWH data well for early death (C statistic = .906), 3-year survival (C statistic = .735), 5-year

  13. Online prevention of postpartum depression for Spanish- and English-speaking pregnant women: A pilot randomized controlled trial

    PubMed Central

    Barrera, Alinne Z.; Wickham, Robert E.; Muñoz, Ricardo F.

    2015-01-01

    Background Postpartum depression (PPD) is a maternal mental health problem that affects women from all regions of the world. Unfortunately, even in developed countries, half of the cases go undetected and, consequently, untreated. Individuals from low and middle income countries trend toward underutilization of mental health services, partly due to the limited number of available psychological resources. The primary aims of this pilot randomized controlled trial were to adapt to the Internet the Mothers and Babies Course/Curso Mamás y Bebés, a prevention of PPD intervention, to describe the characteristics of the pregnant women who engaged in the intervention site, and to obtain preliminary data on the efficacy of the Internet intervention to reduce the risk of PPD. Methods Pregnant women, 18 years or older who were interested in using the site for themselves were recruited and randomly assigned to a fully-automated self-help Internet intervention or to an information-only control condition. Randomized participants were invited to complete monthly depression assessments up to six months postpartum. To examine the prevention effects of the Internet intervention, pregnant women who did not meet current criteria for a major depressive episode, who engaged with the study website, and who provided depression data during the postpartum follow-up period were included in the study analyses. Results Participants were 111 predominantly Spanish-speaking (82.9%) and Latino/Hispanic (71.3%) pregnant women residing in 23 countries worldwide. The effect of the prevention intervention condition failed to reach significance at the a priori alpha-level. However, the observed coefficient trended in the hypothesized direction (b = −0.514, χ2 (1) = 3.43, p = .061; HR = 0.598). The benefits of receiving the e-MB Internet intervention was greater for pregnant women reporting high (vs. low) levels of prenatal depression symptoms (b = −0.605, χ2 (1) = 5.20, p =.023). Conclusions

  14. The Use of a Narrative Simulation in Rural Residential Fire Prevention: A Preliminary Study in Changes of Behaviorial Intention

    ERIC Educational Resources Information Center

    Goetz, William Clark

    2013-01-01

    Rural Kentucky residents suffer twice as many fire residential deaths than the national average. Fire prevention programs are primarily aimed at elementary school children however these children do not make the decisions nor take the precautions necessary to alter these conditions; their adult parents do. There is little research into the…

  15. Preliminary measurements of 135Cs with AMS

    NASA Astrophysics Data System (ADS)

    Yin, Xinyi; He, Ming; Dong, Kejun; Dou, Liang; Lan, Xiaoxi; Pang, Fangfang; Wu, Shaoyong; Jiang, Shan

    2015-10-01

    135Cs is an interesting nuclide in many research fields, especially in environmental study. Preliminary measurements of the long-lived 135Cs with accelerator mass spectrometry (AMS) have been developed with the HI-13 tandem AMS facility at China Institute of Atomic Energy (CIAE). In order to improve ion extracting current and depressing background interference, experiments were carried out on different ions of Cs extracted from different samples. It was found that Cs- extracted from CsNO3 can be used for AMS measurement of 135Cs. According to the preliminary results, the background level can be obtained with blanks was 135Ba/Cs ∼ 8.8 × 10-12 with the CIAE-AMS system.

  16. Lessons from obesity prevention for the prevention of mental disorders: the primordial prevention approach.

    PubMed

    Hayward, Joshua; Jacka, Felice N; Waters, Elizabeth; Allender, Steven

    2014-09-10

    Emerging evidence supports a relationship between risk factors for obesity and the genesis of the common mental disorders, depression and anxiety. This suggests common mental disorders should be considered as a form of non-communicable disease, preventable through the modification of lifestyle behaviours, particularly diet and physical activity. Obesity prevention research since the 1970's represents a considerable body of knowledge regarding strategies to modify diet and physical activity and so there may be clear lessons from obesity prevention that apply to the prevention of mental disorders. For obesity, as for common mental disorders, adolescence represents a key period of vulnerability. In this paper we briefly discuss relationships between modifiable lifestyle risk factors and mental health, lifestyle risk factor interventions in obesity prevention research, the current state of mental health prevention, and the implications of current applications of systems thinking in obesity prevention research for lifestyle interventions. We propose a potential focus for future mental health promotion interventions and emphasise the importance of lessons available from other lifestyle modification intervention programmes.

  17. Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample.

    PubMed

    Horton, Sarah E; Hughes, Jennifer L; King, Jessica D; Kennard, Betsy D; Westers, Nicholas J; Mayes, Taryn L; Stewart, Sunita M

    2016-08-01

    This study offers a preliminary examination of the Interpersonal-Psychological Theory of Suicide (IPTS; Joiner 2005) in an adolescent clinical sample. The IPTS offers a nuanced framework that has many conceptual and practical merits. Although this theory has a growing base of evidence among adults, it has yet to be tested in adolescents using direct measures of its central constructs. Participants were 147 adolescents (76.2 % girls) on an inpatient psychiatric unit, who completed measures of key IPTS constructs of thwarted belongingness, perceived burdensomeness, acquired capability for suicide, as well as depression severity, hopelessness, and severity of suicidal symptoms. Our findings were largely consistent with hypotheses derived from the IPTS: perceived burdensomeness, and at a marginal level, thwarted belongingness, were independently associated with current suicidal ideation. The thwarted belongingness by perceived burdensomeness interaction marginally distinguished between adolescents with passive and active suicidal ideation. Acquired capability for suicide was associated with recent suicidal intent. Examination of all three IPTS constructs simultaneously revealed main effects of each construct (with a marginal effect of thwarted belongingness), and interaction effects for thwarted belongingness by perceived burdensomeness, and thwarted belongingness by perceived burdensomeness by acquired capability for suicide in association with suicidal symptom severity. Sex, age, depression severity, and hopelessness were controlled in all analyses. This study offers strong, albeit preliminary, support of the IPTS in a clinical adolescent sample. Assessment of IPTS constructs may be useful in determining persistent risk for suicide attempt. Prospective tests of the theory, and extensions to intervention and prevention should be considered in future IPTS research.

  18. Preliminary design report for OTEC stationkeeping subsystems (SKSS)

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

    Not Available

    1979-12-12

    Lockheed Ocean Systems with IMODCO prepared these preliminary designs for OTEC Stationkeeping Subsystems (SKSS) under contract to NOAA in support of the Department of Energy OTEC program. The results of Tasks III, V, and VI are presented in this design report. The report consists of five sections: introduction, preliminary designs for the multiple anchor leg (MAL) and tension anchor leg (TAL), costs and schedule, and conclusions. Extensive appendixes provide detailed descriptions of design methodology and include backup calculations and data to support the results presented. The objective of this effort is to complete the preliminary designs for the barge-MAL andmore » Spar-TAL SKSS. A set of drawings is provided for each which show arrangements, configuration, component details, engineering description, and deployment plan. Loads analysis, performance assessment, and sensitivity to requirements are presented, together with the methodology employed to analyze the systems and to derive the results presented. Life cycle costs and schedule are prepared and compared on a common basis. Finally, recommendations for the Commercial Plant SKSS are presented for both platform types.« less

  19. Politics of prevention: The emergence of prevention science.

    PubMed

    Roumeliotis, Filip

    2015-08-01

    This article critically examines the political dimension of prevention science by asking how it constructs the problems for which prevention is seen as the solution and how it enables the monitoring and control of these problems. It also seeks to examine how prevention science has established a sphere for legitimate political deliberation and which kinds of statements are accepted as legitimate within this sphere. The material consists of 14 publications describing and discussing the goals, concepts, promises and problems of prevention science. The analysis covers the period from 1993 to 2012. The analysis shows that prevention science has established a narrow definition of "prevention", including only interventions aimed at the reduction of risks for clinical disorders. In publications from the U.S. National Institute of Drug Abuse, the principles of prevention science have enabled a commitment to a zero-tolerance policy on drugs. The drug using subject has been constructed as a rational choice actor lacking in skills in exerting self-control in regard to drug use. Prevention science has also enabled the monitoring and control of expertise, risk groups and individuals through specific forms of data gathering. Through the juxtaposition of the concepts of "objectivity" and "morality", prevention science has constituted a principle of delineation, disqualifying statements not adhering to the principles of prevention science from the political field, rendering ethical and conflictual dimensions of problem representations invisible. The valorisation of scientific accounts of drugs has acted to naturalise specific political ideals. It simultaneously marginalises the public from the public policy process, giving precedence to experts who are able to provide information that policy-makers are demanding. Alternative accounts, such as those based on marginalisation, poverty or discrimination are silenced within prevention science. Copyright © 2015 Elsevier B.V. All rights

  20. 10 CFR 60.7 - License not required for certain preliminary activities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false License not required for certain preliminary activities. 60.7 Section 60.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES General Provisions § 60.7 License not required for certain preliminary...

  1. 10 CFR 60.7 - License not required for certain preliminary activities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false License not required for certain preliminary activities. 60.7 Section 60.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES General Provisions § 60.7 License not required for certain preliminary...

  2. 42 CFR 455.14 - Preliminary investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid Agency Fraud Detection and Investigation Program § 455.14 Preliminary investigation. If the agency receives a complaint of Medicaid fraud...

  3. San Mateo Creek Basin Preliminary Assessment

    EPA Pesticide Factsheets

    The objective of this Preliminary Assessment is to evaluate the site using the Hazard Ranking System and the Superfund Chemical Data Matrix to determine if a threat to human health and the environment exists such that further action is warranted.

  4. ISSA/TSS power preliminary design

    NASA Technical Reports Server (NTRS)

    Main, John A.

    1996-01-01

    A projected power shortfall during the initial utilization flights of the International Space Station Alpha (ISSA) has prompted an inquiry into the use of the Tethered Satellite System (TSS) to provide station power. The preliminary design of the combined ISSA/TSS system is currently underway in the Preliminary Design Office at the Marshall Space Flight Center. This document focuses on the justification for using a tether system on space station, the physical principles behind such a system, and how it might be operated to best utilize its capabilities. The basic components of a simple DC generator are a magnet of some type and a conductive wire. Moving the wire through the magnetic field causes forces to be applied to the electric charges in the conductor, and thus current is induced to flow. This simple concept is the idea behind generating power with space-borne tether systems. The function of the magnet is performed by the earth's magnetic field, and orbiting a conductive tether about the earth effectively moves the tether through the field.

  5. Descent advisor preliminary field test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were to evaluate the accuracy of DA trajectory predictions for conventional- and flight-management-system-equipped jet transports, to identify significant sources of trajectory prediction error, and to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 sec late with a standard deviation of 13.1 sec. This paper describes the field test and presents preliminary results for the commercial flights.

  6. Descent Advisor Preliminary Field Test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were: (1) to evaluate the accuracy of DA trajectory predictions for conventional and flight-management system equipped jet transports, (2) to identify significant sources of trajectory prediction error, and (3) to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 seconds late with a standard deviation of 13.1 seconds. This paper describes the field test and presents preliminary results for the commercial flights.

  7. A Review of Intervention Programs to Prevent and Treat Behavioral Problems in Young Children with Developmental Disabilities

    PubMed Central

    Petrenko, Christie L. M.

    2013-01-01

    Children with developmental disabilities are at higher risk for internalizing and externalizing behavioral problems than children in the general population. Effective prevention and treatment programs are necessary to reduce the burden of behavioral problems in this population. The current review identified 17 controlled trials of nine intervention programs for young children with developmental disabilities, with parent training the most common type of intervention in this population. Nearly all studies demonstrated medium to large intervention effects on child behavior post-intervention. Preliminary evidence suggests interventions developed for the general population can be effective for children with developmental disabilities and their families. A greater emphasis on the prevention of behavior problems in young children with developmental disabilities prior to the onset of significant symptoms or clinical disorders is needed. Multi-component interventions may be more efficacious for child behavior problems and yield greater benefits for parent and family adjustment. Recommendations for future research directions are provided. PMID:24222982

  8. [Evaluation of preliminary grades and credits in nurse training programs].

    PubMed

    Darmann-Finck, Ingrid; Duveneck, Nicole

    2016-01-01

    In the federal state of Bremen preliminary grades were included to the extent of 25 % in written, oral and practical final grades during the time period 2009-2014. The evaluation focuses on the effects of preliminary grades on the scale of final grades and the performance of learners as well as on the assessment of the appropriateness of final grades. A mixed-methods design was employed that consisted of a quasi-experimental study comprising of surveys of students and teachers of comparative and model courses as well as a qualitative study using group discussions. The results confirm that preliminary grades lead to a minimal improvement of the final grades of some exclusively low-achieving students. The assessment of appropriateness hardly changed. From both learners' and teachers' point of view there is still great dissatisfaction concerning the practical final grades. With regard to learning habits an increased willingness to learn new skills on the one hand and a partly increased performance pressure on the other hand were demonstrated. On the basis of these research results, the authors recommend the regular introduction of preliminary marks into the nursing training. Copyright © 2016. Published by Elsevier GmbH.

  9. A systematic review of psychosocial suicide prevention interventions for youth.

    PubMed

    Calear, Alison L; Christensen, Helen; Freeman, Alexander; Fenton, Katherine; Busby Grant, Janie; van Spijker, Bregje; Donker, Tara

    2016-05-01

    Youth suicide is a significant public health problem. A systematic review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12-25 years. PsycInfo, PubMed and Cochrane databases were searched to the end of December 2014 to identify randomised controlled trials evaluating the effectiveness of psychosocial interventions for youth suicide. In total, 13,747 abstracts were identified and screened for inclusion in a larger database. Of these, 29 papers describing 28 trials fulfilled the inclusion criteria for the current review. The results of the review indicated that just over half of the programs identified had a significant effect on suicidal ideation (Cohen's d = 0.16-3.01), suicide attempts (phi = 0.04-0.38) or deliberate self-harm (phi = 0.29-0.33; d = 0.42). The current review provides preliminary support for the implementation of universal and targeted interventions in all settings, using a diverse range of psychosocial approaches. Further quality research is needed to strengthen the evidence-base for suicide prevention programs in this population. In particular, the development of universal school-based interventions is promising given the potential reach of such an approach.

  10. Renewable Energy Park - Preliminary Feasibility & Engineering Report

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

    Ariwite, Roderick

    This "Renewable Energy Park - Preliminary Feasibility & Engineering Report" seeks to provide an overall assessment and review of renewable energy development opportunities on the Fallon Indian Reservation and Colony Lands.

  11. The development of an inherent safety approach to the prevention of domino accidents.

    PubMed

    Cozzani, Valerio; Tugnoli, Alessandro; Salzano, Ernesto

    2009-11-01

    The severity of industrial accidents in which a domino effect takes place is well known in the chemical and process industry. The application of an inherent safety approach for the prevention of escalation events leading to domino accidents was explored in the present study. Reference primary scenarios were analyzed and escalation vectors were defined. Inherent safety distances were defined and proposed as a metric to express the intensity of the escalation vectors. Simple rules of thumb were presented for a preliminary screening of these distances. Swift reference indices for layout screening with respect to escalation hazard were also defined. Two case studies derived from existing layouts of oil refineries were selected to understand the potentialities coming from the application in the methodology. The results evidenced that the approach allows a first comparative assessment of the actual domino hazard in a layout, and the identification of critical primary units with respect to escalation events. The methodology developed also represents a useful screening tool to identify were to dedicate major efforts in the design of add-on measures, optimizing conventional passive and active measures for the prevention of severe domino accidents.

  12. 40 CFR 161.170 - Preliminary analysis.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Preliminary analysis. 161.170 Section 161.170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR REGISTRATION OF ANTIMICROBIAL PESTICIDES Product Chemistry Data Requirements § 161.170...

  13. 40 CFR 161.170 - Preliminary analysis.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Preliminary analysis. 161.170 Section 161.170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR REGISTRATION OF ANTIMICROBIAL PESTICIDES Product Chemistry Data Requirements § 161.170...

  14. 76 FR 9345 - Soule Hydro, LLC; Notice of Draft License Application and Preliminary Draft Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ...] Soule Hydro, LLC; Notice of Draft License Application and Preliminary Draft Environmental Assessment (PDEA) and Request for Preliminary Terms and Conditions Take notice that the following hydroelectric... Project: With this notice the Commission is soliciting (1) preliminary terms, conditions, and...

  15. 78 FR 34648 - Citric Acid and Certain Citrate Salts: Preliminary Results of Countervailing Duty Administrative...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... Citrate Salts: Preliminary Results of Countervailing Duty Administrative Review; 2011 AGENCY: Import... December 31, 2011. These preliminary results cover RZBC Group Shareholding Co., Ltd., RZBC Co., Ltd., RZBC... Memorandum for the Preliminary Results of the Countervailing Duty Administrative Review: Citric Acid and...

  16. Polarisation Measurement with a Dual Beam Interferometer (CATSI). Exploratory Results and Preliminary Phenomenological Analysis

    DTIC Science & Technology

    2006-06-01

    Polarisation measurement with a dual beam interferometer (CATSI) Exploratory results and preliminary phenomenological analysis H. Lavoie J.-M... Polarisation measurement with a dual beam interferometer (CATSI) Exploratory results and preliminary phenomenological analysis H. Lavoie J.-M. Thériault... Polarisation measurement with a dual beam interferometer (CATSI) - Exploratory results and preliminary phenomenological analysis. ECR 2004-372. DRDC Valcartier

  17. Field Learning as a powerful tool of Education for geoscience, environment and disaster prevention.

    NASA Astrophysics Data System (ADS)

    Matsumoto, I.; LI, W.

    2015-12-01

    Field learning in through elementary school to University is very important for cultivation of science, environment and disaster prevention literacy. In Japan, we have various natural disasters such as earthquakes and volcanoes based on its geological settings ( Island-arc with subduction zone settings). And, it is a challenge environmental problem such as global warming prevention and energy problem to be solved by a human. For the above problem solving, it said that science education plays very important role. Especially learning with direct experience in the field is not only to get the only knowledge, we believe that greater development of science literacy, environmental literacy and disaster prevention literacy. In this presentation, we propose the new teaching method of field learning not only provided by school but also provided by outside school. We show following four studies that are (1) function of running water and origin of the land (science education and disaster prevention), (2) environmental consciousness of student (environmental education), (3) radiation education (scientific technology and its utilization) and (4) astronomical observation (acquisition of time and space concept). We were led to the preliminary conclusion of above four categories in practice research in and out of school. That is, the teacher is teaching the essence and phenomena of science to focus on science learning of school, in addition to environmental awareness, disaster prevention awareness, use of scientific technology are also important to teach at the same time. To do this, it is to make effective use of field learning. It can be said that the field study is a perfect and power place to perform learning such simultaneity. Because, natural field is originally the place can learn along with the feeling through the five senses of human. It is important especially for the growth stage of the student.

  18. Direct costs of preventive headache treatments: comparison of behavioral and pharmacologic approaches.

    PubMed

    Schafer, Allison M; Rains, Jeanetta C; Penzien, Donald B; Groban, Leanne; Smitherman, Todd A; Houle, Timothy T

    2011-06-01

    This study provides preliminary data and a framework to facilitate cost comparisons for pharmacologic vs behavioral approaches to headache prophylactic treatment. There are few empirical demonstrations of cumulative costs for pharmacologic and behavioral headache treatments, and there are no direct comparisons of short- and long-range (5-year) costs for pharmacologic vs behavioral headache treatments. Two separate pilot surveys were distributed to a convenience sample of behavioral specialists and physicians identified from the membership of the American Headache Society. Costs of prototypical regimens for preventive pharmacologic treatment (PPT), clinic-based behavioral treatment (CBBT), minimal contact behavioral treatment (MCBT), and group behavioral treatment were assessed. Each survey addressed total cost accumulated during treatment (ie, intake, professional fees) excluding costs of acute medications. The total costs of preventive headache therapy by type of treatment were then evaluated and compared over time. During the initial months of treatment, PPT with inexpensive mediations (<0.75 $/day) represents the least costly regimen and is comparable to MCBT in expense until 6 months. After 6 months, PPT is expected to become more costly, particularly when medication cost exceeds 0.75$ a day. When using an expensive medication (>3 $/day), preventive drug treatment becomes more expensive than CBBT after the first year. Long-term, and within year 1, MCBT was found to be the least costly approach to migraine prevention. Through year 1 of treatment, inexpensive prophylactic medications (such as generically available beta-blocker or tricyclic antidepressant medications) and behavioral interventions utilizing limited delivery formats (MCBT) are the least costly of the empirically validated interventions. This analysis suggests that, relative to pharmacologic options, limited format behavioral interventions are cost-competitive in the early phases of treatment and

  19. 19 CFR 207.108 - Preliminary conference.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Preliminary conference. 207.108 Section 207.108 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS OF WHETHER INJURY TO DOMESTIC INDUSTRIES RESULTS FROM IMPORTS SOLD AT LESS THAN FAIR VALUE OR FROM...

  20. 28 CFR 36.604 - Preliminary determination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Preliminary determination. 36.604 Section 36.604 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION ON THE BASIS OF DISABILITY BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Certification of State Laws or Local Building Codes...

  1. 15 CFR 270.101 - Preliminary reconnaissance.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.101 Preliminary reconnaissance. (a) To... the site of a building failure. The Director may establish and deploy a Team to conduct the...

  2. 15 CFR 270.101 - Preliminary reconnaissance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.101 Preliminary reconnaissance. (a) To... the site of a building failure. The Director may establish and deploy a Team to conduct the...

  3. 15 CFR 270.101 - Preliminary reconnaissance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.101 Preliminary reconnaissance. (a) To... the site of a building failure. The Director may establish and deploy a Team to conduct the...

  4. 15 CFR 270.101 - Preliminary reconnaissance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.101 Preliminary reconnaissance. (a) To... the site of a building failure. The Director may establish and deploy a Team to conduct the...

  5. 15 CFR 270.101 - Preliminary reconnaissance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.101 Preliminary reconnaissance. (a) To... the site of a building failure. The Director may establish and deploy a Team to conduct the...

  6. 76 FR 79655 - Honey From Argentina: Notice of Extension of Time Limit for Preliminary Results

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... of Extension of Time Limit for Preliminary Results AGENCY: Import Administration, International Trade... preliminary results of this administrative review to no later than January 3, 2012. DATES: Effective Date... Initiation Notice. On September 7, 2011, the Department extended the time limit for the preliminary results...

  7. 76 FR 76374 - Honey From Argentina: Notice of Extension of Time Limit for Preliminary Results

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ... of Extension of Time Limit for Preliminary Results AGENCY: Import Administration, International Trade... preliminary results of this administrative review to no later than December 15, 2011. DATES: Effective Date... Initiation Notice. On September 7, 2011, the Department extended the time limit for the preliminary results...

  8. Preliminary design studies of an advanced general aviation aircraft

    NASA Technical Reports Server (NTRS)

    Barrett, Ron; Demoss, Shane; Dirkzwager, AB; Evans, Darryl; Gomer, Charles; Keiter, Jerry; Knipp, Darren; Seier, Glen; Smith, Steve; Wenninger, ED

    1991-01-01

    The preliminary design results are presented of the advanced aircraft design project. The goal was to take a revolutionary look into the design of a general aviation aircraft. Phase 1 of the project included the preliminary design of two configurations, a pusher, and a tractor. Phase 2 included the selection of only one configuration for further study. The pusher configuration was selected on the basis of performance characteristics, cabin noise, natural laminar flow, and system layouts. The design was then iterated to achieve higher levels of performance.

  9. Preliminary results on heavy flavor physics at SLD

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

    Usher, T.

    1994-12-01

    The author reports on preliminary heavy flavor physics results from the SLD detector at the SLAC Linear Collider. Efficient tagging of b{bar b} events is achieved with an impact parameter technique that takes advantage of the small and stable interaction point of the SLC and all charged tracks in Z{sup 0} decays. This technique is applied to samples of Z{sup 0} events collected during the 1992 and 1993 physics runs. Preliminary measurements of the ratio R{sub b} = {Gamma}(Z{sup 0} {yields} b{bar b})/{Gamma}(Z{sup 0} {yields} hadrons) and the average B hadron lifetime <{tau}{sub B}> are reported. In a sample ofmore » 27K Z{sup 0} events, values of R{sub b} = 0.235 {+-} 0.006(stat.) {+-} 0.018(syst.) and <{tau}{sub B}> = 1.53 {+-} 0.006(stat.) {+-} 0.018(syst.) are obtained. In addition, the first measurement of the left-right asymmetry A{sub b} is reported. Using a sample of 38K Z{sup 0} events with a luminosity weighted electron polarization of 62%, the author obtains a preliminary value of A{sub b} = 0.94 {+-} 0.006(stat.) {+-} 0.018(syst.).« less

  10. Births: Preliminary Data for 1999.

    ERIC Educational Resources Information Center

    Curtin, Sally C.; Martin, Joyce A.

    2000-01-01

    This report presents preliminary data for 1999 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of the mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight rate are also presented. Data are based on a more than 97% sample of births for 1999. The crude birth rate in…

  11. 46 CFR 115.635 - Preliminary examination requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) If you exclusively use divers to examine the underwater hull plating, you must arrange to have a... underwater ROV as the predominate means to examine your vessel's hull plating, a preliminary examination and...

  12. A robust optimization methodology for preliminary aircraft design

    NASA Astrophysics Data System (ADS)

    Prigent, S.; Maréchal, P.; Rondepierre, A.; Druot, T.; Belleville, M.

    2016-05-01

    This article focuses on a robust optimization of an aircraft preliminary design under operational constraints. According to engineers' know-how, the aircraft preliminary design problem can be modelled as an uncertain optimization problem whose objective (the cost or the fuel consumption) is almost affine, and whose constraints are convex. It is shown that this uncertain optimization problem can be approximated in a conservative manner by an uncertain linear optimization program, which enables the use of the techniques of robust linear programming of Ben-Tal, El Ghaoui, and Nemirovski [Robust Optimization, Princeton University Press, 2009]. This methodology is then applied to two real cases of aircraft design and numerical results are presented.

  13. Energy Efficient Engine: Control system preliminary definition report

    NASA Technical Reports Server (NTRS)

    Howe, David C.

    1986-01-01

    The object of the Control Preliminary Definition Program was to define a preliminary control system concept as a part of the Energy Efficient Engine program. The program was limited to a conceptual definition of a full authority digital electronic control system. System requirements were determined and a control system was conceptually defined to these requirements. Areas requiring technological development were identified and a plan was established for implementing the identified technological features, including a control technology demonstration. A significant element of this program was a study of the potential benefits of closed-loop active clearance control, along with laboratory tests of candidate clearance sensor elements for a closed loop system.

  14. 75 FR 39207 - Purified Carboxymethylcellulose From Finland: Extension of Time Limit for Preliminary Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Carboxymethylcellulose From Finland: Extension of Time Limit for Preliminary Results of Antidumping Duty Administrative...: Extension of Time Limit for Preliminary Results of Antidumping Duty Administrative Review, 75 FR 3444... than July 7, 2010. Extension of Time Limits for Preliminary Results Section 751(a)(3)(A) of the Tariff...

  15. Indexing Guidelines: Applications in Use of Pulmonary Artery Catheters and Pressure Ulcer Prevention

    PubMed Central

    Jenders, Robert A.; Estey, Greg; Martin, Martha; Hamilton, Glenys; Ford-Carleton, Penny; Thompson, B. Taylor; Oliver, Diane E.; Eccles, Randy; Barnett, G. Octo; Zielstorff, Rita D.; Fitzmaurice, Joan B.

    1994-01-01

    In a busy clinical environment, access to knowledge must be rapid and specific to the clinical query at hand. This requires indices which support easy navigation within a knowledge source. We have developed a computer-based tool for trouble-shooting pulmonary artery waveforms using a graphical index. Preliminary results of domain knowledge tests for a group of clinicians exposed to the system (N=33) show a mean improvement on a 30-point test of 5.33 (p<0.001) compared to a control group (N=19) improvement of 0.47 (p=0.61). Survey of the experimental group (N=25) showed 84% (p=0.001) found the system easy to use. We discuss lessons learned in indexing this domain area to computer-based indexing of guidelines for pressure ulcer prevention. PMID:7950035

  16. 75 FR 54117 - Building Energy Standards Program: Preliminary Determination Regarding Energy Efficiency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... Response to Comments on Previous Analysis C. Summary of the Comparative Analysis 1. Quantitative Analysis 2... preliminary quantitative analysis are specific building designs, in most cases with specific spaces defined... preliminary determination. C. Summary of the Comparative Analysis DOE carried out both a broad quantitative...

  17. The benefits of EVAR planning using a 3D workstation.

    PubMed

    Sobocinski, J; Chenorhokian, H; Maurel, B; Midulla, M; Hertault, A; Le Roux, M; Azzaoui, R; Haulon, S

    2013-10-01

    To evaluate the influence of planning endovascular aneurysm repair (EVAR) with a three-dimensional (3D) workstation on early and midterm outcomes. All patients undergoing infrarenal EVAR performed between 2006 and 2009 at our institution were included in the current study. Prior to 2008 (group 1), endograft sizing was performed by interrogation of computed tomography angiography axial images. After 2008 (group 2), endograft sizing was routinely performed using a 3D workstation (Aquarius, Terarecon), allowing for multiplanar reconstruction and centerline analysis. Pre-, peri-, postoperative, and follow-up data were prospectively entered in an electronic database. All postoperative complications and subsequent secondary interventions depicted during the 2-year period following EVAR were compared. Secondary intervention and mortality rates were defined at 2 years and compared. Freedom from secondary intervention and overall survival rates were calculated using the Kaplan-Meier method during follow-up and compared by log-rank test. A total of 295 patients (149 patients in group 1 and 146 patients in group 2) were included. All patients had completed a minimum of 2 years of follow-up. During this 2-year period following EVAR, the type 1 endoleak rate was 8.7% in group 1 and 1.4% in group 2 (p = .004) respectively. Secondary intervention rates related to type 1 endoleak was 5.4% in group 1 and 0 in group 2 (p < .001). No difference was observed regarding all-cause mortality, aneurysm-related death, and freedom from secondary intervention rates during follow-up. The routine use of 3D workstations for EVAR planning significantly reduces the rate of type 1 endoleaks and, therefore, the rate of related secondary interventions. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Dutch experience with the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair.

    PubMed

    Dijkstra, Martijn L; Tielliu, Ignace F J; Meerwaldt, Robbert; Pierie, Maurice; van Brussel, Jerome; Schurink, Geert Willem H; Lardenoye, Jan-Willem; Zeebregts, Clark J

    2014-08-01

    In the past decennium, the management of short-neck infrarenal and juxtarenal aortic aneurysms with fenestrated endovascular aneurysm repair (FEVAR) has been shown to be successful, with good early and midterm results. Recently, a new fenestrated device, the fenestrated Anaconda (Vascutek, Renfrewshire, Scotland), was introduced. The aim of this study was to present the current Dutch experience with this device. A prospectively held database of patients treated with the fenestrated Anaconda endograft was analyzed. Decision to treat was based on current international guidelines. Indications for FEVAR included an abdominal aortic aneurysm (AAA) with unsuitable neck anatomy for EVAR. Planning was performed on computed tomography angiography images using a three-dimensional workstation. Between May 2011 and September 2013, 25 patients were treated in eight institutions for juxtarenal (n = 23) and short-neck AAA (n = 2). Median AAA size was 61 mm (59-68.5 mm). All procedures except one were performed with bifurcated devices. A total of 56 fenestrations were incorporated, and 53 (94.6%) were successfully cannulated and stented. One patient died of bowel ischemia caused by occlusion of the superior mesenteric artery. On completion angiography, three type I endoleaks and seven type II endoleaks were observed. At 1 month of follow-up, all endoleaks had spontaneously resolved. Median follow-up was 11 months (range, 1-29 months). There were no aneurysm ruptures or aneurysm-related deaths and no reinterventions to date. Primary patency at 1 month of cannulated and stented target vessels was 96%. Initial and short-term results of FEVAR using the fenestrated Anaconda endograft are promising, with acceptable technical success and short-term complication rates. Growing experience and long-term results are needed to support these findings. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  19. Hybrid endovascular repair for aortic arch pathology: intermediate outcomes and complications: a retrospective analysis.

    PubMed

    Kang, Woong Chol; Shin, Eak Kyun; Park, Chul-Hyun; Kang, Jin Mo; Ko, Young-Guk; Choi, Donghoon; Youn, Young Nam; Shim, Won-Heum

    2013-08-01

    To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥ 10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky. © 2013 Wiley Periodicals, Inc.

  20. Initial Clinical Experience Using the Low-Profile Altura Endograft System With Double D-Shaped Proximal Stents for Endovascular Aneurysm Repair.

    PubMed

    Krievins, Dainis; Krämer, Albrecht; Savlovskis, Janis; Oszkinis, Georgij; Debus, E Sebastian; Oberhuber, Alexander; Zarins, Christopher K

    2018-06-01

    To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double "D-shaped" stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft. Outcomes evaluated included mortality, major adverse events (MAEs: all-cause death, stroke, paraplegia, myocardial infarction, respiratory failure, bowel ischemia, and blood loss ≥1000 mL), and clinical success (freedom from procedure-related death, type I/III endoleak, migration, thrombosis, and reintervention). Endografts were successfully implanted in 89 (99%) patients; the single failure was due to delivery system malfunction before insertion in the early-generation device. One (1%) patient died and 4 patients underwent reinterventions (1 type I endoleak, 2 iliac limb stenoses, and 1 endograft occlusion) within the first 30 days. During a median follow-up of 12.5 months (range 11.5-50.9), there were no aneurysm ruptures, surgical conversions, or AAA-related deaths. The cumulative MAE rates were 3% (3/89) at 6 months and 7% (6/89) at 1 year. Two patients underwent coil embolization of type II endoleaks at 6.5 months and 2.2 years, respectively. Clinical success was 94% (84/89) at 30 days, 98% (85/87) at 6 months, and 99% (82/83) at 1 year. Early results suggest that properly selected AAA patients can be safely treated using the Altura Endograft System with favorable midterm outcome. Thus, further clinical investigation is warranted to evaluate the role of this device in the treatment of AAA.

  1. Rape prevention

    MedlinePlus

    Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention website. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. www.cdc.gov/std/tg2015/sexual-assault.htm . Updated June 4, ...

  2. [Does the Prevention Act Improve Prevention in Pediatric Outpatient Settings!?

    PubMed

    Schoierer, J; Lob-Corzilius, T; Wermuth, I; Nowak, D; Böse-O'Reilly, S

    2017-03-01

    Aim of the study: The Prevention Act was adopted by the German Federal Parliament on 18.06.2015. The paediatric practice is an important place from which to reach out to children and teenagers and to positively influence them through targeted prevention services in their health-related behaviour. It is therefore an important setting for the implementation of the Prevention Act. Could the delegation of prevention services to qualified medical assistants promote the successful implementation of the Prevention Act? Since 2003, medical assistants have qualified as "Prevention Assistants" after completing training courses and offered support in preventive services to children and teenagers in the paediatrician's office. The aim of this study was to improve the effectiveness of the training to increase the competence of the participants, expansion of preventive services for children and teenagers in the paediatrician's office and reduction of physician workload. Methodology: Training was accompanied by ongoing evaluation; there were two extensive studies in 2009 and 2011, respectively. Between 2003 and 2006 (n=126, after 75% response rate) and in 2011 (n=119 after 24% response rate), participants were assessed with standardized questionnaires, and in the survey of 2011, their employers also were interviewed, (n=76, after 22% response rate). Results: The prevention assistants assess their learning successes as good and are able to take over delegated tasks in the paediatrician's office. The involvement of a trained prevention assistant contributed to the transformation and re-establishment of prevention offers in paediatrician's offices and reduced physician workload. 44% of physicians felt that the time saved by prevention assistant was very good or good, 80% of physicians surveyed also indicated that prevention assistants carried out preventive consultations in the doctor's office. Conclusion: In light of the paediatricians' workload and their own wishes and demands

  3. Multiple brief interventions in police custody: The MuBIC randomized controlled study for primary prevention in police custody. Protocol and preliminary results of a feasibility study in the Paris metropolitan area, France.

    PubMed

    Lefèvre, Thomas; Denis, Céline; Marchand, Claire; Vidal, Camille; Gagnayre, Rémi; Chariot, Patrick

    2018-07-01

    The 15- to 35-year-old population has little contact with the health care system and is exposed to risk factors. Several studies demonstrated the feasibility of brief interventions (BIs) in different settings, e.g., in addiction medicine during police custody, where arrestees are entitled to a medical examination. Approximately 700,000 individuals are detained in police custody in France annually, and custody is an opportunity for young people to be medically examined. The characteristics of the detainees and previous experience with BIs suggest that custody is an opportunity to contribute to primary prevention. We propose to investigate the feasibility of such a contribution. The aim of this article is to present a study protocol and some preliminary results. The primary research objective is to assess the feasibility of performing brief interventions without a specific topic in police custody settings in arrestees aged 15-35 years. The secondary research objectives include i) testing four strategies for engaging in BIs that maximize the chances of success of the BI; ii) identifying the determinants that can orient the practitioner's choice to use a specific strategy over another one; and iii) analysing the differences between individuals who engage in BIs and those who do not and, in those who do engage, the determinants of success of the intervention. A two-step randomized and prospective study: i) randomization of eligible patients into 4 groups of 500 patients each; analysis of the response rates for each strategy; performance of the BI; and analyses of the associated factors and ii) a real-life, full-scale phase study evaluating the effectiveness of BIs performance of the BI; and analyses of the interventions. Analyses of the determinants of a positive response to BI, of success and of the topic of intervention will be conducted. The rates of BI performed, rates of success, and characteristics associated with response and with success are the main expected

  4. SURFACES PRELIMINARY REMEDIATION GOALS FOR RADIONUCLIDES (SPRG)

    EPA Science Inventory

    Internet based Calculational tool for establishing 10(-6) cancer risk based Preliminary Remediation Goals (PRGs) for radioactively contaminated outside hard surfaces (e.g., streets, sidewalks, slabs, and outside of buildings) for CERCLA remedial response actions.

  5. 32 CFR 1700.4 - Preliminary information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... receive a FOIA request shall expeditiously forward the request to the Director, Information Management... 32 National Defense 6 2011-07-01 2011-07-01 false Preliminary information. 1700.4 Section 1700.4... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.4...

  6. 32 CFR 1700.4 - Preliminary information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... receive a FOIA request shall expeditiously forward the request to the Director, Information Management... 32 National Defense 6 2014-07-01 2014-07-01 false Preliminary information. 1700.4 Section 1700.4... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.4...

  7. 32 CFR 1700.4 - Preliminary information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... receive a FOIA request shall expeditiously forward the request to the Director, Information Management... 32 National Defense 6 2012-07-01 2012-07-01 false Preliminary information. 1700.4 Section 1700.4... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.4...

  8. 32 CFR 1700.4 - Preliminary information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... receive a FOIA request shall expeditiously forward the request to the Director, Information Management... 32 National Defense 6 2010-07-01 2010-07-01 false Preliminary information. 1700.4 Section 1700.4... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.4...

  9. 32 CFR 1700.4 - Preliminary information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... receive a FOIA request shall expeditiously forward the request to the Director, Information Management... 32 National Defense 6 2013-07-01 2013-07-01 false Preliminary information. 1700.4 Section 1700.4... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.4...

  10. 32 CFR 1803.11 - Preliminary information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Preliminary information. 1803.11 Section 1803.11... REQUESTS FOR MANDATORY DECLASSIFICATION REVIEW OF CLASSIFIED INFORMATION PURSUANT TO SECTION 3.6 OF... information. Members of the public shall address all communications to the point of contact specified above...

  11. Renal Fenestration Closure Technique in Fenestrated Endovascular Repair for Pararenal Aortic Aneurysm.

    PubMed

    Gallitto, Enrico; Gargiulo, Mauro; Faggioli, Gianluca; Sonetto, Alessia; Mascoli, Chiara; Pini, Rodolfo; Abualhin, Mohamhed; Stella, Andrea

    2018-05-01

    To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a pararenal abdominal aortic aneurysm (p-AAA) without interfering with other visceral vessels. A 76-year-old man with p-AAA underwent repair by a 4 fenestrations custom-made endograft. At the intraprocedural angiography, the right renal artery was occluded. To avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F sheath through the fenestration into aneurism. A balloon-expandable covered stent was deployed across the fenestration and then occluded by 2 vascular plugs. At the completion angiography, there was no endoleak from the right renal fenestration, and at 6-month period, p-AAA remained completely excluded. The present technique can be a safe and effective therapeutic option to propose in cases of impossible target visceral vessels cannulation during p-AAA repair using a custom-made device to avoid the aneurysmal sac perfusion. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents.

    PubMed

    Lin, Jing; Guidoin, Robert; Du, Jia; Wang, Lu; Douglas, Graeham; Zhu, Danjie; Nutley, Mark; Perron, Lygia; Zhang, Ze; Douville, Yvan

    2016-02-16

    Whereas buckling can cause type III endoleaks, long-term twisting of a stent-graft was investigated here as a mechanism leading to type V endoleak or endotension. Two experimental device designs supported with Z-stents having strut angles of 35° or 45° were compared to a ringed control under accelerated twisting. Damage to each device was assessed and compared after different durations of twisting, with focus on damage that may allow leakage. Stent-grafts with 35° Z-stents had the most severe distortion and damage to the graft fabric. The 45° Z-stents caused less fabric damage. However, consistent stretching was still seen around the holes for sutures, which attach the stents to the graft fabric. Larger holes may become channels for fluid percolation through the wall. The ringed stent-graft had the least damage observed. Stent apexes with sharp angles appear to be responsible for major damage to the fabrics. Device manufacturers should consider stent apex angle when designing stent-grafts, and ensure their devices are resistant to twisting.

  13. An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents

    PubMed Central

    Lin, Jing; Guidoin, Robert; Du, Jia; Wang, Lu; Douglas, Graeham; Zhu, Danjie; Nutley, Mark; Perron, Lygia; Zhang, Ze; Douville, Yvan

    2016-01-01

    Whereas buckling can cause type III endoleaks, long-term twisting of a stent-graft was investigated here as a mechanism leading to type V endoleak or endotension. Two experimental device designs supported with Z-stents having strut angles of 35° or 45° were compared to a ringed control under accelerated twisting. Damage to each device was assessed and compared after different durations of twisting, with focus on damage that may allow leakage. Stent-grafts with 35° Z-stents had the most severe distortion and damage to the graft fabric. The 45° Z-stents caused less fabric damage. However, consistent stretching was still seen around the holes for sutures, which attach the stents to the graft fabric. Larger holes may become channels for fluid percolation through the wall. The ringed stent-graft had the least damage observed. Stent apexes with sharp angles appear to be responsible for major damage to the fabrics. Device manufacturers should consider stent apex angle when designing stent-grafts, and ensure their devices are resistant to twisting. PMID:28787913

  14. Mindfulness Meditation for Alcohol Relapse Prevention: A Feasibility Pilot Study

    PubMed Central

    Zgierska, Aleksandra; Rabago, David; Zuelsdorff, Megan; Coe, Christopher; Miller, Michael; Fleming, Michael

    2014-01-01

    Objectives Meditation is a promising treatment for alcohol dependence. This 16-week prospective case series was designed to gather preliminary data about the efficacy of meditation for relapse prevention and to evaluate study methods feasibility. Methods Nineteen adult alcohol-dependent graduates of an intensive outpatient program were enrolled. Fifteen subjects completed the 8-week meditation course supplemented by at-home meditation and “standard of care” therapy. Outcome measures included surveys and 2 stress-responsive biomarkers. Results Subjects (N = 19, 38.4 standard deviation [SD] = 8.6-year-old) were abstinent for 30.9 (SD = 22.2) days at enrollment. Completers (N = 15) attended 82% of meditation course sessions and meditated on average 4.6 (SD = 1.1) days per week; they were abstinent on 94.5% (SD = 7.4) of study days, with 47% reporting complete abstinence and 47% reporting 1 or more heavy drinking days. Their severity of depression, anxiety, stress (P < 0.05), and craving (P < 0.08), documented relapse triggers, decreased, and the degree of mindfulness increased (P < 0.05). The meditation course was rated as a “very important” (8.7/10, SD = 1.8) and “useful relapse prevention tool” (8.5/10, SD = 2.1); participants reported being “very likely” to continue meditating (9.0/10, SD = 1.5). “Gaining skills to reduce stress,” “coping with craving,” and “good group support” were the most common qualitative comments about the course value. Compared with baseline, at 16 weeks, interleukin-6 levels decreased (N = 12, P = 0.05); cortisol levels (N = 10) were reduced but not significantly. There were no adverse events or side effects. Conclusions Meditation may be an effective adjunctive therapy for relapse prevention in alcohol dependence, worthy of investigation in a larger trial. The study methods are appropriate for such a trial. PMID:21768988

  15. Method of preliminary localization of the iris in biometric access control systems

    NASA Astrophysics Data System (ADS)

    Minacova, N.; Petrov, I.

    2015-10-01

    This paper presents a method of preliminary localization of the iris, based on the stable brightness features of the iris in images of the eye. In tests on images of eyes from publicly available databases method showed good accuracy and speed compared to existing methods preliminary localization.

  16. Preliminary engineering cost trends for highway projects.

    DOT National Transportation Integrated Search

    2011-10-21

    Preliminary engineering (PE) for a highway project encompasses two efforts: planning to minimize the physical, social, and human environmental impacts of projects and engineering design to deliver the best alternative. PE efforts begin years in advan...

  17. A preliminary look at AVE-SESAME 2 conducted on 19-20 April 1979

    NASA Technical Reports Server (NTRS)

    Williams, S. F.; Horvath, N.; Turner, R. E.

    1980-01-01

    Preliminary information on data collected, synoptic conditions, and severe and unusual weather reported during the AVE-SESAME 2 period is presented. The information provides researchers a preliminary look at conditions during the AVE-SESAME 2 period.

  18. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.

    PubMed

    Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Knorr, Svetlana; Patterson, Kara K

    2015-05-01

    Older adults and individuals with neurological conditions are at an increased risk for falls. Although physical exercise can prevent falls, certain types of exercise may be more effective. Perturbation-based balance training is a novel intervention involving repeated postural perturbations aiming to improve control of rapid balance reactions. The purpose of this study was to estimate the effect of perturbation-based balance training on falls in daily life. MEDLINE (1946-July 2014), EMBASE (1974-July 2014), PEDro (all dates), CENTRAL (1991-July 2014), and Google Scholar (all dates) were the data sources used in this study. Randomized controlled trials written in English were included if they focused on perturbation-based balance training among older adults or individuals with neurological conditions and collected falls data posttraining. Two investigators extracted data independently. Study authors were contacted to obtain missing information. A PEDro score was obtained for each study. Primary outcomes were proportion of participants who reported one or more falls (ie, number of "fallers") and the total number of falls. The risk ratio (proportion of fallers) and rate ratio (number of falls) were entered into the analysis. Eight studies involving 404 participants were included. Participants who completed perturbation-based balance training were less likely to report a fall (overall risk ratio=0.71; 95% confidence interval=0.52, 0.96; P=.02) and reported fewer falls than those in the control groups (overall rate ratio=0.54; 95% confidence interval=0.34, 0.85; P=.007). Study authors do not always identify that they have included perturbation training in their intervention; therefore, it is possible that some appropriate studies were not included. Study designs were heterogeneous, preventing subanalyses. Perturbation-based balance training appears to reduce fall risk among older adults and individuals with Parkinson disease. © 2015 American Physical Therapy Association.

  19. Estimation of the Relative Severity of Floods in Small Ungauged Catchments for Preliminary Observations on Flash Flood Preparedness: A Case Study in Korea

    PubMed Central

    Kim, Eung Seok; Choi, Hyun Il

    2012-01-01

    An increase in the occurrence of sudden local flooding of great volume and short duration has caused significant danger and loss of life and property in Korea as well as many other parts of the World. Since such floods usually accompanied by rapid runoff and debris flow rise quite quickly with little or no advance warning to prevent flood damage, this study presents a new flash flood indexing methodology to promptly provide preliminary observations regarding emergency preparedness and response to flash flood disasters in small ungauged catchments. Flood runoff hydrographs are generated from a rainfall-runoff model for the annual maximum rainfall series of long-term observed data in the two selected small ungauged catchments. The relative flood severity factors quantifying characteristics of flood runoff hydrographs are standardized by the highest recorded maximum value, and then averaged to obtain the flash flood index only for flash flood events in each study catchment. It is expected that the regression equations between the proposed flash flood index and rainfall characteristics can provide the basis database of the preliminary information for forecasting the local flood severity in order to facilitate flash flood preparedness in small ungauged catchments. PMID:22690208

  20. 37 CFR 1.115 - Preliminary amendments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Preliminary amendments. 1.115 Section 1.115 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF... or before the mail date of the first Office action under § 1.104. The patent application publication...

  1. 37 CFR 1.115 - Preliminary amendments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Preliminary amendments. 1.115 Section 1.115 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF... or before the mail date of the first Office action under § 1.104. The patent application publication...

  2. Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

    PubMed

    Sranacharoenpong, Kitti; Hanning, Rhona M

    2011-10-01

    The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the

  3. A preliminary ferritic-martensitic stainless steel constitution diagram

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

    Balmforth, M.C.; Lippold, J.C.

    1998-01-01

    This paper describes preliminary research to develop a constitution diagram that will more accurately predict the microstructure of ferritic and martensitic stainless steel weld deposits. A button melting technique was used to produce a wide range of compositions using mixtures of conventional ferritic and martensitic stainless steels, including types 403, 409, 410, 430, 439 and 444. These samples were prepared metallographically, and the vol-% ferrite and martensite was determined quantitatively. In addition, the hardness and ferrite number (FN) were measured. Using this data, a preliminary constitution diagram is proposed that provides a more accurate method for predicting the microstructures ofmore » arc welds in ferritic and martensitic stainless steels.« less

  4. Study on the Preliminary Design of ARGO-M Operation System

    NASA Astrophysics Data System (ADS)

    Seo, Yoon-Kyung; Lim, Hyung-Chul; Rew, Dong-Young; Jo, Jung Hyun; Park, Jong-Uk; Park, Eun-Seo; Park, Jang-Hyun

    2010-12-01

    Korea Astronomy and Space Science Institute has been developing one mobile satellite laser ranging system named as accurate ranging system for geodetic observation-mobile (ARGO-M). Preliminary design of ARGO-M operation system (AOS) which is one of the ARGO-M subsystems was completed in 2009. Preliminary design results are applied to the following development phase by performing detailed design with analysis of pre-defined requirements and analysis of the derived specifications. This paper addresses the preliminary design of the whole AOS. The design results in operation and control part which is a key part in the operation system are described in detail. Analysis results of the interface between operation-supporting hardware and the control computer are summarized, which is necessary in defining the requirements for the operation-supporting hardware. Results of this study are expected to be used in the critical design phase to finalize the design process.

  5. 77 FR 6061 - Citric Acid and Certain Citrate Salts From Canada: Preliminary Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-07

    ... Citrate Salts From Canada: Preliminary Results of Antidumping Duty Administrative Review AGENCY: Import... below normal value (NV). If the preliminary results are adopted in the final results of the... all appropriate entries. Interested parties are invited to comment on the preliminary results. FOR...

  6. A Preliminary Trial of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program for Young Women with Body Image Concerns

    ERIC Educational Resources Information Center

    Stice, Eric; Rohde, Paul; Durant, Shelley; Shaw, Heather

    2012-01-01

    Objective: A group dissonance-based eating disorder prevention program, in which young women critique the thin ideal, reduces eating disorder risk factors and symptoms, but it can be difficult to identify school clinicians with the time and expertise to deliver the intervention. Thus, we developed a prototype Internet version of this program and…

  7. Preliminary estimates of the economic implications of addiction in the United Arab Emirates.

    PubMed

    Doran, C M

    2017-01-23

    This study aimed to provide preliminary estimates of the economic implications of addiction in the United Arab Emirates (UAE). Local and international data sources were used to derive estimates of substancerelated healthcare costs, lost productivity and criminal behaviour. From an estimated population of 8.26 million: ~1.47 million used tobacco (20.5% of adults); 380 085 used cannabis (> 5%); 14 077 used alcohol in a harmful manner (0.2%); and 1408 used opiates (0.02%). The cost of addiction was estimated at US$ 5.47 billion in 2012, equivalent to 1.4% of gross domestic product. Productivity costs were the largest contributor at US$ 4.79 billion (88%) followed by criminal behaviour at US$ 0.65 billion (12%). There were no data to estimate cost of: treating tobacco-related diseases, community education and prevention efforts, or social disharmony. Current data collection efforts are limited in their capacity to fully inform an appropriate response to addiction in the UAE. Resources are required to improve indicators of drug use, monitor harm and evaluate treatment.

  8. Community How To Guide On Underage Drinking Prevention: Prevention & Education.

    ERIC Educational Resources Information Center

    National Association of Governors' Highway Safety Representatives.

    Underage drinking prevention has two goals: prevent harm to the individual drinker and prevent harm to society. Modern prevention programs should be measured not by their intentions, but by their consequences: reducing the number of criminal events, reducing the amount of harm to individuals, and reducing the harm to society. This guide discusses…

  9. Airport Surface Delays and Causes: A Preliminary Analysis

    NASA Technical Reports Server (NTRS)

    Chin, David K.; Goldberg, Jay; Tang, Tammy

    1997-01-01

    This report summarizes FAA Program Analysis and Operations Research Service (ASD-400)/Lockheed Martin activities and findings related to airport surface delays and causes, in support of NASA Langley Research Center's Terminal Area Productivity (TAP) Program. The activities described in this report were initiated in June 1995. A preliminary report was published on September 30, 1995. The final report incorporates data collection forms filled out by traffic managers, other FAA staff, and an airline for the New York City area, some updates, data previously requested from various sources to support this analysis, and further quantification and documentation than in the preliminary report. This final report is based on data available as of April 12, 1996. This report incorporates data obtained from review and analysis of data bases and literature, discussions/interviews with engineers, air-traffic staff, other FAA technical personnel, and airline staff, site visits, and a survey on surface delays and causes. It includes analysis of delay statistics; preliminary findings and conclusions on surface movement, surface delay sources and causes, runway occupancy time (ROT), and airport characteristics impacting surface operations and delays; and site-specific data on the New York City area airports, which are the focus airports for this report.

  10. Global anti-corporate struggle: a preliminary analysis.

    PubMed

    Crossley, Nick

    2002-12-01

    This paper offers a preliminary analysis of the recent wave of anti-corporate protest that has swept across numerous countries throughout the world. In the first part of the paper the social structure of this phenomenon is examined. Specifically, it is argued that it should be understood as a 'field', in Pierre Bourdieu's sense of the term. In the second part of the paper the factors which account for the emergence of this field are explored, using a 'value-added' model which focuses upon the interplay of strains, situational definitions, focal events, opportunities and the circulation of protest relevant resources. The paper is conceived as a preliminary analysis which outlines a framework and draws out important themes. It is not offered as a complete account but rather as a basis from which more specific and focused studies might stem.

  11. Translating an effective group-based HIV prevention program to a program delivered primarily by a computer: methods and outcomes.

    PubMed

    Card, Josefina J; Kuhn, Tamara; Solomon, Julie; Benner, Tabitha A; Wingood, Gina M; DiClemente, Ralph J

    2011-04-01

    We describe development of SAHARA (SISTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1) video clips featuring group discussions and modeling of appropriate sexual- and contraceptive-related behavior; and (2) interactive Flash modules facilitating cognitive rehearsal, providing learning experiences through games and quizzes, and providing opportunities for simulated role-play. A preliminary outcome study of SAHARA conducted at Planned Parenthood, Atlanta, found that SAHARA, when followed by a brief 20-minute wrap-up group session facilitated by a health educator, was effective in promoting consistent condom use for vaginal sex. We discuss the potential advantages and challenges of an intervention like SAHARA delivered by computer to an individual, versus one like SiSTA delivered by a health educator to a small group.

  12. Preliminary Vibration Measurements on Mark I Vehicle

    DOT National Transportation Integrated Search

    1971-01-01

    Preliminary measurements have been made on the acceleration and vibration environment of the Mark I vehicle while operating on the New York City Transit System. Measurements at the journal box indicated shor period high acceleration pulses as lage as...

  13. 25 CFR 11.1005 - Preliminary inquiry.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... that the minor will commit a serious act causing damage to person or property. (g) The children's court... detention or shelter care, the children's court shall conduct a preliminary inquiry within 24 hours for the.... (b) If a minor has been released to the parents, guardian or custodian, the children's court shall...

  14. 25 CFR 11.1005 - Preliminary inquiry.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... that the minor will commit a serious act causing damage to person or property. (g) The children's court... detention or shelter care, the children's court shall conduct a preliminary inquiry within 24 hours for the.... (b) If a minor has been released to the parents, guardian or custodian, the children's court shall...

  15. 25 CFR 11.1005 - Preliminary inquiry.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... that the minor will commit a serious act causing damage to person or property. (g) The children's court... detention or shelter care, the children's court shall conduct a preliminary inquiry within 24 hours for the.... (b) If a minor has been released to the parents, guardian or custodian, the children's court shall...

  16. 25 CFR 11.1005 - Preliminary inquiry.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... that the minor will commit a serious act causing damage to person or property. (g) The children's court... detention or shelter care, the children's court shall conduct a preliminary inquiry within 24 hours for the.... (b) If a minor has been released to the parents, guardian or custodian, the children's court shall...

  17. 25 CFR 11.1005 - Preliminary inquiry.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... that the minor will commit a serious act causing damage to person or property. (g) The children's court... detention or shelter care, the children's court shall conduct a preliminary inquiry within 24 hours for the.... (b) If a minor has been released to the parents, guardian or custodian, the children's court shall...

  18. 28 CFR 18.4 - Preliminary hearings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions of the Crime Control Act, the Juvenile Justice Act or the Victims of Crime Act may request a... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Preliminary hearings. 18.4 Section 18.4 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18...

  19. 28 CFR 18.4 - Preliminary hearings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provisions of the Crime Control Act, the Juvenile Justice Act or the Victims of Crime Act may request a... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Preliminary hearings. 18.4 Section 18.4 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18...

  20. 28 CFR 18.4 - Preliminary hearings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provisions of the Crime Control Act, the Juvenile Justice Act or the Victims of Crime Act may request a... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Preliminary hearings. 18.4 Section 18.4 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18...

  1. 28 CFR 18.4 - Preliminary hearings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provisions of the Crime Control Act, the Juvenile Justice Act or the Victims of Crime Act may request a... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Preliminary hearings. 18.4 Section 18.4 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18...

  2. 28 CFR 18.4 - Preliminary hearings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provisions of the Crime Control Act, the Juvenile Justice Act or the Victims of Crime Act may request a... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Preliminary hearings. 18.4 Section 18.4 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18...

  3. Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa.

    PubMed

    McNaghten, Ad; Kearns, Rachel; Siegler, Aaron J; Phaswana-Mafuya, Nancy; Bekker, Linda-Gail; Stephenson, Rob; Baral, Stefan D; Brookmeyer, Ron; Yah, Clarence S; Lambert, Andrew J; Brown, Benjamin; Rosenberg, Eli; Blalock Tharp, Mondie; de Voux, Alex; Beyrer, Chris; Sullivan, Patrick S

    2014-10-16

    Human immunodeficiency virus (HIV) prevention intervention programs and related research for men who have sex with men (MSM) in the southern African region remain limited, despite the emergence of a severe epidemic among this group. With a lack of understanding of their social and sexual lives and HIV risks, and with MSM being a hidden and stigmatized group in the region, optimized HIV prevention packages for southern African MSM are an urgent public health and research priority. The objective of the Sibanye Health Project is to develop and evaluate a combination package of biomedical, behavioral, and community-level HIV prevention interventions and services for MSM in South Africa. The project consists of three phases: (1) a comprehensive literature review and summary of current HIV prevention interventions (Phase I), (2) agent-based mathematical modeling of HIV transmission in southern African MSM (Phase II), and (3) formative and stigma-related qualitative research, community engagement, training on providing health care to MSM, and the pilot study (Phase III). The pilot study is a prospective one-year study of 200 men in Cape Town and Port Elizabeth, South Africa. The study will assess a package of HIV prevention services, including condom and condom-compatible lubricant choices, risk-reduction counseling, couples HIV testing and counseling, pre-exposure prophylaxis (PrEP) for eligible men, and non-occupational post-exposure prophylaxis for men with a high risk exposure. The pilot study will begin in October 2014. Preliminary results from all components but the pilot study are available. We developed a literature review database with meta-data extracted from 3800 documents from 67 countries. Modeling results indicate that regular HIV testing and promotion of condom use can significantly impact new HIV infections among South African MSM, even in the context of high coverage of early treatment of HIV-positive men and high coverage of PrEP for at-risk HIV

  4. Effectiveness of preventive and treatment interventions for primary headaches in the workplace: A systematic review of the literature.

    PubMed

    Lardon, Arnaud; Girard, Marie-Pier; Zaïm, Chérine; Lemeunier, Nadège; Descarreaux, Martin; Marchand, Andrée-Anne

    2017-01-01

    Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration's risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers' headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.

  5. 78 FR 43870 - Hydrogen Energy California's Integrated Gasification Combined Cycle Project; Preliminary Staff...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... Combined Cycle Project; Preliminary Staff Assessment and Draft Environmental Impact Statement AGENCY... Combined Cycle Project Preliminary Staff Assessment/Draft Environmental Impact Statement (PSA/DEIS) (DOE... Gasification Combined Cycle Project, which would be designed, constructed, and operated by HECA, LLC. HECA's...

  6. 75 FR 11847 - Certain Magnesia Carbon Bricks From the People's Republic of China: Preliminary Determination of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... if, in the event of an affirmative preliminary determination, a request for such postponement is made... the event of a negative preliminary determination, a request for such postponement is made by the... Mayeton, respectively, requested that in the event of an affirmative preliminary determination in this...

  7. Dual-fuel, dual-throat engine preliminary analysis

    NASA Technical Reports Server (NTRS)

    Obrien, C. J.

    1979-01-01

    A propulsion system analysis of the dual fuel, dual throat engine for launch vehicle applications was conducted. Basic dual throat engine characterization data were obtained to allow vehicle optimization studies to be conducted. A preliminary baseline engine system was defined.

  8. 29 CFR 1601.23 - Preliminary or temporary relief.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., or political subdivision. (b) In a case involving a government, governmental agency, or political... private individuals from exercising their rights to seek temporary or preliminary relief on their own...

  9. Cancer Prevention Fellowship Program (CPFP) | Division of Cancer Prevention

    Cancer.gov

    The Cancer Prevention Fellowship provides a strong foundation for scientists and clinicians to train in the field of cancer prevention and control. This structured, multidisciplinary program offers early career scientists from different health disciplines a variety of postdoctoral training opportunities . | Training to form a strong foundation in cancer prevention and control

  10. 77 FR 74845 - AJT Mining Properties, Inc.; Notice of Surrender of Preliminary Permit

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14115-001] AJT Mining Properties, Inc.; Notice of Surrender of Preliminary Permit Take notice that AJT Mining Properties, Inc., permittee for the proposed Yeldagalga Creek Hydroelectric Project, has requested that its preliminary permit...

  11. 76 FR 2655 - Honey From Argentina: Preliminary Results of Antidumping Duty Administrative Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ...: Preliminary Results of Antidumping Duty Administrative Review AGENCY: Import Administration, International... S.A. (CIPSA), or Patagonik S.A. (Patagonik) during the POR. If these preliminary results are adopted in our final results of administrative review, we will issue appropriate assessment instructions to U...

  12. Cognitive Task Analysis of Business Jet Pilots' Weather Flying Behaviors: Preliminary Results

    NASA Technical Reports Server (NTRS)

    Latorella, Kara; Pliske, Rebecca; Hutton, Robert; Chrenka, Jason

    2001-01-01

    This report presents preliminary findings from a cognitive task analysis (CTA) of business aviation piloting. Results describe challenging weather-related aviation decisions and the information and cues used to support these decisions. Further, these results demonstrate the role of expertise in business aviation decision-making in weather flying, and how weather information is acquired and assessed for reliability. The challenging weather scenarios and novice errors identified in the results provide the basis for experimental scenarios and dependent measures to be used in future flight simulation evaluations of candidate aviation weather information systems. Finally, we analyzed these preliminary results to recommend design and training interventions to improve business aviation decision-making with weather information. The primary objective of this report is to present these preliminary findings and to document the extended CTA methodology used to elicit and represent expert business aviator decision-making with weather information. These preliminary findings will be augmented with results from additional subjects using this methodology. A summary of the complete results, absent the detailed treatment of methodology provided in this report, will be documented in a separate publication.

  13. Suicide Prevention: Suicide Prevention for Department of the Army Civilians

    DTIC Science & Technology

    2009-12-01

    TG 325D December 2009 SUICIDE PREVENTION SUICIDE PREVENTION FOR DEPARTMENT OF THE ARMY CIVILIANS PREPARED BY THE U. S. ARMY... Suicide Prevention 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT... SUICIDE PREVENTION PROGRAM 2 INSTRUCTIONAL PROCEDURES 3 INSTRUCTOR NOTE 3 SUICIDE AWARENESS TRAINING FOR CIVILIAN EMPLOYEES

  14. Preliminary design of a solar central receiver for site-specific repowering application (Saguaro Power Plant). Volume II. Preliminary design. Final report, October 1982-September 1983

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

    Weber, E.R.

    1983-09-01

    The solar central receiver technology, site, and specific unit for repowering were selected in prior analyses and studies. The objectives of this preliminary design study were to: develop a solar central receiver repowering design for Saguaro that (1) has potential to be economically competitive with fossil fueled plants in near and long term applications, (2) has the greatest chance for completion without further government funding, (3) will further define technical and economic feasibility of a 66 MWe gross size plant that is adequate to meet the requirements for utility and industrial process heat applications, (4) can potentially be constructed andmore » operated within the next five years, and (5) incorporates solar central receiver technology and represents state-of-the-art development. This volume on the preliminary design includes the following sections: executive summary; introduction; changes from advanced conceptual design; preliminary design; system characteristics; economic analysis; and development plan.« less

  15. 44 CFR 206.33 - Preliminary damage assessment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Preliminary damage assessment. 206.33 Section 206.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

  16. 44 CFR 206.33 - Preliminary damage assessment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Preliminary damage assessment. 206.33 Section 206.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

  17. 44 CFR 206.33 - Preliminary damage assessment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Preliminary damage assessment. 206.33 Section 206.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

  18. 44 CFR 206.33 - Preliminary damage assessment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Preliminary damage assessment. 206.33 Section 206.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

  19. 44 CFR 206.33 - Preliminary damage assessment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Preliminary damage assessment. 206.33 Section 206.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

  20. 7 CFR 3430.32 - Preliminary application review.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Preliminary application review. 3430.32 Section 3430.32 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND AGRICULTURE COMPETITIVE AND NONCOMPETITIVE NON-FORMULA FEDERAL ASSISTANCE PROGRAMS-GENERAL AWARD...