The Effects of Augmented Reality-based Otago Exercise on Balance, Gait, and Falls Efficacy of Elderly Women.

PubMed

Yoo, Ha-Na; Chung, Eunjung; Lee, Byoung-Hee

2013-07-01

[Purpose] The purpose of this study was to determine the effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. [Subjects] The subjects were 21 elderly women, who were randomly divided into two groups: an augmented reality-based Otago exercise group of 10 subjects and an Otago exercise group of 11 subjects. [Methods] All subjects were evaluated for balance (Berg Balance Scale, BBS), gait parameters (velocity, cadence, step length, and stride length), and falls efficacy. Within 12 weeks, Otago exercise for muscle strengthening and balance training was conducted three times, for a period of 60 minutes each, and subjects in the experimental group performed augmented reality-based Otago exercise. [Results] Following intervention, the augmented reality-based Otago exercise group showed significant increases in BBS, velocity, cadence, step length (right side), stride length (right side and left side) and falls efficacy. [Conclusion] The results of this study suggest the feasibility and suitability of this augmented reality-based Otago exercise for elderly women.

A Web-Based Mindfulness Stress Management Program in a Corporate Call Center

PubMed Central

Allexandre, Didier; Bernstein, Adam M.; Walker, Esteban; Hunter, Jennifer; Roizen, Michael F.; Morledge, Thomas J.

2016-01-01

Objective: The objective of this study is to determine the effectiveness of an 8-week web-based, mindfulness stress management program (WSM) in a corporate call center and added benefit of group support. Methods: One hundred sixty-one participants were randomized to WSM, WSM with group support, WSM with group and expert clinical support, or wait-list control. Perceived stress, burnout, emotional and psychological well-being, mindfulness, and productivity were measured at baseline, weeks 8 and 16, and 1 year. Results: Online usage was low with participants favoring CD use and group practice. All active groups demonstrated significant reductions in perceived stress and increases in emotional and psychological well-being compared with control. Group support improved participation, engagement, and outcomes. Conclusion: A self-directed mindfulness program with group practice and support can provide an affordable, effective, and scalable workplace stress management solution. Engagement may also benefit from combining web-based and traditional CD delivery. PMID:26949875

Variations in enamel damage after debonding of two different bracket base designs: An in vitro study.

PubMed

Ahangar Atashi, Mohammad Hossein; Sadr Haghighi, Amir Hooman; Nastarin, Parastou; Ahangar Atashi, Sina

2018-01-01

Background. Bracket base design is a factor influencing shear bond strength. High shear bond strength leads to enamel crack formation during debonding. The aim of this study was to compare enamel damage variations, including the number and length of enamel cracks after debonding of two different base designs. Methods. Eighty-eight extracted human premolars were randomly divided into2 groups (n=44). The teeth in each group were bonded by two types of brackets with different base designs: 80-gauge mesh design versus anchor pylon design with pylons for adhesive retention. The number and length of enamel cracks before bonding and after debonding were evaluated under an optical stereomicroscope ×40 in both groups. Mann-Whitney U test was used to compare the number of cracks between the two groups. ANCOVA was used for comparison of crack lengths after and before debonding in each group and between the two groups. Results. There was a significant increase in enamel crack length and numbers in each group after debonding. There was no significant difference in enamel crack numbers after debonding between the two groups, whereas the length of enamel cracks was significantly greater in anchor pylon base design after debonding. Conclusion. Bracket bases with pylon design for adhesive retention caused more iatrogenic debonding damage to enamel surface.

Biosynthesis of S-Methylcysteine in Radish Leaves1

PubMed Central

Thompson, John F.; Gering, Rose K.

1966-01-01

Investigation on the biosynthesis of S-methyl-L-cysteine in radish leaves has shown that it is formed by the methylation of cysteine. This conclusion is based on: A) the relatively high recovery of radioactivity in methylcysteine sulfoxide after the administration of cysteine or methyl-labeled methionine to radish leaves; B) the nearly complete recovery of label from methyl-labeled methionine in the methyl group of methylcysteine sulfoxide; and C) the similarity in the ratio of tritium to 14C in methylcysteine sulfoxide and in its methyl group to this ratio in the methyl group of methionine given to radish leaves. Direct evidence for the synthesis of methylcysteine in radishes was obtained for the first time. Conclusive evidence against the formation of methylcysteine from serine and a thiomethyl group from methionine as suggested for garlic was the more efficient incorporation of the methyl group of methionine as compared to the sulfur atom into methylcysteine sulfoxide. Images Fig. 1 PMID:16656400

Application of Competency-Based Education in Laparoscopic Training

PubMed Central

Xue, Dongbo; Bo, Hong; Zhao, Song; Meng, Xianzhi

2015-01-01

Background and Objectives: To induce competency-based education/developing a curriculum in the training of postgraduate students in laparoscopic surgery. Methods: This study selected postgraduate students before the implementation of competency-based education (n = 16) or after the implementation of competency-based education (n = 17). On the basis of the 5 competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, and professionalism, the research team created a developing a curriculum chart and specific improvement measures that were implemented in the competency-based education group. Results: On the basis of the developing a curriculum chart, the assessment of the 5 comprehensive competencies using the 360° assessment method indicated that the competency-based education group's competencies were significantly improved compared with those of the traditional group (P < .05). The improvement in the comprehensive assessment was also significant compared with the traditional group (P < .05). Conclusion: The implementation of competency-based education/developing a curriculum teaching helps to improve the comprehensive competencies of postgraduate students and enables them to become qualified clinicians equipped to meet society's needs. PMID:25901105

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

PubMed Central

Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

2015-01-01

Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. Methods: The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results: The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion: The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders. PMID:26877751

Molecular bases of the ABO blood groups of Indians from the Brazilian Amazon region.

PubMed

Franco, R F; Simões, B P; Guerreiro, J F; Santos, S E; Zago, M A

1994-01-01

Phenotype studies of ABO blood groups in most Amerindian populations revealed the exclusive presence of group O. Since group O is the result of the absence of glycosyltransferase activity, its molecular bases may be heterogeneous. We carried out ABO blood group genotyping by analysis of DNA of 30 Indians from 2 Amazonian tribes (Yanomami and Arara), and compared the findings with other populations (Caucasians and Blacks). Two segments of the glycosyltransferase gene were amplified by PCR and digested with KpnI or AluI to detect deletion or base change at positions 258 and 700, respectively. For all subjects, the gene basis of blood group O is the deletion of a single nucleotide at position 258 of the glycosyltransferase A gene, similar to that observed in Caucasoids and Negroids. DNA sequencing of limited regions of the gene supports this conclusion. This finding does not exclude, however, that a heterogeneity of the O allele may be revealed by a more extensive analysis.

Ambulatory orthopaedic surgery patients' knowledge with internet-based education.

PubMed

Heikkinen, Katja; Leino-Kilpi, H; Salanterä, S

2012-01-01

There is a growing need for patient education and an evaluation of its outcomes. The aim of this study was to compare ambulatory orthopaedic surgery patients' knowledge with Internet-based education and face-to-face education with a nurse. The following hypothesis was proposed: Internet-based patient education (experiment) is as effective as face-to-face education with a nurse (control) in increasing patients' level of knowledge and sufficiency of knowledge. In addition, the correlations of demographic variables were tested. The patients were randomized to either an experiment group (n = 72) or a control group (n = 75). Empirical data were collected with two instruments. Patients in both groups showed improvement in their knowledge during their care. Patients in the experiment group improved their knowledge level significantly more in total than those patients in the control group. There were no differences in patients' sufficiency of knowledge between the groups. Knowledge was correlated especially with patients' age, gender and earlier ambulatory surgeries. As a conclusion, positive results concerning patients' knowledge could be achieved with the Internet-based education. The Internet is a viable method in ambulatory care.

Parametric analyses of summative scores may lead to conflicting inferences when comparing groups: A simulation study.

PubMed

Khan, Asaduzzaman; Chien, Chi-Wen; Bagraith, Karl S

2015-04-01

To investigate whether using a parametric statistic in comparing groups leads to different conclusions when using summative scores from rating scales compared with using their corresponding Rasch-based measures. A Monte Carlo simulation study was designed to examine between-group differences in the change scores derived from summative scores from rating scales, and those derived from their corresponding Rasch-based measures, using 1-way analysis of variance. The degree of inconsistency between the 2 scoring approaches (i.e. summative and Rasch-based) was examined, using varying sample sizes, scale difficulties and person ability conditions. This simulation study revealed scaling artefacts that could arise from using summative scores rather than Rasch-based measures for determining the changes between groups. The group differences in the change scores were statistically significant for summative scores under all test conditions and sample size scenarios. However, none of the group differences in the change scores were significant when using the corresponding Rasch-based measures. This study raises questions about the validity of the inference on group differences of summative score changes in parametric analyses. Moreover, it provides a rationale for the use of Rasch-based measures, which can allow valid parametric analyses of rating scale data.

Ecological Fallacy in Reading Acquisition Research: Masking Constructive Processes of the Learner.

ERIC Educational Resources Information Center

Berninger, Virginia W.; Abbott, Robert D.

A study examined whether conclusions about constructive processes in reading based on analysis of group data were consistent with those based on an analysis of individual data. Subjects, selected from a larger sample of 45 first grade students who had participated in a longitudinal study on acquisition of linguistic procedures for printed words,…

Resistance to fracture of roots filled with different sealers.

PubMed

Sağsen, Burak; Ustün, Yakup; Pala, Kanşad; Demırbuğa, Sezer

2012-01-01

The aim of this study was to compare the fracture resistance of roots filled with gutta percha (GP) and different root canal sealers.Fifty-five human maxillary central incisors were selected and randomly divided into three experimental groups (Groups 1-3) and two control groups (Groups 4 and 5). They were Group 1-15 root canals filled with an epoxy resin-based sealer (AH Plus) and GP, Group 2 -15 root canals filled with a calcium silicate-based sealer (iRoot SP) and GP, Group 3: 15 root canals filled with another calcium silicate-based sealer (MTA Fillapex) and GP, Group 4: five roots were instrumented but not filled, and Group 5: five roots were neither instrumented nor filled. Compressive loading was carried out using a universal testing machine until fracture occurred. Force applied at time of fracture was recorded as fracture strength of specimen in Newtons. There were no significant differences in fracture strength among the three experimental groups (p>0.05), whose results were significantly superior to that of Group 4 (p<0.05). In conclusion, all the root canal sealers used in the present study increased the fracture resistance of instrumented root canals.

Effects of brain-computer interface-based functional electrical stimulation on brain activation in stroke patients: a pilot randomized controlled trial.

PubMed

Chung, EunJung; Kim, Jung-Hee; Park, Dae-Sung; Lee, Byoung-Hee

2015-03-01

[Purpose] This study sought to determine the effects of brain-computer interface-based functional electrical stimulation (BCI-FES) on brain activation in patients with stroke. [Subjects] The subjects were randomized to in a BCI-FES group (n=5) and a functional electrical stimulation (FES) group (n=5). [Methods] Patients in the BCI-FES group received ankle dorsiflexion training with FES for 30 minutes per day, 5 times under the brain-computer interface-based program. The FES group received ankle dorsiflexion training with FES for the same amount of time. [Results] The BCI-FES group demonstrated significant differences in the frontopolar regions 1 and 2 attention indexes, and frontopolar 1 activation index. The FES group demonstrated no significant differences. There were significant differences in the frontopolar 1 region activation index between the two groups after the interventions. [Conclusion] The results of this study suggest that BCI-FES training may be more effective in stimulating brain activation than only FES training in patients recovering from stroke.

Use of latissimus dorsi muscle onlay patch alternative to acellular dermal matrix in implant-based breast reconstruction

PubMed Central

Lee, Jeeyeon

2015-01-01

Background An acellular dermal matrix (ADM) is applied to release the surrounding muscles and prevent dislocation or rippling of the implant. We compared implant-based breast reconstruction using the latissimus dorsi (LD) muscle, referred to as an “LD muscle onlay patch,” with using an ADM. Method A total of 56 patients (60 breasts) underwent nipple sparing mastectomy with implant-based breast reconstruction using an ADM or LD muscle onlay patch. Cosmetic outcomes were assessed 4 weeks after chemotherapy or radiotherapy, and statistical analyses were performed. Results Mean surgical time and hospital stay were significantly longer in the LD muscle onlay patch group than the ADM group. However, there were no statistically significant differences between groups in postoperative complications. Cosmetic outcomes for breast symmetry and shape were higher in the LD muscle onlay patch group. Conclusions Implant-based breast reconstruction with an LD muscle onlay patch would be a feasible alternative to using an ADM. PMID:26161312

Effects of online group exercises for older adults on physical, psychological and social wellbeing: a randomized pilot trial

PubMed Central

Khaghani Far, Iman; Ibarra, Francisco; Ferron, Michela; Didino, Daniele; Casati, Fabio

2017-01-01

Background Intervention programs to promote physical activity in older adults, either in group or home settings, have shown equivalent health outcomes but different results when considering adherence. Group-based interventions seem to achieve higher participation in the long-term. However, there are many factors that can make of group exercises a challenging setting for older adults. A major one, due to the heterogeneity of this particular population, is the difference in the level of skills. In this paper we report on the physical, psychological and social wellbeing outcomes of a technology-based intervention that enable online group exercises in older adults with different levels of skills. Methods A total of 37 older adults between 65 and 87 years old followed a personalized exercise program based on the OTAGO program for fall prevention, for a period of eight weeks. Participants could join online group exercises using a tablet-based application. Participants were assigned either to the Control group, representing the traditional individual home-based training program, or the Social group, representing the online group exercising. Pre- and post- measurements were taken to analyze the physical, psychological and social wellbeing outcomes. Results After the eight-weeks training program there were improvements in both the Social and Control groups in terms of physical outcomes, given the high level of adherence of both groups. Considering the baseline measures, however, the results suggest that while in the Control group fitter individuals tended to adhere more to the training, this was not the case for the Social group, where the initial level had no effect on adherence. For psychological outcomes there were improvements on both groups, regardless of the application used. There was no significant difference between groups in social wellbeing outcomes, both groups seeing a decrease in loneliness despite the presence of social features in the Social group. However, online social interactions have shown to be correlated to the decrease in loneliness in the Social group. Conclusion The results indicate that technology-supported online group-exercising which conceals individual differences in physical skills is effective in motivating and enabling individuals who are less fit to train as much as fitter individuals. This not only indicates the feasibility of training together despite differences in physical skills but also suggests that online exercise might reduce the effect of skills on adherence in a social context. However, results from this pilot are limited to a small sample size and therefore are not conclusive. Longer term interventions with more participants are instead recommended to assess impacts on wellbeing and behavior change. PMID:28392983

Preliminary evaluation of a self-directed video-based 1-2-3 Magic parenting program: a randomized controlled trial.

PubMed

Porzig-Drummond, Renata; Stevenson, Richard J; Stevenson, Caroline

2015-03-01

The current study examined the effectiveness of a self-directed video-based format of the 1-2-3 Magic parenting program in reducing dysfunctional parenting and child problem behaviors. Eighty-four parents of children aged 2-10 were randomly assigned to either the intervention group (n = 43) or the waitlist control group (n = 41). Participants in the intervention group reported significantly less problem behaviors for their children, and significantly less dysfunctional parenting, at post-intervention when compared to the control group. The results were maintained at 6-month follow-up. There was no significant change on measures of parental adjustment for either group. The current results provide preliminary support for the conclusion that the video-based self-directed format of the 1-2-3 Magic parenting program is suitable as an entry-level intervention in a multi-level intervention model and is suitable for inclusion in a population approach to parenting program delivery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of effectiveness of class lecture versus workshop-based teaching of basic life support on acquiring practice skills among the health care providers

PubMed Central

Karim, Habib Md. Reazaul; Yunus, Md.; Bhattacharyya, Prithwis; Ahmed, Ghazal

2016-01-01

Background: Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. Objectives: This study is designed to assess the effectiveness of class lecture versus workshop-based teaching of BLS on acquiring the practice skills on mannequin. Methods: After ethical approval and informed consent from the participants, the present study was conducted among the health care providers. Participants were grouped in lecture-based class teaching and workshop-based teaching. They were then asked to practice BLS on mannequin (Resusci Anne with QCPR) and evaluated as per performance parameters based on American Heart Association BLS. Statistical analyses are done by Fisher's exact t-test using GraphPad INSTAT software and P < 0.05 is taken as significant. Results: There were 55 participants in lecture-based teaching and 50 in workshop-based teaching group. There is no statistical difference in recognition of arrest, checking pulse, and starting chest compression (P > 0.05). Though more than 83% of lecture-based teaching group has started chest compression as compared 96% of workshop group; only 49% of the participants of lecture-based group performed quality chest compression as compared to 82% of other group (P = 0.0005). The workshop group also performed better bag mask ventilation and defibrillation (P < 0.0001). Conclusion: Workshop-based BLS teaching is more effective and lecture-based class teaching better is replaced in medical education curriculum. PMID:27308252

Moving Forward in Fall Prevention: An Intervention to Improve Balance Among Older Adults in Real-World Settings

PubMed Central

Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Gauvin, Lise; Parisien, Manon; Corriveau, Hélène; Trickey, Francine; Damestoy, Nicole

2005-01-01

Objectives. We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. Methods. The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. Results. Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. Conclusion. Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls. PMID:16195514

Effects of MicroCAD on Learning Fundamental Engineering Graphical Concepts: A Qualitative Study.

ERIC Educational Resources Information Center

Leach, James A.; Gull, Randall L.

1990-01-01

Students' reactions and performances were examined when taught engineering geometry concepts using a standard microcomputer-aided drafting software package. Two sample groups were compared based on their computer experience. Included are the methodology, data analysis, and conclusions. (KR)

Effects of the Schema Therapy and Mindfulness on the Maladaptive Schemas Hold by the Psoriasis Patients with the Psychopathology Symptoms

PubMed Central

Gojani, Parvin Jamali; Masjedi, Mohsen; Khaleghipour, Shahnaz; Behzadi, Ehsan

2017-01-01

Background: This study aimed to compare the effects of the schema along with mindfulness-based therapies in the psoriasis patients. Materials and Methods: This semi-experimental study with post- and pre-tests was conducted on the psoriasis patients in the Dermatology Clinic of the Isfahan Alzahra Hospital, Iran using the convenience sampling in 2014. The patients had a low general health score. The experimental groups included two treatment groups of schema-based (n = 8) and mindfulness (n = 8). Both groups received eight 90-min sessions therapy once a week; they were compared with 8 patients in the control group. To evaluate the psoriasis patients’ maladaptive schema, Young schema questionnaire was used. Data were analyzed through the covariance analysis test. Results: There was a significant difference between the schema-based therapy and mindfulness groups with the control group. There was also a significant difference between the schema-based therapy groups consisting of the defeated schema, dependence/incompetence schema, devotion schema, stubbornly criteria schema, merit schema, restraint/inadequate self-discipline schema, and the control group. Moreover, a significant difference existed between the maladaptive schema of mindfulness therapy group and the controls. There was a significant difference concerning the improvement of the psychopathologic symptoms between the mindfulness therapy group and the control group. Conclusions: This study showed similar effects of both the schema and mindfulness-based therapies on the maladaptive schemas in improving the psoriasis patients with the psychopathologic symptoms. PMID:28217649

The effects of a multisensory dynamic balance training on the thickness of lower limb muscles in ultrasonography in children with spastic diplegic cerebral palsy.

PubMed

Nam, Seung-Min; Kim, Won-Hyo; Yun, Chang-Kyo

2017-04-01

[Purpose] This study aimed to investigate the effects of multisensory dynamic balance training on muscles thickness such as rectus femoris, anterior tibialis, medial gastrocnemius, lateral gastrocnemius in children with spastic diplegic cerebral palsy by using ultrasonography. [Subjects and Methods] Fifteen children diagnosed with spastic diplegic cerebral palsy were divided randomly into the balance training group and control group. The experimental group only received a multisensory dynamic balance training, while the control group performed general physiotherapy focused balance and muscle strengthening exercise based Neurodevelopmental treatment. Both groups had a therapy session for 30 minutes per day, three times a week for six weeks. The ultrasonographic muscle thickness were obtained in order to compare and analyze muscle thickness before and after in each group. [Result] The experimental group had significant increases in muscle thickness in the rectus femoris, tibialis anterior, medial gastrocnemius and lateral gastrocnemius muscles. The control group had significant increases in muscle thickness in the tibialis anterior. The test results of the rectus femoris, medial gastrocnemius and lateral gastrocnemius muscle thickness values between the groups showed significant differences. [Conclusion] In conclusion, a multisensory dynamic balance training can be recommended as a treatment method for patients with spastic diplegic cerebral palsy.

Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

PubMed Central

2007-01-01

Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

An analysis of 1986 drug procurement practices in hospitals within the United States.

PubMed

Smolarek, R T; Powell, M F; Solomon, D K; Boike, S C

1989-09-01

The purpose of this study was to statistically answer a set of predefined objectives concerning pharmaceutical procurement. The key indicators were assumed to be cost per patient day and turnover rate. Of the 5,911 surveys mailed, 709 surveys were returned for a 12% response rate. The following statements were based on attempts to answer the six predetermined objectives. Pharmaceutical purchasing is controlled by pharmacy departments to the extent that comparisons to pharmaceutical purchasing by materials management departments was not possible. Prime vendor purchasing is the procurement method of choice. Competitive bidding through a group process is so popular that a valid comparison to nongroup bidding could not be accomplished with the results of this survey. Certain variables of group purchasing such as group age, contract adherence, and volume commitment, do not appear to be correlated to purchasing outcomes in this study. When comparing government to private hospitals, the private sector seems to have an advantage in managing turnover rates. Cost per patient day results were less conclusive. As single and multiple hospital systems were compared for purchasing outcomes, the results were not totally conclusive. Although, multiple hospital systems had a significantly higher turnover rate. Finally, a comparison based on the use, or lack of use, of prime vendor arrangements demonstrated interesting results. The duration of contract did not significantly affect the purchasing outcomes. Other hospital variables such as size, type, ownership, and organization, demonstrated notable trends. The importance of examining hospitals based on case mix and mission seems to be most important. Also, the ability to relate purchasing outcomes with formulary management strategies needs further study before conclusive statements can be adopted.

Effects of by-product feed-based silage on feeding, rumination, and excretion in growing Hanwoo heifers.

PubMed

Kim, Young-Il; Lee, Sang Moo; Lee, Youn Hee; Lee, Myeon; Choi, Do Young; Kwak, Wan Sup

2015-01-01

This study investigated the effects of feeding by-product feed (BF)-based silage on the behavior of growing Hanwoo heifers. Twelve Hanwoo heifers (13.2 months-old, 315 kg body weight; four heifers per pen) were assigned to three diets: a rice straw (RS) diet (concentrate mix and free access to RS), a RS and BF-based silage (RSBFS) diet (concentrate mix and free access to RS and BF-based silage), and a BF-based silage (BFS) diet (concentrate mix and free access to BF-based silage). Behavior was recorded for 5 days using camcorders. Compared to the RS group, the BFS group showed 21.7% higher dry matter intake, shorter feeding, rumination, and chewing times, as well as longer resting time (p < 0.05). Although all groups exhibited similar drinking, urination, and defecation frequencies, the BFS group exhibited higher feeding rates, rumination efficiency, and chewing efficiency than the RS group (p < 0.05). Compared to the BFS group, the RSBFS group showed higher peNDF8.0 intake (15.2% vs. 25.0% dry matter intake), longer feeding and sitting times, lower defecation frequency (p < 0.05), and similar rumination efficiency. In conclusion, complete replacement of conventional RS with BF-based silage reduced rumination and chewing activity in growing Hanwoo heifers, and BF-based silage feeding with large-particle straw is an effective approach in improving heifer behavior.

Pitfalls associated with the therapeutic reference pricing practice of asthma medication

PubMed Central

2012-01-01

Background Therapeutic reference pricing (TRP) based on the WHO daily defined dose (DDD) is a method frequently employed for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in the real world with DDD and to evaluate whether TRP based on DDD could result in cost savings on maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT) and Seretide Diskus (SED) in Hungary. Methods Real-world data were derived from the Hungarian National Health Insurance Fund database. Average doses and costs were compared between the high-dose and medium-dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. Results 27,779 patients with asthma were included in the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. Conclusions Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits after exclusion of the effect of generic price erosion. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD does not result in reduced public healthcare spending in Hungary. Further analysis is required to show whether TRP generates additional expenditures by inducing switching costs and reducing patient compliance. Potential confounding factors may limit the generalisability of our conclusions. PMID:22818402

Child mental health differences amongst ethnic groups in Britain: a systematic review

PubMed Central

Goodman, Anna; Patel, Vikram; Leon, David A

2008-01-01

Background Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use. Methods A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0–19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample. Results 31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children. Conclusion Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences. PMID:18655701

Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses

PubMed Central

Moazzami, Zeinab; Dehdari, Tahere; Taghdisi, Mohammad Hosein; Soltanian, Alireza

2016-01-01

Background: One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Methods: Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and 6 months after the intervention. A four-week ergonomics educational intervention based on TTM variables was designed and conducted for the nurses in the intervention group. Results: Following the intervention, a higher proportion of nurses in the intervention group moved into the action stage (p < 0.05). Mean scores of self-efficacy, pros, experimental processes and correct body posture were also significantly higher in the intervention group (p < 0.05). No significant differences were found in the cons and behavioral processes, except for self-liberation, between the two groups (p > 0.05) after the intervention. Conclusions: The TTM provides a suitable framework for developing stage-based ergonomics interventions for postural behavior. PMID:26925897

A rapid method for soil cement design : Louisiana slope value method : part II : evaluation.

DOT National Transportation Integrated Search

1966-05-01

This report is an evaluation of the recently developed "Louisiana Slope Value Method". : The conclusion drawn are based on data from 637 separate samples representing nearly all major soil groups in Louisiana that are suitable for cement stabilizatio...

Historical limitations of determinant based exposure groupings in the rubber manufacturing industry

PubMed Central

Vermeulen, R; Kromhout, H

2005-01-01

Aims: To study the validity of using a cross-sectional industry-wide exposure survey to develop exposure groupings for epidemiological purposes that extend beyond the time period in which the exposure data were collected. Methods: Exposure determinants were used to group workers into high, medium, and low exposure groups. The contrast of this grouping and other commonly used grouping schemes based on plant and department within this exposure survey and a previously conducted survey within the same industry (and factories) were estimated and compared. Results: Grouping of inhalable and dermal exposure based on exposure determinants resulted in the highest, but still modest, contrast (ε ∼ 0.3). Classifying subjects based on a combination of plant and department resulted in a slightly lower contrast (ε ∼ 0.2). If the determinant based grouping derived from the 1997 exposure survey was used to classify workers in the 1988 survey the average contrast decreased significantly for both exposures (ε ∼ 0.1). On the contrary, the exposure classification based on plant and department increased in contrast (from ε ∼ 0.2 to ε ∼ 0.3) and retained its relative ranking overtime. Conclusions: Although determinant based groupings seem to result in more efficient groupings within a cross-sectional survey, they have to be used with caution as they might result in significant less contrast beyond the studied population or time period. It is concluded that a classification based on plant and department might be more desirable for retrospective studies in the rubber manufacturing industry, as they seem to have more historical relevance and are most likely more accurately recorded historically than information on exposure determinants in a particular industry. PMID:16234406

A randomized controlled trial of water-based exercise for cardiovascular fitness in individuals with chronic stroke

PubMed Central

Chu, Kelly S; Eng, Janice J; Dawson, Andrew S; Harris, Jocelyn E.; Ozkaplan, Atila; Gylfadóttir, Sif

2011-01-01

Objective To evaluate the effect of an 8-week water-based exercise program (experimental group) over an upper extremity function program (control group) to increase cardiovascular fitness within a community setting for individuals with stroke. Design Single-blind randomized controlled trial Setting Public community centre Participants 12 community-dwelling individuals who have had a stroke with mild to moderate motor deficits; volunteer sample Intervention Experimental and control groups participated in group exercise programs undertaken in one hour sessions, three times per week for 8 weeks. The experimental group undertook chest deep water exercises at targeted heart rates. The control group performed arm and hand exercises while sitting. Main Outcome Measures The primary outcome measure was cardiovascular fitness (VO2max). Secondary measures were maximal workload, muscle strength, gait speed, and the Berg Balance Score. Results The experimental group attained significant improvements over the control group in cardiovascular fitness, maximal workload, gait speed, and paretic lower extremity muscle strength. The relatively short program (8 weeks) of water-based exercise resulted in a large improvement (22%) in cardiovascular fitness in a small group of individuals with stroke with relatively high function. Conclusions A water-based exercise program can be undertaken in the community as a group program and may be an effective means to promote fitness in individuals with stroke. PMID:15179638

Chemistry, Biochemistry, Pharmacology, and Toxicology of CS and Synthesis of Its Novel Analogs

DTIC Science & Technology

2007-10-01

fluorine and fluorine -containing groups have been synthesized using microwave irradiation and novel catalysts. The structures and physical properties and...safe, and biologically more potent CS analogs. To this end, the synthesis of a novel group of CS-agents incorporating fluorine and fluorine ...CONCLUSION The new CS-analogs are expected to be more potent than CS. This observation is based on the following considerations. First, fluorine is

Node, Node-Link, and Node-Link-Group Diagrams: An Evaluation.

PubMed

Saket, Bahador; Simonetto, Paolo; Kobourov, Stephen; Börner, Katy

2014-12-01

Effectively showing the relationships between objects in a dataset is one of the main tasks in information visualization. Typically there is a well-defined notion of distance between pairs of objects, and traditional approaches such as principal component analysis or multi-dimensional scaling are used to place the objects as points in 2D space, so that similar objects are close to each other. In another typical setting, the dataset is visualized as a network graph, where related nodes are connected by links. More recently, datasets are also visualized as maps, where in addition to nodes and links, there is an explicit representation of groups and clusters. We consider these three Techniques, characterized by a progressive increase of the amount of encoded information: node diagrams, node-link diagrams and node-link-group diagrams. We assess these three types of diagrams with a controlled experiment that covers nine different tasks falling broadly in three categories: node-based tasks, network-based tasks and group-based tasks. Our findings indicate that adding links, or links and group representations, does not negatively impact performance (time and accuracy) of node-based tasks. Similarly, adding group representations does not negatively impact the performance of network-based tasks. Node-link-group diagrams outperform the others on group-based tasks. These conclusions contradict results in other studies, in similar but subtly different settings. Taken together, however, such results can have significant implications for the design of standard and domain snecific visualizations tools.

Use of High Throughput Screening Data in IARC Monograph Evaluations (SOT)

EPA Science Inventory

Purpose: Evaluation of carcinogenic mechanisms serves a critical role in IARC monograph evaluations, and can lead to “upgrade” or “downgrade” of the carcinogenicity conclusions based on human and animal evidence alone. Three recent IARC monograph Working Groups (110, 112, and 11...

Differences in Brain Metabolic Impairment between Chronic Mild/Moderate TBI Patients with and without Visible Brain Lesions Based on MRI.

PubMed

Ito, Keiichi; Asano, Yoshitaka; Ikegame, Yuka; Shinoda, Jun

2016-01-01

Introduction. Many patients with mild/moderate traumatic brain injury (m/mTBI) in the chronic stage suffer from executive brain function impairment. Analyzing brain metabolism is important for elucidating the pathological mechanisms associated with their symptoms. This study aimed to determine the differences in brain glucose metabolism between m/mTBI patients with and without visible traumatic brain lesions based on MRI. Methods. Ninety patients with chronic m/mTBI due to traffic accidents were enrolled and divided into two groups based on their MRI findings. Group A comprised 50 patients with visible lesions. Group B comprised 40 patients without visible lesions. Patients underwent FDG-PET scans following cognitive tests. FDG-PET images were analyzed using voxel-by-voxel univariate statistical tests. Results. There were no significant differences in the cognitive tests between Group A and Group B. Based on FDG-PET findings, brain metabolism significantly decreased in the orbital gyrus, cingulate gyrus, and medial thalamus but increased in the parietal and occipital convexity in Group A compared with that in the control. Compared with the control, patients in Group B exhibited no significant changes. Conclusions. These results suggest that different pathological mechanisms may underlie cognitive impairment in m/mTBI patients with and without organic brain damage.

Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

PubMed Central

Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

2015-01-01

[Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health. PMID:26311955

Effects of Functional Groups in Redox-Active Organic Molecules: A High-Throughput Screening Approach

DOE PAGES

Pelzer, Kenley M.; Cheng, Lei; Curtiss, Larry A.

2016-12-08

Nonaqueous redox flow batteries have attracted recent attention with their potential for high electrochemical storage capacity, with organic electrolytes serving as solvents with a wide electrochemical stability window. Organic molecules can also serve as electroactive species, where molecules with low reduction potentials or high oxidation potentials can provide substantial chemical energy. To identify promising electrolytes in a vast chemical space, high-throughput screening (HTS) of candidate molecules plays an important role, where HTS is used to calculate properties of thousands of molecules and identify a few organic molecules worthy of further attention in battery research. Here, in this work, we presentmore » reduction and oxidation potentials obtained from HTS of 4178 molecules. The molecules are composed of base groups of five- or six-membered rings with one or two functional groups attached, with the set of possible functional groups including both electron-withdrawing and electron-donating groups. In addition to observing the trends in potentials that result from differences in organic base groups and functional groups, we analyze the effects of molecular characteristics such as multiple bonds, Hammett parameters, and functional group position. In conclusion, this work provides useful guidance in determining how the identities of the base groups and functional groups are correlated with desirable reduction and oxidation potentials.« less

Effects of Functional Groups in Redox-Active Organic Molecules: A High-Throughput Screening Approach

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

Pelzer, Kenley M.; Cheng, Lei; Curtiss, Larry A.

Nonaqueous redox flow batteries have attracted recent attention with their potential for high electrochemical storage capacity, with organic electrolytes serving as solvents with a wide electrochemical stability window. Organic molecules can also serve as electroactive species, where molecules with low reduction potentials or high oxidation potentials can provide substantial chemical energy. To identify promising electrolytes in a vast chemical space, high-throughput screening (HTS) of candidate molecules plays an important role, where HTS is used to calculate properties of thousands of molecules and identify a few organic molecules worthy of further attention in battery research. Here, in this work, we presentmore » reduction and oxidation potentials obtained from HTS of 4178 molecules. The molecules are composed of base groups of five- or six-membered rings with one or two functional groups attached, with the set of possible functional groups including both electron-withdrawing and electron-donating groups. In addition to observing the trends in potentials that result from differences in organic base groups and functional groups, we analyze the effects of molecular characteristics such as multiple bonds, Hammett parameters, and functional group position. In conclusion, this work provides useful guidance in determining how the identities of the base groups and functional groups are correlated with desirable reduction and oxidation potentials.« less

The effects of bridge exercise on an unstable base of support on lumbar stability and the thickness of the transversus abdominis.

PubMed

Cho, Misuk; Jeon, Hyewon

2013-06-01

[Purpose] We examined the effects of an abdominal drawing-in bridge exercise using a pressure biofeedback unit on different bases on the thickness of trunk and abdominal muscles, and lumbar stability. [Subjects] Thirty healthy young adults (2 males, 28 females) took part in this study. The subjects were randomly and equally assigned to a stable bridge exercise group and an unstable bridge exercise group. [Methods] The subjects performed bridge exercises using an abdominal drawing-in method on a stable base and on an unstable base, and changes in their abdominal muscle thickness and on the stable and on unstable bases lumbar stability were evaluated. [Results] After the intervention, the stable bridge exercise group showed a statistically significantly increased muscle thickness in the transversus abdominis, and the unstable bridge exercise group showed significantly increased muscle thicknesses of the transversus abdominis and internal obliques in static and dynamic lumbar stability. The unstable bridge exercise group showed significant increase after performing the exercise. [Conclusion] Lumbar stability exercise, with the compensation of the lumbar spine minimized, using an abdominal drawing-in method on an unstable support of base is effective and efforts to prevent the compensation may induce a greater exercise effect.

How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards

PubMed Central

Rooney, Andrew A.; Cooper, Glinda S.; Jahnke, Gloria D.; Lam, Juleen; Morgan, Rebecca L.; Boyles, Abee L.; Ratcliffe, Jennifer M.; Kraft, Andrew D.; Schünemann, Holger J.; Schwingl, Pamela; Walker, Teneille D.; Thayer, Kristina A.; Lunn, Ruth M.

2016-01-01

Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or “risk of bias” — the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program’s (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or “domains” for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. PMID:26857180

How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards.

PubMed

Rooney, Andrew A; Cooper, Glinda S; Jahnke, Gloria D; Lam, Juleen; Morgan, Rebecca L; Boyles, Abee L; Ratcliffe, Jennifer M; Kraft, Andrew D; Schünemann, Holger J; Schwingl, Pamela; Walker, Teneille D; Thayer, Kristina A; Lunn, Ruth M

2016-01-01

Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or "risk of bias" - the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program's (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or "domains" for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. Published by Elsevier Ltd.

The Efficacy of Internet-based Cognitive Behavioral Therapy on the Anxiety Disorders among Adolescent Girls

PubMed Central

Karbasi, Afsaneh; Haratian, Azadeh

2018-01-01

Background: The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8–12 and 5–10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT) in treating the anxiety disorders among adolescent females. Materials and Methods: The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. Results: The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another (P < 0.001). Conclusions: This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms’ scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT. PMID:29456984

Microtensile bond strength of silorane-based composite specific adhesive system using different bonding strategies

PubMed Central

Bastos, Laura Alves; Sousa, Ana Beatriz Silva; Drubi-Filho, Brahim; Panzeri Pires-de-Souza, Fernanda de Carvalho

2015-01-01

Objectives The aim of this study was to evaluate the effect of pre-etching on the bond strength of silorane-based composite specific adhesive system to dentin. Materials and Methods Thirty human molars were randomly divided into 5 groups according to the different bonding strategies. For teeth restored with silorane-based composite (Filtek Silorane, 3M ESPE), the specific self-etching adhesive system (Adhesive System P90, 3M ESPE) was used with and without pre-etching (Pre-etching/Silorane and Silorane groups). Teeth restored with methacrylate based-composite (Filtek Z250, 3M ESPE) were hybridized with the two-step self-etching system (Clearfil SE Bond, Kuraray), with and without pre-etching (Pre-etching/Methacrylate and Methacrylate groups), or three-step adhesive system (Adper Scotchbond Multi-Purpose, 3M ESPE) (Three-step/Methacrylate group) (n = 6). The restored teeth were sectioned into stick-shaped test specimens (1.0 × 1.0 mm), and coupled to a universal test machine (0.5 mm/min) to perform microtensile testing. Results Pre-etching/Methacrylate group presented the highest bond strength values, with significant difference from Silorane and Three-step/Methacrylate groups (p < 0.05). However, it was not significantly different from Preetching/Silorane and Methacrylate groups. Conclusions Pre-etching increased bond strength of silorane-based composite specific adhesive system to dentin. PMID:25671209

The effect of short fiber composite base on microleakage and load-bearing capacity of posterior restorations

PubMed Central

Garoushi, Sufyan K.; Hatem, Marwa; Lassila, Lippo V. J.; Vallittu, Pekka K.

2015-01-01

Abstract Objectives: To determine the marginal microleakage of Class II restorations made with different composite base materials and the static load-bearing capacity of direct composite onlay restorations. Methods: Class II cavities were prepared in 40 extracted molars. They were divided into five groups (n = 8/group) depending on composite base material used (everX Posterior, SDR, Tetric EvoFlow). After Class II restorations were completed, specimens were sectioned mid-sagitally. For each group, sectioned restorations were immersed in dye. Specimens were viewed under a stereo-microscope and the percentage of cavity leakage was calculated. Ten groups of onlay restorations were fabricated (n = 8/group); groups were made with composite base materials (everX Posterior, SDR, Tetric EvoFlow, Gradia Direct LoFlo) and covered by 1 mm layer of conventional (Tetric N-Ceram) or bulk fill (Tetric EvoCeram Bulk Fill) composites. Groups made only from conventional, bulk fill and short fiber composites were used as control. Specimens were statically loaded until fracture. Data were analyzed using ANOVA (p = 0.05). Results: Microleakage of restorations made of plain conventional composite or short fiber composite base material showed statistically (p < 0.05) lower values compared to other groups. ANOVA revealed that onlay restorations made from short fiber-reinforced composite (FRC) as base or plain restoration had statistically significant higher load-bearing capacity (1593 N) (p < 0.05) than other restorations. Conclusion: Restorations combining base of short FRC and surface layer of conventional composite displayed promising performance related to microleakage and load-bearing capacity. PMID:28642894

A Quality Improvement Activity to Promote Interprofessional Collaboration Among Health Professions Students

PubMed Central

Stevenson, Katherine; Busch, Angela; Scott, Darlene J.; Henry, Carol; Wall, Patricia A.

2009-01-01

Objectives To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care. Design Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process. Assessment One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience. Conclusion Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students. PMID:19657497

A Feasibility Study of Virtual Reality-Based Coping Skills Training for Nicotine Dependence

PubMed Central

Bordnick, Patrick S.; Traylor, Amy C.; Carter, Brian L.; Graap, Ken M.

2014-01-01

Objective Virtual reality (VR)-based cue reactivity has been successfully used for the assessment of drug craving. Going beyond assessment of cue reactivity, a novel VR-based treatment approach for smoking cessation was developed and tested for feasibility. Method In a randomized experiment, 10-week treatment feasibility trial, 46 nicotine-dependent adults, completed the10-week program. Virtual reality skills training (VRST) combined with nicotine replacement therapy (NRT) was compared to NRT alone. Participants were assessed for smoking behavior and coping skills during, at end of treatment, and at posttreatment follow-up. Results Smoking rates and craving for nicotine were significantly lower for the VRST group compared to NRT-only group at the end of treatment. Self-confidence and coping skills were also significantly higher for the VRST group, and number of cigarettes smoked was significantly lower, compared to the control group at follow-up. Conclusions Feasibility of VRST was supported in the current study. PMID:25484549

Pre-university Chemistry Students in a Mimicked Scholarly Peer Review

NASA Astrophysics Data System (ADS)

van Rens, Lisette; Hermarij, Philip; Pilot, Albert; Beishuizen, Jos; Hofman, Herman; Wal, Marjolein

2014-10-01

Peer review is a significant component in scientific research. Introducing peer review into inquiry processes may be regarded as an aim to develop student understanding regarding quality in inquiries. This study examines student understanding in inquiry peer reviews among pre-university chemistry students, aged 16-17, when they enact a design of a mimicked scholarly peer review. This design is based on a model of a human activity system. Twenty-five different schools in Brazil, Germany, Poland and The Netherlands participated. The students (n = 880) conducted in small groups (n = 428) open inquiries on fermentation. All groups prepared an inquiry report for peer review. These reports were published on a website. Groups were randomly paired in an internet symposium, where they posted review comments to their peers. These responses were qualitatively analyzed on small groups' level of understanding regarding seven categories: inquiry question, hypothesis, management of control variables, accurate measurement, presenting results, reliability of results, discussion and conclusion. The mimicked scholarly review prompted a collective practice. Student understanding was significantly well on presenting results, discussion and conclusion, and significantly less on inquiry question and reliability of results. An enacted design, based on a model of a human activity system, created student understanding of quality in inquiries as well as an insight in a peer-reviewing practice. To what extent this model can be applied in a broader context of design research in science education needs further study.

Effects of Brief Communication Skills Training for Workers Based on the Principles of Cognitive Behavioral Therapy

PubMed Central

Sasaki, Norio; Somemura, Hironori; Nakamura, Saki; Yamamoto, Megumi; Isojima, Manabu; Shinmei, Issei; Horikoshi, Masaru; Tanaka, Katsutoshi

2017-01-01

Objective: Stimulating communication is an important workplace issue. We investigated the effects of a brief communication skills training (CST) program based on the principles of cognitive behavioral therapy (CBT). Methods: A randomized controlled trial was conducted on 206 white-collar workers. The intervention group underwent a 2-hour CST group training conducted by an occupational physician. Result: The results of the intention-to-treat analysis using a mixed-effects model showed that there was a significant interaction between group and time observed for the item “thinking together to solve problems and issues” (P = 0.02). The effect size (Cohen d) was 0.35 (95% confidence interval, 0.07 to 0.62). Conclusions: The present study suggests that a brief CST based on the principles of CBT could improve the communication behavior of workers. PMID:28045799

Impact of Participation in TimeSlips, a Creative Group-Based Storytelling Program, on Medical Student Attitudes Toward Persons With Dementia: A Qualitative Study

PubMed Central

George, Daniel R.; Stuckey, Heather L.; Dillon, Caroline F.; Whitehead, Megan M.

2011-01-01

Purpose: To evaluate whether medical student participation in TimeSlips (TS), a creative group-based storytelling program, with persons affected by dementia would improve student attitudes toward this patient population. Design and Methods: Fifteen fourth-year medical students from Penn State College of Medicine participated in a month-long regimen of TS sessions at a retirement community. Student course evaluations were analyzed at the conclusion of the program to examine perceived qualitative changes in attitude. Findings: Qualitative data revealed insights into the manner in which student attitudes toward a geriatric patient population became more positive. Implications: This is the first known pilot study to suggest that participation in a creative group-based storytelling program might improve medical student attitudes toward persons with dementia. PMID:21665958

Providing web-based mental health services to at-risk women

PubMed Central

2011-01-01

Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. Conclusions We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes. PMID:21854563

Recruiting Research Participants at Community Education Sites

PubMed Central

SADLER, GEORGIA ROBINS; PETERSON, MELANIE; WASSERMAN, LINDA; MILLS, PAUL L.; MALCARNE, VANESSA L.; ROCK, CHERYL; ANCOLI-ISRAEL, SONIA; MOORE, AMANDA; WELDON, RAI-NESHA; GARCIA, TENISHA; KOLODNER, RICHARD D.

2006-01-01

Background Minority groups are underrepresented in research, making it difficult to apply medical advances with confidence. In this study, we explored whether community-based cancer education sites and educators serving the African American community could be used to recruit minority participants to research. Methods We invited Individuals at community education sites to provide buccal scrapings, saliva samples, psychometric data, and personal information anonymously. Results Culturally aligned community sites (100%) collaborated in the research recruitment, as did 83% of the individuals at those sites. Conclusion Community-based education sites offer exceptional promise for teaching about research benefits and recruiting members of minority groups to research studies. PMID:16497136

Effect of aquatic versus land based exercise programs on physical performance in severely burned patients: a randomized controlled trial.

PubMed

Zoheiry, Ibrahim M; Ashem, Haidy N; Ahmed, Hamada Ahmed Hamada; Abbas, Rami

2017-12-01

[Purpose] To compare the effect of an aquatic-based versus a land-based exercise regimen on the physical performance of severely burned patients. [Subjects and Methods] Forty patients suffering from severe burn (total body surface area more than 30%) were recruited from several outpatient clinics in Greater Cairo. Their ages ranged between 20 to 40 years and were randomly assigned into two equal groups: group (A), which received an aquatic based exercise program, and group (B), which received a land-based exercise program. The exercise program, which took place in 12 consecutive weeks, consisted of flexibility, endurance, and lower and upper body training. Physical performance was assessed using 30 seconds chair stand test, stair climb test, 30 meter fast paced walk test, time up and go test, 6-minute walk test and a VO2max evaluation. [Results] Significantly increase in the 30 second chair stand, 6-minute walk, 30 meter fast paced walk, stair climb, and VO2 max tests and significantly decrease in the time up and go test in group A (aquatic based exercise) compared with group B (a land-based exercise) at the post treatment. [Conclusion] Twelve-week program of an aquatic program yields improvement in both physical performance and VO2 max in patients with severe burns.

Effect of aquatic versus land based exercise programs on physical performance in severely burned patients: a randomized controlled trial

PubMed Central

Zoheiry, Ibrahim M.; Ashem, Haidy N.; Ahmed, Hamada Ahmed Hamada; Abbas, Rami

2017-01-01

[Purpose] To compare the effect of an aquatic-based versus a land-based exercise regimen on the physical performance of severely burned patients. [Subjects and Methods] Forty patients suffering from severe burn (total body surface area more than 30%) were recruited from several outpatient clinics in Greater Cairo. Their ages ranged between 20 to 40 years and were randomly assigned into two equal groups: group (A), which received an aquatic based exercise program, and group (B), which received a land-based exercise program. The exercise program, which took place in 12 consecutive weeks, consisted of flexibility, endurance, and lower and upper body training. Physical performance was assessed using 30 seconds chair stand test, stair climb test, 30 meter fast paced walk test, time up and go test, 6-minute walk test and a VO2max evaluation. [Results] Significantly increase in the 30 second chair stand, 6-minute walk, 30 meter fast paced walk, stair climb, and VO2 max tests and significantly decrease in the time up and go test in group A (aquatic based exercise) compared with group B (a land-based exercise) at the post treatment. [Conclusion] Twelve-week program of an aquatic program yields improvement in both physical performance and VO2 max in patients with severe burns. PMID:29643605

Didactic Lecture Versus Interactive Workshop for Continuing Pharmacy Education on Reproductive Health: A Randomized Controlled Trial.

PubMed

Javadi, Mohammadreza; Kargar, Alireza; Gholami, Kheirollah; Hadjibabaie, Molouk; Rashidian, Arash; Torkamandi, Hassan; Sarayani, Amir

2015-09-01

Pharmacists are routinely providing reproductive health counseling in community pharmacies, but studies have revealed significant deficits in their competencies. Therefore, continuing pharmacy education (CPE) could be utilized as a valuable modality to upgrade pharmacists' capabilities. A randomized controlled trial was designed to compare the efficacy of CPE meetings (lecture based vs. workshop based) on contraception and male sexual dysfunctions. Sixty pharmacists were recruited for each CPE meeting. Small group training using simulated patients was employed in the workshop-based CPE. Study outcomes were declarative/procedural knowledge, attitudes, and satisfaction of the participants. Data were collected pre-CPE, post-CPE, and 2 months afterward and were analyzed using repeated measure analysis of variance and Mann-Whitney U test. Results showed that lecture-based CPE was more successful in improving pharmacists' knowledge post-CPE (p < .001). In contrast, a significant decrease was observed in the lecture-based group at follow-up (p = .002), whereas the workshop-based group maintained their knowledge over time (p = 1.00). Knowledge scores of both groups were significantly higher at follow-up in comparison with pre-CPE (p < .01). No significant differences were observed regarding satisfaction and attitudes scores between groups. In conclusion, an interactive workshop might not be superior to lecture-based training for improving pharmacists' knowledge and attitudes in a 1-day CPE meeting. © The Author(s) 2013.

Randomized Controlled Trial Comparing Tailoring Methods of Multimedia-Based Fall Prevention Education for Community-Dwelling Older Adults

PubMed Central

Schepens, Stacey L.; Panzer, Victoria; Goldberg, Allon

2012-01-01

OBJECTIVE We attempted to determine whether multimedia fall prevention education using different instructional strategies increases older adults’ knowledge of fall threats and their fall prevention behaviors. METHOD Fifty-three community-dwelling older adults were randomized to two educational groups or a control group. Multimedia-based educational interventions to increase fall threats knowledge and encourage fall prevention behaviors had two tailoring strategies: (1) improve content realism for individual learners (authenticity group) and (2) highlight program goals and benefits while using participants’ content selections (motivation group). Knowledge was measured at baseline and 1-mo follow-up. Participants recorded prevention behaviors for 1 mo. RESULTS Intervention group participants showed greater knowledge gains and posttest knowledge than did control group participants. The motivation group engaged in more prevention behaviors over 1 mo than did the other groups. CONCLUSION Tailoring fall prevention education by addressing authenticity and motivation successfully improved fall threats knowledge. Combining motivational strategies with multimedia education increased the effectiveness of the intervention in encouraging fall prevention behaviors. PMID:22214115

Comparison between the Correlations of Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography and Visual Field Defects in Standard Automated White-on-White Perimetry versus Pulsar Perimetry

PubMed Central

Hömberg, Lisann; Eter, Nicole

2017-01-01

Purpose To compare the structure-function relationships between retinal nerve fiber layer thickness (RNFLT) and visual field defects measured either by standard automated perimetry (SAP) or by Pulsar perimetry (PP). Materials and Methods 263 eyes of 143 patients were prospectively included. Depending on the RNFLT, patients were assigned to the glaucoma group (group A: RNFL score 3–6) or the control group (group B: RNFL score 0–2). Structure-function relationships between RNFLT and mean sensitivity (MS) measured by SAP and PP were analyzed. Results Throughout the entire group, the MS assessed by PP and SAP correlated significantly with RNFLT in all sectors. In the glaucoma group, there was no significant difference between the correlations RNFL-SAP and RNFL-PP, whereas a significant difference was found in the control group. Conclusions In the control group, the correlation between structure and function based on the PP data was significantly stronger than that based on SAP. PMID:29119021

Outcome-based and Participation-based Wellness Incentives

PubMed Central

Barleen, Nathan A.; Marzec, Mary L.; Boerger, Nicholas L.; Moloney, Daniel P.; Zimmerman, Eric M.; Dobro, Jeff

2017-01-01

Objective: This study examined whether worksite wellness program participation or achievement of health improvement targets differed according to four incentive types (participation-based, hybrid, outcome-based, and no incentive). Methods: The study included individuals who completed biometric health screenings in both 2013 and 2014 and had elevated metrics in 2013 (baseline year). Multivariate logistic regression modeling tested for differences in odds of participation and achievement of health improvement targets between incentive groups; controlling for demographics, employer characteristics, incentive amounts, and other factors. Results: No statistically significant differences between incentive groups occurred for odds of participation or achievement of health improvement target related to body mass index, blood pressure, or nonhigh-density lipoprotein cholesterol. Conclusions: Given the null findings of this study, employers cannot assume that outcome-based incentives will result in either increased program participation or greater achievement of health improvement targets than participation-based incentives. PMID:28146041

Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma

PubMed Central

Song, Do Seon; Nam, Soon Woo; Bae, Si Hyun; Kim, Jin Dong; Jang, Jeong Won; Song, Myeong Jun; Lee, Sung Won; Kim, Hee Yeon; Lee, Young Joon; Chun, Ho Jong; You, Young Kyoung; Choi, Jong Young; Yoon, Seung Kew

2015-01-01

AIM: To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC). METHODS: A total of 146 consecutive patients were included in the analysis, and their medical records and radiological data were reviewed retrospectively. RESULTS: In total, 119 patients received TACE-based multi-modal treatments, and the remaining 27 received conservative management. Overall survival (P < 0.001) and objective tumor response (P = 0.003) were significantly better in the treatment group than in the conservative group. After subgroup analysis, survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group (P = 0.002) but also in the surgical treatment group compared with the loco-regional treatment-only group (P < 0.001). Multivariate analysis identified tumor stage (P < 0.001) and tumor type (P = 0.009) as two independent pre-treatment factors for survival. After adjusting for significant pre-treatment prognostic factors, objective response (P < 0.001), surgical treatment (P = 0.009), and multi-modal treatment (P = 0.002) were identified as independent post-treatment prognostic factors. CONCLUSION: TACE-based multi-modal treatments were safe and more beneficial than conservative management. Salvage surgery after successful downstaging resulted in long-term survival in patients with large, unresectable HCC. PMID:25741147

Introducing the fit-criteria assessment plot - A visualisation tool to assist class enumeration in group-based trajectory modelling.

PubMed

Klijn, Sven L; Weijenberg, Matty P; Lemmens, Paul; van den Brandt, Piet A; Lima Passos, Valéria

2017-10-01

Background and objective Group-based trajectory modelling is a model-based clustering technique applied for the identification of latent patterns of temporal changes. Despite its manifold applications in clinical and health sciences, potential problems of the model selection procedure are often overlooked. The choice of the number of latent trajectories (class-enumeration), for instance, is to a large degree based on statistical criteria that are not fail-safe. Moreover, the process as a whole is not transparent. To facilitate class enumeration, we introduce a graphical summary display of several fit and model adequacy criteria, the fit-criteria assessment plot. Methods An R-code that accepts universal data input is presented. The programme condenses relevant group-based trajectory modelling output information of model fit indices in automated graphical displays. Examples based on real and simulated data are provided to illustrate, assess and validate fit-criteria assessment plot's utility. Results Fit-criteria assessment plot provides an overview of fit criteria on a single page, placing users in an informed position to make a decision. Fit-criteria assessment plot does not automatically select the most appropriate model but eases the model assessment procedure. Conclusions Fit-criteria assessment plot is an exploratory, visualisation tool that can be employed to assist decisions in the initial and decisive phase of group-based trajectory modelling analysis. Considering group-based trajectory modelling's widespread resonance in medical and epidemiological sciences, a more comprehensive, easily interpretable and transparent display of the iterative process of class enumeration may foster group-based trajectory modelling's adequate use.

Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia

PubMed Central

Udani, Ankeet D.; Macario, Alex; Tanaka, Maria A.; Tanaka, Pedro P.

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear. PMID:25157263

Simulation-based mastery learning with deliberate practice improves clinical performance in spinal anesthesia.

PubMed

Udani, Ankeet D; Macario, Alex; Nandagopal, Kiruthiga; Tanaka, Maria A; Tanaka, Pedro P

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Community based participatory research of breastfeeding disparities in African American women.

PubMed

Kulka, Tamar Ringel; Jensen, Elizabeth; McLaurin, Sue; Woods, Elizabeth; Kotch, Jonathan; Labbok, Miriam; Bowling, Mike; Dardess, Pamela; Baker, Sharon

2011-08-01

OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Using a community-based participatory approach, academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, North Carolina. METHODS: Eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of community stakeholder interviews; 41 interviews were conducted with community representatives. These findings informed the development of a support group pilot intervention. The pilot support groups were evaluated for increase in knowledge of attendees. RESULTS: Focus group and community interviews indicate that African Americans may disproportionately experience inadequate support for breastfeeding. This lack of support was reported in the home, the workplace, among peers, and from healthcare providers. The pilot support groups resulted in increased knowledge of breastfeeding among group participants OR=3.6 (95% CI: 2.5, 5.2). CONCLUSIONS: The findings from this research underscore the importance of a multi-level approach to breastfeeding support for African American women to address breastfeeding disparities.

Anthropometric Profile in Different Event Categories of Acrobatic Gymnastics

PubMed Central

Taboada-Iglesias, Yaiza; Santana, Mercedes Vernetta; Gutiérrez-Sánchez, Águeda

2017-01-01

Abstract There is a specific anthropometric profile for each sport, which may be differentiated even in relation to the position, role or event category within each sport discipline. However, there are few studies on acrobatic gymnastics, and the goal of this work was to determine the anthropometric profile depending on the event category, as well as factors that predisposed to performance in these categories. The sample consisted of 150 gymnasts from Spain, divided into 8 groups according to the event category and the role played. The kinanthropometric measurements were taken through the procedures established by the International Society for the Advancement of Kineantropometry. The anthropometric characteristics, including body mass index, somatotype, body composition and proportionality using the Phantom stratagem were analyzed, and the results obtained from the different groups were compared. A regression analysis was performed with particular groups of gymnasts. No significant differences (p < 0.05) were observed between groups of female tops or male bases, although differences were found between female group bases and female pair bases. It could be suggested that higher values of body height, sitting height, the minimum abdominal circumference, percentage of fat and low biliocristal breadth predispose female bases to work in pairs rather than in groups. The conclusion is that the anthropometric measurements are not decisive when guiding a gymnast toward choosing one event category or another, except for female bases. PMID:28713469

Energetic-particle abundances in impulsive solar flares

NASA Technical Reports Server (NTRS)

Reames, D. V.; Cane, H. V.; Von Rosenvinge, T. T.

1990-01-01

The abundances of elements and of He-3 in 90 solar electron events have been examined. It is found that the events fall into two distinct groups based upon their F/C ratio. Events in the F-rich group frequently have high He-3/He-4 ratios and are associated with type III and type V radio bursts in the parent flare. The F-poor events are associated with type IV bursts. These results on individual events support the conclusions of earlier work done with daily-averaged abundances.

DoD High Performance Computing Modernization Program Users Group Conference (HPCMP UGC 2011) Held in Portland, Oregon on June 20-23, 2011

DTIC Science & Technology

2011-06-01

4. Conclusion The Web -based AGeS system described in this paper is a computationally-efficient and scalable system for high- throughput genome...method for protecting web services involves making them more resilient to attack using autonomic computing techniques. This paper presents our initial...20–23, 2011 2011 DoD High Performance Computing Modernzation Program Users Group Conference HPCMP UGC 2011 The papers in this book comprise the

Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

PubMed

Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

2016-01-01

Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

Effect of five commercial mouth rinses on the microhardness of a nanofilled resin composite restorative material: An in vitro study

PubMed Central

Jyothi, KN; Crasta, Shanol; Venugopal, P

2012-01-01

Aim and Objectives: This in vitro study was designed to comparatively evaluate the effect of five commercial mouth rinses on the micro hardness of a nanofilled resin based restorative material. Materials and Methods: Fifty specimens of resin composite material (Filtek Z350XT, 3M ESPE, St.Paul, MN USA) were prepared and immersed in artificial saliva for 24 h. The base line micro hardness of specimens was recorded using Vicker's micro hardness tester (MMT – X7 Matsuzawa, Japan). The specimens were randomly distributed into five groups, each containing 10 specimens (n=10) as follows – Group I Listerine (alcohol based), Group II Periogard (alcohol based), Group III Colgate plax (alcohol based), Group IV C- prev (alcohol free), Group V Hiora(alcohol free). The specimens were immersed in 20 ml of mouth rinses and incubated for 24 h at 37°C. The post immersion micro hardness values of the specimens were recorded and the data was tabulated for statistical analysis. Kruskal–Wallis test was used for inter group comparison followed by pair wise comparison of groups using Mann–Whitney U test. The level of significance was set at P=0.05. Results: Significant reduction in the mean VHN (Vicker's micro hardness number) was observed in all the groups after exposure to the tested mouth rinses (P<0.01) and the reduction in mean VHN values were as follows: Group I 12.09, Group II 3.42, Group II 1.51, Group IV 1.03, Group V 0.57. Inter group comparison showed statistically significant reduction in micro hardness in Groups I and II compared to all other groups with P<0.001. There was no significant difference between Groups III, IV and V. Conclusion: All the mouth rinses showed a reduction in the microhardness of nanofilled resin composite material with listerine (Group I) containing maximum amount of alcohol, showing highest reduction in micro hardness value. PMID:22876004

Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance.

PubMed

Leak, Tashara M; Swenson, Alison; Vickers, Zata; Mann, Traci; Mykerezi, Elton; Redden, Joseph P; Rendahl, Aaron; Reicks, Marla

2015-01-01

To test the effectiveness of behavioral economics strategies for increasing vegetable intake, variety, and liking among children residing in homes receiving food assistance. A randomized controlled trial with data collected at baseline, once weekly for 6 weeks, and at study conclusion. Family homes. Families with a child (9-12 years) will be recruited through community organizations and randomly assigned to an intervention (n = 36) or control (n = 10) group. The intervention group will incorporate a new behavioral economics strategy during home dinner meal occasions each week for 6 weeks. Strategies are simple and low-cost. The primary dependent variable will be child's dinner meal vegetable consumption based on weekly reports by caregivers. Fixed independent variables will include the strategy and week of strategy implementation. Secondary dependent variables will include vegetable liking and variety of vegetables consumed based on data collected at baseline and study conclusion. Mean vegetable intake for each strategy across families will be compared using a mixed-model analysis of variance with a random effect for child. In additionally, overall mean changes in vegetable consumption, variety, and liking will be compared between intervention and control groups. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Rabeprazole- versus esomeprazole-based eradication regimens for H. pylori infection.

PubMed

Wu, I-Chen; Wu, Deng-Chyang; Hsu, Ping-I; Lu, Chien-Yu; Yu, Fang-Jung; Wang, Tsang-En; Chang, Wen-Hsiung; Chen, Jyh-Jon; Kuo, Fu-Chen; Wu, Jeng-Yih; Wang, Wen-Ming; Bair, Ming-Jong

2007-12-01

Different kinds of proton pump inhibitor-based triple therapies could result in different Helicobacter pylori eradication rates. The aims of this study were to compare the efficacy and safety of rabeprazole- and esomeprazole-based triple therapy in primary treatment of H. pylori infection in Taiwan. From June 2005 to March 2007, 420 H. pylori-infected patients were randomly assigned to receive a 7-day eradication therapy with either esomeprazole 40 mg daily (EAC group, n = 209) or rabeprazole 20 mg b.i.d. (RAC group, n = 211) in combination with amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d.. Follow-up endoscopy with biopsy was done 12-16 weeks after completion of eradication therapy. Those who refused endoscopic exams underwent (13)C-urea breath test to assess the treatment response. Intention-to-treat analysis revealed that the eradication rate was 89.4% in the EAC group and 90.5% in RAC groups (p-value = .72). All of the subjects returned for assessment of compliance (100% in EAC group vs. 99.5% in RAC group, p-value = .32) and adverse events (3.83% in EAC group vs. 6.16% in RAC group, p-value = .27). Sixty (28.7%) and 37 (17.6%) patients in EAC and RAC group, respectively, refused endoscopy and underwent a (13)C-urea breath test to determine the treatment effect. In conclusion, rabeprazole- and esomeprazole-based primary therapies for H. pylori infection are comparable in efficacy and safety.

An Ex-vivo Shear and tensile bond strengths of orthodontic molar tubes bonded using different techniques

PubMed Central

Alwahadni, Ahed

2017-01-01

Background Molar bonding procedures need continuous improvement to be widely accepted clinically and eventually replace molar bands. Material and Methods The purpose of this study was to determine the effects of enamel micro-abrasion and silane coating of the base of molar tubes on shear and tensile bond strengths of orthodontic molar tubes. A total of 200 third molars were randomly allocated into five groups of 40 teeth as follows: group 1: molar tubes bonded to etched teeth (37% phosphoric acid gel; control group); group 2: molar tubes bonded to etched teeth (37% phosphoric acid) with the addition of silane to the base of molar tubes; group 3: molar tubes bonded to teeth pre-treated with 18% hydrochloric acid and pumice (micro-abrasion); group 4: molar tubes bonded to teeth pre-treated with microabrasion with the addition of silane to the base of molar tubes; group 5: molar tubes bonded to teeth pre-treated with microabrasion before conventional acid etching combined with the addition of silane to the base of molar tubes. The bond strength testing was performed using a computer control electromechanical universal testing machine. Results The highest mean shear and tensile bond strengths were recorded in group 5 (13.81±2.54MPa and 13.97±2.29 MPa, respectively). Micro-abrasion alone (group 3) and the combination of enamel micro-abrasion and the addition of silane (group 4) produced bond strength values comparable to the control. Conclusions Enamel surface pre-treatment (micro abrasion) before conventional acid etching combined with the addition of silane to the base of the molar tube produced the highest bond strengths among all tested groups. Key words:Molar, shear strength, tensile strength, orthodontic appliances. PMID:28298990

Results of a Community-Based Randomized Trial to Increase Colorectal Cancer Screening Among Filipino Americans

PubMed Central

Bastani, Roshan; Danao, Leda L.; Antonio, Cynthia; Garcia, Gabriel M.; Crespi, Catherine M.

2010-01-01

Objectives. We conducted 1 of the first community-based trials to develop a multicomponent intervention that would increase colorectal cancer screening among an Asian American population. Methods. Filipino Americans (n = 548) nonadherent to colorectal cancer (CRC) screening guidelines were randomized into an intervention group that received an education session on CRC screening and free fecal occult blood test (FOBT) kits; a second intervention group that received an education session but no free FOBT kits; and a control group that received an education session on the health benefits of physical activity. Results. Self-reported CRC screening rates during the 6-month follow-up period were 30%, 25%, and 9% for participants assigned to intervention with FOBT kit, intervention without the kit, and control group, respectively. Participants in either of the 2 intervention groups were significantly more likely to report screening at follow-up than were participants in the control group. Conclusions. A multicomponent intervention that includes an educational group session in a community setting can significantly increase CRC screening among Filipino Americans, even when no free FOBT kits are distributed. PMID:20864724

29 CFR 2590.702-1 - Additional requirements prohibiting discrimination based on genetic information.

Code of Federal Regulations, 2013 CFR

2013-07-01

...). Because completing the health risk assessment results in a premium reduction, the request for genetic.... (ii) Conclusion. In this Example 3, because the health risk assessment includes a request for genetic.... Individual A's group health plan covers genetic testing for celiac disease for individuals who have family...

29 CFR 2590.702-1 - Additional requirements prohibiting discrimination based on genetic information.

Code of Federal Regulations, 2014 CFR

2014-07-01

...). Because completing the health risk assessment results in a premium reduction, the request for genetic.... (ii) Conclusion. In this Example 3, because the health risk assessment includes a request for genetic.... Individual A's group health plan covers genetic testing for celiac disease for individuals who have family...

29 CFR 2590.702-1 - Additional requirements prohibiting discrimination based on genetic information.

Code of Federal Regulations, 2011 CFR

2011-07-01

...). Because completing the health risk assessment results in a premium reduction, the request for genetic.... (ii) Conclusion. In this Example 3, because the health risk assessment includes a request for genetic.... Individual A's group health plan covers genetic testing for celiac disease for individuals who have family...

29 CFR 2590.702-1 - Additional requirements prohibiting discrimination based on genetic information.

Code of Federal Regulations, 2012 CFR

2012-07-01

...). Because completing the health risk assessment results in a premium reduction, the request for genetic.... (ii) Conclusion. In this Example 3, because the health risk assessment includes a request for genetic.... Individual A's group health plan covers genetic testing for celiac disease for individuals who have family...

Social Interaction and Stereotypic Responses to Homosexuals.

ERIC Educational Resources Information Center

Farrell, Ronald A.; Morrione, Thomas J.

This work focuses on the variations in societal responses perceived by male homosexuals in various group settings of interaction and on the relationship of these responses to their social status and related behavioral characteristics. Conclusions were based on the analysis of data collected from a sampling of 148 male homosexuals in and around a…

Physical Test Prototypes Based on Microcontroller

NASA Astrophysics Data System (ADS)

Paramitha, S. T.

2017-03-01

The purpose of this study was to produce a prototype of a physical test-based microcontroller. The research method uses the research and development of the Borg and gall. The procedure starts from the study; research and information collecting, planning, develop preliminary form of product, preliminary field testing, main product revision, playing field testing, operational product revision, field operational testing, final product revision, dissemination and implementation. Validation of the product, obtained through expert evaluation; test products of small scale and large scale; effectiveness test; evaluation of respondents. The results showed that the eligibility assessment of prototype products based physical tests microcontroller. Based on the ratings of seven experts showed that 87% included in the category of “very good” and 13% included in the category of “good”. While the effectiveness of the test results showed that 1). The results of the experimental group to test sit-ups increase by 40% and the control group by 15%. 2). The results of the experimental group to test push-ups increased by 30% and the control group by 10%. 3). The results of the experimental group to test the Back-ups increased by 25% and the control group by 10%. With a significant value of 0.002 less than 0.05, product means a physical test prototype microcontroller based, proven effective in improving the results of physical tests. Conclusions and recommendations; Product physical microcontroller-based assays, can be used to measure the physical tests of pushups, sit ups, and back-ups.

Report of the submillimeter splinter group

NASA Astrophysics Data System (ADS)

Harris, A. I.; Lequeux, J.

1992-12-01

The aim of the submillimeter splinter group of the LIST (Lunar Interferometry Study Team) was to examine the scientific and technical aspects of a submillimeter interferometer with an emphasis on heterodyne detection. The main elements of the scientific logic that lead to the conclusions that a heterodyne submillimeter array should have a collecting area of at order 1000 sq m are summarized. This conclusion is based on sensitivity constraints and the following points: anything that can be done from the ground, will be; an instrument as complex and expensive as a large submillimeter interferometer must be capable of significant extragalactic observations; and no matter what the future scientific trends are, looking at the main coolants will always be important. It is clear that an instrument of this size is several steps past the next generation of spaceborne observatories.

Using synchronous software in Web-based nursing courses.

PubMed

Little, Barbara Battin; Passmore, Denise; Schullo, Shauna

2006-01-01

To promote learning and enhance immediacy and satisfaction, a college of nursing at a large research I southern university undertook a pilot project to incorporate synchronous classroom software into an ongoing online program. Two synchronous class sessions using voice over Internet protocol were offered in the Community/Public Health Nursing course through Elluminate Live! Upon conclusion of the lecture, students were divided into breakout groups to work on group projects. Surveys were administered to the students and faculty before and after the class sessions. Evaluation of the pedagogical strategies used in the synchronous sessions was conducted by instructional technology faculty. Students in the pilot group reported higher levels of satisfaction with the Web-based course with synchronous sessions. In addition, students reported that group time at the end of the session was helpful for completing group projects. A majority responded that synchronous session activities and assignments facilitated their understanding of course content. This article presents a description of the synchronous classroom pilot project along with recommendations for implementation and pedagogical approaches.

Impact Evaluation of an Addiction Intervention Program in a Quebec Prison

PubMed Central

Arseneault, Catherine; Alain, Marc; Plourde, Chantal; Ferland, Francine; Blanchette-Martin, Nadine; Rousseau, Michel

2015-01-01

OBJECTIVES This study evaluates the effects of a prison-based addiction intervention program. The evaluation is based on a multidimensional data collection that draws a portrait of the respondents’ substance use, and of their psychological/emotional, social, and judicial spheres. It measures the changes, or lack thereof, in substance use; the psychological/emotional, social, and judicial spheres; as well as the post-treatment services used. METHOD A quasi-experimental repeated measures design (0, 6 weeks, and 6 months) was used. Effects of the program were identified by comparing the results obtained by a group of inmates who had participated in the program (n = 80; experimental group) with those of another group who had received no intervention (n = 70; control group). RESULTS The preliminary results suggested a certain treatment effect related to impulsivity and psychological distress. CONCLUSION Although the preliminary results were promising, the experimental and control groups did not differ significantly when more robust analyses were used. PMID:26056466

Adenosine triphosphate-based chemotherapy response assay-guided chemotherapy in unresectable colorectal liver metastasis

PubMed Central

Hur, H; Kim, N K; Kim, H G; Min, B S; Lee, K Y; Shin, S J; Cheon, J H; Choi, S H

2012-01-01

Background: This study aims to evaluate the effectiveness of adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided neoadjuvant chemotherapy for increasing resectability in patients with unresectable colorectal liver metastasis. Patients and methods: Patients were randomised into two groups: Group A was treated by conventional chemotherapy regimen and Group B was treated by chemotherapy regimen according to the ATP-CRA. Three chemotherapeutic agents (5-fluorouracil, oxaliplatin and irinotecan) were tested by ATP-CRA and more sensitive agents were selected. Either FOLFOX or FOLFIRI was administered. Between Group A and B, treatment response and resectability were compared. Results: Between November 2008 and October 2010, a total 63 patients were randomised to Group A (N=32) or Group B (N=31). FOLFOX was more preferred in Group A than in Group B (26 out of 32 (81.3%) vs 20 out of 31 (64.5%)). Group B showed better treatment response than Group A (48.4% vs 21.9%, P=0.027). The resectability of hepatic lesion was higher in Group B (35.5% vs 12.5%, P=0.032). Mean duration from chemotherapy onset to the time of liver resection was 11 cycles (range 4–12) in Group A and 8 cycles (range 8–16) in Group B. Conclusion: This study showed that tailored-chemotherapy based on ATP-CRA could improve the treatment response and resectability in initially unresectable colorectal liver metastasis. PMID:22068817

Comparison of the effect of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume on midwifery students: A randomized clinical trial

PubMed Central

Kordi, Masoumeh; Fakari, Farzaneh Rashidi; Mazloum, Seyed Reza; Khadivzadeh, Talaat; Akhlaghi, Farideh; Tara, Mahmoud

2016-01-01

Introduction: Delay in diagnosis of bleeding can be due to underestimation of the actual amount of blood loss during delivery. Therefore, this research aimed to compare the efficacy of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume. Materials and Methods: This three-group randomized clinical trial study was performed on 105 midwifery students in Mashhad School of Nursing and Midwifery in 2013. The samples were selected by the convenience method and were randomly divided into three groups of web-based, simulation-based, and conventional training. The three groups participated before and 1 week after the training course in eight station practical tests, then, the students of the web-based group were trained on-line for 1 week, the students of the simulation-based group were trained in the Clinical Skills Centre for 4 h, and the students of the conventional group were trained for 4 h presentation by researchers. The data gathering tool was a demographic questionnaire designed by the researchers and objective structured clinical examination. Data were analyzed by software version 11.5. Results: The accuracy of visual estimation of postpartum hemorrhage volume after training increased significantly in the three groups at all stations (1, 2, 4, 5, 6 and 7 (P = 0.001), 8 (P = 0.027)) except station 3 (blood loss of 20 cc, P = 0.095), but the mean score of blood loss estimation after training did not significantly different between the three groups (P = 0.95). Conclusion: Training increased the accuracy of estimation of postpartum hemorrhage, but no significant difference was found among the three training groups. We can use web-based training as a substitute or supplement of training along with two other more common simulation and conventional methods. PMID:27500175

Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

PubMed

Park, Yu-Hyung; Lee, Chi-Ho; Lee, Byoung-Hee

2013-01-01

This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (P< 0.05), however, no significant difference was observed in other gait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

Effect of surface preparation with Nd:YAG and Er,Cr:YSGG lasers on the repair bond strength of lithium disilicate glass ceramic to a silorane-based composite resin.

PubMed

Ebrahimi Chaharom, Mohammad Esmaeel; Pournaghi Azar, Fatemeh; Mohammadi, Narmin; Nasiri, Rezvan

2018-01-01

Background. This study was undertaken to evaluate the repair bond strength of lithium disilicate glass ceramic to a silorane-based composite resin after surface preparation with Nd:YAG and Er,Cr:YSGG lasers. Methods. A total of 102 lithium disilicate glass ceramic samples (IPS e.max Press), measuring 5 mm in diameter and 4 mm in thickness, were randomly assigned to 6 groups (n=17): group 1, no surface preparation (control); group 2, acid etching with 9.5% hydrofluoric acid (HF); group 3, surface preparation with 4.5-W Nd:YAG laser; group 4, surface preparation with 6-W Nd:YAG laser; group 5, surface preparation with 1.5-W Er,Cr:YSGG laser; and group 6, surface preparation with 6-W Er,Cr:YSGG laser. After preparation of surfaces and application of silane, all the samples were repaired with the use of a silorane-based composite resin, followed by storage in distilled water at a temperature of 37°C for 24 hours and thermocycling. Finally, the samples were subjected to a shearing bond strength test; the fracture modes were determined under a stereomi-croscope. Results. There were significant differences between the HF group and the other groups (P=0.000). Two-by-two comparisons of the other groups revealed no significant differences (P>0.05). Conclusion. Use of HF proved the most effective surface preparation technique to increase the repair bond strength between lithium disilicate glass ceramic and silorane-based composite resin; compared to the control group.

Evaluating the short-term and long-term effects of an internet-based aural rehabilitation programme for hearing aid users in general clinical practice: a randomised controlled trial

PubMed Central

Malmberg, Milijana; Lunner, Thomas; Kähäri, Kim; Andersson, Gerhard

2017-01-01

Objective Guided internet-based intervention beyond hearing aid (HA) fitting has been shown to be efficacious in randomised controlled trials (RCTs). However, internet interventions have rarely been applied clinically as a part of regular aural rehabilitation (AR). Our aim was to evaluate the effectiveness of internet-based AR for HA users from a clinical population. Outcome measures The Hearing Handicap Inventory for the Elderly (HHIE) was used as the primary outcome measure, and the Communication Strategies Scale (CSS) and the Hospital Anxiety and Depression Scale were used as secondary outcome measures. All questionnaires were administered before and directly after the intervention and at 6 months postintervention. Methods We used a parallel group design (RCT). The data were collected in 2013–2014 at three different clinics. Seventy-four HA users were randomly assigned to receive either full internet-based AR (intervention group, n=37) or one element of the internet-based AR (control group, n=37). Results Data were analysed following the intention-to-treat principle. Each group showed improved HHIE scores over time and did not differ significantly from each other. The intervention group showed significantly greater improvement compared with the control group for the CSS total and the non-verbal subscale scores. The intervention group and control group were also subdivided into two age groups: 20–59 years and 60–80 years. Significantly better improvement on the CSS total and non-verbal subscale scores was found in the older group compared with the younger participants. Conclusions This study indicates that participants in an internet-based intervention applied in general clinical practice showed improved self-reported communication skills compared with a control group. Receiving a full intervention was not more effective in improving self-reported hearing problems than receiving just one element of the internet-based intervention. Trial registration number This trial is registered at ClinicalTrals.gov, NCT01837550; results. PMID:28592571

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

PubMed

Lee, Myung-Mo; Shin, Doo-Chul; Song, Chang-Ho

2016-07-01

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

Effects of Mobile Phone-Based App Learning Compared to Computer-Based Web Learning on Nursing Students: Pilot Randomized Controlled Trial

PubMed Central

2015-01-01

Objectives This study aimed to determine the effect of mobile-based discussion versus computer-based discussion on self-directed learning readiness, academic motivation, learner-interface interaction, and flow state. Methods This randomized controlled trial was conducted at one university. Eighty-six nursing students who were able to use a computer, had home Internet access, and used a mobile phone were recruited. Participants were randomly assigned to either the mobile phone app-based discussion group (n = 45) or a computer web-based discussion group (n = 41). The effect was measured at before and after an online discussion via self-reported surveys that addressed academic motivation, self-directed learning readiness, time distortion, learner-learner interaction, learner-interface interaction, and flow state. Results The change in extrinsic motivation on identified regulation in the academic motivation (p = 0.011) as well as independence and ability to use basic study (p = 0.047) and positive orientation to the future in self-directed learning readiness (p = 0.021) from pre-intervention to post-intervention was significantly more positive in the mobile phone app-based group compared to the computer web-based discussion group. Interaction between learner and interface (p = 0.002), having clear goals (p = 0.012), and giving and receiving unambiguous feedback (p = 0.049) in flow state was significantly higher in the mobile phone app-based discussion group than it was in the computer web-based discussion group at post-test. Conclusions The mobile phone might offer more valuable learning opportunities for discussion teaching and learning methods in terms of self-directed learning readiness, academic motivation, learner-interface interaction, and the flow state of the learning process compared to the computer. PMID:25995965

Comparing the effect of group-based and compact disk-based training on midwives’ knowledge and attitude toward domestic violence in women of reproductive age

PubMed Central

Vakily, Masoomeh; Noroozi, Mahnaz; Yamani, Nikoo

2017-01-01

BACKGROUND: Training the health personnel about domestic violence would cause them to investigate and evaluate this issue more than before. Considering the new educational approaches for transferring knowledge, the goal of this research was to compare the effect of group-based and compact disk (CD)-based training on midwives’ knowledge and attitude toward domestic violence. METHODS: In this clinical experiment, seventy midwives working at health centers and hospitals of Isfahan were randomly allocated into two classes of group-based and CD-based trainings and were trained in the fields of recognition, prevention, and management of domestic violence. Data were collected by questionnaires which were completed by the midwives for evaluation of their knowledge and attitude. RESULTS: The mean score of midwives’ knowledge and attitude toward domestic violence had a meaningful increase after the training (16.1, 46.9) compared to the score of before the training (12.1, 39.1) in both of the classes (group-based training: 17.7, 45.4) (CD-based training: 11.7, 38.6). No meaningful difference was observed between the two groups regarding midwives’ attitude toward domestic violence after the intervention; however, regarding their knowledge level, the difference was statistically meaningful (P = 0.001), and this knowledge increase was more in the CD-based training group. CONCLUSIONS: In spite of the effectiveness of both of the training methods in promoting midwives’ knowledge and attitude about domestic violence, training with CD was more effective in increasing their knowledge; as a result, considering the benefits of CD-based training such as cost-effectiveness and possibility of use at any time, it is advised to be used in training programs for the health personnel. PMID:28852660

Effect of high pressurization versus normal pressurization on changes in intraocular pressure immediately after clear corneal cataract surgery.

PubMed

Hayashi, Ken; Yoshida, Motoaki; Manabe, Shin-Ichi; Yoshimura, Koichi

2014-01-01

To compare changes in intraocular pressure (IOP) immediately after clear corneal incision (CCI) cataract surgery between eyes in which IOP was adjusted to a high or normal range at the conclusion of surgery. Hayashi Eye Hospital, Fukuoka, Japan. Comparative case series. Either eye of patients scheduled for phacoemulsification was randomized to 1 of 2 groups as follows: eyes that were to be adjusted to (1) high IOP (22 to 40 mm Hg) or (2) normal IOP (10 to 21 mm Hg). The IOP was measured using a rebound tonometer preoperatively; at the conclusion of surgery; and 15, 30, 60, 120, and 180 minutes and 24 hours postoperatively. The Seidel test and anterior segment optical coherence tomography (AS-OCT) were performed. The mean IOP at the conclusion of surgery was 31.3 mm Hg in the high IOP group and 17.1 mm Hg in the normal IOP group. The IOP decreased to approximately 15 mm Hg by 15 minutes and did not change until 60 minutes in either group. The mean IOP did not differ significantly between groups throughout the observation period (P ≥.0634). Hypotony of 5 mm Hg or less was not detected in any eye. The Seidel test was negative and based on AS-OCT, the wound was closed at 60 minutes in all eyes. After adjusting IOP to a high or normal range, the IOP normalized within 15 minutes postoperatively and was stable for 24 hours. The wound was closed within 60 minutes postoperatively. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

The U.S. Food and Drug Administration Risk Assessment on Lead in Women’s and Children’s Vitamins Is Based on Outdated Assumptions

PubMed Central

Miodovnik, Amir; Landrigan, Philip J.

2009-01-01

Background Following a recent report of lead in certain commercial vitamin products, the U.S. Food and Drug Administration (FDA) conducted a nationwide survey to determine the Pb content in 324 multivitamin/mineral products labeled for use by women and children. The FDA compared estimated Pb exposures from each product with safe/tolerable exposure levels, termed provisional total tolerable intake (PTTI) levels, previously developed for at-risk population groups in 1992. Objective We investigated the FDA’s conclusions that Pb concentrations in all vitamin products examined do not pose a hazard to health because they are below the PTTI levels for all groups considered. Discussion For their initial estimations of PTTI levels, the FDA used a blood lead level (BLL) of 10 μg/dL as the threshold for adverse effects in children and in pregnant or lactating women. Studies have repeatedly linked chronic exposure to BLLs < 10 μg/dL with impairments in cognitive function and behavior in young children despite the absence of overt signs of toxicity. The FDA analysis also omitted any consideration of nonfood sources of Pb exposure, which is inconsistent with our current understanding of how most children develop elevated BLLs. Conclusion We feel that based on these oversights, the FDA’s conclusions are unduly reassuring and that reconsideration of their current recommendations appears warranted. PMID:19654907

The Effect of Obstacle Training in Water on Static Balance of Chronic Stroke Patients

PubMed Central

Jung, JaeHyun; Lee, JiYeun; Chung, EunJung; Kim, Kyoung

2014-01-01

[Purpose] This study evaluated the effects of water and land-based obstacle training on static balance of chronic stroke patients. [Subjects] The subjects were randomly allocated to an aqua group (n=15) and a land group (n=15). [Methods] Both groups trained for 40 minutes, 3 times a week for 12 weeks. Static balance was assessed by measuring the mean velocities of mediolateral (ML) and anteroposterior (AP), and sway area with the eyes closed. [Results] Following the intervention, both groups showed significant changes in ML velocity, AP velocity, and sway area. The static balance of the aqua group was significantly better than the land group. [Conclusion] The results of this study suggest the feasibility and suitability of obstacle training in water for stroke patients. PMID:24707102

Regional health care planning: a methodology to cluster facilities using community utilization patterns

PubMed Central

2013-01-01

Background Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state’s Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. Methods The clustering methodology employs a 2-step K-means + Ward’s clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Results Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Conclusions Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units. PMID:23964905

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

Yang, Xiaofeng; Yoshida, Emi; Cassidy, Richard J.

Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performedmore » in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.« less

The Impact of Financial Incentives on Physician Productivity in Medical Groups

PubMed Central

Conrad, Douglas A; Sales, Anne; Liang, Su-Ying; Chaudhuri, Anoshua; Maynard, Charles; Pieper, Lisa; Weinstein, Laurel; Gans, David; Piland, Neill

2002-01-01

Objective To estimate the effect of financial incentives in medical groups—both at the level of individual physician and collectively—on individual physician productivity. Data Sources/Study Setting Secondary data from 1997 on individual physician and group characteristics from two surveys: Medical Group Management Association (MGMA) Physician Compensation and Production Survey and the Cost Survey; Area Resource File data on market characteristics, and various sources of state regulatory data. Study Design Cross-sectional estimation of individual physician production function models, using ordinary least squares and two-stage least squares regression. Data Collection Data from respondents completing all items required for the two stages of production function estimation on both MGMA surveys (with RBRVS units as production measure: 102 groups, 2,237 physicians; and with charges as the production measure: 383 groups, 6,129 physicians). The 102 groups with complete data represent 1.8 percent of the 5,725 MGMA member groups. Principal Findings Individual production-based physician compensation leads to increased productivity, as expected (elasticity=.07, p<.05). The productivity effects of compensation methods based on equal shares of group net income and incentive bonuses are significantly positive (p<.05) and smaller in magnitude. The group-levelfinancial incentive does not appear to be significantly related to physician productivity. Conclusions Individual physician incentives based on own production do increase physician productivity. PMID:12236389

Initial construct validity evidence of a virtual human application for competency assessment in breaking bad news to a cancer patient

PubMed Central

Guetterman, Timothy C; Kron, Frederick W; Campbell, Toby C; Scerbo, Mark W; Zelenski, Amy B; Cleary, James F; Fetters, Michael D

2017-01-01

Background Despite interest in using virtual humans (VHs) for assessing health care communication, evidence of validity is limited. We evaluated the validity of a VH application, MPathic-VR, for assessing performance-based competence in breaking bad news (BBN) to a VH patient. Methods We used a two-group quasi-experimental design, with residents participating in a 3-hour seminar on BBN. Group A (n=15) completed the VH simulation before and after the seminar, and Group B (n=12) completed the VH simulation only after the BBN seminar to avoid the possibility that testing alone affected performance. Pre- and postseminar differences for Group A were analyzed with a paired t-test, and comparisons between Groups A and B were analyzed with an independent t-test. Results Compared to the preseminar result, Group A’s postseminar scores improved significantly, indicating that the VH program was sensitive to differences in assessing performance-based competence in BBN. Postseminar scores of Group A and Group B were not significantly different, indicating that both groups performed similarly on the VH program. Conclusion Improved pre–post scores demonstrate acquisition of skills in BBN to a VH patient. Pretest sensitization did not appear to influence posttest assessment. These results provide initial construct validity evidence that the VH program is effective for assessing BBN performance-based communication competence. PMID:28794664

Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia

PubMed Central

Barrio, Concepción; Yamada, Ann-Marie

2011-01-01

Objectives This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. Results Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. Conclusions This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations. PMID:22121328

Ability Group Configuration for the High School Physics Classroom

NASA Astrophysics Data System (ADS)

Zitnik, Scott

This research project looks to investigate the effectiveness of different ability grouping arrangements for the high school physics classroom. Students were first organized based on their academic aptitude in physics into three general groups of high, medium, and low achieving students. They were then divided into both groups of four and dyads that were constructed in one of four arrangements, namely: random, homogeneous, heterogeneous, or student choice. Data was collected based on their academic performance as well as survey responses regarding the group and dyad performance. Students worked in a rotation of these groups and dyads for a unit to measure student preference and introduce collaborative work formally to the classes. At this point it was evident that students preferred the student choice arrangement based on survey responses, yet the student choice survey responses also resulted in the lowest level of reliability when compared to all other grouping methods. For the next unit students were kept in either the random, homogeneous, or heterogeneous grouping arrangement for the entirety of the unit. At the conclusion of the second unit student achievement as well as survey responses were analyzed. As a result of this research there appears to be a slight student preference as well as academic benefit to homogeneous group and dyad arrangements for each of the three ability groups of students in the high school physics classroom when compared to random and heterogeneous grouping methods of academic group arrangement.

The Effect of Magnetic Fields on Wound Healing

PubMed Central

Henry, Steven L; Concannon, Matthew J; Yee, Gloria J

2008-01-01

Objective: Magnets are purported to aid wound healing despite a paucity of scientific evidence. The purpose of this study was to evaluate the effect of static magnetic fields on cutaneous wound healing in an animal model. The literature was reviewed to explore the historical and scientific basis of magnet therapy and to define its current role in the evidence-based practice of plastic surgery. Methods: Standardized wounds were created on the backs of 33 Sprague-Dawley rats, which were divided into 3 groups with either a 23 gauss magnet (group 1), a sham magnet (group 2), or nothing (group 3) positioned over the wound. The rate of wound closure by secondary intention was compared between the groups. Literature review was conducted through searches of PubMed and Ovid databases for articles pertinent to magnets and wound healing. Results: Wounds in the magnet group healed in an average of 15.3 days, significantly faster than those in either the sham group (20.9 days, P = .006) or control group (20.3 days, P < .0001). There was no statistically significant difference between the sham and control groups (P = .45). Conclusions: An externally applied, low-power, static magnetic field increases the rate of secondary healing. Review of the literature reveals conflicting evidence regarding the use of magnetic energy to aid the healing of bone, tendon, and skin. Level I studies are lacking and difficult to execute but are needed to define conclusively the role of magnets in clinical practice. PMID:18725953

A review of evaluative studies of computer-based learning in nursing education.

PubMed

Lewis, M J; Davies, R; Jenkins, D; Tait, M I

2001-01-01

Although there have been numerous attempts to evaluate the learning benefits of computer-based learning (CBL) packages in nursing education, the results obtained have been equivocal. A literature search conducted for this review found 25 reports of the evaluation of nursing CBL packages since 1966. Detailed analysis of the evaluation methods used in these reports revealed that most had significant design flaws, including the use of too small a sample group, the lack of a control group, etc. Because of this, the conclusions reached were not always valid. More effort is required in the design of future evaluation studies of nursing CBL packages. Copyright 2001 Harcourt Publishers Ltd.

Empirical Studies on the Network of Social Groups: The Case of Tencent QQ

PubMed Central

You, Zhi-Qiang; Han, Xiao-Pu; Lü, Linyuan; Yeung, Chi Ho

2015-01-01

Background Participation in social groups are important but the collective behaviors of human as a group are difficult to analyze due to the difficulties to quantify ordinary social relation, group membership, and to collect a comprehensive dataset. Such difficulties can be circumvented by analyzing online social networks. Methodology/Principal Findings In this paper, we analyze a comprehensive dataset released from Tencent QQ, an instant messenger with the highest market share in China. Specifically, we analyze three derivative networks involving groups and their members—the hypergraph of groups, the network of groups and the user network—to reveal social interactions at microscopic and mesoscopic level. Conclusions/Significance Our results uncover interesting behaviors on the growth of user groups, the interactions between groups, and their relationship with member age and gender. These findings lead to insights which are difficult to obtain in social networks based on personal contacts. PMID:26176850

Effects of a Combined Exercise Program Using an iPad for Older Adults

PubMed Central

Lee, Juhee; Byun, Jinyee; Lee, Minkyung

2016-01-01

Objectives The purpose of this study was to examine the function, health status, and efficacy effects of a combined exercise program using an iPad among older women in Korea, a tech-savvy country. Methods The study employed a pretest and posttest experimental design with a control group. The experimental group of subjects comprised 16 female older adults and the control group comprised 10 who were aged 65 years or older. The experimental group participated in a supervised group-based exercise program and an individualized home-based exercise program that involved the use of an iPad. The combined group and home-based exercise program consisted of group exercise, which took place in a senior center for 30 minutes weekly, and a home-based iPad exercise program, which the subjects followed at least 3 times a week. The collected data were analyzed using the Statistical Analysis System (SAS ver. 9.3 TS Level 1M0) program, which utilized a chi-square test, a Fisher exact test, a t-test, and a repeated-measures ANOVA. Results The results showed that cognitive status changed significantly over time, and there was an interaction between group and time. Further, self-efficacy for exercise and outcome expectations for exercise changed significantly over time. Conclusions Exercise programs using iPad interventions may be useful for the management of cognitive functioning and the integration of functional physical abilities in older adults. PMID:27200215

Recommendations for a Culturally Relevant Internet-Based Tool to Promote Physical Activity Among Overweight Young African American Women, Alabama, 2010–2011

PubMed Central

Joseph, Rodney P.; Cherrington, Andrea; Cuffee, Yendelela; Knight, BernNadette; Lewis, Dwight; Allison, Jeroan J.

2014-01-01

Introduction Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women. Methods A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes. Results Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter). Conclusion Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population. PMID:24433625

Evaluation of the Shear Bond Strength of Composite Resin to Wet and Dry Enamel Using Dentin Bonding Agents Containing Various Solvents

PubMed Central

Ramarao, Sathyanarayanan; John, Bindu Meera; Rajesh, Praveen; Swatha, S

2017-01-01

Introduction Bonding of composite resin to dentin mandates a wet substrate whereas, enamel should be dry. This may not be easily achievable in intracoronal preparations where enamel and dentin are closely placed to each other. Therefore, Dentin Bonding Agents (DBA) are recommended for enamel and dentinal bonding, where enamel is also left moist. A research question was raised if the “enamel-only” preparations will also benefit from wet enamel bonding and contemporary DBA. Aim The aim of this study was to compare the shear bond strengths of composite resin, bonded to dry and wet enamel using fifth generation DBA (etch and rinse system) containing various solvents such as ethanol/water, acetone and ethanol. Materials and Methods The crowns of 120 maxillary premolars were split into buccal and lingual halves. They were randomly allocated into four groups of DBA: Group 1-water/ethanol based, Group 2-acetone based, Group 3-ethanol based, Group 4-universal bonding agent (control group). The buccal halves and lingual halves were bonded using the wet bonding and dry bonding technique respectively. After application of the DBAs and composite resin build up, shear bond strength testing was done. Results Group 1 (ethanol/water based ESPE 3M, Adper Single Bond) showed highest bond strength of (23.15 MPa) in dry enamel. Group 2 (acetone based Denstply, Prime and Bond NT, showed equal bond strength in wet and dry enamel condition (18.87 MPa and 18.02 MPa respectively). Conclusion Dry enamel bonding and ethanol/water based etch and rinse DBA can be recommended for “enamel-only” tooth preparations. PMID:28274042

An Elective Course on Antimicrobial Stewardship

PubMed Central

Sherman, Elizabeth M.; Unger, Nathan R.

2015-01-01

Objective. To implement an antimicrobial stewardship (AS) elective course for second-year and third-year pharmacy students and to assess its impact on students’ perceptions regarding the application of AS principles. Design. A 2-credit elective course focusing on principles of AS incorporated prelecture didactic recordings with primary literature and guideline-based reading assignments, in-class active-learning group work and student-led presentations, and student-generated examination items. Assessment. Perceptions were assessed by precourse and postcourse survey items. Graded course assessments included completion of preclass assignments (readings, prerecorded lecture and writing assessment items), in-class active participation and group presentations, a midpoint examination, and a final examination. Conclusion. An AS-themed elective course in a doctor of pharmacy curriculum incorporating preclass, self-directed learning and in-class group-based active-learning strategies positively impacted students’ perceived understanding of AS strategies. PMID:26889069

Activating Lay Health Influencers to Promote Tobacco Cessation

PubMed Central

Muramoto, Myra L.; Hall, John R.; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z.; Lando, Harry A.

2014-01-01

Objective Evaluate the effect of tobacco cessation brief-intervention (BI) training for lay “health influencers,” on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Methods Randomized, community-based study comparing In-person or Web-based training, with mailed materials. Results In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants’ prior intervention experience, 80–86% reported BIs within the past 90 days; 71–79% reported ≥1 in the past 30. Conclusions Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation. PMID:24636035

Effect of an Extra Hydrophobic Resin Layer on Repair Shear Bond Strength of a Silorane-Based Composite Resin

PubMed Central

Mohammadi, Narmin; Bahari, Mahmoud; Kimyai, Soodabeh; Rahbani Nobar, Behnam

2015-01-01

Objectives: Composite repair is a minimally invasive and conservative approach. This study aimed to evaluate the effect of an additional hydrophobic resin layer on the repair shear bond strength of a silorane-based composite repaired with silorane or methacrylate-based composite. Materials and Methods: Sixty bar-shaped composite blocks were fabricated and stored in saline for 72 hours. The surface of the samples were roughened by diamond burs and etched with phosphoric acid; then, they were randomly divided into three groups according to the repairing process: Group 1: Silorane composite-silorane bonding agent-silorane composite; group 2: Silorane composite-silorane bonding agent-hydrophobic resin-silorane composite, and group 3: Silorane composite-silorane bonding agent-hydrophobic resin methacrylate-based composite. Repairing composite blocks measured 2.5×2.5×5mm. After repairing, the samples were stored in saline for 24 hours and thermocycled for 1500 cycles. The repair bond strength was measured at a strain rate of 1mm/min. Twenty additional cylindrical composite blocks (diameter: 2.5mm, height: 6mm) were also fabricated for measuring the cohesive strength of silorane-based composite. The data were analyzed using One-way ANOVA and the post hoc Tukey’s test (α=0.05). Results: Cohesive bond strength of silorane composite was significantly higher than the repair bond strengths in other groups (P<0.001). The repair bond strength of group 3 was significantly higher than that of group 1 (P=0.001). Conclusion: Application of an additional hydrophobic resin layer for repair of silorane-based composite with a methacrylate-based composite enhanced the repair shear bond strength. PMID:27559348

Effects of malate supplementation on acid-base balance and productive performance in growing/finishing bull calves fed a high-grain diet.

PubMed

Castillo, Cristina; Benedito, Jose Luis; Pereira, Victor; Méndez, Jesus; Vazquez, Patricia; López-Alonso, Marta; Hernández, Joaquin

2008-02-01

This study investigated the effects of malate supplementation on blood acid-base balance and serum lactate levels in a 137-day feedlot experiment with bull calves. Animals were allotted to one of two experimental groups: (1) A control group (no supplementation), and (2) a group receiving a salt of DL-malic acid. Blood pH, pCO2, HCO3-, base excess, serum L-lactate and productivity parameters were evaluated. Our data reveal that under the conditions of the present experiment malate supplementation did not have any significant effect on productivity parameters by comparison with non-supplemented animals. As regards acid-base balance, no significant effects attributable only to malate were observed. In conclusion, the time-course and the overall means of serum L-lactate for both groups in both growing and finishing periods (0.44 +/- 0.04 mmol/l and 0.39 +/- 0.02 mmol/l, respectively, for control animal; and 0.54 +/- 0.03 mmol/l and 0.49 +/- 0.01 mmol/l, respectively, for supplemented animals) suggests that malate does not have any beneficial effects in animals fed a diet of similar characteristics to that given in this study.

A Lunar Optical-Ultraviolet-Infrared Synthesis Array (LOUISA)

NASA Technical Reports Server (NTRS)

Burns, Jack O. (Editor); Johnson, Stewart W. (Editor); Duric, Nebojsa (Editor)

1992-01-01

This document contains papers presented at a workshop held to consider 'optical ultraviolet infrared' interferometric observations from the moon. Part 1 is an introduction. Part 2 is a description of current and planned ground-based interferometers. Part 3 is a description of potential space-based interferometers. Part 4 addresses the potential for interferometry on the moon. Part 5 is the report of the workshop's working groups. Concluding remarks, summary, and conclusions are presented in Part 6.

The Effect of Latent Binary Variables on the Uncertainty of the Prediction of a Dichotomous Outcome Using Logistic Regression Based Propensity Score Matching.

PubMed

Szekér, Szabolcs; Vathy-Fogarassy, Ágnes

2018-01-01

Logistic regression based propensity score matching is a widely used method in case-control studies to select the individuals of the control group. This method creates a suitable control group if all factors affecting the output variable are known. However, if relevant latent variables exist as well, which are not taken into account during the calculations, the quality of the control group is uncertain. In this paper, we present a statistics-based research in which we try to determine the relationship between the accuracy of the logistic regression model and the uncertainty of the dependent variable of the control group defined by propensity score matching. Our analyses show that there is a linear correlation between the fit of the logistic regression model and the uncertainty of the output variable. In certain cases, a latent binary explanatory variable can result in a relative error of up to 70% in the prediction of the outcome variable. The observed phenomenon calls the attention of analysts to an important point, which must be taken into account when deducting conclusions.

Reduction of Cancer-Specific Thought Intrusions and Anxiety Symptoms With a Stress Management Intervention Among Women Undergoing Treatment for Breast Cancer

PubMed Central

Antoni, Michael H.; Wimberly, Sarah R.; Lechner, Suzanne C.; Kazi, Aisha; Sifre, Tammy; Urcuyo, Kenya R.; Phillips, Kristin; Smith, Roselyn G.; Petronis, Vida M.; Guellati, Sophie; Wells, Kurrie A.; Blomberg, Bonnie; Carver, Charles S.

2017-01-01

Objective After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. Method A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. Results The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. Conclusions Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer. PMID:17012691

School-based violence prevention strategy: a pilot evaluation

PubMed Central

Thakore, Rachel V.; Apfeld, Jordan C.; Johnson, Ronald K.; Sathiyakumar, Vasanth; Jahangir, A. Alex; Sethi, Manish K.

2015-01-01

Abstract: Background: Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Methods: Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program’s effectiveness in a pilot study in a Nashville middle school with high rates of violence. Results: 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students’ competencies to deal with violence (p less than 0.05). Conclusions: This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. PMID:24879077

Field of study variation throughout the college pipeline and its effect on the earnings gap: Differences between ethnic and immigrant groups in Israel.

PubMed

Alon, Sigal

2015-07-01

This study demonstrates the analytical leverage gained from considering the entire college pipeline-including the application, admission and graduation stages-in examining the economic position of various groups upon labor market entry. The findings, based on data from three elite universities in Israel, reveal that the process that shapes economic inequality between different ethnic and immigrant groups is not necessarily cumulative. Field of study stratification does not expand systematically from stage to stage and the position of groups on the field of study hierarchy at each stage is not entirely explained by academic preparation. Differential selection and attrition processes, as well as ambition and aspirations, also shape the position of ethnic groups in the earnings hierarchy and generate a non-cumulative pattern. These findings suggest that a cross-sectional assessment of field of study inequality at the graduation stage can generate misleading conclusions about group-based economic inequality among workers with a bachelor's degree. Copyright © 2015 Elsevier Inc. All rights reserved.

A comparison of the pharmacokinetic and pharmacodynamic properties of nitroglycerin according to the composition of the administration set

PubMed Central

Kim, Choon Ok; Song, Jeongyun; Min, Ji Young; Park, Su Jung; Lee, Hye Mi; Byon, Hyo-Jin

2018-01-01

Abstract Background: There is a risk of drug sorption into an intravenous administration set composed of polyvinyl chloride (PVC), polyurethane (PU), or polyolefin (PO). This has implications on the dose of the active ingredient the patient receives, and thus therapeutic success. This study aimed to determine the plasma concentration of nitroglycerin and the effect of nitroglycerin on patients based on the composition of the administration set. Methods: Using a randomized, open-labeled, 3 × 3 crossover method, 9 volunteers were assigned to 3 groups. In period I, nitroglycerin (100 μg/mL) was infused via a PVC- (group A), PU- (group B), or PO-based (group C) administration set. In period II, PU- (group A), PO- (group B), and PVC-based (group C) administration sets were used, and in period III, PO- (group A), PVC- (group B), and PU-based (group C) administration sets were used. The rate of drug administration in all periods was 12 mL/hour for 30 minutes using an infusion pump. Blood samples were collected, and the plasma concentrations of nitroglycerin were analyzed using validated high-performance liquid chromatography coupled with tandem mass spectrometry. Blood pressure was determined using a sphygmomanometer applied to the other upper arm at an interval of 5 minutes. Results: We observed that the mean plasma concentration of nitroglycerin over time when administered using a PO-based tube was higher than that when using a PU- or PVC-based tube. When the percent change of the mean arterial pressure from baseline at each time point was compared among groups, there were statistically significant differences between PU and PO or PVC at most points during nitroglycerin infusion. Conclusion: Our results showed higher nitroglycerin plasma concentration and lower arterial pressure when a PO-based administration set was used than when a PVC- or PU-based administration set was used. PO-based administration sets may be more appropriate for nitroglycerin administration compared to those composed of PVC or PU. PMID:29489681

Effect of temporary cements on the shear bond strength of luting cements

PubMed Central

FIORI-JÚNIOR, Marco; MATSUMOTO, Wilson; SILVA, Raquel Assed Bezerra; PORTO-NETO, Sizenando Toledo; SILVA, Jaciara Miranda Gomes

2010-01-01

Objective The purpose of this study was to evaluate, by shear bond strength (SBS) testing, the influence of different types of temporary cements on the final cementation using conventional and self-etching resin-based luting cements. Material and Methods Forty human teeth divided in two halves were assigned to 8 groups (n=10): I and V (no temporary cementation); II and VI: Ca(OH)2-based cement; III and VII: zinc oxide (ZO)based cement; IV and VIII: ZO-eugenol (ZOE)-based cement. Final cementation was done with RelyX ARC cement (groups I to IV) and RelyX Unicem cement (groups V to VIII). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. Results Means were (MPa): I - 3.80 (±1.481); II - 5.24 (±2.297); III - 6.98 (±1.885); IV - 6.54 (±1.459); V - 5.22 (±2.465); VI - 4.48 (±1.705); VII - 6.29 (±2.280); VIII - 2.47 (±2.076). Comparison of the groups that had the same temporary cementation (Groups II and VI; III and VII; IV and VIII) showed statistically significant difference (p<0.001) only between Groups IV and VIII, in which ZOE-based cements were used. The use of either Ca(OH)2 based (Groups II and VI) or ZO-based (Groups III and VII) cements showed no statistically significant difference (p>0.05) for the different luting cements (RelyXTM ARC and RelyXTM Unicem). The groups that had no temporary cementation (Groups I and V) did not differ significantly from each other either (p>0.05). Conclusion When temporary cementation was done with ZO- or ZOE-based cements and final cementation was done with RelyX ARC, there was an increase in the SBS compared to the control. In the groups cemented with RelyX Unicem, however, the use of a ZOE-based temporary cement affected negatively the SBS of the luting agent used for final cementation. PMID:20379679

The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

PubMed

Park, Jin-Hyuck; Park, Ji-Hyuk

2016-03-01

[Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement.

Neural adaptations after short-term wingate-based high-intensity interval training

PubMed Central

Vera-Ibañez, Antonio; Colomer-Poveda, David; Romero-Arenas, Salvador; Viñuela-García, Manuel; Márquez, Gonzalo

2017-01-01

Objectives: This study examined the neural adaptations associated with a low-volume Wingate-based High Intensity Interval Training (HIIT). Methods: Fourteen recreationally trained males were divided into an experimental (HIIT) and a control group to determine whether a short-term (4 weeks) Wingate-based HIIT program could alter the Hoffmann (H-) reflex, volitional (V-) wave and maximum voluntary contraction (MVC) of the plantar-flexor muscles, and the peak power achieved during a Wingate test. Results: Absolute and relative peak power increased in the HIIT group (ABS_Ppeak: +14.7%, P=0.001; and REL_Ppeak: +15.0%, P=0.001), but not in the control group (ABS_Ppeak: P=0.466; and REL_Ppeak: P=0.493). However, no significant changes were found in the MVC (P>0.05 for both groups). There was a significant increase in H-reflex size after HIIT (+24.5%, P=0.004), while it remained unchanged in the control group (P=0.134). No significant changes were observed either in the V-wave or in the Vwave/Mwave ratio (P>0.05 for both groups). Conclusion: The Wingate-based training led to an increased peak power together with a higher spinal excitability. However, no changes were found either in the volitional wave or in the MVC, indicating a lack of adaptation in the central motor drive. PMID:29199186

Comparison of the outcome of burn patients using acute-phase plasma base deficit.

PubMed

Salehi, S H; As'adi, K; Mousavi, J

2011-12-31

Background. In recent years, plasma base deficit has been used as a marker to determine the status of tissue perfusion in trauma patients and also to predict the outcome of these patients. This study was performed to investigate the effect of plasma base deficit in predicting burn patient outcome. Methods. This prospective cohort study was performed from October 2009 to October 2010 in the acute phase of burn patients who were admitted within 6 h post-injury to Motahari Burn Hospital in Iran. The patients were divided into two groups based on the plasma base deficit in the first 24 h post-injury: group A, in which the mean plasma base deficit was less than or equal to -6 (more negative), and group B, in which the mean plasma base deficit greater than -6. Statistical analysis was performed using SPSS v.16 software. Results. Thirty-eight patients were enrolled in each group. The mean plasma base deficit in group A (-7.76 ± 2.18 mmol) was significantly less than that in group B (-1.19 ± 2.82) mmol (p < 0.05). Although there was no significant difference between the mean of fluid resuscitation and urine output in the first 24 h after injury between the two groups (p > 0.05) and despite removal of interfering factors, there were significant differences between the systemic inflammatory response syndrome and the multiple organ dysfunction syndrome score and the percentage of sepsis between the two groups (p < 0.05). The mortality rate in group A (63.2%) was significantly higher than that in group B (36.8%) (p > 0.05). Conclusion. The plasma base deficit can be used as a valuable marker in the resuscitation of burn patients, along with clinical criteria. Physiological indicators (burn percentage, age, and mucosal burns) are not sufficient to predict mortality and morbidity in burn patients, and it is necessary to investigate the role of biochemical markers such as base deficit in determining the final outcome of burn patients.

Active-learning versus teacher-centered instruction for learning acids and bases

NASA Astrophysics Data System (ADS)

Acar Sesen, Burcin; Tarhan, Leman

2011-07-01

Background and purpose: Active-learning as a student-centered learning process has begun to take more interest in constructing scientific knowledge. For this reason, this study aimed to investigate the effectiveness of active-learning implementation on high-school students' understanding of 'acids and bases'. Sample The sample of this study was 45 high-school students (average age 17 years) from two different classes, which were randomly assigned to the experimental (n = 21) and control groups (n = 25), in a high school in Turkey. Design and methods A pre-test consisting of 25 items was applied to both experimental and control groups before the treatment in order to identify student prerequisite knowledge about their proficiency for learning 'acids and bases'. A one-way analysis of variance (ANOVA) was conducted to compare the pre-test scores for groups and no significant difference was found between experimental (ME = 40.14) and control groups (MC = 41.92) in terms of mean scores (F 1,43 = 2.66, p > 0.05). The experimental group was taught using an active-learning curriculum developed by the authors and the control group was taught using traditional course content based on teacher-centered instruction. After the implementation, 'Acids and Bases Achievement Test' scores were collected for both groups. Results ANOVA results showed that students' 'Acids and Bases Achievement Test' post-test scores differed significantly in terms of groups (F 1,43 = 102.53; p < 0.05). Additionally, in this study 54 misconceptions, 14 of them not reported in the literature before, were observed in the following terms: 'acid and base theories'; 'metal and non-metal oxides'; 'acid and base strengths'; 'neutralization'; 'pH and pOH'; 'hydrolysis'; 'acid-base equilibrium'; 'buffers'; 'indicators'; and 'titration'. Based on the achievement test and individual interview results, it was found that high-school students in the experimental group had fewer misconceptions and understood the concepts more meaningfully than students in control group. Conclusion The study revealed that active-learning implementation is more effective at improving students' learning achievement and preventing misconceptions.

The Evaluation of the College Graduate--Logic, Method and Findings. AIR Forum 1981 Paper.

ERIC Educational Resources Information Center

Nelson, Kim; Lewis, John

The extent to which graduates of Winona State University (WSU) Minnesota, attained their goals after college graduation was investigated, based on a survey mailed to all WSU graduates. Returns were obtained for 4,660 graduates, representing 33 percent of the total group. Survey results suggest the following conclusions: the vast majority of…

Research Review: Reading Comprehension in Developmental Disorders of Language and Communication

ERIC Educational Resources Information Center

Ricketts, Jessie

2011-01-01

Background: Deficits in reading airment (SLI), Down syndrome (DS) and autism spectrum disorders (ASD). Methods: In this review (based on a search of the ISI Web of Knowledge database to 2011), the Simple View of Reading is used as a framework for considering reading comprehension in these groups. Conclusions: There is substantial evidence for…

Synthesis of Aryl-Substituted 2,4-Dinitrophenylamines: Nucleophilic Aromatic Substitution as a Problem-Solving and Collaborative-Learning Approach

ERIC Educational Resources Information Center

Santos, Elvira Santos; Garcia, Irma Cruz Gavilan; Gomez, Eva Florencia Lejarazo; Vilchis-Reyes, Miguel Angel

2010-01-01

A series of experiments based on problem-solving and collaborative-learning pedagogies are described that encourage students to interpret results and draw conclusions from data. Different approaches including parallel library synthesis, solvent variation, and leaving group variation are used to study a nucleophilic aromatic substitution of…

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

ERIC Educational Resources Information Center

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

2011-01-01

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

37: COMPARISON OF TWO METHODS: TBL-BASED AND LECTURE-BASED LEARNING IN NURSING CARE OF PATIENTS WITH DIABETES IN NURSING STUDENTS

PubMed Central

Khodaveisi, Masoud; Qaderian, Khosro; Oshvandi, Khodayar; Soltanian, Ali Reza; Vardanjani, Mehdi molavi

2017-01-01

Background and aims learning plays an important role in developing nursing skills and right care-taking. The Present study aims to evaluate two learning methods based on team –based learning and lecture-based learning in learning care-taking of patients with diabetes in nursing students. Method In this quasi-experimental study, 64 students in term 4 in nursing college of Bukan and Miandoab were included in the study based on knowledge and performance questionnaire including 15 questions based on knowledge and 5 questions based on performance on care-taking in patients with diabetes were used as data collection tool whose reliability was confirmed by cronbach alpha (r=0.83) by the researcher. To compare the mean score of knowledge and performance in each group in pre-test step and post-test step, pair –t test and to compare mean of scores in two groups of control and intervention, the independent t- test was used. Results There was not significant statistical difference between two groups in pre terms of knowledge and performance score (p=0.784). There was significant difference between the mean of knowledge scores and diabetes performance in the post-test in the team-based learning group and lecture-based learning group (p=0.001). There was significant difference between the mean score of knowledge of diabetes care in pre-test and post-test in base learning groups (p=0.001). Conclusion In both methods team-based and lecture-based learning approaches resulted in improvement in learning in students, but the rate of learning in the team-based learning approach is greater compared to that of lecture-based learning and it is recommended that this method be used as a higher education method in the education of students.

Comparison of SMR, PMR, and PCMR in a cohort of union members potentially exposed to diesel exhaust emissions.

PubMed Central

Wong, O; Morgan, R W; Kheifets, L; Larson, S R

1985-01-01

A comparison of cause specific standarised mortality ratios (SMRs) and proportionate mortality ratios (PMRs) or proportionate cancer mortality ratios (PCMRs) was made based on the mortality experience of a cohort of 34 156 members of a heavy equipment operators union. Two types of PMRs or PCMRs were used in the comparison: those based on all deaths and those based on deaths known to the union only. The comparison indicated that, for the entire cohort, both types of PMRs were poor indicators for cancer risk and produced a large number of false positives. On the other hand, PCMRs appeared to be better than PMRs for assessing the direction of site specific cancer risk, but they tended to overstate the magnitude of risk. Analysis by duration of union membership or latency indicated that PMRs or PCMRs based on deaths known to the union tended to overestimate the risk of lung cancer by disproportionately larger amounts in groups with shorter time than in groups with longer time. This differential bias had the net effect of reducing the gradient of any trend or eliminating the trend entirely. In conclusion, PMR or PCMR, based on reasonably sufficient death ascertainment, has a certain usefulness in generating hypotheses, but they are not useful or reliable in measuring the magnitude of risk or in detecting trends in dose response analysis. No conclusion should be drawn from either PMR or PCMR. PMID:2410011

Preliminary investigation into application of problem-based learning in the practical teaching of diagnostics

PubMed Central

Rui, Zeng; Rong-Zheng, Yue; Hong-Yu, Qiu; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

2015-01-01

Background Problem-based learning (PBL) is a pedagogical approach based on problems. Specifically, it is a student-centered, problem-oriented teaching method that is conducted through group discussions. The aim of our study is to explore the effects of PBL in diagnostic teaching for Chinese medical students. Methods A prospective, randomized controlled trial was conducted. Eighty junior clinical medical students were randomly divided into two groups. Forty students were allocated to a PBL group and another 40 students were allocated to a control group using the traditional teaching method. Their scores in the practice skills examination, ability to write and analyze medical records, and results on the stage test and behavior observation scale were compared. A questionnaire was administered in the PBL group after class. Results There were no significant differences in scores for writing medical records, content of interviewing, physical examination skills, and stage test between the two groups. However, compared with the control group, the PBL group had significantly higher scores on case analysis, interviewing skills, and behavioral observation scales. Conclusion The questionnaire survey revealed that PBL could improve interest in learning, cultivate an ability to study independently, improve communication and analytical skills, and good team cooperation spirit. However, there were some shortcomings in systematization of imparting knowledge. PBL has an obvious advantage in teaching with regard to diagnostic practice. PMID:25848334

Consumers’ Perceptions of Preconception Health

PubMed Central

Squiers, Linda; Mitchell, Elizabeth W.; Levis, Denise M.; Lynch, Molly; Dolina, Suzanne; Margolis, Marjorie; Scales, Monica; Kish-Doto, Julia

2015-01-01

Purpose To inform the development of a preconception health (PCH) social marketing plan, we conducted qualitative research with prospective consumers. Approach We present formative findings based on the four Ps of social marketing: product, price, promotion, and place. Setting We conducted focus groups with 10 groups of women in Atlanta, Georgia, in fall 2010. Participants We classified women aged 18 to 44 into five groups based on their pregnancy plans, and then further segmented the groups based on socioeconomic status for a total of 10 groups. Method The focus group guide was designed to elicit participants’ responses about the product, price, promotion, and placement of PCH. We used NVivo 9 software to analyze focus group data. Results Women planning a pregnancy in the future had different perspectives on PCH as a product than women not planning a pregnancy. Barriers to PCH included lack of social support, addiction, and lack of awareness about PCH. Participants preferred to think of PCH behaviors as “promoting” a healthy baby rather than preventing an unhealthy birth outcome. Many women in the focus groups preferred to hear PCH messages from a health care provider, among other channels. Conclusion The results from this research will inform the development of a social marketing plan for PCH and the development of concepts that will be tested with consumers to determine their viability for use in a national campaign. PMID:23286658

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses 1

PubMed Central

Cónsul-Giribet, María; Medina-Moya, José Luis

2014-01-01

OBJECTIVE: to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups. METHOD: an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups. RESULTS: the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice. CONCLUSIONS: the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life. PMID:25493666

Is Time an Important Problem in Management of Hypertension and Hypercholesterolemia by Using an Amlodipine-Atorvastatin Single Pill Combination?

PubMed

Zeng, Rui; Wang, Mian; Zhang, Li

2016-07-26

BACKGROUND Is the timing of dosing for amlodipine and atorvastatin important with regard to therapeutic efficacy? To answer this question, we designed an outpatient, practice-based, case-control study lasting 8 weeks. MATERIAL AND METHODS Two hundred patients were divided into 2 groups: in Group I, patients were provided with a single pill containing amlodipine/atorvastatin (5/20 mg) to be taken each night at 10 pm, and in Group II, patients were taking amlodipine (5 mg) and atorvastatin (20 mg) each morning at 7 am. RESULTS Our results indicated no obvious difference in blood pressure control between the 2 groups. Taking amlodipine at night not only lowered blood pressure, but it also provided better control during the peak blood pressure in the morning. Hypercholesterolemia control in the 2 groups was also not significantly different, taking atorvastatin in the morning was as effective as dosing at night in patients with hypercholesterolemia. While the carotid IMT, hs-CRP, and LVMI were significantly lower after treatment, no differences were found between the 2 groups. Although no obvious difference was found in adverse drug reactions between the 2 groups, compliance was much better in the single-pill group than in patients taking the 2 medications separately. CONCLUSIONS In conclusion, single-pill amlodipine-atorvastatin taken at night can lower blood pressure and reduce the morning peak blood pressure levels the next day. Additionally, this dosing method could improve patient adherence to the therapy.

Effects of school-based deworming on hemoglobin level, growth development and school performance of primary school children in North Sumatera

NASA Astrophysics Data System (ADS)

Pasaribu, A. P.; Angellee, J.; Pasaribu, S.

2018-03-01

Worm infestation is mainly caused by soil-transmitted helminths (STH) infecting one-third of the world’s population, where the most affected are primary school children. This chronic, long-lasting infection can affect the growth aspects in children. A school-based deworming is one of the treatments recommended by WHO to counterattack worm infection in primary school children. To evaluate the effect of school-based deworming on the hemoglobin level, growth and school performance of primary school children, an open randomized clinical trial was conducted on 165 targeted populations in SukaKaro village, North Sumatra; 156 of which were then chosen based on inclusion and exclusion criteria. The samples’ feces- sampling, hemoglobin level, and growth chart data were recorded on the first day of study before any treatment was given. They were then divided into two groups; the first group of 80 samples did not receive any treatment, while the second group of 76 samples received 400mg of albendazole as part of a school-based deworming program. The samples were being followed up after sixth months of study. In conclusion, albendazole is able to improve the hemoglobin level, growth development, and school performance of the samples, although there were no significant differences between the two groups.

Effect of different bleaching strategies on microhardness of a silorane-based composite resin.

PubMed

Bahari, Mahmoud; Savadi Oskoee, Siavash; Mohammadi, Narmin; Ebrahimi Chaharom, Mohammad Esmaeel; Godrati, Mostafa; Savadi Oskoee, Ayda

2016-01-01

Background. Dentists' awareness of the effects of bleaching agents on the surface and mechanical properties of restorative materials is of utmost importance. Therefore, this in vitro study was undertaken to investigate the effects of different bleaching strategies on the microhardness of a silorane-based composite resin. Methods. Eighty samples of a silorane-based composite resin (measuring 4 mm in diameter and 2 mm in thickness) were prepared within acrylic molds. The samples were polished and randomly assigned to 4 groups (n=20). Group 1 (controls) were stored in distilled water for 2 weeks. The samples in group 2 underwent a bleaching procedure with 15% carbamide peroxide for two weeks two hours daily. The samples in group 3 were bleached with 35% hydrogen peroxide twice 5 days apart for 30 minutes each time. The samples in group 4 underwent a bleaching procedure with light-activated 35% hydrogen peroxide under LED light once for 40 minutes. Then the microhardness of the samples was determined using Vickers method. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P < 0.05). Results. All the bleaching agents significantly decreased microhardness compared to the control group (P < 0.05). In addition, there were significant differences in microhardness between groups 2 and 4 (P = 0.001) and between groups 3 and 4 (P<0.001). However, no significant differences were detected in microhardness between groups 2 and 3 (P > 0.05). Conclusion. Bleaching agents decreased microhardness of silorane-based composite resin restorations, the magnitude of which depending on the bleaching strategy used.

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

PubMed Central

Luo, Ai-Jing; Chang, Wei-Fu; Xin, Zi-Rui; Ling, Hao; Li, Jun-Jie; Dai, Ping-Ping; Deng, Xuan-Tong; Zhang, Lei; Li, Shao-Gang

2018-01-01

AIM To figure out the contributed factors of the hospitalization expenses of senile cataract patients (HECP) and build up an area-specified senile cataract diagnosis related group (DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund. METHODS The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector (E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc. RESULTS The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases. CONCLUSION The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund. PMID:29487824

Accounting for group differences in appraisals of social inequality: differential injustice standards.

PubMed

Miron, Anca M; Warner, Ruth H; Branscombe, Nyla R

2011-06-01

We tested whether differential appraisals of inequality are a function of the injustice standards used by different groups. A confirmatory standard of injustice is defined as the amount of evidence needed to arrive at the conclusion that injustice has occurred. Consistent with a motivational shifting of standards view, we found that advantaged and disadvantaged group members set different standards of injustice when judging the magnitude of gender (Study 1) and racial (Study 2) wage inequality. In addition, because advantaged and disadvantaged group members formed - based on their differential standards - divergent appraisals of wage inequality, they experienced differential desire to restore inter-group justice. We discuss the implications of promoting low confirmatory standards for changing perceptions of social reality and for motivating justice-restorative behaviour. ©2011 The British Psychological Society.

StreptoBase: An Oral Streptococcus mitis Group Genomic Resource and Analysis Platform.

PubMed

Zheng, Wenning; Tan, Tze King; Paterson, Ian C; Mutha, Naresh V R; Siow, Cheuk Chuen; Tan, Shi Yang; Old, Lesley A; Jakubovics, Nicholas S; Choo, Siew Woh

2016-01-01

The oral streptococci are spherical Gram-positive bacteria categorized under the phylum Firmicutes which are among the most common causative agents of bacterial infective endocarditis (IE) and are also important agents in septicaemia in neutropenic patients. The Streptococcus mitis group is comprised of 13 species including some of the most common human oral colonizers such as S. mitis, S. oralis, S. sanguinis and S. gordonii as well as species such as S. tigurinus, S. oligofermentans and S. australis that have only recently been classified and are poorly understood at present. We present StreptoBase, which provides a specialized free resource focusing on the genomic analyses of oral species from the mitis group. It currently hosts 104 S. mitis group genomes including 27 novel mitis group strains that we sequenced using the high throughput Illumina HiSeq technology platform, and provides a comprehensive set of genome sequences for analyses, particularly comparative analyses and visualization of both cross-species and cross-strain characteristics of S. mitis group bacteria. StreptoBase incorporates sophisticated in-house designed bioinformatics web tools such as Pairwise Genome Comparison (PGC) tool and Pathogenomic Profiling Tool (PathoProT), which facilitate comparative pathogenomics analysis of Streptococcus strains. Examples are provided to demonstrate how StreptoBase can be employed to compare genome structure of different S. mitis group bacteria and putative virulence genes profile across multiple streptococcal strains. In conclusion, StreptoBase offers access to a range of streptococci genomic resources as well as analysis tools and will be an invaluable platform to accelerate research in streptococci. Database URL: http://streptococcus.um.edu.my.

The Effectiveness of Educational Interventions to Enhance the Adoption of Fee-Based Arsenic Testing in Bangladesh: A Cluster Randomized Controlled Trial

PubMed Central

George, Christine Marie; Inauen, Jennifer; Rahman, Sheikh Masudur; Zheng, Yan

2013-01-01

Arsenic (As) testing could help 22 million people, using drinking water sources that exceed the Bangladesh As standard, to identify safe sources. A cluster randomized controlled trial was conducted to evaluate the effectiveness of household education and local media in the increasing demand for fee-based As testing. Randomly selected households (N = 452) were divided into three interventions implemented by community workers: 1) fee-based As testing with household education (HE); 2) fee-based As testing with household education and a local media campaign (HELM); and 3) fee-based As testing alone (Control). The fee for the As test was US$ 0.28, higher than the cost of the test (US$ 0.16). Of households with untested wells, 93% in both intervention groups HE and HELM purchased an As test, whereas only 53% in the control group. In conclusion, fee-based As testing with household education is effective in the increasing demand for As testing in rural Bangladesh. PMID:23716409

The effectiveness of educational interventions to enhance the adoption of fee-based arsenic testing in Bangladesh: a cluster randomized controlled trial.

PubMed

George, Christine Marie; Inauen, Jennifer; Rahman, Sheikh Masudur; Zheng, Yan

2013-07-01

Arsenic (As) testing could help 22 million people, using drinking water sources that exceed the Bangladesh As standard, to identify safe sources. A cluster randomized controlled trial was conducted to evaluate the effectiveness of household education and local media in the increasing demand for fee-based As testing. Randomly selected households (N = 452) were divided into three interventions implemented by community workers: 1) fee-based As testing with household education (HE); 2) fee-based As testing with household education and a local media campaign (HELM); and 3) fee-based As testing alone (Control). The fee for the As test was US$ 0.28, higher than the cost of the test (US$ 0.16). Of households with untested wells, 93% in both intervention groups HE and HELM purchased an As test, whereas only 53% in the control group. In conclusion, fee-based As testing with household education is effective in the increasing demand for As testing in rural Bangladesh.

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

PubMed Central

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

2013-01-01

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

Chemopreventive Evaluation of a Schiff Base Derived Copper (II) Complex against Azoxymethane-Induced Colorectal Cancer in Rats

PubMed Central

Hajrezaie, Maryam; Hassandarvish, Pouya; Moghadamtousi, Soheil Zorofchian; Gwaram, Nura Suleiman; Golbabapour, Shahram; NajiHussien, Abdrabuh; Almagrami, Amel Abdullah; Zahedifard, Maryam; Rouhollahi, Elham; Karimian, Hamed; Fani, Somaye; Kamalidehghan, Behnam; Majid, Nazia Abdul; Ali, Hapipah Mohd; Abdulla, Mahmood Ameen

2014-01-01

Background Based on the potential of Schiff base compounds to act as sources for the development of cancer chemotherapeutic agents, this in vivo study was performed to investigate the inhibitory properties of the synthetic Schiff base compound Cu(BrHAP)2 on colonic aberrant crypt foci (ACF). Methodology This study involved five groups of male rats. The negative control group was injected with normal saline once a week for 2 weeks and fed 10% Tween 20 for 10 weeks, the cancer control group was subcutaneously injected with 15 mg/kg azoxymethane once per week for two consecutive weeks, the positive control group was injected with 15 mg/kg azoxymethane once per week for two consecutive weeks and 35 mg/kg 5-fluorouracil (injected intra-peritoneally) for 4 weeks, and the experimental groups were first injected with 15 mg/kg azoxymethane once per week for two consecutive weeks and then fed 2.5 or 5 mg/kg of the Schiff base compound once a day for 10 weeks. Application of the Schiff base compound suppressed total colonic ACF formation by up to 72% to 74% (P<0.05) when compared with the cancer control group. Analysis of colorectal specimens revealed that treatments with the Schiff base compound decreased the mean crypt scores in azoxymethane-treated rats. Significant elevations of superoxide dismutase, glutathione peroxidase and catalase activities and a reduction in the level of malondialdehyde were also observed. Histologically, all treatment groups exhibited significant decreases in dysplasia compared to the cancer control group (P<0.05). Immunohistochemical staining demonstrated down-regulation of the PCNA protein. Comparative western blot analysis revealed that COX-2 and Bcl2 were up-regulated and Bax was down-regulated compared with the AOM control group. Conclusion The current study demonstrated that the Cu(BrHAP)2 compound has promising chemoprotective activities that are evidenced by significant decreases in the numbers of ACFs in azoxymethane-induced colon cancer. PMID:24618844

Large Independent Primary Care Medical Groups

PubMed Central

Casalino, Lawrence P.; Chen, Melinda A.; Staub, C. Todd; Press, Matthew J.; Mendelsohn, Jayme L.; Lynch, John T.; Miranda, Yesenia

2016-01-01

PURPOSE In the turbulent US health care environment, many primary care physicians seek hospital employment. Large physician-owned primary care groups are an alternative, but few physicians or policy makers realize that such groups exist. We wanted to describe these groups, their advantages, and their challenges. METHODS We identified 21 groups and studied 5 that varied in size and location. We conducted interviews with group leaders, surveyed randomly selected group physicians, and interviewed external observers—leaders of a health plan, hospital, and specialty medical group that shared patients with the group. We triangulated responses from group leaders, group physicians, and external observers to identify key themes. RESULTS The groups’ physicians work in small practices, with the group providing economies of scale necessary to develop laboratory and imaging services, health information technology, and quality improvement infrastructure. The groups differ in their size and the extent to which they engage in value-based contracting, though all are moving to increase the amount of financial risk they take for their quality and cost performance. Unlike hospital-employed and multispecialty groups, independent primary care groups can aim to reduce health care costs without conflicting incentives to fill hospital beds and keep specialist incomes high. Each group was positively regarded by external observers. The groups are under pressure, however, to sell to organizations that can provide capital for additional infrastructure to engage in value-based contracting, as well as provide substantial income to physicians from the sale. CONCLUSIONS Large, independent primary care groups have the potential to make primary care attractive to physicians and to improve patient care by combining human scale advantages of physician autonomy and the small practice setting with resources that are important to succeed in value-based contracting. PMID:26755779

A method for assigning species into groups based on generalized Mahalanobis distance between habitat model coefficients

USGS Publications Warehouse

Williams, C.J.; Heglund, P.J.

2009-01-01

Habitat association models are commonly developed for individual animal species using generalized linear modeling methods such as logistic regression. We considered the issue of grouping species based on their habitat use so that management decisions can be based on sets of species rather than individual species. This research was motivated by a study of western landbirds in northern Idaho forests. The method we examined was to separately fit models to each species and to use a generalized Mahalanobis distance between coefficient vectors to create a distance matrix among species. Clustering methods were used to group species from the distance matrix, and multidimensional scaling methods were used to visualize the relations among species groups. Methods were also discussed for evaluating the sensitivity of the conclusions because of outliers or influential data points. We illustrate these methods with data from the landbird study conducted in northern Idaho. Simulation results are presented to compare the success of this method to alternative methods using Euclidean distance between coefficient vectors and to methods that do not use habitat association models. These simulations demonstrate that our Mahalanobis-distance- based method was nearly always better than Euclidean-distance-based methods or methods not based on habitat association models. The methods used to develop candidate species groups are easily explained to other scientists and resource managers since they mainly rely on classical multivariate statistical methods. ?? 2008 Springer Science+Business Media, LLC.

Protease-modulating polyacrylate-based hydrogel stimulates wound bed preparation in venous leg ulcers – a randomized controlled trial

PubMed Central

Humbert, P; Faivre, B; Véran, Y; Debure, C; Truchetet, F; Bécherel, P-A; Plantin, P; Kerihuel, J-C; Eming, SA; Dissemond, J; Weyandt, G; Kaspar, D; Smola, H; Zöllner, P

2014-01-01

Background Stringent control of proteolytic activity represents a major therapeutic approach for wound-bed preparation. Objectives We tested whether a protease-modulating polyacrylate- (PA-) containing hydrogel resulted in a more efficient wound-bed preparation of venous leg ulcers when compared to an amorphous hydrogel without known protease-modulating properties. Methods Patients were randomized to the polyacrylate-based hydrogel (n = 34) or to an amorphous hydrogel (n = 41). Wound beds were evaluated by three blinded experts using photographs taken on days 0, 7 and 14. Results After 14 days of treatment there was an absolute decrease in fibrin and necrotic tissue of 37.6 ± 29.9 percentage points in the PA-based hydrogel group and by 16.8 ± 23.0 percentage points in the amorphous hydrogel group. The absolute increase in the proportion of ulcer area covered by granulation tissue was 36.0 ± 27.4 percentage points in the PA-based hydrogel group and 14.5 ± 22.0 percentage points in the control group. The differences between the groups were significant (decrease in fibrin and necrotic tissue P = 0.004 and increase in granulation tissue P = 0.0005, respectively). Conclusion In particular, long-standing wounds profited from the treatment with the PA-based hydrogel. These data suggest that PA-based hydrogel dressings can stimulate normalization of the wound environment, particularly in hard-to-heal ulcers. PMID:24612304

Exploring the benefits of an optional theatre module on medical student well-being.

PubMed

Nagji, Alim; Brett-MacLean, Pamela; Breault, Lorraine

2013-01-01

Medical students struggle with varied stressors and developing adequate coping mechanisms is essential. This study examined medical student perceptions of the well-being impact of a theatre-based course. Eighteen 1st-year medical students at the University of Alberta participated in 3 focus groups following the conclusion of a theatre-based module that was piloted in the first quarter of 2010. A semistructured protocol was used to guide the focus groups, which were audiotaped and transcribed. Along with general feedback, impact on personal development and student well-being were discussed. Thematic aspects of these discussions were qualitatively analyzed. During the focus groups, medical students identified three aspects of the theatre-based module that contributed to their sense of overall well-being. These included (a) fun/relaxation, (b) enhanced relationships with each other, and (c) personal growth/resilience. Our findings suggest that participating in an optional theatre module can enhance medical student well-being. Our analysis suggests the need to consider novel, humanities-based curriculum offerings in relation to personal development and well- being.

[Prevention groups for school-age children of mentally ill parents ("Auryn Groups")].

PubMed

Dierks, H

2001-09-01

Children of psychiatrically ill parents have a high risk themselves to develop a psychiatric illness in adulthood. Prevention aims at strengthening the resilience of these children and reducing psychosocial risk factors. This article found and describes a theoretical concept of prevention groups for children in schoolage (7-16 years) whose parents are psychiatrically ill. First practical experiences are depicted. The Hamburgian model of prevention works with closed and temporary limited groups of children as well as with the parents. It is based on supporting the children's existing coping strategies and the children are encouraged to exchange their individual experiences of the relationships within their families. One conclusion was, that the main thematic emphasis varied considerably depending on the age of the children.

Effect of Reinforcement Using Stainless Steel Mesh, Glass Fibers, and Polyethylene on the Impact Strength of Heat Cure Denture Base Resin - An In Vitro Study

PubMed Central

Murthy, H B Mallikarjuna; Shaik, Sharaz; Sachdeva, Harleen; Khare, Sumit; Haralur, Satheesh B; Roopa, K T

2015-01-01

Background: The impact strength of denture base resin is of great concern and many approaches have been made to strengthen acrylic resin dentures. The objective of this study was to compare the impact strength of the denture base resin with and without reinforcement and to evaluate the impact strength of denture base resin when reinforced with stainless steel mesh, glass fiber, and polyethylene fibers in the woven form. Materials and Methods: The specimens (maxillary denture bases) were fabricated using a standard polyvinylsiloxane mold with conventional heat cured polymethyl methacrylate resin. The specimens were divided into four groups (n = 10). Group I specimens or control group were not reinforced. Group II specimens were reinforced with stainless steel mesh and Group III and Group IV specimens were reinforced with three percent by weight of glass fibers and polyethylene fibers in weave form respectively. All the specimens were immersed in water for 1-week before testing. The impact strength was measured with falling weight impact testing machine. One-way analysis of variance and Tukey’s post-hoc test were used for statistical analysis. Results: Highest impact strength values were exhibited by the specimens reinforced with polyethylene fibers followed by glass fibers, stainless steel mesh, and control group. Conclusions: Reinforcement of maxillary complete dentures showed a significant increase in impact strength when compared to unreinforced dentures. Polyethylene fibers exhibit better impact strength followed by glass fibers and stainless steel mesh. By using pre-impregnated glass and polyethylene fibers in woven form (prepregs) the impact strength of the denture bases can be increased effectively. PMID:26124604

Installation Restoration Program. Phase 1. Records Search for the 190th Air Refueling Group, Forbes Field Air National Guard Base, Topeka, Kansas.

DTIC Science & Technology

1986-06-01

l C. Review of Weston’s Report .................. IV-8 D. Critical Habitats /Endangered or Threatened Species ....... IV-13 V. CONCLUSIONS...Critical Habitats /Endangered or Threatened Species Discussions with personnel from the Kansas Department of Natural Resources disclosed that there are no...Reticulated Giraffe . This area is upgradient of the base and several miles distant, so it is not thought that the area is affected by past or present

Inductive reasoning and doubt in obsessive compulsive disorder.

PubMed

O'Connor, Kieron; Wilson, Samantha; Taillon, Annie; Pélissier, Marie-Claude; Audet, Jean-Sebastien

2018-06-01

Previous studies show that individuals with obsessive compulsive disorder (OCD) accord more importance than healthy controls (HC) to alternative conclusions, resulting in increased doubt regarding an initial conclusion. The goal of the present study was to replicate and extend this finding. Eighteen participants diagnosed with OCD and 16 HC completed the Reasoning with Inductive Arguments Task (RIAT), which operationalizes doubt as change in confidence towards a conclusion after alternative conclusions are presented. To examine conditions that facilitate doubt, the impact of alternative conclusions that both supported and contradicted the initial conclusion was compared, as well as the effect of neutral and OCD-relevant item content. Both the OCD and HC groups decreased confidence after contradicting conclusions, but only the HC group increased confidence when presented with supporting conclusions. Furthermore, decrease in confidence in the OCD group correlated with OCD symptom severity. The RIAT could be adapted to better take into account of OCD subtypes. Doubt generation may contribute to obsessional doubting. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Small Randomized Pilot Study of a Workplace Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel: Effects on Salivary α-Amylase Levels

PubMed Central

Duchemin, Anne-Marie; Steinberg, Beth A.; Marks, Donald R.; Vanover, Kristin; Klatt, Maryanna

2015-01-01

Objective To determine if a workplace stress-reduction intervention decreases reactivity to stress among personnel exposed to a highly stressful occupational environment. Methods Personnel from a surgical intensive care unit (SICU) were randomized to a stress reduction intervention or a wait-list control group. The 8-week group mindfulness-based intervention (MBI) included mindfulness, gentle yoga and music. Psychological and biological markers of stress were measured one week before and one week after the intervention. Results Levels of salivary α-amylase, an index of sympathetic activation, were significantly decreased between the 1st and 2nd assessments in the intervention group with no changes in the control group. There was a positive correlation between salivary α-amylase levels and burnout scores. Conclusions These data suggest that this type of intervention could not only decrease reactivity to stress, but also decrease the risk of burnout. PMID:25629803

The effects of cognitive rehabilitation on Alzheimer's dementia patients' cognitive assessment reference diagnosis system performance based on level of cognitive functioning.

PubMed

Hwang, Jung-Ha; Cha, Hyun-Gyu; Cho, Hyuk-Shin

2015-09-01

[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer's disease (AD) patients' level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.

Effects of Topic Simvastatin for the Treatment of Chronic Vascular Cutaneous Ulcers: A Pilot Study.

PubMed

Raposio, Edoardo; Libondi, Guido; Bertozzi, Nicolò; Grignaffini, Eugenio; Grieco, Michele P

2015-12-01

Recent research suggests that statins might be useful in the process of wound healing, playing a positive immune-modulatory role, improving microvascular function and reducing oxidative stress. The aim of this pilot study was to evaluate the efficacy of topic application of Simvastatin-based cream in the treatment of chronic vascular cutaneous ulcers, comparing this type of treatment to a collagen-based dressing, proven to be effective for ulcer treatment. A total of 20 ulcers were studied in 2 Groups of randomly-chosen patients for a period of one month. In the first Group a 0.5% Simvastatin-based cream was topically administered, while the second Group (control) was treated with an absorbable type I bovine collagen-based medication. Each week, wound healing progress was observed in both Groups, and the ulcers photographed. Wound healing rate was calculated by considering the absolute change in area and by the formula "healing ratio (%) = [(Area 0 - Area t4 )/Area 0 ] × 100," both sets of data being related to the days comprised in the study in order to calculate healing rate per day. Statistical analysis was performed by Student t test. Study endpoint equaling the time-course changes of ulcer areas. At the end of the study, when considering absolute change in area, the experimental Group appeared to heal better and faster than the control Group although differences between the Groups were not statistically significant. Conversely, rates of wound healing in the experimental and control Groups were 46.88% and 64% respectively, revealing statistically significant differences. ( P < 0.05). In conclusion, topic application of a simvastatin-based cream proved to be well- tolerated but not effective in the management of vascular leg ulcers in a 4 week-period.

Exercise for Everyone: A randomized controlled trial of Project Workout On Wheels in promoting exercise among wheelchair users

PubMed Central

Froehlich-Grobe, Katherine; Lee, Jaehoon; Aaronson, Lauren; Nary, Dorothy E.; Washburn, Richard A; Little, Todd D

2015-01-01

Objective To compare the effectiveness of two home-based behavioral interventions to promote wheelchair users exercise adoption and maintenance over 12 months. Design Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability. Setting Exercise occurred in participant preferred locations (e.g., home, recreation center), with physiological data collected at the university-based exercise lab. Participants One hundred twenty-eight inactive wheelchair users (64 women) with sufficient upper arm mobility for arm-based exercise enrolled. Participants on average were 45 years old, lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment. Interventions Both groups received home-based exercise interventions. The staff-supported group (n= 69) received intensive exercise support, while the self-guided group (n= 59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly-scheduled phone calls, and handwritten cards. Main Outcome Measures The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation. Results The staff-supported group reported significantly greater exercise (~ 16 minutes/week) than the self-guided group over the year (t=10.6, p=0.00), with no significant between group difference in aerobic capacity (t=0.76, p=0.45) and strength (t=1.5, p=0.14). Conclusions Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant as they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations. PMID:23872080

The Effect of Sterile Acellular Dermal Matrix Use on Complication Rates in Implant-Based Immediate Breast Reconstructions

PubMed Central

Park, Youngsoo; Choi, Kyoung Wook; Chung, Kyu-Jin; Kim, Tae Gon; Kim, Yong-Ha

2016-01-01

Background The use of acellular dermal matrix (ADM) in implant-based immediate breast reconstruction has been increasing. The current ADMs available for breast reconstruction are offered as aseptic or sterile. No published studies have compared aseptic and sterile ADM in implant-based immediate breast reconstruction. The authors performed a retrospective study to evaluate the outcomes of aseptic versus sterile ADM in implant-based immediate breast reconstruction. Methods Implant-based immediate breast reconstructions with ADM conducted between April 2013 and January 2016 were included. The patients were divided into 2 groups: the aseptic ADM (AlloDerm) group and the sterile ADM (MegaDerm) group. Archived records were reviewed for demographic data and postoperative complication types and frequencies. The complications included were infection, flap necrosis, capsular contracture, seroma, hematoma, and explantation for any cause. Results Twenty patients were reconstructed with aseptic ADM, and 68 patients with sterile ADM. Rates of infection (15.0% vs. 10.3%), flap necrosis (5.0% vs. 7.4%), capsular contracture (20.0% vs. 14.7%), seroma (10.0% vs. 14.7%), hematoma (0% vs. 1.5%), and explantation (10.0% vs. 8.8%) were not significantly different in the 2 groups. Conclusions Sterile ADM did not provide better results regarding infectious complications than aseptic ADM in implant-based immediate breast reconstruction. PMID:27896182

Students' reflections on shadowing interprofessional teamwork: a Norwegian case study.

PubMed

Fougner, M; Horntvedt, T

2011-01-01

This article reports the students' reflections on interprofessional teamwork during brief exposures to real-life experiences in hospitals or home-based rehabilitation service. Each of the 10 interprofessional groups, comprising three students, followed a rehabilitation team for a day. The composition of each student group correlated with the rehabilitation team. Data were collected from interviews with the student groups and subjected to a thematic analysis. The following four main themes were identified for which the students seemed to affect collaboration: sharing knowledge; team setting and position within the organisation; patient centred focus; and challenges in crossing professional borders when performing tasks. Each of these themes is presented and discussed in relation to the educational literature. In conclusion, the data suggest that a well organized, one-day observation-based learning experience helped to motivate students and helped to enable them to relate theory and practice.

Driving Behavior among Different Groups of Iranian Drivers Based on Driver Coping Styles

PubMed Central

Lotfi, Saeid; Yazdanirad, Saeid; Pourabdiyan, Siyamak; Hassanzadeh, Akbar; Lotfi, Aliakbar

2017-01-01

Background: This study aimed to assess driving behavior of Iranian drivers based on their coping styles (problem-oriented, emotion-oriented, and avoiding). Methods: This study was conducted on 610 drivers divided into four different groups. The drivers’ behaviors and coping styles were evaluated using driver behavior questionnaire (DBQ) and coping inventory for stressful situations. Results: The results showed a significant difference among the three coping styles regarding the mean scores of DBQ dimensions (P < 0.001). In addition, the emotion-oriented drivers obtained higher mean scores compared to those with other coping styles. Conclusions: It can be concluded that emotion-oriented drivers were more susceptible to crashes compared to those with problem-solving and avoidance coping styles. PMID:28757929

Undoing an Epidemiological Paradox: The Tobacco Industry’s Targeting of US Immigrants

PubMed Central

Acevedo-Garcia, Dolores; Barbeau, Elizabeth; Bishop, Jennifer Anne; Pan, Jocelyn; Emmons, Karen M.

2004-01-01

Objectives. We sought to ascertain whether the tobacco industry has conceptualized the US immigrant population as a separate market. Methods. We conducted a content analysis of major tobacco industry documents. Results. The tobacco industry has engaged in 3 distinct marketing strategies aimed at US immigrants: geographically based marketing directed toward immigrant communities, segmentation based on immigrants’ assimilation status, and coordinated marketing focusing on US immigrant groups and their countries of origin. Conclusions. Public health researchers should investigate further the tobacco industry’s characterization of the assimilated and non-assimilated immigrant markets, and its specific strategies for targeting these groups, in order to develop informed national and international tobacco control countermarketing strategies designed to protect immigrant populations and their countries of origin. PMID:15569972

Verification of learner’s differences by team-based learning in biochemistry classes

PubMed Central

2017-01-01

Purpose We tested the effect of team-based learning (TBL) on medical education through the second-year premedical students’ TBL scores in biochemistry classes over 5 years. Methods We analyzed the results based on test scores before and after the students’ debate. The groups of students for statistical analysis were divided as follows: group 1 comprised the top-ranked students, group 3 comprised the low-ranked students, and group 2 comprised the medium-ranked students. Therefore, group T comprised 382 students (the total number of students in group 1, 2, and 3). To calibrate the difficulty of the test, original scores were converted into standardized scores. We determined the differences of the tests using Student t-test, and the relationship between scores before, and after the TBL using linear regression tests. Results Although there was a decrease in the lowest score, group T and 3 showed a significant increase in both original and standardized scores; there was also an increase in the standardized score of group 3. There was a positive correlation between the pre- and the post-debate scores in group T, and 2. And the beta values of the pre-debate scores and “the changes between the pre- and post-debate scores” were statistically significant in both original and standardized scores. Conclusion TBL is one of the educational methods for helping students improve their grades, particularly those of low-ranked students. PMID:29207457

Student peer assessment in evidence-based medicine (EBM) searching skills training: an experiment

PubMed Central

Eldredge, Jonathan D.; Bear, David G.; Wayne, Sharon J.; Perea, Paul P.

2013-01-01

Background: Student peer assessment (SPA) has been used intermittently in medical education for more than four decades, particularly in connection with skills training. SPA generally has not been rigorously tested, so medical educators have limited evidence about SPA effectiveness. Methods: Experimental design: Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups, and then these assigned groups were randomized further into intervention and control groups. All students received evidence-based medicine (EBM) training. Only the intervention group members received SPA training, practice with assessment rubrics, and then application of anonymous SPA to assignments submitted by other members of the intervention group. Results: Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group, 45.7 and 43.5, respectively (P = 0.06). Conclusions: SPA training and the application of these skills by the intervention group resulted in higher scores on formative tests compared to those in the control group, a difference approaching statistical significance. The extra effort expended by librarians, other personnel, and medical students must be factored into the decision to use SPA in any specific educational context. Implications: SPA has not been rigorously tested, particularly in medical education. Future, similarly rigorous studies could further validate use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula. PMID:24163593

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

PubMed Central

Khosla, Rahul; McLean, Anna W; Smith, Jessica A

2016-01-01

Background: Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities. Methods: A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups. Results: A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P < 0.0001). Conclusions: For pleural-based lesions the diagnostic accuracy of US guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure. PMID:27625440

The Extract of Lycium depressum Stocks Enhances Wound Healing in Streptozotocin-Induced Diabetic Rats.

PubMed

Naji, Siamak; Zarei, Leila; Pourjabali, Masoumeh; Mohammadi, Rahim

2017-06-01

In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. The aim of the present study was to assess the wound-healing activity of methanolic extracts of the extract of Lycium depressum leaves. A total of 60 healthy male Wistar diabetic rats weighing approximately 160 to 180 g and 7 weeks of age were randomized into 10 groups for incision and excision wound models: sham surgery group (SHAM), including creation of wounds and no treatment; base formulation group (FG) with creation of wounds and application of base formulation ointment; treatment group 1 (TG1) with 1 g of powder extract of the plant material in ointment; treatment group 2 (TG2) with 2 g; and treatment group 4 (TG3) with 4 g of powder extract of the plant material in ointment. A wound was induced by an excision- and incision-based wound model in male rats. The mature green leaves of L depressum were collected and authenticated. Extractions of dried leaves were carried out. For wound-healing activity, the extracts were applied topically in the form of ointment and compared with control groups. The healing of the wound was assessed based on excision, incision, hydroxyproline estimation, and biomechanical and biochemical studies. The extract of L depressum leaves enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content, and improved mechanical indices and histological characteristics in treatment groups compared with SHAM and FG ( P < .05). These findings permit the conclusion the extract of L depressum benefits parameters of wound healing in a diabetes induced model.

A comprehensive strategy for the subtyping of patients with Fanconi anaemia: conclusions from the Spanish Fanconi Anemia Research Network

PubMed Central

Casado, José Antonio; Callén, Elsa; Jacome, Ariana; Río, Paula; Castella, Maria; Lobitz, Stephan; Ferro, Teresa; Muñoz, Arturo; Sevilla, Julián; Cantalejo, Ángeles; Cela, Elena; Cervera, José; Sánchez‐Calero, Jesús; Badell, Isabel; Estella, Jesús; Dasí, Ángeles; Olivé, Teresa; Ortega, Juan José; Rodriguez‐Villa, Antonia; Tapia, María; Molinés, Antonio; Madero, Luis; Segovia, José C; Neveling, Kornelia; Kalb, Reinhard; Schindler, Detlev; Hanenberg, Helmut; Surrallés, Jordi; Bueren, Juan A

2007-01-01

Background Fanconi anaemia is a heterogeneous genetic disease, where 12 complementation groups have been already described. Identifying the complementation group in patients with Fanconi anaemia constitutes a direct procedure to confirm the diagnosis of the disease and is required for the recruitment of these patients in gene therapy trials. Objective To determine the subtype of Fanconi anaemia patients in Spain, a Mediterranean country with a relatively high population (23%) of Fanconi anaemia patients belonging to the gypsy race. Methods Most patients could be subtyped by retroviral complementation approaches in peripheral blood T cells, although some mosaic patients were subtyped in cultured skin fibroblasts. Other approaches, mainly based on western blot analysis and generation of nuclear RAD51 and FANCJ foci, were required for the subtyping of a minor number of patients. Results and conclusions From a total of 125 patients included in the Registry of Fanconi Anaemia, samples from 102 patients were available for subtyping analyses. In 89 cases the subtype could be determined and in 8 cases exclusions of common complementation groups were made. Compared with other international studies, a skewed distribution of complementation groups was observed in Spain, where 80% of the families belonged to the Fanconi anaemia group A (FA‐A) complementation group. The high proportion of gypsy patients, all of them FA‐A, and the absence of patients with FA‐C account for this characteristic distribution of complementation groups. PMID:17105750

Animal Study on Primary Dysmenorrhoea Treatment at Different Administration Times

PubMed Central

Pu, Bao-Chan; Fang, Ling; Gao, Li-Na; Liu, Rui; Li, Ai-zhu

2015-01-01

The new methods of different administration times for the treatment of primary dysmenorrhea are more widely used clinically; however, no obvious mechanism has been reported. Therefore, an animal model which is closer to clinical evaluation is indispensable. A novel animal experiment with different administration times, based on the mice oestrous cycle, for primary dysmenorrhoea treatment was explored in this study. Mice were randomly divided into two parts (one-cycle and three-cycle part) and each part includes five groups (12 mice per group), namely, Jingqian Zhitong Fang (JQF) 6-day group, JQF last 3-day group, Yuanhu Zhitong tablet group, model control group, and normal control group. According to the one-way ANOVAs, results (writhing reaction, and PGF2α, PGE2, NO, and calcium ions analysis by ELISA) of the JQF cycle group were in accordance with those of JQF last 3-day group. Similarly, results of three-cycle continuous administration were consistent with those of one-cycle treatment. In conclusion, the consistency of the experimental results illustrated that the novel animal model based on mice oestrous cycle with different administration times is more reasonable and feasible and can be used to explore in-depth mechanism of drugs for the treatment of primary dysmenorrhoea in future. PMID:25705236

[How to assess and reduce social inequalities in cancer screening programmes].

PubMed

Binefa, Gemma; García, Montse; Peiró, Rosana; Molina-Barceló, Ana; Ibáñez, Raquel

2016-01-01

This field note presents the conclusions and recommendations made at the meeting 'How to reduce social inequalities in cancer screening programmes?' held at the XXVI School of Public Health of Mahon (Menorca, Spain). Participants developed recommendations based on experiences of population-based screening programmes (breast and colorectal) and opportunistic screening (cervical). The conclusions and recommendations focused on four main areas (information systems, evaluation and quality, research, and interventions): the inclusion of social variables at an individual level in health information systems; the establishment of minimum standards for gathering information regarding inequalities in access to preventive services; the performance of actions in vulnerable populations; and the promotion of the exchange of experiences and best practices through the Cancer Screening Programmes Network and working groups of the scientific societies. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

IWGT report on quantitative approaches to genotoxicity risk assessment I. Methods and metrics for defining exposure-response relationships and points of departure (PoDs)

EPA Science Inventory

This report summarizes the discussion, conclusions, and points of consensus of the IWGT Working Group on Quantitative Approaches to Genetic Toxicology Risk Assessment (QWG) based on a meeting in Foz do Iguaçu, Brazil October 31–November 2, 2013. Topics addressed incl...

Fluoride concentration in saliva after use of oral hygiene products.

PubMed

Campus, Guglielmo; Lallai, Maria Rosario; Carboni, Roberto

2003-01-01

The purpose of this in vivo, single-blind, randomized study was to compare fluoride concentrations in saliva of patients treated with oral hygiene products containing different fluoride salts. The study involved 104 students attending the University of Sassari. Participants were subdivided: group A used a sodium monofluorophosphate (NaMFP) toothpaste; groups B and C used an amine fluoride (AmF) toothpaste; group D used a toothpaste and a mouthwash both based on AmF, and group E used a toothpaste and a varnish both on an NaMFP base. Samples of unstimulated saliva were collected at baseline (t(0)), at the end of the 20 days' treatment phase (t(1)) and after 24 h, during which the volunteers refrained from any oral hygiene measure (t(2)). Saliva fluoride concentrations were measured using an ion-specific electrode. All measurements were made in triplicate and analysed statistically using ANOVA. In saliva, the mean fluoride concentration increased significantly in each treatment group. In conclusion, the fluoride concentration in saliva can be maintained to an optimal therapeutic level with the regular use of fluoridated products. Copyright 2003 S. Karger AG, Basel

[The Thule case. Mortality and hospitalization after the crash of an American B-52 bomber in 1968].

PubMed

Juel, K

1993-07-26

In 1968, a B-52 bomber carrying nuclear bombs crashed near the Thule US Air-Base in Greenland. By 1986, many cases of disease had been reported among Danish workers employed at the base. A database has been constructed from staff files of workers employed from 1963 to 1971. Of 4,322 workers, 98.7% were identified in 1987. The study group consisted of 1,202 workers employed during the clean up period (from the time of the crash until the last of the contaminated material had been removed). The reference group consisted of 3,120 workers employed outside the clean up period. No differences were found in total mortality, or mortality from cancer, heart disease or accidents between the groups after adjusting for age, marital status and length of employment. Mortality from suicide was lower in the study group. The hospitalization rates for the period 1977-1985 also showed no differences between the two groups. The conclusion of the register surveys is that no harmful effect on health due to the crash can be established by measuring mortality or hospital admissions.

Evaluation of polymethyl methacrylate resin mechanical properties with incorporated halloysite nanotubes

PubMed Central

2016-01-01

PURPOSE This study inspects the effect of incorporating halloysite nanotubes (HNTs) into polymethyl methacrylate (PMMA) resin on its flexural strength, hardness, and Young's modulus. MATERIALS AND METHODS Four groups of acrylic resin powder were prepared. One group without HNTs was used as a control group and the other three groups contained 0.3, 0.6 and 0.9 wt% HNTs. For each one, flexural strength, Young's modulus and hardness values were measured. One-way ANOVA and Tukey's test were used for comparison (P<.05). RESULTS At lower concentration (0.3 wt%) of HNT, there was a significant increase of hardness values but no significant increase in both flexural strength and Young's modulus values of PMMA resin. In contrast, at higher concentration (0.6 and 0.9 wt%), there was a significant decrease in hardness values but no significant decrease in flexural strength and Young's modulus values compared to those of the control group. CONCLUSION Addition of lower concentration of halloysite nanotubes to denture base materials could improve some of their mechanical properties. Improving the mechanical properties of acrylic resin base material could increase the patient satisfaction. PMID:27350849

Phylogenetic community structure: temporal variation in fish assemblage

PubMed Central

Santorelli, Sergio; Magnusson, William; Ferreira, Efrem; Caramaschi, Erica; Zuanon, Jansen; Amadio, Sidnéia

2014-01-01

Hypotheses about phylogenetic relationships among species allow inferences about the mechanisms that affect species coexistence. Nevertheless, most studies assume that phylogenetic patterns identified are stable over time. We used data on monthly samples of fish from a single lake over 10 years to show that the structure in phylogenetic assemblages varies over time and conclusions depend heavily on the time scale investigated. The data set was organized in guild structures and temporal scales (grouped at three temporal scales). Phylogenetic distance was measured as the mean pairwise distances (MPD) and as mean nearest-neighbor distance (MNTD). Both distances were based on counts of nodes. We compared the observed values of MPD and MNTD with values that were generated randomly using null model independent swap. A serial runs test was used to assess the temporal independence of indices over time. The phylogenetic pattern in the whole assemblage and the functional groups varied widely over time. Conclusions about phylogenetic clustering or dispersion depended on the temporal scales. Conclusions about the frequency with which biotic processes and environmental filters affect the local assembly do not depend only on taxonomic grouping and spatial scales. While these analyzes allow the assertion that all proposed patterns apply to the fish assemblages in the floodplain, the assessment of the relative importance of these processes, and how they vary depending on the temporal scale and functional group studied, cannot be determined with the effort commonly used. It appears that, at least in the system that we studied, the assemblages are forming and breaking continuously, resulting in various phylogeny-related structures that makes summarizing difficult. PMID:25360256

Effect of Gap Distance on Tensile Strength of Preceramic Base Metal Solder Joints

PubMed Central

Fattahi, Farnaz; Motamedi, Milad

2011-01-01

Background and aims In order to fabricate prostheses with high accuracy and durability, soldering techniques have been introduced to clinical dentistry. However, these prostheses always fail at their solder joints. The purpose of this study was to evaluate the effect of gap distance on the tensile strength of base metal solder joints. Materials and methods Based on ADA/ISO 9693 specifications for tensile test, 40 specimens were fabricated from a Ni-Cr alloy and cut at the midpoint of 3-mm diameter bar and placed at desired positions by a specially designed device. The specimens were divided into four groups of 10 samples according to the desired solder gap distance: Group1: 0.1mm; Group2: 0.25mm; Group3: 0.5mm; and Group4: 0.75mm. After soldering, specimens were tested for tensile strength by a universal testing machine at a cross-head speed of 0.5mm/min with a preload of 10N. Results The mean tensile strength values of the groups were 162, 307.8, 206.1 and 336.7 MPa, respectively. The group with 0.75-mm gap had the highest and the group with 0.1-mm gap had the lowest tensile strength. Bonferroni test showed that Group1 and Group4 had statistically different values (P=0.023), but the differences between other groups were not sig-nificant at a significance level of 0.05. Conclusion There was no direct relationship between increasing soldering gap distance and tensile strength of the solder joints. PMID:22991610

COMPARISON OF CHILDREN'S FOLLOW-ON INSTANT POWDERED COW'S MILK FORMULA, BUFFALO MILK FORMULA AND CHICKEN-BASED FORMULA ON ENAMEL MICROHARDNESS OF BOVINE TEETH IN VITRO.

PubMed

Vongsavan, Kadkao; Rirattanapong, Praphasri; Surarit, Rudee

2016-03-01

Dental caries are a major public health problem worldwide. The aim of this study was to compare the effects of children's follow-on instant powdered cow's milk formula, buffalo milk formula and a chicken-based formula on microhardness of bovine enamel with artificial caries-like lesions. Forty bovine teeth were each placed in acrylic blocks and the enamel surfaces were polished to create flat 5 x 5 millimeter surfaces. The teeth surfaces were then demineralized using 0.1M lactic acid (pH 4.5) to achieve an enamel microhardness of 35-65 Vickers Hardness Numbers (VHN). All specimens were then randomly allocated into one of 4 groups (n=10/group). For remineralization, each group was soaked in a different kind of milk formula for 2 hours at 37°C except group 1 which was a negative control (artificial saliva) group. Group 2 was soaked in Murrah™ buffalo milk formula (a positive control ), group 3 in S-26-Promil-Gold™ (cow's milk formula) and group 4 in a chicken-based formula (Siriraj Hospital, Mahidol University). The microhardness of the specimens was then measured again. Data were analyzed using a one-way ANOVA and paired t-test with a 95% confidence interval. After exposure to the formula, the mean VHN for each study group was significantly higher (paired t-test, p < 0.05) except for group 1 (p = 0.345). The mean VHN for the the Murrah™ buffalo milk formula, the chicken-based formula and the S-26-Promil-Gold™ formula group were not significantly different from each other (one-way ANOVA, p > 0.05). In conclusion, S-26-Promil-Gold™ follow-on cow milk formula, Murrah™ buffalo milk formula and the chicken-based formula all increased bovine enamel microhardness after soaking for 2 hours.

Community-Based Participatory Research Approach to Evidence-Based Research: Lessons From the Pacific Islander American Health Study

PubMed Central

Panapasa, Sela; Jackson, James; Caldwell, Cleopatra; Heeringa, Steve; McNally, James; Williams, David; Coral, Debra; Taumoepeau, Leafa; Young, Louisa; Young, Setafano; Fa'asisila, Saia

2013-01-01

Objectives Reports on the challenges and lessons learned from the Pacific Island American Health Study engagement with community-based organizations (CBOs) and faith-based organizations (FBOs) in Pacific Islander (PI) communities and mechanisms to facilitate the collection of robust data. Methods Academic–community partnership building was achieved with PI CBOs and FBOs. Focus group meetings were organized to plan various aspects of the study, develop questionnaire themes and protocols for survey, assist with the interviewer recruitment process, and strategize data dissemination plan. Lessons Learned The PIA-HS represents a model for overcoming challenges in data collection among small understudied populations. FBOs represent a valuable resource for community-based participatory research (CBPR) data collection and for effective interventions. Conclusion The study methodology can be replicated for other racial/ethnic groups with high levels of religiosity combined with concentrated levels of residential clustering. Expansion of the Pacific Islander American Health Study (PIA-HS) to include other PI subgroups is encouraged. PMID:22643788

Effect of Internet-based Intervention on Obesity among Adolescents in Kuala Lumpur: A School-based Cluster Randomised Trial

PubMed Central

Mohammed Nawi, AZMAWATI; Che Jamaludin, FARRAH ILYANI

2015-01-01

Background: Co-morbidities in adulthood is a significant problem and is associated with obesity during adolescent. Methods: This 3-months randomised controlled trial was aimed at determining the effectiveness of having internet-based intervention (obeseGO!) toward obesity among adolescents in Kuala Lumpur. Forty seven students were assigned randomly to the obeseGO! (intervention) group for internet-based intervention i.e., information on healthy lifestyle and diet were provided via the internet. Fifty students were assigned to the control group, where pamphlets containing health education were provided to these students. The measurement of body mass index (BMI), waist circumference, and the body fat percentage was taken at baseline and after 12 weeks of intervention. Results: The multivariate analysis of variance (MANOVA) analysis found that obeseGO! had a small effect in reducing BMI, waist circumference and body fat percentage. Conclusion: The internet-based obesity intervention program may be an effective medium for promoting healthy diet and physical activity among the obese adolescents. PMID:26715908

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

Matthews, Patrick K.

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 550: Smoky Contamination Area, Nevada National Security Site, Nevada. CAU 550 includes 19 corrective action sites (CASs), which consist of one weapons-related atmospheric test (Smoky), three safety experiments (Ceres, Oberon, Titania), and 15 debris sites (Table ES-1). The CASs were sorted into the following study groups based on release potential and technical similarities: • Study Group 1, Atmospheric Test • Study Group 2, Safety Experiments • Study Group 3, Washes • Study Group 4, Debris The purpose of this document is to provide justificationmore » and documentation supporting the conclusion that no further corrective action is needed for CAU 550 based on implementation of the corrective actions listed in Table ES-1. Corrective action investigation (CAI) activities were performed between August 2012 and October 2013 as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 550: Smoky Contamination Area; and in accordance with the Soils Activity Quality Assurance Plan. The approach for the CAI was to investigate and make data quality objective (DQO) decisions based on the types of releases present. The purpose of the CAI was to fulfill data needs as defined during the DQO process. The CAU 550 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated the dataset is complete and acceptable for use in fulfilling the DQO data needs.« less

Study on the Effectiveness of Virtual Reality Game-Based Training on Balance and Functional Performance in Individuals with Paraplegia

PubMed Central

Khurana, Meetika; Walia, Shefali

2017-01-01

Objective: To determine whether there is any difference between virtual reality game–based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test–post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game–based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure–III (SCIM-III). Results: There was a significant difference for time (p = .001) and Time × Group effect (p = .001) in mFRT scores, group effect (p = .05) in t-shirt test scores, and time effect (p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game–based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training. PMID:29339902

Study on the Effectiveness of Virtual Reality Game-Based Training on Balance and Functional Performance in Individuals with Paraplegia.

PubMed

Khurana, Meetika; Walia, Shefali; Noohu, Majumi M

2017-01-01

Objective: To determine whether there is any difference between virtual reality game-based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test-post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game-based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure-III (SCIM-III). Results: There was a significant difference for time ( p = .001) and Time × Group effect ( p = .001) in mFRT scores, group effect ( p = .05) in t-shirt test scores, and time effect ( p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game-based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training.

Does hydrotherapy improve strength and physical function in patients with osteoarthritis—a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme

PubMed Central

Foley, A; Halbert, J; Hewitt, T; Crotty, M

2003-01-01

Objective: To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Design: Single blind, three arm, randomised controlled trial. Subjects: 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Methods: Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). Results: In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Conclusion: Functional gains were achieved with both exercise programmes compared with the control group. PMID:14644853

Expeditionary Air Base Defense: Historical Cases and Modern Implications

DTIC Science & Technology

2017-06-01

and redesigning is based on peacetime criteria. Seventh Air Force Base Defense Study Group, 1967 The Dien Bien Phu case study offered many...Freedom in 2004-2012. Analysis of these case studies reveals several themes of expeditionary air base defense in the modern era, including: the...IRAQ AND AFGHANISTAN……………………….48 6 ANALYSIS OF CASE STUDIES ………………………………………………62 7 CONCLUSIONS ……………………………………………………………..…67

Spectrum of Abdominal Aortic Disease in a Tertiary Health Care Setup: MDCT Based Observational Study

PubMed Central

Kumar, DG Santosh; Gadabanahalli, Karthik; Kalyanpur, Arjun

2016-01-01

Introduction Abdominal aortic disease is an important cause of clinical disability that requires early detection by imaging methods for prompt and effective management. Understanding regional disease pattern and prevalence has a bearing on healthcare management and resource planning. Non-invasive, conclusive imaging strategy plays an important role in the detection of disease. Multi-Detector Computed Tomography (MDCT) with its technological developments provides affordable, accurate and comprehensive imaging solution. Aim To evaluate regional demography of abdominal aortic disease spectrum detected using MDCT imaging data in a tertiary hospital. Materials and Methods A descriptive study was conducted based on MDCT imaging data of patients who were investigated with clinical diagnosis of abdominal aortic disease, from March 2008-2010, over a period of 24 months. Patients were examined with the contrast-enhanced MDCT examination. Morphological diagnosis of the aortic disease was based on changes in relative aortic caliber, luminal irregularity, presence of wall calcification, dissection or thrombus and evidence of major branch occlusion. Patients were categorized into four groups based on imaging findings. MDCT information and associated clinical parameters were examined and correlated to management of patient. Descriptive statistical data, namely mean, standard deviation and frequency of disease were evaluated. Results A total of 90 out of 210 patients (43%) were detected with the abdominal aortic abnormality defined by imaging criteria. Group I, comprising of patients with atherosclerosis –including those with complications, constituted 65.5% of the patients. Group II represented patients with aneurysms (45.5%). Group III, consisting of 32.2% of the patients, contained those with dissections. The rest of the patients, including patients with aorto-arteritis, were classified as group IV. Eight patients with aneurysm and one patient with aorto-arteritis were considered for surgical treatment. Ten patients with dissection underwent endovascular procedure. Rest of the patients was managed conservatively. Conclusion Aortic disease was observed in 43% of investigated patients. Atherosclerosis with and without aortic aneurysm constituted the largest group. MDCT provided comprehensive information about the lesion and associated complications. In view of the wider availability and desired imaging qualities, MDCT provided optimal information for diagnosis and management of aortic pathology. Majority of our patients (90%) were treated conservatively. PMID:28050476

Comparison of the effect of rocuronium dosing based on corrected or lean body weight on rapid sequence induction and neuromuscular blockade duration in obese female patients

PubMed Central

Sakızcı-Uyar, Bahar; Çelik, Şeref; Postacı, Aysun; Bayraktar, Yeşim; Dikmen, Bayazit; Özkoçak-Turan, Işıl; Saçan, Özlem

2016-01-01

Objectives: To compare onset time, duration of action, and tracheal intubation conditions in obese patients when the intubation dose of rocuronium was based on corrected body weight (CBW) versus lean body weight (LBW) for rapid sequence induction. Methods: This prospective study was carried out at Numune Education and Research Hospital, Ankara, Turkey between August 2013 and May 2014. Forty female obese patients scheduled for laparoscopic surgery under general anesthesia were randomized into 2 groups. Group CBW (n=20) received 1.2 mg/kg rocuronium based on CBW, and group LBW (n=20) received 1.2 mg/kg rocuronium based on LBW. Endotracheal intubation was performed 60 seconds after injection of muscle relaxant, and intubating conditions were evaluated. Neuromuscular transmission was monitored using acceleromyography of the adductor pollicis. Onset time, defined as time to depression of the twitch tension to 95% of its control value, and duration of action, defined as time to achieve one response to train-of-four stimulation (T1) were recorded. Results: No significant differences were observed between the groups in intubation conditions or onset time (50-60 seconds median, 30-30 interquartile range [IQR]). Duration of action was significantly longer in the CBW group (60 minutes median, 12 IQR) than the LBW group (35 minutes median, 16 IQR; p<0.01). Conclusion: In obese patients, dosing of 1.2 mg/kg rocuronium based on LBW provides excellent or good tracheal intubating conditions within 60 seconds after administration and does not lead to prolonged duration of action. PMID:26739976

The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial

PubMed Central

Park, Jin-Hyuck; Park, Ji-Hyuk

2016-01-01

[Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

Increasing number of small hole diameter microfracture compared with traditional microfracture in same size cartilage defects and effect of HA based aselluler scaffold. An animal study

PubMed Central

Uzer, Gökçer; Elmadağ, Nuh Mehmet; Yıldız, Fatih; Güzel, Yunus; Tok, Olgu Enis

2017-01-01

Purpose: The purpose of this study is small hole microfracure method comparing with traditional microfracture method and investigation of effect of HA based acellular matrix scaffold on microfracture area. Materials-Methods: 21 Twenty-one New Zealand white rabbits were used for the in vitro portion of this study, bilateral knee joint from the same rabbit were same technic. An articular cartilage defect was established in the femoral trochlear groove about 5 mm. Control group was established alone microfracture (MF). 6 groups were formed in this study and each group has 3 rabbits and their six knees. In 3 groups were applied different number of small diameter hole microfracture (4,5,6 small holes microfracture respectively)and the other 3 groups were applied different number of small diameter hole microfracture (4,5,6 small holes micro fracture respectively added HA based acellular matrix scaffold in the same size ostechondral lesion. The regenerated tissues were harvested for gross morphology, histology at 12 weeks postoperatively. Results: Cartilage were regenerated, maintaining a constant thickness of cartilage. MF group has worse Wakitani scores than 6 small diameter holes mıcrofracture groups(group 6 and group 7) in either parameter of the score. (p=0,043, p=0,016) Matrix addition did not contribute to healing. (p=1,000) Conclusions: Increasing number of the small diameter holes microfracture (minimum %15 of defect size) improves cartilage repair compared with traditional MF in the same size ostechondral lesion. Also small diameter holes microfracture combined with HA-based AM implantation didn’t result in improved quality of the regenerated cartilage tissue.

Effect of Vitamin E on Oxaliplatin-induced Peripheral Neuropathy Prevention: A Randomized Controlled Trial

PubMed Central

Salehi, Zeinab; Roayaei, Mahnaz

2015-01-01

Background: Peripheral neuropathy is one of the most important limitations of oxaliplatin base regimen, which is the standard for the treatment of colorectal cancer. Evidence has shown that Vitamin E may be protective in chemotherapy-induced peripheral neuropathy. The aim of this study is to evaluate the effect of Vitamin E administration on prevention of oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer. Methods: This was a prospective randomized, controlled clinical trial. Patients with colorectal cancer and scheduled to receive oxaliplatin-based regimens were enrolled in this study. Enrolled patients were randomized into two groups. The first group received Vitamin E at a dose of 400 mg daily and the second group observed, until after the sixth course of the oxaliplatin regimen. For oxaliplatin-induced peripheral neuropathy assessment, we used the symptom experience diary questionnaire that completed at baseline and after the sixth course of chemotherapy. Only patients with a score of zero at baseline were eligible for this study. Results: Thirty-two patients were randomized to the Vitamin E group and 33 to the control group. There was no difference in the mean peripheral neuropathy score changes (after − before) between two groups, after sixth course of the oxaliplatin base regimen (mean difference [after − before] of Vitamin E group = 6.37 ± 2.85, control group = 6.57 ± 2.94; P = 0.78). Peripheral neuropathy scores were significantly increased after intervention compared with a base line in each group (P < 0.001). Conclusions: The results from this current trial demonstrate a lack of benefit for Vitamin E in preventing oxaliplatin-induced peripheral neuropathy. PMID:26682028

A Comparison of Educational Interventions to Enhance Cultural Competency in Pharmacy Students

PubMed Central

Jonkman, Lauren; Connor, Sharon; Hall, Deanne

2013-01-01

Objective. To determine the degree to which 3 different educational interventions enhance cultural competency in pharmacy students. Methods. Students were equally divided among a simulated-patient activity group, a written case-scenarios group, and a formal lecture group. Mean scores for pre- and post-intervention cultural self-assessment surveys were compared. Results. In the simulation group, there were significant positive changes in the cultural skills and cultural desire components; in the case-scenario group, there was a significant positive change in the cultural awareness component; and in the lecture group, there were significant positive changes in the cultural skills and cultural empathy components. With respect to the cultural skills component, there was greater post-intervention improvement in the simulation and lecture groups than in the case-scenario group. Conclusions. There were significant positive changes within each group, indicating that ideologies and behaviors may be altered based on the educational intervention received. However, a 1-hour practicum may not be sufficient to enhance cultural competency. PMID:23716744

High burden of Aspergillus fumigatus infection among chronic respiratory diseases.

PubMed

Fukuda, Yosuke; Homma, Tetsuya; Suzuki, Shintaro; Takuma, Takahiro; Tanaka, Akihiko; Yokoe, Takuya; Ohnishi, Tsukasa; Niki, Yoshihito; Sagara, Hironori

2018-01-01

Aspergillus fumigatus (AF) is a ubiquitous fungus in our environment and causes severe airway disorders. Chronic respiratory diseases (CRDs) are a series of chronic airway and lung diseases. Although both are chronic disorders, however, the relationships between AF and CRDs are still unclear. Therefore, we examined 104 Aspergillus species (spp.) isolated samples in our hospital during three consecutive years to further elucidate the relationships between Aspergillus spp. and CRDs. Based on sample isolates, we then grouped these into two groups, AF and non-AF, to retrospectively analyse the clinical features and to clarify the relationships between AF and CRDs. Importantly, the manifestation of CRD was more frequent in the AF group than in the non-AF group ( p = 0.035). Among CRDs, lung fibrosis was more evident in the AF group ( p = 0.025). Moreover, diabetes mellitus was tended to be evident in AF group than non-AF group ( p = 0.035). In conclusion, CRDs, especially lung fibrosis, were highly prevalent in AF group than non-AF group.

The Effect of Underwater Gait Training on Balance Ability of Stroke Patients

PubMed Central

Park, Seok Woo; Lee, Kyoung Jin; Shin, Doo Chul; Shin, Seung Ho; Lee, Myung Mo; Song, Chang Ho

2014-01-01

[Purpose] The purpose of this study was to investigate the effects of underwater treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a control group (n =11). [Methods] Both groups received general rehabilitation for 30 min per session, 5 times per week, over a 4-week period. The underwater treadmill group received additional underwater gait training for 30 min per session, 5 times per week, over the same 4-week period. Static and dynamic balances were evaluated before and after the intervention. [Results] The means of static and dynamic balance ability increased significantly in both groups, but there was no significant difference between the two groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill gait training was not more effective at improving the balance ability of stroke patients than land-based training. PMID:25013292

A symmetry model for genetic coding via a wallpaper group composed of the traditional four bases and an imaginary base E: Towards category theory-like systematization of molecular/genetic biology

PubMed Central

2014-01-01

Background Previously, we suggested prototypal models that describe some clinical states based on group postulates. Here, we demonstrate a group/category theory-like model for molecular/genetic biology as an alternative application of our previous model. Specifically, we focus on deoxyribonucleic acid (DNA) base sequences. Results We construct a wallpaper pattern based on a five-letter cruciform motif with letters C, A, T, G, and E. Whereas the first four letters represent the standard DNA bases, the fifth is introduced for ease in formulating group operations that reproduce insertions and deletions of DNA base sequences. A basic group Z5 = {r, u, d, l, n} of operations is defined for the wallpaper pattern, with which a sequence of points can be generated corresponding to changes of a base in a DNA sequence by following the orbit of a point of the pattern under operations in group Z5. Other manipulations of DNA sequence can be treated using a vector-like notation ‘Dj’ corresponding to a DNA sequence but based on the five-letter base set; also, ‘Dj’s are expressed graphically. Insertions and deletions of a series of letters ‘E’ are admitted to assist in describing DNA recombination. Likewise, a vector-like notation Rj can be constructed for sequences of ribonucleic acid (RNA). The wallpaper group B = {Z5×∞, ●} (an ∞-fold Cartesian product of Z5) acts on Dj (or Rj) yielding changes to Dj (or Rj) denoted by ‘Dj◦B(j→k) = Dk’ (or ‘Rj◦B(j→k) = Rk’). Based on the operations of this group, two types of groups—a modulo 5 linear group and a rotational group over the Gaussian plane, acting on the five bases—are linked as parts of the wallpaper group for broader applications. As a result, changes, insertions/deletions and DNA (RNA) recombination (partial/total conversion) are described. As an exploratory study, a notation for the canonical “central dogma” via a category theory-like way is presented for future developments. Conclusions Despite the large incompleteness of our methodology, there is fertile ground to consider a symmetry model for genetic coding based on our specific wallpaper group. A more integrated formulation containing “central dogma” for future molecular/genetic biology remains to be explored. PMID:24885369

Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: Results of the FIT@Home study.

PubMed

Kraal, Jos J; Van den Akker-Van Marle, M Elske; Abu-Hanna, Ameen; Stut, Wim; Peek, Niels; Kemps, Hareld Mc

2017-08-01

Aim Although cardiac rehabilitation improves physical fitness after a cardiac event, many eligible patients do not participate in cardiac rehabilitation and the beneficial effects of cardiac rehabilitation are often not maintained over time. Home-based training with telemonitoring guidance could improve participation rates and enhance long-term effectiveness. Methods and results We randomised 90 low-to-moderate cardiac risk patients entering cardiac rehabilitation to three months of either home-based training with telemonitoring guidance or centre-based training. Although training adherence was similar between groups, satisfaction was higher in the home-based group ( p = 0.02). Physical fitness improved at discharge ( p < 0.01) and at one-year follow-up ( p < 0.01) in both groups, without differences between groups (home-based p = 0.31 and centre-based p = 0.87). Physical activity levels did not change during the one-year study period (centre-based p = 0.38, home-based p = 0.80). Healthcare costs were statistically non-significantly lower in the home-based group (€437 per patient, 95% confidence interval -562 to 1436, p = 0.39). From a societal perspective, a statistically non-significant difference of €3160 per patient in favour of the home-based group was found (95% confidence interval -460 to 6780, p = 0.09) and the probability that it was more cost-effective varied between 97% and 75% (willingness-to-pay of €0 and €100,000 per quality-adjusted life-years, respectively). Conclusion We found no differences between home-based training with telemonitoring guidance and centre-based training on physical fitness, physical activity level or health-related quality of life. However, home-based training was associated with a higher patient satisfaction and appears to be more cost-effective than centre-based training. We conclude that home-based training with telemonitoring guidance can be used as an alternative to centre-based training for low-to-moderate cardiac risk patients entering cardiac rehabilitation.

Designing and Evaluating an Interactive Multimedia Web-Based Simulation for Developing Nurses’ Competencies in Acute Nursing Care: Randomized Controlled Trial

PubMed Central

Wong, Lai Fun; Chan, Sally Wai-Chi; Ho, Jasmine Tze Yin; Mordiffi, Siti Zubaidah; Ang, Sophia Bee Leng; Goh, Poh Sun; Ang, Emily Neo Kim

2015-01-01

Background Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice. Objective This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses’ competencies in acute nursing care. Methods Authentic nursing activities were developed in a Web-based simulation using a variety of instructional strategies including animation video, multimedia instructional material, virtual patients, and online quizzes. A randomized controlled study was conducted on 67 registered nurses who were recruited from the general ward units of an acute care tertiary hospital. Following a baseline evaluation of all participants’ clinical performance in a simulated clinical setting, the experimental group received 3 hours of Web-based simulation and completed a survey to evaluate their perceptions of the program. All participants were re-tested for their clinical performances using a validated tool. Results The clinical performance posttest scores of the experimental group improved significantly (P<.001) from the pretest scores after the Web-based simulation. In addition, compared to the control group, the experimental group had significantly higher clinical performance posttest scores (P<.001) after controlling the pretest scores. The participants from the experimental group were satisfied with their learning experience and gave positive ratings for the quality of the Web-based simulation. Themes emerging from the comments about the most valuable aspects of the Web-based simulation include relevance to practice, instructional strategies, and fostering problem solving. Conclusions Engaging in authentic nursing activities using interactive multimedia Web-based simulation can enhance nurses’ competencies in acute care. Web-based simulations provide a promising educational tool in institutions where large groups of nurses need to be trained in acute nursing care and accessibility to repetitive training is essential for achieving long-term retention of clinical competency. PMID:25583029

A Modified Personalized Image-Based Drill Guide Template for Atlantoaxial Pedicle Screw Placement: A Clinical Study

PubMed Central

Jiang, Lianghai; Dong, Liang; Tan, Mingsheng; Qi, Yingna; Yang, Feng; Yi, Ping; Tang, Xiangsheng

2017-01-01

Background Atlantoaxial posterior pedicle screw fixation has been widely used for treatment of atlantoaxial instability (AAI). However, precise and safe insertion of atlantoaxial pedicle screws remains challenging. This study presents a modified drill guide template based on a previous template for atlantoaxial pedicle screw placement. Material/Methods Our study included 54 patients (34 males and 20 females) with AAI. All the patients underwent posterior atlantoaxial pedicle screw fixation: 25 patients underwent surgery with the use of a modified drill guide template (template group) and 29 patients underwent surgery via the conventional method (conventional group). In the template group, a modified drill guide template was designed for each patient. The modified drill guide template and intraoperative fluoroscopy were used for surgery in the template group, while only intraoperative fluoroscopy was used in the conventional group. Results Of the 54 patients, 52 (96.3%) completed the follow-up for more than 12 months. The template group had significantly lower intraoperative fluoroscopy frequency (p<0.001) and higher accuracy of screw insertion (p=0.045) than the conventional group. There were no significant differences in surgical duration, intraoperative blood loss, or improvement of neurological function between the 2 groups (p>0.05). Conclusions Based on the results of this study, it is feasible to use the modified drill guide template for atlantoaxial pedicle screw placement. Using the template can significantly lower the screw malposition rate and the frequency of intraoperative fluoroscopy. PMID:28301445

Change in surface roughness of esthetic restorative materials after exposure to different immersion regimes in a cola drink.

PubMed

Bajwa, Navroop Kaur; Pathak, Anuradha

2014-01-01

Context. An in vitro study carried out to evaluate and compare the effect of Cola drink on surface roughness of esthetic restorative materials. Purpose. To compare the effect of different immersion regimes in a Cola drink on surface roughness of esthetic restorative materials. Method. Two hundred samples were grouped into 4 equal groups of 50 samples each: Group I: conventional glass ionomer, Group II: resin modified glass ionomer, Group III: polyacid-modified resin composite, Group IV: Composite resin. Each group was further subdivided into 5 subgroups of 10 samples each. Subgroup A (Control Subgroup). Samples were kept immersed in artificial saliva. Subgroup B. Samples were immersed in Cola drink once a day. Subgroup C. Samples were immersed in Cola drink, 3 times a day. Subgroup D. Samples were immersed in Cola drink 5 times a day. Subgroup E. Samples were immersed in Cola drink 10 times a day. Each immersion lasted 5 minutes. The immersion protocol was repeated for 7 days. Results. Maximum surface roughness was seen in Group I conventional glass ionomer cement, followed by Group II resin modified glass ionomer, Group III polyacid modified resin composite, and Group IV composite resin samples. Conclusion. Resistance to change in surface roughness is more in resin based restorative materials as compared to glass ionomer based materials.

Change in Surface Roughness of Esthetic Restorative Materials after Exposure to Different Immersion Regimes in a Cola Drink

PubMed Central

Bajwa, Navroop Kaur; Pathak, Anuradha

2014-01-01

Context. An in vitro study carried out to evaluate and compare the effect of Cola drink on surface roughness of esthetic restorative materials. Purpose. To compare the effect of different immersion regimes in a Cola drink on surface roughness of esthetic restorative materials. Method. Two hundred samples were grouped into 4 equal groups of 50 samples each: Group I: conventional glass ionomer, Group II: resin modified glass ionomer, Group III: polyacid-modified resin composite, Group IV: Composite resin. Each group was further subdivided into 5 subgroups of 10 samples each. Subgroup A (Control Subgroup). Samples were kept immersed in artificial saliva. Subgroup B. Samples were immersed in Cola drink once a day. Subgroup C. Samples were immersed in Cola drink, 3 times a day. Subgroup D. Samples were immersed in Cola drink 5 times a day. Subgroup E. Samples were immersed in Cola drink 10 times a day. Each immersion lasted 5 minutes. The immersion protocol was repeated for 7 days. Results. Maximum surface roughness was seen in Group I conventional glass ionomer cement, followed by Group II resin modified glass ionomer, Group III polyacid modified resin composite, and Group IV composite resin samples. Conclusion. Resistance to change in surface roughness is more in resin based restorative materials as compared to glass ionomer based materials. PMID:25006464

Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke.

PubMed

Kim, Nara; Park, YuHyung; Lee, Byoung-Hee

2015-03-01

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit(™) balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

Redesign of a large lecture course into a small-group learning course.

PubMed

Ferreri, Stefanie P; O'Connor, Shanna K

2013-02-12

Objective. To describe the redesign of a large self-care course previously delivered in a traditional lecture format to a small-group case-based course.Design. Prereadings and study guides were used to facilitate students' independent learning prior to class. Large lecture classes were replaced with smaller group-based learning classes. This change in delivery format allowed students to spend the majority of class time conducting small-group learning activities, such as case studies to promote communication, problem solving, and interpersonal skills.Assessment. Changes in course delivery were assessed over a 2-year period by comparing students' grades and satisfaction ratings on course evaluations. A comparison of course evaluations between the class formats revealed that students were provided more opportunities to develop verbal communication skills and tackle and resolve unfamiliar problems in the revised course. The activities resulted in better overall course grades.Conclusions. Redesigning to a small-group discussion format for a self-care course can be accomplished by increasing student accountability for acquiring factual content outside the classroom. Compared with student experiences in the previous large lecture-based class, students in the smaller-class format reported a preference for working in teams and achieved significantly better academic grades with the new course format.

Sustained effect of simulation-based ultrasound training on clinical performance: a randomized trial

PubMed Central

Tolsgaard, M G; Ringsted, C; Dreisler, E; Nørgaard, L N; Petersen, J H; Madsen, M E; Freiesleben, N L C; Sørensen, J L; Tabor, A

2015-01-01

Objective To study the effect of initial simulation-based transvaginal sonography (TVS) training compared with clinical training only, on the clinical performance of residents in obstetrics and gynecology (Ob-Gyn), assessed 2 months into their residency. Methods In a randomized study, new Ob-Gyn residents (n = 33) with no prior ultrasound experience were recruited from three teaching hospitals. Participants were allocated to either simulation-based training followed by clinical training (intervention group; n = 18) or clinical training only (control group; n = 15). The simulation-based training was performed using a virtual-reality TVS simulator until an expert performance level was attained, and was followed by training on a pelvic mannequin. After 2 months of clinical training, one TVS examination was recorded for assessment of each resident's clinical performance (n = 26). Two ultrasound experts blinded to group allocation rated the scans using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. Results During the 2 months of clinical training, participants in the intervention and control groups completed an average ± SD of 58 ± 41 and 63 ± 47 scans, respectively (P = 0.67). In the subsequent clinical performance test, the intervention group achieved higher OSAUS scores than did the control group (mean score, 59.1% vs 37.6%, respectively; P < 0.001). A greater proportion of the intervention group passed a pre-established pass/fail level than did controls (85.7% vs 8.3%, respectively; P < 0.001). Conclusion Simulation-based ultrasound training leads to substantial improvement in clinical performance that is sustained after 2 months of clinical training. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. PMID:25580809

Effectiveness of brief school-based interventions for adolescents: A meta-analysis of alcohol use prevention programs

PubMed Central

Hennessy, Emily A.; Tanner-Smith, Emily E.

2015-01-01

Objective To conduct a meta-analysis summarizing the effectiveness of school-based brief alcohol interventions (BAIs) among adolescents, and to examine possible iatrogenic effects due to deviancy training in group-delivered interventions. Method A systematic search for eligible studies was undertaken, current through December 31, 2012. Studies were eligible for inclusion if they used an experimental/quasi-experimental design; focused on school-based BAIs; enrolled adolescent participants; and reported an alcohol-related outcome measure. Studies were coded for key variables, and outcome effect sizes were analyzed as standardized mean differences adjusted for small samples (Hedges’ g). Analyses were conducted using inverse-variance weighted mixed effects meta-regression models. Sensitivity analyses were also conducted. Results Across all 17 studies eligible for inclusion, school-based BAIs were associated with significant improvements among adolescents, whereby adolescents in the BAI groups reduced their alcohol consumption relative to the control groups (ḡ = 0.34, 95% CI [0.11, 0.56]). Subgroup analyses indicated that whereas individually-delivered BAIs were effective (ḡ = 0.58, 95% CI [0.23, 0.92]), there was no evidence that group-delivered BAIs were associated with reductions in alcohol use (ḡ = −0.02, 95% CI [−0.17, 0.14]). Delivery format was confounded with program modality, however, such that motivational enhancement therapy was the most effective modality, but was rarely implemented in group-delivered interventions. Conclusions Some school-based BAIs are effective in reducing adolescent alcohol consumption, but may be ineffective if delivered in group settings. Future research should explore whether group-delivered BAIs that use motivational enhancement therapy components may yield beneficial outcomes like those observed in individually-delivered programs. PMID:25294110

The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations.

PubMed

Alizadeh Oskoee, Parnian; Pournaghi Azar, Fatemeh; Jafari Navimipour, Elmira; Ebrahimi Chaharom, Mohammad Esmaeel; Naser Alavi, Fereshteh; Salari, Ashkan

2017-01-01

Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations. Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05. Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001). Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation.

The effect of repeated preheating of dimethacrylate and silorane-based composite resins on marginal gap of class V restorations

PubMed Central

Alizadeh Oskoee, Parnian; Pournaghi Azar, Fatemeh; Jafari Navimipour, Elmira; Ebrahimi chaharom, Mohammad Esmaeel; Naser Alavi, Fereshteh; Salari, Ashkan

2017-01-01

Background. One of the problems with composite resin restorations is gap formation at resin‒tooth interface. The present study evaluated the effect of preheating cycles of silorane- and dimethacrylate-based composite resins on gap formation at the gingival margins of Class V restorations. Methods. In this in vitro study, standard Class V cavities were prepared on the buccal surfaces of 48 bovine incisors. For restorative procedure, the samples were randomly divided into 2 groups based on the type of composite resin (group 1: di-methacrylate composite [Filtek Z250]; group 2: silorane composite [Filtek P90]) and each group was randomly divided into 2 subgroups based on the composite temperature (A: room temperature; B: after 40 preheating cycles up to 55°C). Marginal gaps were measured using a stereomicroscope at ×40 and analyzed with two-way ANOVA. Inter- and intra-group comparisons were analyzed with post-hoc Tukey tests. Significance level was defined at P < 0.05. Results. The maximum and minimum gaps were detected in groups 1-A and 2-B, respectively. The effects of composite resin type, preheating and interactive effect of these variables on gap formation were significant (P<0.001). Post-hoc Tukey tests showed greater gap in dimethacrylate compared to silorane composite resins (P< 0.001). In each group, gap values were greater in composite resins at room temperature compared to composite resins after 40 preheating cycles (P<0.001). Conclusion. Gap formation at the gingival margins of Class V cavities decreased due to preheating of both composite re-sins. Preheating of silorane-based composites can result in the best marginal adaptation. PMID:28413594

Cost-effectiveness analysis of telephone-based support for the management of pressure ulcers in people with spinal cord injury in India and Bangladesh.

PubMed

Arora, M; Harvey, L A; Glinsky, J V; Chhabra, H S; Hossain, M S; Arumugam, N; Bedi, P K; Cameron, I D; Hayes, A J

2017-08-15

To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers. Cost-effectiveness and cost-utility analysis of a randomised clinical trial. Tertiary centre in India and Bangladesh. An economic evaluation was conducted alongside a randomised clinical trial comparing 12 weeks of telephone-based support (intervention group) with usual care (control group). The analyses evaluated costs and health outcomes in terms of cm 2 reduction of pressure ulcers size and quality-adjusted life years (QALYs) gained. All costs were in Indian Rupees (INR) and then converted to US dollars (USD). The mean (95% confidence interval) between-group difference for the reduction in size of pressure ulcers was 0.53 (-3.12 to 4.32) cm 2 , favouring the intervention group. The corresponding QALYs were 0.027 (0.004-0.051), favouring the intervention group. The mean total cost per participant in the intervention group was INR 43 781 (USD 2460) compared to INR 42 561 (USD 2391) for the control group. The per participant cost of delivering the intervention was INR 2110 (USD 119). The incremental cost-effectiveness ratio was INR 2306 (USD 130) per additional cm 2 reduction in the size of the pressure ulcer and INR 44 915 (USD 2523) per QALY gained. In terms of QALYs, telephone-based support to help people manage pressure ulcers at home provides good value for money and has an 87% probability of being cost-effective, based on 3 times gross domestic product. Sensitivity analyses were performed using the overall cost data with and without productivity costs, and did not alter this conclusion.Spinal Cord advance online publication, 15 August 2017; doi:10.1038/sc.2017.87.

Cisplatin-Based Chemotherapy versus Cetuximab in Concurrent Chemoradiotherapy for Locally Advanced Head and Neck Cancer Treatment

PubMed Central

Hu, Ming-Hung; Wang, Ling-Wei; Lu, Hsueh-Ju; Chu, Pen-Yuan; Tai, Shyh-Kuan; Lee, Tsung-Lun; Chen, Ming-Huang; Yang, Muh-Hwa; Chang, Peter Mu-Hsin

2014-01-01

Background and Purpose. This study aimed to analyze survival, clinical responses, compliance, and adverse effects in locally advanced head and neck cancer (LAHNC) patients treated with split-dose cisplatin-based concurrent chemoradiation therapy (SD-CCRT) or cetuximab with concurrent radiation therapy (BioRT). Materials and Methods. We retrospectively evaluated 170 LAHNC patients diagnosed between January 1, 2009, and July 31, 2012: 116 received CCRT and 54 received BioRT. Results. Complete response rates were similar in the SD-CCRT and BioRT groups (63.8% versus 59.3%; P = 0.807), and locoregional relapse rates were 18.1% and 13.0%, respectively (P = 0.400). The 3-year relapse-free survival rate was 65.8% in the SD-CCRT group and 65.5% in the BioRT group, respectively (P = 0.647). The 3-year overall survival rate was 78.5% in the SD-CCRT group and 70.9% in the BioRT group, respectively (P = 0.879). Hematologic side effects were significantly more frequent in the SD-CCRT than in the BioRT group. Mucositis frequency was similar. Conclusions. Primary SD-CCRT and BioRT both showed good clinical response and survival. Hematologic toxicities were more frequent, but tolerable, in the SD-CCRT group. Both groups showed good compliance. PMID:25110705

A "safe space" for learning and reflection: one school's design for continuity with a peer group across clinical clerkships.

PubMed

Chou, Calvin L; Johnston, C Bree; Singh, Bobby; Garber, Jonathan D; Kaplan, Elizabeth; Lee, Kewchang; Teherani, Arianne

2011-12-01

The value of continuity in medical education, particularly during clerkships, is increasingly recognized. Previous clerkship-based models have described changes that emphasize continuity in patient care, learner supervision, and curriculum. The creation of continuous student peer groups can foster interactions that enhance mutual support through uncomfortable professional transitions during the clerkship years. Here, the authors describe a third-year clerkship model based at the San Francisco Veterans Affairs (VA) Medical Center called VA Longitudinal Rotations (VALOR), designed explicitly to establish a supportive learning environment for small peer groups.Seven groups of medical students (42 total) completed VALOR across three academic years between 2007 and 2009. On clerkships during VALOR, one hour per week was designated for faculty-facilitated sessions amongst peer groups. Students' perceptions of peer group support and overall program satisfaction were determined with immediate post surveys and focus groups at the end of VALOR, and with follow-up surveys 5 to 27 months after completing VALOR. Students strongly valued several elements of VALOR peer groups, including support through clerkship challenges, meeting for facilitated reflection, and appreciating patient experiences across the continuum of care. Students' appreciation for their peer group experiences persisted well after the conclusion of VALOR. VALOR students performed the same as or better than traditional clerkship students on knowledge and skill-based outcomes. The authors demonstrate that their third-year clerkship program using peer groups has built supportive learning networks and facilitated reflection, allowing students to develop critical professional skills. Student communication around patient care was also feasible and highly valued.

Effect of Fat-based versus Carbohydrate-based Enteral Feeding on Glycemic Control in Critically Ill Patients: A Randomized Clinical Trial

PubMed Central

Nourmohammadi, Mahdieh; Moghadam, Omid Moradi; Lahiji, Mohammad Niakan; Hatamian, Sevak; Shariatpanahi, Zahra Vahdat

2017-01-01

Background and Aims: The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial. Materials and Methods: This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission. Results: Basal characteristics of participants were the same. After the feeding trial, there was no difference between the groups in mean plasma and capillary glucose levels and insulin requirements. Serum high density lipoprotein (HDL)-cholesterol level was increased significantly in Group B on day 10 compared to admission level (40.75 ± 5.58 vs. 43.56 ± 2.25, P = 0.05). We did not find any difference in organ failure involvement and mortality rate between groups. The number of ICU free days was significantly more in Group B compared to the control group (P = 0.04). Conclusion: High-fat diets have no preventive effect on stress hyperglycemia. High monounsaturated fat diet may increase serum HDL-cholesterol level and decrease the length of stay in ICU. PMID:28904479

Microcredit, family planning programs, and contraceptive behavior: evidence from a field experiment in Ethiopia.

PubMed

Desai, Jaikishan; Tarozzi, Alessandro

2011-05-01

The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women's preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).

A Randomized Controlled Trial of COMPASS Web-Based and Face-to-Face Teacher Coaching in Autism

PubMed Central

Ruble, Lisa A.; McGrew, John H.; Toland, Michael D.; Dalrymple, Nancy J.; Jung, Lee Ann

2013-01-01

Objective Most children with autism rely on schools as their primary source of intervention, yet research has suggested that teachers rarely use evidence-based practices. To address the need for improved educational outcomes, a previously tested consultation intervention called the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble, Dalrymple, & McGrew, 2010; Ruble, Dalrymple, & McGrew, 2012) was evaluated in a 2nd randomized controlled trial, with the addition of a web-based group. Method Forty-nine teacher–child dyads were randomized into 1 of 3 groups: (1) a placebo control (PBO) group, (2) COMPASS followed by face-to-face (FF) coaching sessions, and (3) COMPASS followed by web-based (WEB) coaching sessions. Three individualized goals (social, communication, and independence skills) were selected for intervention for each child. The primary outcome of independent ratings of child goal attainment and several process measures (e.g., consultant and teacher fidelity) were evaluated. Results Using an intent-to-treat approach, findings replicated earlier results with a very large effect size (d = 1.41) for the FF group and a large effect size (d = 1.12) for the WEB group relative to the PBO group. There were no differences in overall change across goal domains between the FF and WEB groups, suggesting the efficacy of videoconferencing technology. Conclusions COMPASS is effective and results in improved educational outcomes for young children with autism. Videoconferencing technology, as a scalable tool, has promise for facilitating access to autism specialists and bridging the research-to-practice gap. PMID:23438314

Effects of congruence between preferred and perceived learning environments in nursing education in Taiwan: a cross-sectional study

PubMed Central

Yeh, Ting-Kuang; Huang, Hsiu-Mei; Chan, Wing P; Chang, Chun-Yen

2016-01-01

Objective To investigate the effects of congruence between preferred and perceived learning environments on learning outcomes of nursing students. Setting A nursing course at a university in central Taiwan. Participants 124 Taiwanese nursing students enrolled in a 13-week problem-based Fundamental Nursing curriculum. Design and methods Students' preferred learning environment, perceptions about the learning environment and learning outcomes (knowledge, self-efficacy and attitudes) were assessed. On the basis of test scores measuring their preferred and perceived learning environments, students were assigned to one of two groups: a ‘preferred environment aligned with perceived learning environment’ group and a ‘preferred environment discordant with perceived learning environment’ group. Learning outcomes were analysed by group. Outcome measures Most participants preferred learning in a classroom environment that combined problem-based and lecture-based instruction. However, a mismatch of problem-based instruction with students' perceptions occurred. Learning outcomes were significantly better when students' perceptions of their instructional activities were congruent with their preferred learning environment. Conclusions As problem-based learning becomes a focus of educational reform in nursing, teachers need to be aware of students' preferences and perceptions of the learning environment. Teachers may also need to improve the match between an individual student's perception and a teacher's intention in the learning environment, and between the student's preferred and actual perceptions of the learning environment. PMID:27207620

Context Matters: Volunteer Bias, Small Sample Size, and the Value of Comparison Groups in the Assessment of Research-Based Undergraduate Introductory Biology Lab Courses

PubMed Central

Brownell, Sara E.; Kloser, Matthew J.; Fukami, Tadashi; Shavelson, Richard J.

2013-01-01

The shift from cookbook to authentic research-based lab courses in undergraduate biology necessitates the need for evaluation and assessment of these novel courses. Although the biology education community has made progress in this area, it is important that we interpret the effectiveness of these courses with caution and remain mindful of inherent limitations to our study designs that may impact internal and external validity. The specific context of a research study can have a dramatic impact on the conclusions. We present a case study of our own three-year investigation of the impact of a research-based introductory lab course, highlighting how volunteer students, a lack of a comparison group, and small sample sizes can be limitations of a study design that can affect the interpretation of the effectiveness of a course. PMID:24358380

Context matters: volunteer bias, small sample size, and the value of comparison groups in the assessment of research-based undergraduate introductory biology lab courses.

PubMed

Brownell, Sara E; Kloser, Matthew J; Fukami, Tadashi; Shavelson, Richard J

2013-01-01

The shift from cookbook to authentic research-based lab courses in undergraduate biology necessitates the need for evaluation and assessment of these novel courses. Although the biology education community has made progress in this area, it is important that we interpret the effectiveness of these courses with caution and remain mindful of inherent limitations to our study designs that may impact internal and external validity. The specific context of a research study can have a dramatic impact on the conclusions. We present a case study of our own three-year investigation of the impact of a research-based introductory lab course, highlighting how volunteer students, a lack of a comparison group, and small sample sizes can be limitations of a study design that can affect the interpretation of the effectiveness of a course.

Effects of interactive video-game based system exercise on the balance of the elderly.

PubMed

Lai, Chien-Hung; Peng, Chih-Wei; Chen, Yu-Luen; Huang, Ching-Ping; Hsiao, Yu-Ling; Chen, Shih-Ching

2013-04-01

This study evaluated the effects of interactive video-game based (IVGB) training on the balance of older adults. The participants of the study included 30 community-living persons over the age of 65. The participants were divided into 2 groups. Group A underwent IVGB training for 6 weeks and received no intervention in the following 6 weeks. Group B received no intervention during the first 6 weeks and then participated in training in the following 6 weeks. After IVGB intervention, both groups showed improved balance based on the results from the following tests: the Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), Timed Up and Go (TUG) test, and the Sway Velocity (SV) test (assessing bipedal stance center pressure with eyes open and closed). Results from the Sway Area (SA) test (assessing bipedal stance center pressure with eyes open and closed) revealed a significant improvement in Group B after IVGB training. Group A retained some training effects after 6 weeks without IVGB intervention. Additionally, a moderate association emerged between the Xavix measured step system stepping tests and BBS, MFES, Unipedal Stance test, and TUG test measurements. In conclusion, IVGB training improves balance after 6 weeks of implementation, and the beneficial effects partially remain after training is complete. Further investigation is required to determine if this training is superior to traditional physical therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

Antimicrobial resistance of H. pylori to the outcome of 10-days vs. 7-days Moxifloxacin based therapy for the eradication: a randomized controlled trial

PubMed Central

2010-01-01

Introduction Antibiotic resistance decreases success of Helicobacter pylori (Hp) eradication. Recently published results show low rate of resistance and better compliance with moxifloxacin based regiments. Aims&methods Whether 7 days moxifloxacin with lansoprasole and amoxycillin can be compared with 10 days moxifloxacin with lansoprasole and amoxycillin according to moxifloxacin resistance. Patients with non-ulcer dyspepsia who had culture and histology positive Hp infection (n = 150) were randomly assigned into two groups. The first group (n = 75) received moxifloxacin 400 mg/d during 7 days and the other (n = 75) received moxifloxacin 400 mg/d during 10 days. All patients received amoxycillin 1 g twice daily, lansoprasole 30 mg twice daily. All Hp cultures were tested for sensitivity to moxifloxacin. Results 138 patients (92%) completed the study, 68 in the first group and 70 in the second. Eradication rates were 84% (57/68) and 76% (57/75) in the 7 days moxifloxacin group and 90% and 84% in the second group (63/70, 63/75) according to the PP and ITT analysis; p = n.s. Among 129 patients (86% of study group), 6% of strains were primary resistant to moxifloxacin. Eradication of moxifloxacin sensitive/resistant strains was 98%/66%, p < 0.05 Conclusion According to our results we recommend 7 days moxiflixacin based triple therapy. PMID:20398300

Effects of 8 weeks of mat-based Pilates exercise on gait in chronic stroke patients.

PubMed

Roh, SuYeon; Gil, Ho Jong; Yoon, Sukhoon

2016-09-01

[Purpose] The purpose of this study was to investigate the effects of an 8-week program of Pilates exercise on gait in chronic hemiplegia patients and to determine whether or not it can be used for rehabilitation in postsrtoke patients. [Subjects and Methods] Twenty individuals with unilateral chronic hemiparetic stroke (age, 66.1 ± 4.4 yrs; height, 162.3 ± 8.3 cm; weight, 67.4 ± 12.3 kg) participated in this study and were randomly allocated equally to either a Pilates exercise group or a control group. To identify the effects of Pilates exercise, a 3-D motion analysis with 8 infrared cameras was performed. [Results] For the gait parameters, improvements were found in the Pilates exercise group for all variables, and statistical significance was observed for stride length, gait velocity, knee range of motion and hip range of motion. For the asymmetry indexes, insignificant improvements were found for all variables in the Pilates exercise group. [Conclusion] In conclusion, an 8-week program of Pilates exercise had a positive influence on improving the gait ability of poststroke patients, and the intervention could be applied to poststroke patients with various levels of physical disability by adjusting the intensity of training.

Effects of 8 weeks of mat-based Pilates exercise on gait in chronic stroke patients

PubMed Central

Roh, SuYeon; Gil, Ho Jong; Yoon, Sukhoon

2016-01-01

[Purpose] The purpose of this study was to investigate the effects of an 8-week program of Pilates exercise on gait in chronic hemiplegia patients and to determine whether or not it can be used for rehabilitation in postsrtoke patients. [Subjects and Methods] Twenty individuals with unilateral chronic hemiparetic stroke (age, 66.1 ± 4.4 yrs; height, 162.3 ± 8.3 cm; weight, 67.4 ± 12.3 kg) participated in this study and were randomly allocated equally to either a Pilates exercise group or a control group. To identify the effects of Pilates exercise, a 3-D motion analysis with 8 infrared cameras was performed. [Results] For the gait parameters, improvements were found in the Pilates exercise group for all variables, and statistical significance was observed for stride length, gait velocity, knee range of motion and hip range of motion. For the asymmetry indexes, insignificant improvements were found for all variables in the Pilates exercise group. [Conclusion] In conclusion, an 8-week program of Pilates exercise had a positive influence on improving the gait ability of poststroke patients, and the intervention could be applied to poststroke patients with various levels of physical disability by adjusting the intensity of training. PMID:27799706

Unintended Pregnancies Observed With Combined Use of the Levonorgestrel Contraceptive Implant and Efavirenz-based Antiretroviral Therapy: A Three-Arm Pharmacokinetic Evaluation Over 48 Weeks

PubMed Central

Scarsi, Kimberly K.; Darin, Kristin M.; Nakalema, Shadia; Back, David J.; Byakika-Kibwika, Pauline; Else, Laura J.; Dilly Penchala, Sujan; Buzibye, Allan; Cohn, Susan E.; Merry, Concepta; Lamorde, Mohammed

2016-01-01

Background. Levonorgestrel subdermal implants are preferred contraceptives with an expected failure rate of <1% over 5 years. We assessed the effect of efavirenz- or nevirapine-based antiretroviral therapy (ART) coadministration on levonorgestrel pharmacokinetics. Methods. This nonrandomized, parallel group, pharmacokinetic evaluation was conducted in three groups of human immunodeficiency virus–infected Ugandan women: ART-naive (n = 17), efavirenz-based ART (n = 20), and nevirapine-based ART (n = 20). Levonorgestrel implants were inserted at baseline in all women. Blood was collected at 1, 4, 12, 24, 36, and 48 weeks. The primary endpoint was week 24 levonorgestrel concentrations, compared between the ART-naive group and each ART group by geometric mean ratio (GMR) with 90% confidence interval (CI). Secondary endpoints included week 48 levonorgestrel concentrations and unintended pregnancies. Results. Week 24 geometric mean levonorgestrel concentrations were 528, 280, and 710 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.53; 90% CI, .50, .55 and nevirapine: ART-naive GMR, 1.35; 90% CI, 1.29, 1.43). Week 48 levonorgestrel concentrations were 580, 247, and 664 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.43; 90% CI, .42, .44 and nevirapine: ART-naive GMR, 1.14; 90% CI, 1.14, 1.16). Three pregnancies (3/20, 15%) occurred in the efavirenz group between weeks 36 and 48. No pregnancies occurred in the ART-naive or nevirapine groups. Conclusions. Within 1 year of combined use, levonorgestrel exposure was markedly reduced in participants who received efavirenz-based ART, accompanied by contraceptive failures. In contrast, nevirapine-based ART did not adversely affect levonorgestrel exposure or efficacy. Clinical Trials Registration. NCT01789879. PMID:26646680

Habit reversal training and educational group treatments for children with tourette syndrome: A preliminary randomised controlled trial.

PubMed

Yates, Rachel; Edwards, Katie; King, John; Luzon, Olga; Evangeli, Michael; Stark, Daniel; McFarlane, Fiona; Heyman, Isobel; İnce, Başak; Kodric, Jana; Murphy, Tara

2016-05-01

Quality of life of children with Tourette Syndrome (TS) is impacted greatly by its symptoms and their social consequences. Habit Reversal Training (HRT) is effective but has not, until now, been empirically evaluated in groups. This randomised controlled trial evaluated feasibility and preliminary efficacy of eight HRT group sessions compared to eight Education group sessions. Thirty-three children aged 9-13 years with TS or Chronic Tic Disorder took part. Outcomes evaluated were tic severity and quality of life (QoL). Tic severity improvements were found in both groups. Motor tic severity (Yale Global Tic Severity Scale) showed greatest improvements in the HRT group. Both groups showed a strong tendency toward improvements in patient reported QoL. In conclusion, group-based treatments for TS are feasible and exposure to other children with tics did not increase tic expression. HRT led to greater reductions in tic severity than Education. Implications, such as cost-effectiveness of treatment delivery, are discussed. Copyright © 2016. Published by Elsevier Ltd.

Context of the beginning of tobacco use in different social groups

PubMed Central

Panaino, Edina Ferreira; Soares, Cássia Baldini; Campos, Célia Maria Sivalli

2014-01-01

Objective analyze contextual aspects of the beginning of tobacco use in different social groups, from everyday representations about the act of smoking. Methods five focus groups were conducted to promote discussion about the context of beginning of tobacco use, with groups of people who represented different patterns of social reproduction. The data analysis was based on the theory of social representations, which contextualizes how each group presents the tobacco consumption. Results the contexts of the beginning of tobacco use were diverse, according to patterns of social reproduction; there were common representations to all groups, but there were also unique representations of each social group. Tobacco is represented as indispensable for groups in unstable social reproduction situations, and as an instrument of pleasure and stress relief for those who can access other material assets. Conclusions the study contributed to exposing the concepts on tobacco consumption that are socially disseminated, which can serve as an instrument to planning programs and health actions. PMID:25029047

A Comparison of Web-based and Small-Group Palliative and End-of-Life Care Curricula: A Quasi-Randomized Controlled Study at One Institution

PubMed Central

Day, Frank C.; Srinivasan, Malathi; Der-Martirosian, Claudia; Griffin, Erin; Hoffman, Jerome R.; Wilkes, Michael S.

2014-01-01

Purpose Few studies have compared the effect of web-based eLearning versus small-group learning on medical student outcomes. Palliative and end-of-life (PEOL) education is ideal for this comparison, given uneven access to PEOL experts and content nationally. Method In 2010, the authors enrolled all third-year medical students at the University of California, Davis School of Medicine into a quasi-randomized controlled trial of web-based interactive education (eDoctoring) compared to small-group education (Doctoring) on PEOL clinical content over two months. All students participated in three 3-hour PEOL sessions with similar content. Outcomes included a 24-item PEOL-specific self-efficacy scale with three domains (diagnosis/treatment [Cronbach’s alpha = 0.92, CI: 0.91–0.93], communication/prognosis [alpha = 0.95; CI: 0.93–0.96], and social impact/self-care [alpha = 0.91; CI: 0.88–0.92]); eight knowledge items; ten curricular advantage/disadvantages, and curricular satisfaction (both students and faculty). Results Students were randomly assigned to web-based eDoctoring (n = 48) or small-group Doctoring (n = 71) curricula. Self-efficacy and knowledge improved equivalently between groups: e.g., prognosis self-efficacy, 19%; knowledge, 10–42%. Student and faculty ratings of the web-based eDoctoring curriculum and the small group Doctoring curriculum were equivalent for most goals, and overall satisfaction was equivalent for each, with a trend towards decreased eDoctoring student satisfaction. Conclusions Findings showed equivalent gains in self-efficacy and knowledge between students participating in a web-based PEOL curriculum, in comparison to students learning similar content in a small-group format. Web-based curricula can standardize content presentation when local teaching expertise is limited, but may lead to decreased user satisfaction. PMID:25539518

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

PubMed

Chin, Helen B; Sipe, Theresa Ann; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese; Wethington, Holly R; Kirby, Doug; Elliston, Donna B; Griffith, Matt; Chuke, Stella O; Briss, Susan C; Ericksen, Irene; Galbraith, Jennifer S; Herbst, Jeffrey H; Johnson, Robert L; Kraft, Joan M; Noar, Seth M; Romero, Lisa M; Santelli, John

2012-03-01

Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education. Published by Elsevier Inc.

A Randomized Controlled Trial of Home-Based Exercise for Cancer-Related Fatigue in Women during and after Chemotherapy with or without Radiation Therapy

PubMed Central

Dodd, Marylin J.; Cho, Maria H.; Miaskowski, Christine; Painter, Patricia L.; Paul, Steven M.; Cooper, Bruce A.; Duda, John; Krasnoff, Joanne; Bank, Kayee A.

2010-01-01

Background Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment. Objective The purpose was to evaluate the effectiveness of a home-based exercise training intervention, the PRO-SELF FATIGUE CONTROL PROGRAM on the management of cancer related fatigue. Interventions/Methods Participants (N=119) were randomized into one of three groups: Group 1 (EE) received the exercise prescription throughout the study; Group 2 (CE) received their exercise prescription after completing cancer treatment; Group 3 (CC) received usual care. Patients completed the Piper Fatigue Scale, General Sleep Disturbance Scale, Center for Epidemiological Studies-Depression scale, and Worst Pain Intensity Scale. Results All groups reported mild fatigue levels, sleep disturbance and mild pain, but not depression. Using multilevel regression analysis significant linear and quadratic trends were found for change in fatigue and pain (i.e., scores increased, then decreased over time). No group differences were found in the changing scores over time. A significant quadratic effect for the trajectory of sleep disturbance was found, but no group differences were detected over time. No significant time or group effects were found for depression. Conclusions Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment. The optimal timing of exercise remains to be determined. Implications for practice Clinicians need to be aware that some physical activity is better than none, and there is no harm in exercise as tolerated during cancer treatment. Further analysis is needed to examine the adherence to exercise. More frequent assessments of fatigue, sleep disturbance, depression, and pain may capture the effect of exercise. PMID:20467301

The effect of a sequential structure of practice for the training of perceptual-cognitive skills in tennis

PubMed Central

2017-01-01

Objective Anticipation of opponent actions, through the use of advanced (i.e., pre-event) kinematic information, can be trained using video-based temporal occlusion. Typically, this involves isolated opponent skills/shots presented as trials in a random order. However, two different areas of research concerning representative task design and contextual (non-kinematic) information, suggest this structure of practice restricts expert performance. The aim of this study was to examine the effect of a sequential structure of practice during video-based training of anticipatory behavior in tennis, as well as the transfer of these skills to the performance environment. Methods In a pre-practice-retention-transfer design, participants viewed life-sized video of tennis rallies across practice in either a sequential order (sequential group), in which participants were exposed to opponent skills/shots in the order they occur in the sport, or a non-sequential (non-sequential group) random order. Results In the video-based retention test, the sequential group was significantly more accurate in their anticipatory judgments when the retention condition replicated the sequential structure compared to the non-sequential group. In the non-sequential retention condition, the non-sequential group was more accurate than the sequential group. In the field-based transfer test, overall decision time was significantly faster in the sequential group compared to the non-sequential group. Conclusion Findings highlight the benefits of a sequential structure of practice for the transfer of anticipatory behavior in tennis. We discuss the role of contextual information, and the importance of representative task design, for the testing and training of perceptual-cognitive skills in sport. PMID:28355263

A Randomized Trial of a Facebook-based Physical Activity Intervention for Young Adult Cancer Survivors

PubMed Central

Valle, Carmina G.; Tate, Deborah F.; Mayer, Deborah K.; Allicock, Marlyn; Cai, Jianwen

2013-01-01

Purpose Over half of young adult cancer survivors do not meet physical activity (PA) guidelines. PA interventions can enhance health and quality of life among young adult cancer survivors. However, few exercise interventions have been designed and tested in this population. This study evaluated the feasibility and preliminary efficacy of a 12-week, Facebook-based intervention (FITNET) aimed at increasing moderate-to-vigorous intensity PA compared to a Facebook-based self-help comparison (SC) condition. Methods Young adult cancer survivors (n=86) were randomly assigned to the FITNET or SC group. All participants were asked to complete self-administered online questionnaires at baseline and after 12 weeks. Results Seventy-seven percent of participants completed post-intervention assessments, and most participants reported using intervention components as intended. Participants in both groups would recommend the program to other young adult cancer survivors (FITNET: 46.9% vs. SC: 61.8%; p=0.225). Over 12 weeks, both groups increased self-reported weekly minutes of moderate-to-vigorous PA (FITNET: 67 minutes/week, p=0.009 vs. SC: 46 minutes/week, p=0.045), with no significant difference between groups. Increases in light PA were 135 minutes/week greater in the FITNET group relative to the SC group (p=0.032), and the FITNET group reported significant weight loss over time (−2.1 kg, p=0.004; p=0.083 between groups). Conclusions Facebook-based intervention approaches demonstrated potential for increasing PA in young adult cancer survivors. Implications for Cancer Survivors Social networking sites may be a feasible way for young adult cancer survivors to receive health information and support to promote PA and healthy behaviors. PMID:23532799

Community-based HIV/AIDS interventions to promote psychosocial well-being among people living with HIV/AIDS: a literature review

PubMed Central

Wu, Liyun; Li, Xiaoming

2013-01-01

Background: This review explores the current community-based psychosocial interventions among people living with HIV/AIDS (PLWHA) across the globe. Methods: Evaluation studies were retrieved and reviewed regarding study location, characteristics of participants, study design, intervention strategies, outcome indicators, and intervention findings. Results: The 28 studies spanned a broad range of intervention strategies, including coping skills, treatment and cure, cultural activities, community involvement, knowledge education, voluntary counseling and testing, peer-group support, three-layered service provision, child-directed group intervention, adult mentoring, and support group interventions. Regardless of study designs, all studies reported positive intervention effects, ranging from a reduction in HIV/AIDS stigma, loneliness, marginalization, distress, depression, anger, and anxiety to an increase in self-esteem, self-efficacy, coping skills, and quality of life. Conclusion: Although the existing studies have limitation with regard to program coverage, intensity, scope, and methodological challenges, they underscore the importance of developing community-based interventions to promote psychosocial well-being among PLWHA. Future studies need to employ more rigorous methodology and integrate contextual and institutional factors when implementing effective interventions. PMID:25264499

Cardiorespiratory Improvements Achieved by American College of Sports Medicine’s Exercise Prescription Implemented on a Mobile App

PubMed Central

Rospo, Gianluca; Valsecchi, Viola; Bonomi, Alberto G; Thomassen, Inge WJ; van Dantzig, Saskia; La Torre, Antonio

2016-01-01

Background Strong evidence shows that an increase in cardiorespiratory fitness (CRF) and physical activity (PA) reduces cardiovascular disease risk. Objective To test whether a scientifically endorsed program to increase CRF and PA, implemented on an easy-to-use, always-accessible mobile app would be effective in improving CRF. Methods Of 63 healthy volunteers participating, 18 tested the user interface of the Cardio-Fitness App (CF-App); and 45 underwent a 2-week intervention period, of whom 33 eventually concluded it. These were assigned into three groups. The Step-based App (Step-App) group (n=8), followed 10,000 steps/day prescription, the CF-App group (n=13), and the Supervised Cardio-Fitness (Super-CF) group (n=12), both followed a heart rate (HR)-based program according to American College of Sports Medicine (ACSM) guidelines, but either implemented on the app, or at the gym, respectively. Participants were tested for CRF, PA, resting systolic and diastolic blood pressures (SBP, DBP), resting, exercise, and recovery HR. Results CRF increased in all groups (+4.9%; P<.001). SBP decreased in all groups (-2.6 mm Hg; P=.03). DBP decrease was higher in the Super-CF group (-3.5 mm Hg) than in the Step-App group (-2.1 mm Hg; P<.001). Posttest exercise HR decreased in all groups (-3.4 bpm; P=.02). Posttest recovery HR was lower in the Super-CF group (-10.1 bpm) than in the other two groups (CF-App: -4.9 bpm, Step-App: -3.3 bpm; P<.001). The CF-App group, however, achieved these improvements with more training heart beats (P<.01). Conclusions A 10,000 steps/day target-based app improved CRF similar to an ACSM guideline-based program whether it was implemented on a mobile app or in supervised gym sessions. PMID:27339153

Comparison of Gait Aspects According to FES Stimulation Position Applied to Stroke Patients

PubMed Central

Mun, Byeong-mu; Kim, Tae-ho; Lee, Jin-hwan; Lim, Jin-youg; Seo, Dong-kwon; Lee, Dong-jin

2014-01-01

[Purpose] This study sought to identify the gait aspects according to the FES stimulation position in stroke patients during gait training. [Subjects and Methods] To perform gait analysis, ten stroke patients were grouped based on 4 types of gait conditions: gait without FES stimulation (non-FES), gait with FES stimulation on the tibialis anterior (Ta), gait with FES stimulation on the tibialis anterior and quadriceps (TaQ), and gait with FES stimulation on the tibialis anterior and gluteus medius (TaGm). [Results] Based on repeated measures analysis of variance of measurements of gait aspects comprised of gait speed, gait cycle, and step length according to the FES stimulation position, the FES stimulation significantly affected gait aspects. [Conclusion] In conclusion, stimulating the tibialis anterior and quadriceps and stimulating the tibialis anterior and gluteus medius are much more effective than stimulating only the tibialis anterior during gait training in stroke patients using FES. PMID:24764634

Successful model of suicide prevention in the Ukraine military environment.

PubMed

Rozanov, Vsevolod A; Mokhovikov, Alexander N; Stiliha, Richard

2002-01-01

The article deals with the problem of suicidal behavior in the Ukraine military environment and gives an example of the successful prevention approach. The model of prevention is based on (1) education of the responsible officers, (2) training of the representatives of the most vulnerable risk groups, and (3) follow-up procedures based on distribution of pocket books for soldiers, educational booklets, and sets of helpful materials for officers. One of the main conclusions is that the prevention activity must be organized as a continuum of actions, seminars, consultations, and materials distribution.

Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters

PubMed Central

Svendsen, S; Mathiassen, S; Bonde, J

2005-01-01

Aims: To explore the precision of task based estimates of upper arm elevation in three occupational groups, compared to direct measurements of job exposure. Methods: Male machinists (n = 26), car mechanics (n = 23), and house painters (n = 23) were studied. Whole day recordings of upper arm elevation were obtained for four consecutive working days, and associated task information was collected in diaries. For each individual, task based estimates of job exposure were calculated by weighting task exposures from a collective database by task proportions according to the diaries. These estimates were validated against directly measured job exposures using linear regression. The performance of the task based approach was expressed through the gain in precision of occupational group mean exposures that could be obtained by adding subjects with task based estimates to a group of subjects with measured job exposures in a "validation" design. Results: In all three occupations, tasks differed in mean exposure, and task proportions varied between individuals. Task based estimation proved inefficient, with squared correlation coefficients only occasionally exceeding 0.2 for the relation between task based and measured job exposures. Consequently, it was not possible to substantially improve the precision of an estimated group mean by including subjects whose job exposures were based on task information. Conclusions: Task based estimates of mechanical job exposure can be very imprecise, and only marginally better than estimates based on occupation. It is recommended that investigators in ergonomic epidemiology consider the prospects of task based exposure assessment carefully before placing resources at obtaining task information. Strategies disregarding tasks may be preferable in many cases. PMID:15613604

Applications of "Integrated Data Viewer'' (IDV) in the classroom

NASA Astrophysics Data System (ADS)

Nogueira, R.; Cutrim, E. M.

2006-06-01

Conventionally, weather products utilized in synoptic meteorology reduce phenomena occurring in four dimensions to a 2-dimensional form. This constitutes a road-block for non-atmospheric-science majors who need to take meteorology as a non-mathematical and complementary course to their major programs. This research examines the use of Integrated Data Viewer-IDV as a teaching tool, as it allows a 4-dimensional representation of weather products. IDV was tested in the teaching of synoptic meteorology, weather analysis, and weather map interpretation to non-science students in the laboratory sessions of an introductory meteorology class at Western Michigan University. Comparison of student exam scores according to the laboratory teaching techniques, i.e., traditional lab manual and IDV was performed for short- and long-term learning. Results of the statistical analysis show that the Fall 2004 students in the IDV-based lab session retained learning. However, in the Spring 2005 the exam scores did not reflect retention in learning when compared with IDV-based and MANUAL-based lab scores (short term learning, i.e., exam taken one week after the lab exercise). Testing the long-term learning, seven weeks between the two exams in the Spring 2005, show no statistically significant difference between IDV-based group scores and MANUAL-based group scores. However, the IDV group obtained exam score average slightly higher than the MANUAL group. Statistical testing of the principal hypothesis in this study, leads to the conclusion that the IDV-based method did not prove to be a better teaching tool than the traditional paper-based method. Future studies could potentially find significant differences in the effectiveness of both manual and IDV methods if the conditions had been more controlled. That is, students in the control group should not be exposed to the weather analysis using IDV during lecture.

The Group Delay and Suppression Pattern of the Cochlear Microphonic Potential Recorded at the Round Window

PubMed Central

He, Wenxuan; Porsov, Edward; Kemp, David; Nuttall, Alfred L.; Ren, Tianying

2012-01-01

Background It is commonly assumed that the cochlear microphonic potential (CM) recorded from the round window (RW) is generated at the cochlear base. Based on this assumption, the low-frequency RW CM has been measured for evaluating the integrity of mechanoelectrical transduction of outer hair cells at the cochlear base and for studying sound propagation inside the cochlea. However, the group delay and the origin of the low-frequency RW CM have not been demonstrated experimentally. Methodology/Principal Findings This study quantified the intra-cochlear group delay of the RW CM by measuring RW CM and vibrations at the stapes and basilar membrane in gerbils. At low sound levels, the RW CM showed a significant group delay and a nonlinear growth at frequencies below 2 kHz. However, at high sound levels or at frequencies above 2 kHz, the RW CM magnitude increased proportionally with sound pressure, and the CM phase in respect to the stapes showed no significant group delay. After the local application of tetrodotoxin the RW CM below 2 kHz became linear and showed a negligible group delay. In contrast to RW CM phase, the BM vibration measured at location ∼2.5 mm from the base showed high sensitivity, sharp tuning, and nonlinearity with a frequency-dependent group delay. At low or intermediate sound levels, low-frequency RW CMs were suppressed by an additional tone near the probe-tone frequency while, at high sound levels, they were partially suppressed only at high frequencies. Conclusions/Significance We conclude that the group delay of the RW CM provides no temporal information on the wave propagation inside the cochlea, and that significant group delay of low-frequency CMs results from the auditory nerve neurophonic potential. Suppression data demonstrate that the generation site of the low-frequency RW CM shifts from apex to base as the probe-tone level increases. PMID:22470560

A laboratory-based study on patients with Parkinson’s disease and seborrheic dermatitis: the presence and density of Malassezia yeasts, their different species and enzymes production

PubMed Central

2014-01-01

Background Seborrheic dermatitis (SD) and Parkinson’s disease (PD) are frequently associated conditions. Aims of this study were: to determine severity of SD, presence of different species and density of Malassezia yeasts; to assess yeast lipases and phosphatases production in vitro and to compare these results between SD patients with and without PD. Methods This case–control prospective study was conducted at the Dermatology and Neurology Units, Clinical Centre of Serbia and at the National Medical Mycology Reference Laboratory, University of Belgrade Medical School, Serbia. A total of 90 patients and 70 healthy controls (HC) were investigated: 60 patients with SD (SDN) and 30 patients with SD and PD (SDP). Culture-based mycological examination was carried out on lesional skin (LS) and non-lesional skin (NLS). A yeasts density was determined by counting the Malassezia colony forming units per tape (CFU/tape). Enzymes production by isolated Malassezia was investigated. Results The most patients with SD were male (76.7%; SDP and 63.3%; SDN) and the intensity of SD was dominantly severe or moderate (76.7%; SDP and 75%; SDN). The presence of Malasseziа was high on LS in both groups (87.3%; SDP and 86.7%; SDN) (p=0.667). The highest yeasts density (mean CFU/tape=67.8) was detected on LS in 53% of SDP group and in 21.7% of SDN group (mean CFU/tape=31.9) (p < 0.01). The presence of negative cultures was lower in SDP group (13.3%) in comparison to HC and SDN groups (37% and 31.7%, respectively). Malassezia density on NLS in SDP group (mean CFU/tape=44.3) was significantly higher in comparison to SDN and HC (p=0.018). M. globosa was the most abundant species identified amongst isolates from the SDP group (42.3%) and exhibited high production of phosphatase and lipase in vitro. Conclusion From this laboratory-based study a positive correlation between SD, PD, M. globosa incidence, high yeast density and high phosphatase and lipase activity was established. Our data lead to conclusion that local skin performance of PD patient’s characterized with increased sebum excretion ratio play a role in SD by stimulation of yeasts replication and enzyme production. PMID:24628775

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

PubMed Central

Nord, Anette; Svensson, Leif; Hult, Håkan; Kreitz-Sandberg, Susanne; Nilsson, Lennart

2016-01-01

Objectives The aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training. Settings Seventh grade students in two Swedish municipalities. Design A cluster randomised trial. The classes were randomised to receive app-based or DVD-based training. Willingness to act and practical CPR skills were assessed, directly after training and at 6 months, by using a questionnaire and a PC Skill Reporting System. Data on CPR skills were registered in a modified version of the Cardiff test, where scores were given in 12 different categories, adding up to a total score of 12–48 points. Training and measurements were performed from December 2013 to October 2014. Participants 63 classes or 1232 seventh grade students (13-year-old) were included in the study. Primary and secondary outcome measures Primary end point was the total score of the modified Cardiff test. The individual variables of the test and self-reported willingness to make a life-saving intervention were secondary end points. Results The DVD-based group was superior to the app-based group in CPR skills; a total score of 36 (33–38) vs 33 (30–36) directly after training (p<0.001) and 33 (30–36) and 31 (28–34) at 6 months (p<0.001), respectively. At 6 months, the DVD group performed significantly better in 8 out of 12 CPR skill components. Both groups improved compression depth from baseline to follow-up. If a friend suffered cardiac arrest, 78% (DVD) versus 75% (app) would do compressions and ventilations, whereas only 31% (DVD) versus 32% (app) would perform standard CPR if the victim was a stranger. Conclusions At 6 months follow-up, the 50 min DVD-based group showed superior CPR skills compared with the 30 min app-based group. The groups did not differ in regard to willingness to make a life-saving effort. PMID:27130166

Impact of team composition on student perceptions of interprofessional teamwork: A 6-year cohort study.

PubMed

Lairamore, Chad; Morris, Duston; Schichtl, Rachel; George-Paschal, Lorrie; Martens, Heather; Maragakis, Alexandros; Garnica, Mary; Jones, Barbara; Grantham, Myra; Bruenger, Adam

2018-03-01

Interprofessional education (IPE) provides students with opportunities to learn about the roles and responsibilities of other professions and develop communication and teamwork skills. As different health professions have recognised the importance of IPE, the number of disciplines participating in IPE events is increasing. Consequently, it is important to examine the effect group structure has on the learning environment and student knowledge acquisition during IPE events. The purpose of this study was to determine the effect of group composition on student perceptions of interprofessional teamwork and collaboration when participating in a case-based IPE forum. To examine this construct, six cohorts of students were divided into two groups: Group-one (2010-2012) included students from five professions. Group-two (2013-2015) included students from 10 professions. The only other change for group-two was broadening the case scenarios to ensure a role for each profession. At the conclusion of the case-based IPE forums, both groups demonstrated a statistically significant increase in 'readiness for interprofessional learning' and 'interdisciplinary education perceptions'. However, participants in group-one (2010-2012) demonstrated a greater change in scores when compared to group-two (2013-2015). It was concluded a case-based IPE forum with students from numerous health professions participating in a discussion about broad case scenarios was moderately effective at introducing students to other health professions and increasing their knowledge of others' identities. However, a smaller grouping of professions with targeted cases was more effective at influencing student perceptions of the need for teamwork. When planning an IPE event, faculty should focus on intentional groupings of professions to reflect the social context of healthcare teams so all students can fully participate and experience shared learning.

Implementing the Integrated Strategy for the Cultural Adaptation of Evidence-Based Interventions: An Illustration.

PubMed

Sidani, Souraya; Ibrahim, Sarah; Lok, Jana; Fan, Lifeng; Fox, Mary

2018-01-01

Background Persons' cultural beliefs about a health problem can affect their perceived acceptability of evidence-based interventions, undermining evidence-based interventions' adherence, and uptake to manage the problem. Cultural adaptation has the potential to enhance the acceptability, uptake, and adherence to evidence-based interventions. Purpose To illustrate the implementation of the first two phases of the integrated strategy for cultural adaptation by examining Chinese Canadians' perceptions of chronic insomnia and evidence-based behavioral therapies for insomnia. Methods Chinese Canadians ( n = 14) with chronic insomnia attended a group session during which they completed established instruments measuring beliefs about sleep and insomnia, and their perceptions of factors that contribute to chronic insomnia. Participants rated the acceptability of evidence-based behavioral therapies and discussed their cultural perspectives regarding chronic insomnia and its treatment. Results Participants actively engaged in the activities planned for the first two phases of the integrated strategy and identified the most significant factor contributing to chronic insomnia and the evidence-based intervention most acceptable for their cultural group. Conclusions The protocol for implementing the two phases of the integrated strategy for cultural adaptation of evidence-based interventions was feasible, acceptable, and useful in identifying culturally relevant evidence-based interventions.

Should medical students learn to develop a personal formulary?

PubMed Central

Daniels, J. M. A.; Mulder, C. W.; Groot, O. A.; Wewerinke, L.; Barnes, K. I.; Bakathir, H. A.; Hassan, N. A. G. M.; Van Bortel, L.; Kriska, M.; Santoso, B.; Sanz, E. J.; Thomas, M.; Ziganshina, L. E.; Bezemer, P. D.; Van Kan, C.; Richir, M. C.; Hogerzeil, H. V.

2008-01-01

Objective This study was performed to determine whether students who are trained in developing a personal formulary become more competent in rational prescribing than students who have only learned to use existing formularies. Methods This was a multicentre, randomised, controlled study conducted in eight universities in India, Indonesia, the Netherlands, the Russian Federation, Slovakia, South Africa, Spain and Yemen. Five hundred and eighty-three medical students were randomised into three groups: the personal formulary group (PF; 94), the existing formulary group (EF; 98) and the control group (C; 191). The PF group was taught how to develop and use a personal formulary, whereas e the EF group was taught how to review and use an existing formulary. The C group received no additional training and participated only in the tests. Student’s prescribing skills were measured by scoring their treatment plans for written patient cases. Results The mean PF group score increased by 23% compared with 19% for the EF group (p < 0.05) and 6% for controls (p < 0.05). The positive effect of PF training was only significant in universities that had a mainly classic curriculum. Conclusion Training in development and use of a personal formulary was particularly effective in universities with a classic curriculum and with traditional pharmacology teaching. In universities with a general problem-based curriculum, pharmacotherapy teaching can be based on either existing or personal formularies. PMID:18338161

Speech disorders did not correlate with age at onset of Parkinson's disease.

PubMed

Dias, Alice Estevo; Barbosa, Maira Tonidandel; Limongi, João Carlos Papaterra; Barbosa, Egberto Reis

2016-02-01

Speech disorders are common manifestations of Parkinson´s disease. Objective To compare speech articulation in patients according to age at onset of the disease. Methods Fifty patients was divided into two groups: Group I consisted of 30 patients with age at onset between 40 and 55 years; Group II consisted of 20 patients with age at onset after 65 years. All patients were evaluated based on the Unified Parkinson's Disease Rating Scale scores, Hoehn and Yahr scale and speech evaluation by perceptual and acoustical analysis. Results There was no statistically significant difference between the two groups regarding neurological involvement and speech characteristics. Correlation analysis indicated differences in speech articulation in relation to staging and axial scores of rigidity and bradykinesia for middle and late-onset. Conclusions Impairment of speech articulation did not correlate with age at onset of disease, but was positively related with disease duration and higher scores in both groups.

Effect of cavity preparation on the flexural strengths of acrylic resin repairs

PubMed Central

ELHADIRY, Safa Salim; YUNUS, Norsiah; ARIFFIN, Yusnidar Tajul

2010-01-01

Objective To investigate the effect of cavity preparation on the flexural strength of heat-curing denture resin when repaired with an auto-curing resin. Material and methods Ninety-six rectangular specimens (64x10x2.5 mm) prepared from heat-curing denture base resin (Meliodent) were randomly divided into four groups before repair. One group was left intact as control. Each repair specimen was sectioned into two; one group was repaired using the conventional repair method (Group 1). Two groups had an additional transverse cavity (2x3.5x21.5 mm) prepared prior to the repair; one repaired with (Group 2) and one without glass-fiber reinforcement (Group 3). A three-point flexural bending test according to the ISO 1567:1999 specification8 for denture base polymers was carried out on all groups after 1, 7 and 30 days of water immersion. Statistical analysis was carried out using two-way ANOVA, Kruskal Wallis and post-hoc Mann Whitney tests. Results The highest flexural strength was observed in the control group. Control and conventional repairs group (Group 1) showed reduction in the flexural strength 30 days after water immersion. No significant change in the strength was observed for Groups 2 and 3 where the repair joints were similarly prepared with additional transverse cavity. Conclusion Repaired specimens showed lower flexural strength values than intact heat-curing resin. Cavity preparation had no significant effect on the flexural strength of repair with water immersion. PMID:21308283

Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis

PubMed Central

2012-01-01

Background Diabetes self-management education (DSME) can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients. Methods A systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality. Results In total 21 studies (26 publications, 2833 participants) were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P = 0.0006, 13 studies, 1883 participants), 12 months (0.46% points; P = 0.001, 11 studies, 1503 participants) and 2 years (0.87% points; P < 0.00001, 3 studies, 397 participants) and fasting blood glucose levels were also significantly reduced at 12 months (1.26 mmol/l; P < 0.00001, 5 studies, 690 participants) but not at 6 months. For the main lifestyle outcomes, diabetes knowledge was improved significantly at 6 months (SMD 0.83; P = 0.00001, 6 studies, 768 participants), 12 months (SMD 0.85; P < 0.00001, 5 studies, 955 participants) and 2 years (SMD 1.59; P = 0.03, 2 studies, 355 participants) and self-management skills also improved significantly at 6 months (SMD 0.55; P = 0.01, 4 studies, 534 participants). For the main psychosocial outcomes, there were significant improvement for empowerment/self-efficacy (SMD 0.28, P = 0.01, 2 studies, 326 participants) after 6 months. For quality of life no conclusion could be drawn due to high heterogeneity. For the secondary outcomes there were significant improvements in patient satisfaction and body weight at 12 months for the intervention group. There were no differences between the groups in mortality rate, body mass index, blood pressure and lipid profile. Conclusions Group-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes. PMID:22824531

Physical Activity and Physical Fitness in Pediatric Obesity: What are the First Steps for Clinicians? Expert Conclusion from the 2016 ECOG Workshop

PubMed Central

O’MALLEY, GRACE; RING-DIMITRIOU, SUSANNE; NOWICKA, PAULINA; VANIA, ANDREA; FRELUT, MARIE-LAURE; FARPOUR-LAMBERT, NATHALIE; WEGHUBER, DANIEL; THIVEL, DAVID

2017-01-01

One of the main aims of the European Childhood Obesity Group (ECOG) is to assist healthcare workers in delivering evidence-based assessment and treatment of childhood obesity. Every year the ECOG Congress includes working groups whose objective is to highlight concerns faced by clinicians and practitioners who work in the field of pediatric obesity. This year, a working group was devoted to the assessment of physical activity and physical fitness in this population. The present commentary attempts to summarize the main themes identified by practitioners during these workshops in order to provide the basic and essential first steps required to address physical activity and fitness in children with obesity. PMID:28674594

The enhancement of students' mathematical self-efficacy through teaching with metacognitive scaffolding approach

NASA Astrophysics Data System (ADS)

Prabawanto, S.

2018-05-01

This research aims to investigate the enhancement of students’ mathematical self- efficacy through teaching with metacognitive scaffolding approach. This research used a quasi- experimental design with pre-post respon control. The subjects were pre-service elementary school teachers in a state university in Bandung. In this study, there were two groups: experimental and control groups. The experimental group consists of 60 students who acquire teaching mathematics under metacognitive approach, while the control group consists of 58 students who acquire teaching mathematics under direct approach. Students were classified into three categories based on the mathematical prior ability, namely high, middle, and low. Data collection instruments consist of mathematical self-efficacy instruments. By using mean difference test, two conclusions of the research: (1) there is a significant difference in the enhancement of mathematical self-efficacy between the students who attended the course under metacognitive scaffolding approach and students who attended the course under direct approach, and (2) there is no significant interaction effect of teaching approaches and ability level based on the mathematical prior ability toward enhancement of students’ mathematical self-efficacy.

The enhancement of students' mathematical problem solving ability through teaching with metacognitive scaffolding approach

NASA Astrophysics Data System (ADS)

Prabawanto, Sufyani

2017-05-01

This research aims to investigate the enhancement of students' mathematical problem solving through teaching with metacognitive scaffolding approach. This research used a quasi-experimental design with pretest-posttest control. The subjects were pre-service elementary school teachers in a state university in Bandung. In this study, there were two groups: experimental and control groups. The experimental group consists of 60 studentswho acquire teaching mathematicsunder metacognitive scaffolding approach, while the control group consists of 58 studentswho acquire teaching mathematicsunder direct approach. Students were classified into three categories based on the mathematical prior ability, namely high, middle, and low. Data collection instruments consist of mathematical problem solving test instruments. By usingmean difference test, two conclusions of the research:(1) there is a significant difference in the enhancement of mathematical problem solving between the students who attended the course under metacognitive scaffolding approach and students who attended the course under direct approach, and(2) thereis no significant interaction effect of teaching approaches and ability level based on the mathematical prior ability toward enhancement of students' mathematical problem solving.

Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial

PubMed Central

James, Janet; Thomas, Peter; Cavan, David; Kerr, David

2004-01-01

Objective To determine if a school based educational programme aimed at reducing consumption of carbonated drinks can prevent excessive weight gain in children. Design Cluster randomised controlled trial. Setting Six primary schools in southwest England. Participants 644 children aged 7-11 years. Intervention Focused educational programme on nutrition over one school year. Main outcome measures Drink consumption and number of overweight and obese children. Results Consumption of carbonated drinks over three days decreased by 0.6 glasses (average glass size 250 ml) in the intervention group but increased by 0.2 glasses in the control group (mean difference 0.7, 95% confidence interval 0.1 to 1.3). At 12 months the percentage of overweight and obese children increased in the control group by 7.5%, compared with a decrease in the intervention group of 0.2% (mean difference 7.7%, 2.2% to 13.1%). Conclusion A targeted, school based education programme produced a modest reduction in the number of carbonated drinks consumed, which was associated with a reduction in the number of overweight and obese children. PMID:15107313

Levofloxacin-Based First-Line Therapy versus Standard First-Line Therapy for Helicobacter pylori Eradication: Meta-Analysis of Randomized Controlled Trials

PubMed Central

Peedikayil, Musthafa Chalikandy; AlSohaibani, Fahad Ibrahim; Alkhenizan, Abdullah Hamad

2014-01-01

Background First-line levofloxacin-based treatments eradicate Helicobacter pylori with varying success. We examined the efficacy and safety of first-line levofloxacin-based treatment in comparison to standard first-line therapy for H pylori eradication. Materials and Methods We searched literature databases from Medline, EMBASE, and the Cochrane Register of Randomized Controlled Trials through March 2013 for randomized controlled trials comparing first-line levofloxacin and standard therapy. We included randomized controlled trials conducted only on naïve H pylori infected patients in adults. A systematic review was conducted. Meta-analysis was performed with Review Manager 5.2. Treatment effect was determined by relative risk with a random or fixed model by the Mantel-Haenszel method. Results Seven trials were identified with 888 patients receiving 7 days of first-line levofloxacin and 894 treated with standard therapy (Amoxicillin, Clarithromycin and proton pump inhibitor) for 7 days. The overall crude eradication rate in the Levofloxacin group was 79.05% versus 81.4% in the standard group (risk ratio 0.97; 95% CI; 0.93, 1.02). The overall dropout was 46 (5.2%) in the levofloxacin group and 52 (5.8%) for standard therapy. The dizziness was more common among group who took Levofloxacin based treatment and taste disturbance was more common among group who took standard therapy. Meta-analysis of overall adverse events were similar between the two groups with a relative risk of 1.06 (95% CI 0.72, 1.57). Conclusion Helicobacter pylori eradication with 7 days of Levofloxacin-based first line therapy was safe and equal compared to 7 days of standard first-line therapy. PMID:24465624

Paediatric emergency department-based carbon monoxide detector intervention: a randomised trial

PubMed Central

McKenzie, Lara B; Roberts, Kristin J; Kaercher, Roxanne M; Collins, Christy L; Comstock, R Dawn; Fernandez, Soledad; Abdel-Rasoul, Mahmoud; Casavant, Marcel J; Mihalov, Leslie

2017-01-01

Background Although non-fire-related carbon monoxide (CO) poisoning is almost entirely preventable, over 400 people die and 20 000 people are injured each year in the USA from unintentional CO poisoning. Thus, there is a critical need for evidence-based interventions for preventing CO poisoning and increasing the proper use and installation of CO detectors. Methods A randomised, controlled trial (Project CODE, a Carbon Monoxide Detector Education intervention) with 2-week and 6-month follow-up home observations was conducted in 299 parents of children aged ≤18 years recruited in the emergency department of a level 1 paediatric trauma centre. The intervention group received an educational tool, a spiral-bound, laminated booklet that resembled a CO detector containing theory-based safety messages based on the precaution adoption process model, a plug-in CO detector and 9 V battery. The control group received a one page flyer on CO poisoning prevention. Results Although the difference was not statistically significant, mean CO knowledge score increased at a greater rate for the intervention group than the control group. Intervention group parents were more likely to exhibit ‘safe’ CO detector use than control group parents at the 2-week follow-up (RR: 2.75; 95% CI 2.06 to 3.69) and 6-month follow-up (RR: 2.78; 95% CI 2.06 to 3.76), after adjusting for self-reported CO detector use behaviour at enrolment and annual per capita income. Conclusions An emergency department-delivered intervention containing a theory-based educational tool paired with a CO detector can be an effective method for increasing knowledge about CO poisoning, for prevention and for appropriate use of a CO detector. Trial registration number NCT00959478. PMID:28007971

The effects of team-based learning techniques on nursing students' perception of the psycho-social climate of the classroom.

PubMed

Koohestani, Hamid Reza; Baghcheghi, Nayereh

2016-01-01

Background: Team-based learning is a structured type of cooperative learning that is becoming increasingly more popular in nursing education. This study compares levels of nursing students' perception of the psychosocial climate of the classroom between conventional lecture group and team-based learning group. Methods: In a quasi-experimental study with pretest-posttest design 38 nursing students of second year participated. One half of the 16 sessions of cardiovascular disease nursing course sessions was taught by lectures and the second half with team-based learning. The modified college and university classroom environment inventory (CUCEI) was used to measure the perception of classroom environment. This was completed after the final lecture and TBL sessions. Results: Results revealed a significant difference in the mean scores of psycho-social climate for the TBL method (Mean (SD): 179.8(8.27)) versus the mean score for the lecture method (Mean (SD): 154.213.44)). Also, the results showed significant differences between the two groups in the innovation (p<0.001), student cohesiveness (p=0.01), cooperation (p<0.001) and equity (p= 0.03) sub-scales scores (p<0.05). Conclusion: This study provides evidence that team-based learning does have a positive effect on nursing students' perceptions of their psycho-social climate of the classroom.

Safety and Efficacy of Uninterrupted Apixaban Therapy Versus Warfarin During Atrial Fibrillation Ablation.

PubMed

Shah, Ruchit R; Pillai, Ajay; Schafer, Pascha; Meggo, David; McElderry, Tom; Plumb, Vance; Yamada, Takumi; Kumar, Vineet; Doppalapudi, Harish; Gunter, Alicia; Pentecost, Emily; Maddox, William R

2017-08-01

Thromboembolic cerebrovascular accident remains a rare but potentially devastating complication of catheter-based atrial fibrillation (AF) ablation. Uninterrupted oral anticoagulant therapy with warfarin has become the standard of care when performing catheter-based AF ablation. Compared with warfarin, apixaban, a factor Xa inhibitor, has been shown to reduce the risk of stroke and major bleeding in nonvalvular AF. With an increase in apixaban use for stroke prophylaxis in patients with AF, there is an increased interest in the safety and efficacy of uninterrupted apixaban therapy during AF ablation. We compared the safety and efficacy of uninterrupted OA therapy with either warfarin or apixaban in all patients who underwent catheter-based AF ablation at the University of Alabama at Birmingham and at Augusta University Medical Center from January 7, 2013, to February 25, 2016. All patients underwent a transesophageal echocardiogram on the day of their ablation to assess for the presence of intracardiac thrombi. All complications were identified and classified as bleeding, thromboembolic events, or other. A total of 627 patients were analyzed as described earlier. There were 310 patients in the warfarin group and 317 patients in the apixaban group. There were 8 complications in the warfarin group and 5 complications in the apixaban group (p = 0.38). There were no thromboembolic complications in either group. In conclusion, the use of apixaban is as safe and effective as warfarin for uninterrupted OA therapy during catheter-based ablation of AF. Copyright © 2017 Elsevier Inc. All rights reserved.

Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review

PubMed Central

van de Ven, Renate M.; Murre, Jaap M. J.; Veltman, Dick J.; Schmand, Ben A.

2016-01-01

Background: Stroke commonly results in cognitive impairments in working memory, attention, and executive function, which may be restored with appropriate training programs. Our aim was to systematically review the evidence for computer-based cognitive training of executive dysfunctions. Methods: Studies were included if they concerned adults who had suffered stroke or other types of acquired brain injury, if the intervention was computer training of executive functions, and if the outcome was related to executive functioning. We searched in MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Study quality was evaluated based on the CONSORT Statement. Treatment effect was evaluated based on differences compared to pre-treatment and/or to a control group. Results: Twenty studies were included. Two were randomized controlled trials that used an active control group. The other studies included multiple baselines, a passive control group, or were uncontrolled. Improvements were observed in tasks similar to the training (near transfer) and in tasks dissimilar to the training (far transfer). However, these effects were not larger in trained than in active control groups. Two studies evaluated neural effects and found changes in both functional and structural connectivity. Most studies suffered from methodological limitations (e.g., lack of an active control group and no adjustment for multiple testing) hampering differentiation of training effects from spontaneous recovery, retest effects, and placebo effects. Conclusions: The positive findings of most studies, including neural changes, warrant continuation of research in this field, but only if its methodological limitations are addressed. PMID:27148007

A Systems Biology Approach for Identifying Hepatotoxicant Groups Based on Similarity in Mechanisms of Action and Chemical Structure.

PubMed

Hebels, Dennie G A J; Rasche, Axel; Herwig, Ralf; van Westen, Gerard J P; Jennen, Danyel G J; Kleinjans, Jos C S

2016-01-01

When evaluating compound similarity, addressing multiple sources of information to reach conclusions about common pharmaceutical and/or toxicological mechanisms of action is a crucial strategy. In this chapter, we describe a systems biology approach that incorporates analyses of hepatotoxicant data for 33 compounds from three different sources: a chemical structure similarity analysis based on the 3D Tanimoto coefficient, a chemical structure-based protein target prediction analysis, and a cross-study/cross-platform meta-analysis of in vitro and in vivo human and rat transcriptomics data derived from public resources (i.e., the diXa data warehouse). Hierarchical clustering of the outcome scores of the separate analyses did not result in a satisfactory grouping of compounds considering their known toxic mechanism as described in literature. However, a combined analysis of multiple data types may hypothetically compensate for missing or unreliable information in any of the single data types. We therefore performed an integrated clustering analysis of all three data sets using the R-based tool iClusterPlus. This indeed improved the grouping results. The compound clusters that were formed by means of iClusterPlus represent groups that show similar gene expression while simultaneously integrating a similarity in structure and protein targets, which corresponds much better with the known mechanism of action of these toxicants. Using an integrative systems biology approach may thus overcome the limitations of the separate analyses when grouping liver toxicants sharing a similar mechanism of toxicity.

Population genetic analysis of Enterocytozoon bieneusi in humans.

PubMed

Li, Wei; Cama, Vitaliano; Feng, Yaoyu; Gilman, Robert H; Bern, Caryn; Zhang, Xichen; Xiao, Lihua

2012-01-01

Genotyping based on sequence analysis of the ribosomal internal transcribed spacer has revealed significant genetic diversity in Enterocytozoonbieneusi. Thus far, the population genetics of E. bieneusi and its significance in the epidemiology of microsporidiosis have not been examined. In this study, a multilocus sequence typing of E. bieneusi in AIDS patients in Lima, Peru was conducted, using 72 specimens previously genotyped as A, D, IV, EbpC, WL11, Peru7, Peru8, Peru10 and Peru11 at the internal transcribed spacer locus. Altogether, 39 multilocus genotypes were identified among the 72 specimens. The observation of strong intragenic linkage disequilibria and limited genetic recombination among markers were indicative of an overall clonal population structure of E. bieneusi. Measures of pair-wise intergenic linkage disequilibria and a standardised index of association (IAS) based on allelic profile data further supported this conclusion. Both sequence-based and allelic profile-based phylogenetic analyses showed the presence of two genetically isolated groups in the study population, one (group 1) containing isolates of the anthroponotic internal transcribed spacer genotype A, and the other (group 2) containing isolates of multiple internal transcribed spacer genotypes (mainly genotypes D and IV) with zoonotic potential. The measurement of linkage disequilibria and recombination indicated group 2 had a clonal population structure, whereas group 1 had an epidemic population structure. The formation of the two sub-populations was confirmed by STRUCTURE and Wright's fixation index (FST) analyses. The data highlight the power of MLST in understanding the epidemiology of E. bieneusi. Published by Elsevier Ltd.

The recruitment of new members to existing PBSGL small groups: a qualitative study.

PubMed

Park, Julia; Cunningham, David E

2018-04-23

Introduction Practice-Based Small Group Learning (PBSGL) is a learning programme widely adopted by primary healthcare professions (general practitioners, general practice nurses and pharmacists) in Scotland and other countries in the UK. PBSGL groups recruit members and decide on meeting dates and venues. Study aims To determine how groups recruit new members and discern what are the important attributes of the new members. Method A grounded theory approach was used with purposive sampling to recruit PBSGL groups to the study. Focus groups drawn from established PBSGL groups were conducted by two researchers following an iterative process, with interviews audio-recorded and transcribed, and codes and themes constructed. Data saturation was achieved. Results and conclusions Four themes were identified that affected group recruitment: group formation and purpose; group culture and ethos; experience and seniority range of group members; professional socialisation and cross-fertilisation. Groups whose main purpose was learning encouraged diverse membership, while groups that were stricter with recruitment often prioritised friendship, group safety, trust and peer support over learning. The variation in group's openness to recruitment may make it difficult for potential members to find a group and this may affect the development and expansion of the PBSGL programme.

Derivation of Apollo 14 High-Al Basalts from Distinct Source Regions at Discrete Times: New Constraints

NASA Technical Reports Server (NTRS)

Neal, C. R.; Shih, C.-Y.; Reese, Y.; Nyquist, L. E.; Kramer, G. Y.

2006-01-01

Apollo 14 basalts occur predominantly as clasts in breccias, but represent the oldest volcanic products that were returned from the Moon [1]. These basalts are relatively enriched in Al2O3 (11-16 wt%) compared to other mare basalts (7-11 wt%) and were originally classified into 5 compositional groups [2,3]. Neal et al. [4] proposed that a continuum of compositions existed. These were related through assimilation (of KREEP) and fractional crystallization (AFC). Age data, however, show that at least three volcanic episodes are recorded in the sample collection [1,5,6]. Recent work has demonstrated that there are three, possibly four groups of basalts in the Apollo 14 sample collection that were erupted from different source regions at different times [7]. This conclusion was based upon incompatible trace element (ITE) ratios of elements that should not be fractionated from one another during partial melting (Fig. 1). These groups are defined as Group A (Groups 4 & 5 of [3]), Group B (Groups 1 & 2 of [3]), and Group C (Group 3 of [3]). Basalt 14072 is distinct from Groups A-C.

A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

PubMed

Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

2017-09-19

Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study

PubMed Central

Alexopoulos, Evangelos C.; Kavalidou, Katerina; Messolora, Fani

2015-01-01

Background Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000–2009. Methods Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60–X84) was based on the international classification of diseases (ICD-10). Results Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30–39 years in Greek male elementary workers and the 50–59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations. PMID:27014484

Verbal fluency in elderly with and without hypertension and diabetes from the FIBRA study in Ermelino Matarazzo

PubMed Central

Morelli, Nathalia Lais; Cachioni, Meire; Lopes, Andrea; Batistoni, Samila Sathler Tavares; Falcão, Deusivania Vieira da Silva; Neri, Anita Liberalesso; Yassuda, Monica Sanches

2017-01-01

ABSTRACT. Background: There are few studies on the qualitative variables derived from the animal category verbal fluency test (VF), especially with data originating from low-income samples of community-based studies. Objective: To compare elderly with and without hypertension (HTN) and diabetes mellitus (DM) regarding the total number of animals spoken, number of categories, groups and category switches on the VF test. Methods: We used the database of the FIBRA (Frailty in Brazilian Elderly) community-based study. The variables number of Categories, Groups and Category Switches were created for each participant. The total sample (n = 384) was divided into groups of elderly who reported having HTN, DM, both HTN and DM, or neither of these conditions. Results: There were no significant differences between the groups with and without these chronic diseases for VF total score or for the qualitative variables. Conclusion: Among independent community-dwelling elderly, the qualitative variables derived from the VF animal category may not add information regarding the cognitive profile of elderly with chronic diseases. Total VF score and the qualitative variables Category, Group and Switching did not differentiate elderly with and without HTN and DM. PMID:29354222

The value of fixed rasburicase dosing versus weight-based dosing in the treatment and prevention of tumor lysis syndrome.

PubMed

Boutin, Alyssa; Blackman, Alison; O'Sullivan, David M; Forcello, Nicholas

2018-01-01

Background Rasburicase is a recombinant urate oxidase enzyme used for the treatment and prevention of tumor lysis syndrome. Our objective was to assess the efficacy of indication-based, low-dose rasburicase administration compared to the Food and Drug Administration-approved weight-based dosing. Methods This was a retrospective cohort study utilizing data from a tertiary medical center including patients admitted from 2012 to 2016, who received at least one dose of rasburicase. The primary outcome was achieving a uric acid level less than 7.5 mg/dl after a single dose of rasburicase in the preprotocol (Food and Drug Administration-approved weight-based dosing) and postprotocol (indication-based, low-dose) groups. Secondary outcomes included the change in uric acid levels between the pre- and postprotocol groups, adherence to the new institutional protocol, need for repeat rasburicase doses, and a cost analysis. Results Sixty-four patients received at least one dose of rasburicase between 1 January 2012 and 1 December 2016. Twenty-seven (79.4%) doses in the preprotocol group and 28 (82.4%) doses in the postprotocol group successfully achieved a uric acid level less than 7.5 mg/dl after a single dose of rasburicase (p=1.000). The average total monthly cost of rasburicase was reduced by 59.9% after adoption of the new protocol. Conclusions Indication-based, low-dose rasburicase displayed significantly more value when compared to weight-based dosing as shown by achieving cost savings without compromising clinical efficacy.

Effect of communication skills based group counseling on mothers' sex dialogue with their adolescent daughters.

PubMed

Ziaei, Tayebe; Ghanbari Gorji, Maryam; Behnampour, Naser; Rezaei Aval, Masumeh

2018-02-05

Background Sex dialogue is one of the most critical and challenging topics between mothers and adolescents. The knowledge and skills of mothers in sex dialogue with their daughters are essential. The purpose of this study is to determine the effect of group counseling based on communication skills on mothers through their sex dialogue with their daughters. Methods A randomized controlled field trial was conducted on 168 couples of mothers and their daughters selected by the stratified matching method and randomly divided into two control and intervention groups. The mothers in the intervention group participated in a communication-based consultation in groups consisting of 6-12 people for 6-7 weekly sessions, each one lasting 60 min. The data collection tool was a Persian-translated questionnaire by Jaccard for sex dialogue between mother and daughter. The data were analyzed using Chi-square (χ2), ANOVA with repeated measures and modified post hoc Bonferroni tests. Results There was a significant difference in the mean score of mother-daughter sex dialogue 1 week after intervention between the intervention (34.48 ± 8.74) and control (40.44 ± 9.49) groups (p = 0.001) and 1 month after the intervention between the intervention (30.41 ± 10.07) and control (42.47 ± 9.62) groups (p < 0.001). Conclusion Through applying communication skills, an increase in mother-daughter sex dialogue frequency was observed after group counseling. Therefore, it is suggested to promote mother-daughter communication skills by accessing the mothers via schools, health centers and with the aid of midwifery counselors, midwives and other trained caretakers.

A hyaluronan hydrogel scaffold-based xeno-free culture system for ex vivo expansion of human corneal epithelial stem cells.

PubMed

Chen, D; Qu, Y; Hua, X; Zhang, L; Liu, Z; Pflugfelder, S C; Li, D-Q

2017-06-01

PurposeTo develop a hyaluronan hydrogel scaffold-based xeno-free culture system for ex vivo cultivation of human corneal epithelial stem cells (CESCs).Patients and MethodsCESCs were cultivated from donor limbal explants on the HyStem-C Hydrogel bio-scaffold in 12-well plates for 3 weeks. Group A used the traditional supplemented hormonal epidermal medium (SHEM) and group B used the defined SHEM (without fetal bovine serum and toxin A, adding 20% serum replacement). The growth and morphology of the cultured cells were assessed by phase contrast microscope. The expressions of specific cell markers were assessed by immunofluorescence staining and quantitative real-time PCR (qRT-PCR).ResultsSuccessful cultures of CESCs were obtained in both groups, resulting in multilayered stratified epithelia. Comparing to group A, the cells in group B was grown slightly slower and formed less cellular layers at the end of culture. The corneal specific cytokeratin (K) 12 and differentiation markers, involucrin, and connexin 43, were mainly expressed in the superficial cellular layers in both groups. Interestingly, certain basal cells were immune-positive to proposed stem cell markers such as K19, ABCG2, and integrin β1 in both groups. There was no significant difference between the two groups with regard to the gene expression levels of all these selected corneal markers (all P>0.05).ConclusionsThe hyaluronan hydrogel scaffold-based xeno-free culture system may support the expansion of regenerative CESCs without the risk of xeno component contamination. The regenerated epithelium maintains similar characteristics of native corneal epithelium.

Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitor-Based Treatment on Cardiovascular Outcomes in Hypertensive Blacks versus Whites

PubMed Central

Ogedegbe, Gbenga; Shah, Nirav R.; Phillips, Christopher; Goldfeld, Keith; Roy, Jason; Guo, Yu; Gyamfi, Joyce; Torgersen, Christopher; Capponi, Louis; Bangalore, Sripal

2015-01-01

BACKGROUND Clinical trial evidence suggests poorer outcomes in blacks compared to whites when treated with angiotensin-converting enzyme (ACE) inhibitor-based regimen, but this has not been evaluated in clinical practice. OBJECTIVES We evaluated the comparative effectiveness of an ACE inhibitor-based regimen on a composite outcome of all-cause mortality, stroke, and acute myocardial infarction (AMI) in hypertensive blacks compared to whites. METHODS We conducted a retrospective cohort study of 434,646 patients in a municipal health care system. Four exposure groups (Black-ACE, Black-NoACE, White-ACE, White-NoACE) were created based on race and treatment exposure (ACE or NoACE). Risk of the composite outcome and its components was compared across treatment groups and race using weighted Cox proportional hazard models. RESULTS Our analysis included 59,316 new users of ACE inhibitors, 47% of whom were black. Baseline characteristics were comparable for all groups after inverse probability weighting adjustment. For the composite outcome, the race treatment interaction was significant (p = 0.04); ACE use in blacks was associated with poorer cardiovascular outcomes (ACE vs. NoACE: 8.69% vs. 7.74%; p = 0.05) but not in whites (6.40% vs. 6.74%; p = 0.37). Similarly, the Black-ACE group had higher rates of AMI (0.46% vs. 0.26%; p = 0.04), stroke (2.43% vs. 1.93%; p = 0.05) and chronic heart failure (3.75% vs. 2.25%; p < 0.0001) than the Black-NoACE group. However, the Black-ACE group was no more likely to develop adverse effects than the White-ACE group. CONCLUSIONS ACE inhibitor-based therapy was associated with poorer cardiovascular outcomes in hypertensive blacks but not in whites. These findings confirm clinical trial evidence that hypertensive blacks have poorer outcomes than whites when treated with an ACE inhibitor-based regimen. PMID:26361152

Effect of Various Laser Surface Treatments on Repair Shear Bond Strength of Aged Silorane-Based Composite

PubMed Central

Alizadeh Oskoee, Parnian; Savadi Oskoee, Siavash; Rikhtegaran, Sahand; Pournaghi-Azar, Fatemeh; Gholizadeh, Sarah; Aleyasin, Yasaman; Kasrae, Shahin

2017-01-01

Introduction: Successful repair of composite restorations depends on a strong bond between the old composite and the repair composite. This study sought to assess the repair shear bond strength of aged silorane-based composite following surface treatment with Nd:YAG, Er,Cr:YSGG and CO2 lasers. Methods: Seventy-six Filtek silorane composite cylinders were fabricated and aged by 2 months of water storage at 37°C. The samples were randomly divided into 4 groups (n=19) of no surface treatment (group 1) and surface treatment with Er,Cr:YSGG (group 2), Nd:YAG (group 3) and CO2 (group 4) lasers. The repair composite was applied and the shear bond strength was measured. The data were analyzed using one-way analysis of variance (ANOVA) and Tukey posthoc test. Prior to the application of the repair composite, 2 samples were randomly selected from each group and topographic changes on their surfaces following laser irradiation were studied using a scanning electron microscope (SEM). Seventeen other samples were also fabricated for assessment of cohesive strength of composite. Results: The highest and the lowest mean bond strength values were 8.99 MPa and 6.69 MPa for Er,Cr:YSGG and control groups, respectively. The difference in the repair bond strength was statistically significant between the Er,Cr:YSGG and other groups. Bond strength of the control, Nd:YAG and CO2 groups was not significantly different. The SEM micrographs revealed variable degrees of ablation and surface roughness in laser-treated groups. Conclusion: Surface treatment with Er,Cr:YSGG laser significantly increase the repair bond strength of aged silorane-based composite resin. PMID:29071025

Communicating confidence in the detection and attribution of trends relevant to climate change

NASA Astrophysics Data System (ADS)

Ebi, K. L.

2015-12-01

Readily understandable and consistent language for describing confidence in detection and attribution statements can be developed based on the approach used by the International Agency for Research on Cancer (IARC). IARC was founded in 1965 to provide government authorities with expert, independent, scientific opinion on the causes of human cancer. IARC developed four standard terms for evaluations of the strength of evidence for carcinogenicity arising from human and experimental animal data, and for the strength of mechanistic evidence. Evidence is categorized as sufficient, limited, inadequate, and lack of carcinogenicity. The IARC process then combines theory, evidence, and degree of agreement into a summary evaluation that includes concise statements of the principal line(s) of argument that emerged, the conclusions of the working group on the strength of the evidence for each group of studies, citations to indicate which studies were pivotal to these conclusions, and the reasons for any differential weighting of data. The summary IARC categories are: Group 1 for agents carcinogenic to humans; Group 2 includes Group 2A (probably carcinogenic to humans) or Group 2B (possibly carcinogenic to humans) on the basis of epidemiological and experimental evidence of carcinogenicity and mechanistic and other relevant data; Group 3 for agents is not classifiable as to its carcinogenicity to humans; and Group 4 for agents probably not carcinogenic to humans. There are obvious parallels with describing confidence in key findings on detection and attribution of a trend to anthropogenic climate change with the confidence statements used by the IARC. Developing and consistent application of similar categories along with accompanying explanations of the principal lines of evidence, would be a helpful step in clearing communicating the degree and sources of certainty in the findings of detection and attribution.

Revisiting the Benefits of Higher Education. A Report by the Bedford Group for Lifecourse and Statistical Studies, Institute of Education.

ERIC Educational Resources Information Center

Bynner, John; Dolton, Peter; Feinstein, Leon; Makepeace, Gerry; Malmberg, Lars; Woods, Laura

An earlier report presented preliminary findings on the wider benefits of higher education in England, drawing on data collected at age 33 from the National Child Development Study, based on a cohort born in 1958 and a sample of more than 16,000. This report updates the earlier conclusions through new findings from a more extensive analysis…

Three Degrees of Inclusion: the Gossip-Effect in Human Networks

NASA Astrophysics Data System (ADS)

Szekfu˝, Balázs; Szvetelszky, Zsuzsanna

2005-06-01

Using the scientific definition of gossip, an ancient and ubiquitous phenomenon of the social networks, we present our preliminary study and its results on how to measure the networks based on dissemination of connections and information. We try to accurately calculate the gossip-effects in networks with our hypothesis of "three degrees of inclusion". Our preliminary study on the subject of "three degrees of inclusion" gives latency to a very important property of social networks. Observing the human communication of closely knit social groups we came to the conclusion that the human networks are based on not more than three degrees of links. Taking the strong human ties into account our research indicates that whoever is on the fourth degree rarely counts as an in-group member. Our close friend's close friend's close friend — that is about the farthest — three steps — our network can reach out when it comes to telling a story or asking for a favor. Up to now no investigations have been performed to see whether the effects of gossip lead to the phase transition of the content of network's self-organizing communication. Our conclusion is that the gossip-effect must be considered as the prefactor of the news and opinions diffusion and dynamics at the social level.

Three degrees of inclusion: the emergence of self-organizing social beliefs

NASA Astrophysics Data System (ADS)

Szvetelszky, Zsuzsanna; Szekfu˝, Balázs

2005-07-01

Using the scientific definition of gossip, an ancient and ubiquitous phenomenon of the social networks, we present our preliminary study and its results on how to measure the networks based on dissemination of connections and information. We try to accurately calculate the gossip-effects in networks with our hypothesis of "three degrees of inclusion". Our preliminary study on the subject of "three degrees of inclusion" gives latency to a very important property of social networks. Observing the human communication of closely knit social groups we came to the conclusion that the human networks are based on not more than three degrees of links. Taking the strong human ties into account our research indicates that whoever is on the fourth degree rarely counts as an in-group member. Our close friend's close friend's close friend — that is about the farthest — three steps — our network can reach out when it comes to telling a story or asking for a favor. Up to now no investigations have been performed to see whether the effects of gossip lead to the phase transition of the content of network's self-organizing communication. Our conclusion is that the gossip-effect must be considered as the prefactor of the news and opinions diffusion and dynamics at the social level.

Older Adults' Engagement During an Intervention Involving Off-the-Shelf Videogame

PubMed Central

Marsiske, Michael; Leite, Walter L.; Yam, Anna; Thomas, Kelsey; Mann, William

2016-01-01

Abstract Objective: The overall goal of our current study was to examine older adults' experience of Flow (i.e., subjective engagement) during the course of a home-based cognitive training program. Materials and Methods: In this study, participants took part in a home-based training program. They were randomized to one of the two training groups. One group played an off-the-shelf videogame (i.e., Crazy Taxi), and the other group played a brain training game (i.e., Insight). Training consisted of 60 training sessions of 1 hour each, which were completed in 3 months (5 hours a week). After each training session, participants completed a Flow questionnaire to measure their engagement with the training. Results: The analysis was performed with a linear growth curve model. The results indicate that on average, there was no change in flow for the Insight group between time points. There was no difference between the initial flow status of the Insight group and the Crazy Taxi group. However, the interaction between group membership and time was statistically significant, indicating that the participants in the Crazy Taxi group increased their scores at each week at a rate that was 0.99 larger than those in the Insight group. Conclusion: The analyses revealed that both groups experienced increase in Flow over the period, but only participants in the Crazy Taxi group significantly improved in Flow. This has long-term implications since we would expect participation to go beyond 12 weeks in a real-world scenario. PMID:27310479

Sealing ability of MTA, CPM, and MBPc as root-end filling materials: a bacterial leakage study.

PubMed

Medeiros, Paulo Leal; Bernardineli, Norberti; Cavenago, Bruno Cavalini; Torres, Sérgio Aparecido; Duarte, Marco Antonio Hungaro; Bramante, Clovis Monteiro; Marciano, Marina Angélica

2016-04-01

Objectives To evaluate the sealing ability of three root-end filling materials (white MTA, CPM, and MBPc) using an Enterococcus faecalis leakage model. Material and Methods Seventy single-root extracted human teeth were instrumented and root-ends were resected to prepare 3 mm depth cavities. Root-end preparations were filled with white MTA, CPM, and MBPc cements. Enterococcus faecalis was coronally introduced and the apical portion was immersed in BHI culture medium with phenol red indicator. The bacterial leakage was monitored every 24 h for 4 weeks. The statistical analysis was performed using the Wilcoxon-Gehan test (p<0.05). Results All cements showed bacterial leakage after 24 hours, except for the negative control group. The MBPc showed significantly less bacterial leakage compared with the MTA group (p<0.05). No significant differences were found between the CPM and the other groups. Conclusions The epoxy resin-based cement MBPc had lower bacterial leakage compared with the calcium silicate-based cements MTA and CPM.

Increasing Pap Smear Utilization Among Samoan Women: Results from a Community Based Participatory Randomized Trial

PubMed Central

Mishra, Shiraz I.; Luce, Pat H.; Baquet, Claudia R.

2013-01-01

Background We tested the effectiveness of a theory-guided, culturally tailored cervical cancer education program designed to increase Pap smear use among Samoan women residing in the U.S. Territory of American Samoa. Methods We used a two-group, pretest-posttest design. The sample comprised 398 Samoan women age 20 and older who we recruited from Samoan churches. Women in the intervention group received a culturally tailored cervical cancer education program in three weekly sessions. The primary outcome was self-reported receipt of a Pap smear. Results Overall, there was a significant intervention effect, with intervention compared with control group women twice (adjusted odds ratio = 2.0, 95% confidence interval = 1.3–3.2, p<.01) as likely to self-report Pap smear use at the posttest. Conclusions The findings support the efficacy of the multifaceted, theory-guided, culturally tailored community-based participatory cervical cancer education program for Samoan women in effecting positive changes in Pap smear use and cervical cancer related knowledge and attitudes. PMID:19711495

Procedural Learning in Children With Developmental Coordination, Reading, and Attention Disorders.

PubMed

Magallón, Sara; Crespo-Eguílaz, Nerea; Narbona, Juan

2015-10-01

The aim is to assess repetition-based learning of procedures in children with developmental coordination disorder (DCD), reading disorder (RD) and attention-deficit hyperactivity disorder (ADHD). Participants included 187 children, studied in 4 groups: (a) DCD comorbid with RD and ADHD (DCD+RD+ADHD) (n = 30); (b) RD comorbid with ADHD (RD+ADHD) (n = 48); (c) ADHD (n = 19); and typically developing children (control group) (n = 90). Two procedural learning tasks were used: Assembly learning and Mirror drawing. Children were tested on 4 occasions for each task: 3 trials were consecutive and the fourth trial was performed after an interference task. Task performance by DCD+RD+ADHD children improved with training (P < .05); however, the improvement was significantly lower than that achieved by the other groups (RD+ADHD, ADHD and controls) (P < .05). In conclusion, children with DCD+RD+ADHD improve in their use of cognitive-motor procedures over a short training period. Aims of intervention in DCD+RD+ADHD should be based on individual learning abilities. © The Author(s) 2015.

A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages.

PubMed

Vittadello, Fabio; Mischo-Kelling, Maria; Wieser, Heike; Cavada, Luisa; Lochner, Lukas; Naletto, Carla; Fink, Verena; Reeves, Scott

2018-05-01

This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.

Effectiveness of Commercial Gaming-Based Virtual Reality Movement Therapy on Functional Recovery of Upper Extremity in Subacute Stroke Patients

PubMed Central

Choi, Jun Hwan; Kim, Bo Ryun; Kim, Sun Mi; Im, Sang Hee; Lee, So Young; Hyun, Chul Woong

2014-01-01

Objective To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. Methods Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. Results There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. Conclusion These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients. PMID:25229027

Evaluation of the mtDNA-COII Region Based Species Specific Assay for Identifying Members of the Anopheles culicifacies Species Complex

PubMed Central

Manonmani, Arulsamy Mary; Mathivanan, Ashok Kumar; Sadanandane, Candassamy; Jambulingam, Purushothaman

2013-01-01

Background: Anopheles culicifacies, a major malarial vector has been recognized as a complex of five sibling species, A, B, C, D and E. These sibling species exhibit varied vectorial capacity, host specificity and susceptibility to malarial parasites/ insecticides. In this study, a PCR assay developed earlier for distinguishing the five individual species was validated on samples of An. culicifacies collected from various parts of India. Methods: The samples were initially screened using the rDNA-ITS2 region based primers which categorised the samples into either A/D group or B/C/E group. A proportion of samples belonging to each group were subjected to the mtDNA-COII PCR assay for identifying individual species. Results: Among the 615 samples analysed by rDNA-ITS2 PCR assay, 303 were found to belong to A/D group and 299 to B/C/E group while 13 turned negative. Among 163 samples belonging to A/D group, only one sample displayed the profile characteristic of species A and among the 176 samples falling in the B/C/E group, 51 were identified as species B, 14 as species C and 41 as species E respectively by the mtDNA-COII PCR assay. Samples exhibiting products diagnostic of B/C/E, when subjected to PCR-RFLP assay identified 15 samples as species E. Conclusion: Validation of the mtDNA-COII PCR assay on large number of samples showed that this technique cannot be used universally to distinguish the 5 members of this species complex, as it has been designed based on minor/single base differences observed in the COII region. PMID:24409441

Combining levodopa and virtual reality-based therapy for rehabilitation of the upper limb after acute stroke: pilot study Part II

PubMed Central

Samuel, Geoffrey Sithamparapillai; Oey, Nicodemus Edrick; Choo, Min; Ju, Han; Chan, Wai Yin; Kok, Stanley; Ge, Yu; Dongen, Antonius M Van; Ng, Yee Sien

2017-01-01

INTRODUCTION This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke. METHODS This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis. Patients were randomised to standard care with concomitant administration of either levodopa alone (control group) or combination therapy consisting of VR-based motivational visuomotor feedback training with levodopa neuromodulation (VR group). Main clinical outcome measures were the Fugl-Meyer Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of affected upper limb movement were evaluated as a secondary measure of improvement. RESULTS Of 42 patients screened, four patients were enrolled in each of the two groups. Two patients dropped out from the control group during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-point improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-point improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating that the quality of upper limb movement improved in the VR group. CONCLUSION Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. Bedside acquisition of kinematic measurements allows accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke. PMID:27311739

Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample

PubMed Central

Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

2015-01-01

Objective This study tested the new DSM-5 severity criterion for binge eating disorder (BED) based on frequency of binge-eating in a clinical sample. This study also tested overvaluation of shape/weight as an alternative severity specifier. Method Participants were 834 treatment-seeking adults diagnosed with DSM-5 BED using semistructured diagnostic and eating-disorder interviews. Participants sub-grouped based on DSM-5 severity levels and on overvaluation of shape/weight were compared on demographic and clinical variables. Results Based on DSM-5 severity definitions, 331 (39.7%) participants were categorized as mild, 395 (47.5%) as moderate, 83 (10.0%) as severe, and 25 (3.0%) as extreme. Analyses comparing three (mild, moderate, and severe/extreme) severity groups revealed no significant differences in demographic variables or body mass index (BMI). Analyses revealed significantly higher eating-disorder psychopathology in the severe/extreme than moderate and mild groups and higher depression in moderate and severe/extreme groups than the mild group; effect sizes were small. Participants characterized with overvaluation (N = 449; 54%) versus without overvaluation (N = 384; 46%) did not differ significantly in age, sex, BMI, or binge-eating frequency, but had significantly greater eating-disorder psychopathology and depression. The robustly greater eating-disorder psychopathology and depression levels (medium-to-large effect sizes) in the overvaluation group was observed without attenuation of effect sizes after adjusting for ethnicity/race and binge-eating severity/frequency. Conclusions Our findings provide support for overvaluation of shape/weight as a severity specifier for BED as it provides stronger information about the severity of homogeneous groupings of patients than the DSM-5 rating based on binge-eating. PMID:26114779

Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder: A Systematic Review.

PubMed

O'Neil, Maya E; Nugent, Shannon M; Morasco, Benjamin J; Freeman, Michele; Low, Allison; Kondo, Karli; Zakher, Bernadette; Elven, Camille; Motu'apuaka, Makalapua; Paynter, Robin; Kansagara, Devan

2017-09-05

Cannabis is available from medical dispensaries for treating posttraumatic stress disorder (PTSD) in many states of the union, yet its efficacy in treating PTSD symptoms remains uncertain. To identify ongoing studies and review existing evidence regarding the benefits and harms of plant-based cannabis preparations in treating PTSD in adults. MEDLINE, the Cochrane Library, and other sources from database inception to March 2017. English-language systematic reviews, trials, and observational studies with a control group that reported PTSD symptoms and adverse effects of plant-based cannabis use in adults with PTSD. Study data extracted by 1 investigator was checked by a second reviewer; 2 reviewers independently assessed study quality, and the investigator group graded the overall strength of evidence by using standard criteria. Two systematic reviews, 3 observational studies, and no randomized trials were found. The systematic reviews reported insufficient evidence to draw conclusions about benefits and harms. The observational studies found that compared with nonuse, cannabis did not reduce PTSD symptoms. Studies had medium and high risk of bias, and overall evidence was judged insufficient. Two randomized trials and 6 other studies examining outcomes of cannabis use in patients with PTSD are ongoing and are expected to be completed within 3 years. Very scant evidence with medium to high risk of bias. Evidence is insufficient to draw conclusions about the benefits and harms of plant-based cannabis preparations in patients with PTSD, but several ongoing studies may soon provide important results. U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. (PROSPERO: CRD42016033623).

Effect of different concentrations of soybean lecithin and virgin coconut oil in Tris-based extender on the quality of chilled and frozen-thawed bull semen

PubMed Central

Tarig, A. A.; Wahid, H.; Rosnina, Y.; Yimer, N.; Goh, Y. M.; Baiee, F. H.; Khumran, A. M.; Salman, H.; Assi, M. A.; Ebrahimi, M.

2017-01-01

Aim: The objective of this study was to evaluate the effects of different concentrations of soybean lecithin (SL) and virgin coconut oil (VCO) in Tris-based extender on chilled and frozen-thawed bull semen quality parameters. Materials and Methods: A total of 24 ejaculates were collected from four bulls via an electroejaculator. Semen samples were diluted with 2% VCO in Tris-based extender which consists of various concentrations of SL (1, 1.25, 1.5, and 1.75%). A 20% egg yolk in Tris used as a positive control (C+). The diluted semen samples were divided into two fractions; one for chilling which were stored at 4°C for 24, 72, and 144 h before evaluated for semen quality parameters. The second fraction used for freezing was chilled for 3 h at 4°C, packed into 0.25 mL straws and then cryopreserved in liquid nitrogen. The samples were then evaluated after 7 and 14 days. Chilled and frozen semen samples were thawed at 37°C and assessed for general motility using computer-assisted semen analysis, viability, acrosome integrity and morphology (eosin-nigrosin stain), membrane integrity, and lipid peroxidation using thiobarbituric acid reaction test. Results: The results showed that all the quality parameters assessed were significantly (p<0.05) improved at 1.5% SL concentration in chilled semen. Treatment groups of 1, 1.25, 1.5, and 1.75% SL were higher in quality parameters than the control group (C+) in chilled semen. However, all the quality parameters in frozen-thawed semen were significantly higher in the C+ than the treated groups. Conclusion: In conclusion, supplementation of 1.5% SL in 2% VCO Tris-based extender enhanced the chilled bull semen. However, there was no marked improvement in the frozen-thawed quality parameters after treatment. PMID:28717321

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting

PubMed Central

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Antes, Gerd

2015-01-01

Background Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. Objective To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Methods Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Results Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Conclusions Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. PMID:25943371

Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives

PubMed Central

Park, Sophie E; Allfrey, Caroline; Jones, Melvyn M; Chana, Jasprit; Abbott, Ciara; Faircloth, Sofia; Higgins, Nicola; Abdullah, Laila

2017-01-01

Background Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. Aim This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. Design and setting Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching. Method Patients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically. Results Patients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs’ involvement in teaching, and initiating student–patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback. Conclusion This study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters. PMID:28360073

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

Longitudinal Course of Depression Scores with and without Insomnia in Non-Depressed Individuals: A 6-Year Follow-Up Longitudinal Study in a Korean Cohort

PubMed Central

Suh, Sooyeon; Kim, Hyun; Yang, Hae-Chung; Cho, Eo Rin; Lee, Seung Ku; Shin, Chol

2013-01-01

Study Objective: This is a population-based longitudinal study that followed insomnia symptoms over a 6-year period in non-depressed individuals. The purpose of the study was to (1) investigate the longitudinal course of depression based on number of insomnia episodes; and (2) describe longitudinal associations between insomnia and depression, and insomnia and suicidal ideation. Design: Population-based longitudinal study. Setting: Community-based sample from the Korean Genome and Epidemiology Study (KoGES). Participants: 1,282 non-depressed individuals (44% male, mean age 52.3 ± 7.14 years) Measurements and Results: This study prospectively assessed insomnia, depression, and suicidal ideation with 4 time points. Individuals were classified into no insomnia (NI), single episode insomnia (SEI), and persistent insomnia (PI; ≥ insomnia at 2+ time points) groups based on number of times insomnia was indicated. Mixed effects modeling indicated that depression scores increased significantly faster in the PI group compared to the NI (P < 0.001) and SEI (P = 0.02) groups. Additionally, the PI group had significantly increased odds of depression as compared to NI or SEI (OR 2.44, P = 0.001) groups, with 18.7% meeting criteria for depression compared to the NI (5.3%) and SEI (11.6%) groups at end point. The PI group also had significantly increased odds of suicidal ideation as compared to NI or SEI (OR 1.86, P = 0.002) groups. Conclusions: Persistent insomnia significantly increases the rate in which depression occurs over time in non-depressed individuals, which ultimately leads to higher risk for depression. Additionally, having persistent insomnia also increased the risk of suicidal ideation. Citation: Suh S; Kim H; Yang HC; Cho ER; Lee SK; Shin C. Longitudinal course of depression scores with and without insomnia in non-depressed individuals: a 6-year follow-up longitudinal study in a Korean cohort. SLEEP 2013;36(3):369-376. PMID:23449814

Glaucoma Medication Adherence among African Americans: Program Development

PubMed Central

Dreer, Laura E.; Girkin, Christopher A.; Campbell, Lisa; Wood, Andy; Gao, Liyan; Owsley, Cynthia

2014-01-01

Purpose To elucidate barriers and facilitators related to glaucoma medication adherence among African Americans (AA) with glaucoma and to elicit input from a community-based participatory research team in order to guide the development of a culturally informed, health promotion program for improving glaucoma medication adherence among AA’s. Methods The nominal group technique (NGT), a highly structured focus group methodology, was implemented with 12 separate groups of AA’s patients with glaucoma (N = 89) to identify barriers and facilitators related to glaucoma medication usage. Participant rank-ordering votes were summed across groups and categorized into themes. Next, an individually and culturally targeted health promotion program promoting appropriate medication adherence was developed based on focus group results and input from a community-based participatory research team. Results The top five barriers included problems with 1) forgetfulness, 2) side effects, 3) cost/affordability, 4) eye drop administration, and 5) the eye drop schedule. The most salient top five facilitators were 1) fear or thoughts about the consequences of not taking eye drops, 2) use of memory aids, cues, or strategies, 3) maintaining a regular routine or schedule for eye drop administration, 4) ability to afford eye drops, and 5) keeping eye drops in the same area. The resulting health promotion program was based on a multi-component empowerment framework that included glaucoma education, motivational interviewing, and problem-solving training to improve glaucoma medication adherence. Conclusions Barriers and facilitators related to glaucoma medication adherence among AA’s are multifactorial. Based on the NGT themes and input from the community-based participatory research team, a culturally informed, health promotion program was designed and holds great promise for improving medication adherence among this vulnerable population. PMID:23873033

A Three Month Comparative Evaluation of the Effect of Different Surface Treatment Agents on the Surface Integrity and Softness of Acrylic based Soft Liner: An In vivo Study

PubMed Central

Mahajan, Neerja; Naveen, Y. G.; Sethuraman, Rajesh

2017-01-01

Introduction Acrylic based soft liners are cost effective, yet are inferior in durability as compared to silicone based liners. Hence, this study was conducted to evaluate if the softness and surface integrity of acrylic based soft liner can be maintained by using different surface treatment agents. Aim To comparatively evaluate the effects of Varnish, Monopoly and Kregard surface treatment agents on the surface integrity and softness of acrylic based soft liner at baseline, at one month and after three months. Materials and Methods A total of 37 participants who required conventional maxillary dentures were selected according to the determined inclusion and exclusion criteria of the study. In the maxillary denture on the denture bearing surface, eight palatal recesses (5 mm x 3 mm) were made and filled with acrylic based soft liner (Permasoft). The soft liners in these recesses were given surface treatment and divided as control (uncoated), Varnish, Monopoly and Kregard groups. The hardness and surface integrity were evaluated with Shore A Durometer and Scanning Electron Microscope (SEM) respectively at baseline, one month and three months interval. Surface integrity between groups was compared using Kruskal-Wallis test. Intergroup comparison for hardness was done using ANOVA and Tukey’s HSD post-hoc tests. Results Amongst all the groups tested, surface integrity was maintained in the Kregard group, as compared to control, Varnish and Monopoly groups for all three time intervals (p< 0.001). Kregard treated samples also demonstrated significantly higher softness at all the time intervals (p<0.001). Conclusion Surface treatment with Kregard demonstrated better surface integrity and softness at all the time intervals. PMID:29207842

The impact of hearing loss on language performance in older adults with different stages of cognitive function

PubMed Central

Lodeiro-Fernández, Leire; Lorenzo-López, Laura; Maseda, Ana; Núñez-Naveira, Laura; Rodríguez-Villamil, José Luis; Millán-Calenti, José Carlos

2015-01-01

Purpose The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly. PMID:25914528

Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

PubMed Central

López-Liria, Remedios; Padilla-Góngora, David; Catalan-Matamoros, Daniel; Rocamora-Pérez, Patricia; Pérez-de la Cruz, Sagrario; Fernández-Sánchez, Manuel

2015-01-01

Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients' functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The groups did not significantly differ in the leg side (right/left) or clinical characteristics (P > 0.05). After the intervention, both groups showed significant improvements (P < 0.001) from the baseline values in the level of pain (visual analogue scale), the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices), balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective. PMID:25961017

Prospective ECG-Triggered Coronary CT Angiography: Clinical Value of Noise-Based Tube Current Reduction Method with Iterative Reconstruction

PubMed Central

Shen, Junlin; Du, Xiangying; Guo, Daode; Cao, Lizhen; Gao, Yan; Yang, Qi; Li, Pengyu; Liu, Jiabin; Li, Kuncheng

2013-01-01

Objectives To evaluate the clinical value of noise-based tube current reduction method with iterative reconstruction for obtaining consistent image quality with dose optimization in prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). Materials and Methods We performed a prospective randomized study evaluating 338 patients undergoing CCTA with prospective ECG-triggering. Patients were randomly assigned to fixed tube current with filtered back projection (Group 1, n = 113), noise-based tube current with filtered back projection (Group 2, n = 109) or with iterative reconstruction (Group 3, n = 116). Tube voltage was fixed at 120 kV. Qualitative image quality was rated on a 5-point scale (1 = impaired, to 5 = excellent, with 3–5 defined as diagnostic). Image noise and signal intensity were measured; signal-to-noise ratio was calculated; radiation dose parameters were recorded. Statistical analyses included one-way analysis of variance, chi-square test, Kruskal-Wallis test and multivariable linear regression. Results Image noise was maintained at the target value of 35HU with small interquartile range for Group 2 (35.00–35.03HU) and Group 3 (34.99–35.02HU), while from 28.73 to 37.87HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 20% and 51% reduction in effective dose for Group 2 (2.9 mSv) and Group 3 (1.8 mSv) were achieved compared with Group 1 (3.7 mSv). After adjustment for scan characteristics, iterative reconstruction was associated with 26% reduction in effective dose. Conclusion Noise-based tube current reduction method with iterative reconstruction maintains image noise precisely at the desired level and achieves consistent image quality. Meanwhile, effective dose can be reduced by more than 50%. PMID:23741444

Impact of a Low-Glucose Peritoneal Dialysis Regimen on Fibrosis and Inflammation Biomarkers

PubMed Central

Yung, Susan; Lui, Sing Leung; Ng, Chris K.F.; Yim, Andrew; Ma, Maggie K.M.; Lo, Kin Yee; Chow, Chik Cheung; Chu, Kwok Hong; Chak, Wai Leung; Lam, Man Fai; Yung, Chun Yu; Yip, Terence P.S.; Wong, Sunny; Tang, Colin S.O.; Ng, Flora S.K.; Chan, Tak Mao

2015-01-01

♦ Background: The impact of a low-glucose peritoneal dialysis (PD) regimen on biomarkers of peritoneal inflammation, fibrosis and membrane integrity remains to be investigated. ♦ Methods: In a randomized, prospective study, 80 incident PD patients received either a low-glucose regimen comprising Physioneal (P), Extraneal (E) and Nutrineal (N) (Baxter Healthcare Corporation, Deerfield, IL, USA) (PEN group), or Dianeal (control group) for 12 months, after which both groups continued with Dianeal dialysis for 6 months. Serum and dialysate levels of vascular endothelial growth factor (VEGF), decorin, hepatocyte growth factor (HGF), interleukin-6 (IL-6), macrophage migration inhibitory factor (MIF), hyaluronan (HA), adiponectin, soluble-intracellular adhesion molecule (s-ICAM), vascular cell adhesion molecule-1 (VCAM-1) and P-selectin, and dialysate cancer antigen 125 (CA125), were measured after 12 and 18 months. This paper focuses on results after 12 months, when patients in the PEN group changed to glucose-based PD fluid (PDF). ♦ Results: At the end of 12 months, effluent dialysate levels of CA125, decorin, HGF, IL-6, adiponectin and adhesion molecules were significantly higher in the PEN group compared to controls, but all decreased after patients switched to glucose-based PDF. Macrophage migration inhibitory factor level was lower in the PEN group but increased after changing to glucose-based PDF and was similar to controls at 18 months. Serum adiponectin level was higher in the PEN group at 12 months, but was similar in the 2 groups at 18 months. Body weight, residual renal function, ultrafiltration volume and total Kt/V did not differ between both groups. Dialysate-to-plasma creatinine ratio at 4 h was higher in the PEN group at 12 months and remained so after switching to glucose-based PDF. ♦ Conclusion: Changes in the biomarkers suggest that the PEN PD regimen may be associated with better preservation of peritoneal membrane integrity and reduced systemic vascular endothelial injury. PMID:25904773

Pharmacogenetics Biomarkers and Their Specific Role in Neoadjuvant Chemoradiotherapy Treatments: An Exploratory Study on Rectal Cancer Patients

PubMed Central

Dreussi, Eva; Cecchin, Erika; Polesel, Jerry; Canzonieri, Vincenzo; Agostini, Marco; Boso, Caterina; Belluco, Claudio; Buonadonna, Angela; Lonardi, Sara; Bergamo, Francesca; Gagno, Sara; De Mattia, Elena; Pucciarelli, Salvatore; De Paoli, Antonino; Toffoli, Giuseppe

2016-01-01

Background: Pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC) is still ascribed to a minority of patients. A pathway based-approach could highlight the predictive role of germline single nucleotide polymorphisms (SNPs). The primary aim of this study was to define new predictive biomarkers considering treatment specificities. Secondary aim was to determine new potential predictive biomarkers independent from radiotherapy (RT) dosage and cotreatment with oxaliplatin. Methods: Thirty germ-line SNPs in twenty-one genes were selected according to a pathway-based approach. Genetic analyses were performed on 280 LARC patients who underwent fluoropyrimidine-based CRT. The potential predictive role of these SNPs in determining pathological tumor response was tested in Group 1 (94 patients undergoing also oxaliplatin), Group 2 (73 patients treated with high RT dosage), Group 3 (113 patients treated with standard RT dosage), and in the pooled population (280 patients). Results: Nine new predictive biomarkers were identified in the three groups. The most promising one was rs3136228-MSH6 (p = 0.004) arising from Group 3. In the pooled population, rs1801133-MTHFR showed only a trend (p = 0.073). Conclusion: This exploratory study highlighted new potential predictive biomarkers of neoadjuvant CRT and underlined the importance to strictly define treatment peculiarities in pharmacogenetic analyses. PMID:27608007

The effectiveness and cost-effectiveness of a rural employer-based wellness program.

PubMed

Saleh, Shadi S; Alameddine, Mohamad S; Hill, Dan; Darney-Beuhler, Jessica; Morgan, Ann

2010-01-01

The cost-effectiveness of employer-based wellness programs has been previously investigated with favorable financial and nonfinancial outcomes being detected. However, these investigations have mainly focused on large employers in urban settings. Very few studies examined wellness programs offered in rural settings. This paper aims to explore the effectiveness and cost-effectiveness of a rural employer-based wellness program. Six rural employers were categorized into 3 groups: a control group and 2 intervention groups with varying degrees of wellness activities. Participants were asked to complete an annual health risk assessment (HRA) that addressed 16 wellness areas. At the conclusion of 4 years, HRA and effectiveness data were utilized to examine program effectiveness and combined with program costs to estimate cost-effectiveness. The "Coaching and Referral" group-the highest in intensity of participant engagement-exhibited superior improvement in several wellness areas and in percentage of employees with good health indicators compared to the control and the Trail Marker, lower-intensity intervention groups. However, the Trail Markers had more favorable cost-effectiveness ratios. Rural worksite wellness programs have shown great potential in their effectiveness and cost-effectiveness. Such programs need not be too aggressive, tedious, and costly to generate a favorable return for employers and funders. However, employers should be encouraged to experiment with different levels of wellness program intensities until a more favorable outcome can be realized.

A Pilot Study Evaluating Mindfulness-Based Stress Reduction and Massage for the Management of Chronic Pain

PubMed Central

Plews-Ogan, Margaret; Owens, Justine E; Goodman, Matthew; Wolfe, Pamela; Schorling, John

2005-01-01

Background Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain. Objective To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood. Design Randomized trial comparing MBSR or massage with standard care. Participants Thirty patients with chronic musculoskeletal pain. Measurements Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12. Results The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with −1.7 in the standard care group (P<.04). Conclusions It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain. PMID:16423104

Game-Based E-Learning Is More Effective than a Conventional Instructional Method: A Randomized Controlled Trial with Third-Year Medical Students

PubMed Central

Boeker, Martin; Andel, Peter; Vach, Werner; Frankenschmidt, Alexander

2013-01-01

Background When compared with more traditional instructional methods, Game-based e-learning (GbEl) promises a higher motivation of learners by presenting contents in an interactive, rule-based and competitive way. Most recent systematic reviews and meta-analysis of studies on Game-based learning and GbEl in the medical professions have shown limited effects of these instructional methods. Objectives To compare the effectiveness on the learning outcome of a Game-based e-learning (GbEl) instruction with a conventional script-based instruction in the teaching of phase contrast microscopy urinalysis under routine training conditions of undergraduate medical students. Methods A randomized controlled trial was conducted with 145 medical students in their third year of training in the Department of Urology at the University Medical Center Freiburg, Germany. 82 subjects where allocated for training with an educational adventure-game (GbEl group) and 69 subjects for conventional training with a written script-based approach (script group). Learning outcome was measured with a 34 item single choice test. Students' attitudes were collected by a questionnaire regarding fun with the training, motivation to continue the training and self-assessment of acquired knowledge. Results The students in the GbEl group achieved significantly better results in the cognitive knowledge test than the students in the script group: the mean score was 28.6 for the GbEl group and 26.0 for the script group of a total of 34.0 points with a Cohen's d effect size of 0.71 (ITT analysis). Attitudes towards the recent learning experience were significantly more positive with GbEl. Students reported to have more fun while learning with the game when compared to the script-based approach. Conclusions Game-based e-learning is more effective than a script-based approach for the training of urinalysis in regard to cognitive learning outcome and has a high positive motivational impact on learning. Game-based e-learning can be used as an effective teaching method for self-instruction. PMID:24349257

A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women

PubMed Central

Aslami, Elahe; Alipour, Ahmad; Najib, Fatemeh Sadat; Aghayosefi, Alireza

2017-01-01

ABSTRACT Background: Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women. Methods: The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. .The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of multivariate analysis of variance test and tracking Tokey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group. Conclusion: Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more. PMID:28409168

Comparison of Effectiveness of the Metacognition Treatment and the Mindfulness-Based Stress Reduction Treatment on Global and Specific Life Quality of Women with Breast Cancer

PubMed Central

Rahmani, Soheila; Talepasand, Siavash; Ghanbary-Motlagh, ALi

2014-01-01

Background This study is conducted to compare the metacognition treatment and the mindfulness-based stress reduction treatment on life quality of women with breast cancer. Methods In a quasi-experimental design, with pre-test, post-test and control group, 36 patients with diagnosis of breast cancer, among patients who referred to the Division of Oncology and Radiotherapy of Imam Hossein hospital in Tehran, were selected in accessible way and were assigned randomly to three experimental groups, the first group receiving meta-cognition treatment (n=12), the second one receiving mindfulness-based stress reduction program (n=12), and the other was the control group. Participants completed global life quality in cancer patient's questionnaire and specific quality of life in breast cancer patient's questionnaire in three stages: baseline, after intervention and two-month follow-up. Data were analyzed using the multivariate repeated measurement model. Results Findings showed both treatments were effective in improving global and specific quality of life in patients with breast cancer. The mindfulness -based stress reduction treatment excelled in functions and roles, fatigue, pain, future perspective and treatment side effects symptoms at the end of the treatment and follow-up in comparison to the metacognition treatment. Conclusion Results of this research showed the mindfulness-based stress reduction treatment can be effective in improving global and specific life quality of women with breast cancer and is a selective method for improving quality of life in patients. PMID:25628839

Adaptation and Employment of Special Groups of Manpower. Implementing an Active Manpower Policy; Conclusions of the Manpower and Social Affairs Committee.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

Conclusions are presented indicating the role which public bodies, employers, trade unions, and other private groups can play in improving the employment opportunities of special groups, such as older workers, workers with family responsibilities, and workers of rural origin engaged in non-agricultural employment. Because of the increasing number…

Ability grouping and science education reform: Policy and research base

NASA Astrophysics Data System (ADS)

Lynch, Sharon

This article reviews current policy trends concerning the practice of ability grouping in K-12 science education. Relevant statements of key policy-making, policy-influencing organizations such as the NSTA, AAAS, NSF, the National Research Council, the U.S. Office of Education Department of Civil Rights, NAACP, the National Governors' Association, programs related to the Jacob Javits Grants for the Gifted and Talented, and others are summarized. The author's interpretation of the various positions are presented herein. The article also explores the research base supporting the various policies on grouping by examining selected general research literature on grouping, followed by research that is science education specific. Methodological issues color the research findings. The ethical and pragmatic implications of developing research and policy are discussed. The conclusions are that there is a dearth of recent empirical research specifically related to ability grouping in science, and that the time is ripe for the concerted development of a research agenda by key players in science education reform. Moreover, as controversial and value-laden as the topic is, it should be noted that grouping practices alone are unlikely to influence science education reform unless considered in the context of comprehensive restructuring efforts at the local school level.Received: 10 April 1993; Revised: 26 August 1993;

Impact of endoscopic screening on mortality reduction from gastric cancer

PubMed Central

Hamashima, Chisato; Ogoshi, Kazuei; Narisawa, Rintarou; Kishi, Tomoki; Kato, Toshiyuki; Fujita, Kazutaka; Sano, Masatoshi; Tsukioka, Satoshi

2015-01-01

AIM: To investigate mortality reduction from gastric cancer based on the results of endoscopic screening. METHODS: The study population consisted of participants of gastric cancer screening by endoscopy, regular radiography, and photofluorography at Niigata city in 2005. The observed numbers of cumulative deaths from gastric cancers and other cancers were accumulated by linkage with the Niigata Prefectural Cancer Registry. The standardized mortality ratio (SMR) of gastric cancer and other cancer deaths in each screening group was calculated by applying the mortality rate of the reference population. RESULTS: Based on the results calculated from the mortality rate of the population of Niigata city, the SMRs of gastric cancer death were 0.43 (95%CI: 0.30-0.57) for the endoscopic screening group, 0.68 (95%CI: 0.55-0.79) for the regular radiographic screening group, and 0.85 (95%CI: 0.71-0.94) for the photofluorography screening group. The mortality reduction from gastric cancer was higher in the endoscopic screening group than in the regular radiographic screening group despite the nearly equal mortality rates of all cancers except gastric cancer. CONCLUSION: The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer. Further studies and prudent interpretation of results are needed. PMID:25741155

Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults

PubMed Central

Ibrahim, Manal S.; Mattar, Ayman G.; Elhafez, Salam M.

2016-01-01

[Purpose] This study investigated efficacy of virtual reality (VR)-based balance training on enhancing balance and postural reactions of adults as a low-cost new modality compared to the established Biodex Balance System (BBS). [Subjects] Thirty normal adults of both genders were divided randomly into two equal-sized experimental groups of 15: BBS balance training and VR balance training. [Methods] The training programmes were conducted in 12 sessions, three 15-min sessions per week. The Nintendo® Wii Fit Plus (NWFP) and its balance board were used to train of the VR group. Each participant answered a questionnaire concerning usability, enjoyment, balance improvement, and fatigue at the end of the training programs. [Results] The study found a significant increase the measure of mean overall balance (OLB) in both groups. No significant difference was found between the groups, but a significant decrease in the mean balance-test time was found for both groups, with no significant difference between the two training methods. The VR programme was rated highly enjoyable by 81.8% of the group. [Conclusion] The Wii Fit Plus system with the balance board as a new VR balance-training technique, can be considered an effective and enjoyable tool for the training of adults’ body balance. PMID:26957722

Parents or School Health Trainers, which of them is Appropriate for Menstrual Health Education?

PubMed Central

Djalalinia, Shirin; Tehrani, Fahimeh Ramezani; Afzali, Hossein Malek; Hejazi, Farzaneh; Peykari, Niloofar

2012-01-01

Objectives: The purpose of this community-based participatory research was to compare different training sources for adolescents’ menstrual health education. Methods: From 15 middle schools in Tehran, through quota random sampling, 1823 female students were selected proportionally and allocated randomly to three groups (parent trained, schools’ health trainers trained, and control). Following a two-year training program, the adolescents’ menstrual health was compared. Results: In the present study, the school health trainers trained group showed a better feeling for menarche, compared to the two other groups (P < 0.001). The need for adolescent health training was emphasized by 82% of the participants; they also believed that the appropriate age for such empowerment courses was about 12 years. In the school health trainers trained group, the offered age was significantly lower than in other groups (P < 0.001). The adolescents trained by the school health trainers had a better practice of habits related to menstrual and hygiene practices, like having a bath during menstruation and the use of sanitary pads or cotton, compared to their counterpart groups (P > 0.05). Conclusion: It is suggested that school-based health training leads to better menstrual health promotion and healthy puberty transition, and school health trainers play a key role in this regard. PMID:23024851

Evaluation of a Stage-Based, Computer-Tailored Adjunct to Usual Care for Domestic Violence Offenders

PubMed Central

Levesque, Deborah A.; Ciavatta, Mary Margaret; Castle, Patricia H.; Prochaska, Janice M.; Prochaska, James O.

2012-01-01

Objective Research assessing the efficacy of court-mandated domestic violence treatment continues to yield inconsistent results. The current study examined whether Journey to Change, a Transtheoretical Model of Behavior Change-based treatment adjunct that consists of three computer-administered sessions and a print guide, could improve outcomes. Method 492 male domestic violence offenders attending court-mandated batterer treatment were assigned to Usual Care (UC) or Usual Care + Journey to Change (UC + Journey). Results Compared to UC, participants receiving UC + Journey were significantly more likely to be in the Action stage at the end of treatment, and to seek help and services outside of group. Based on victim reports, the UC + Journey group was significantly less likely than UC to engage in physical violence during the 12-month follow-up. Both groups were equally likely to drop out of court-mandated treatment and to have further domestic violence-related police involvement. However, among participants with police involvement, the UC + Journey group had lower rates of documented violence and physical injury. Conclusions The pattern of findings across the multiple outcomes suggests that the Journey to Change program holds promise for improving some outcomes for domestic violence offenders in treatment, and warrants further investigation. PMID:23412627

An evaluation of microleakage of various glass ionomer based restorative materials in deciduous and permanent teeth: An in vitro study

PubMed Central

Singla, Teena; Pandit, I.K.; Srivastava, Nikhil; Gugnani, Neeraj; Gupta, Monika

2011-01-01

Aim To evaluate the microleakage of recently available glass ionomer based restorative materials (GC Fuji IX GP, GC Fuji VII, and Dyract) and compare their microleakage with the previously existing glass ionomer restorative materials (GC Fuji II LC) in primary and permanent teeth. Method One hundred and fifty (75 + 75) non-carious deciduous and permanent teeth were restored with glass ionomer based restorative materials after making class I cavities. Samples were subjected to thermocycling after storing in distilled water for 24 h. Two coats of nail polish were applied 1 mm short of restorative margins and samples sectioned buccolingually after storing in methylene blue dye for 24 h. Microleakage was assessed using stereomicroscope. Result Significant differences (P < 0.05) were found when inter group comparisons were done. Except when GC Fuji VII (Group III) was compared with GC Fuji II LC (Group II) and Dyract (Group IV), non-significant differences (P > 0.05) were observed. It was found that there was no statistically significant difference when the means of microleakage of primary teeth were compared with those of permanent teeth. Conclusions GC Fuji IX GP showed maximum microleakage and GC Fuji VII showed least microleakage. PMID:23960526

Efficacy of Peer Education for Adopting Preventive Behaviors against Head Lice Infestation in Female Elementary School Students: A Randomised Controlled Trial

PubMed Central

Zamani-Alavijeh, Fereshteh; Mojadam, Mehdi

2017-01-01

Background Pediculosis is a common parasitic infestation in students worldwide, including Iran. This condition is more prevalent in populous and deprived communities with poor personal hygiene. This study sought to assess the efficacy of peer education for adopting preventive behaviors against pediculosis in female elementary school students based on the Health Belief Model (HBM). Methods A total of 179 female fifth grade students were selected using multistage random sampling and were randomly allocated to control and intervention groups. A standard questionnaire was designed and administered to collect baseline information. An educational intervention was then designed based on the conducted needs assessment. The educational program consisted of three sessions, held by peers for the intervention group. The questionnaire was re-administered one month after the intervention. Independent and paired t-test, Pearson’s correlation coefficient, and regression analysis were applied as appropriate. Results The two groups had no significant differences in the scores of knowledge, HBM constructs, or behavior before the intervention. After the intervention, however, the mean scores of all parameters significantly improved in the intervention group. Conclusion Peer education based on HBM is an effective strategy to promote preventive behaviors against pediculosis in among fifth grade female elementary school students in Iran. PMID:28072852

Effectiveness of self-management promotion educational program among diabetic patients based on health belief model

PubMed Central

Jalilian, Farzad; Motlagh, Fazel Zinat; Solhi, Mahnaz; Gharibnavaz, Hasan

2014-01-01

Introduction: Diabetes is a chronic disease; it can cause serious complications. Diabetes self-management is essential for prevention of disease complications. This study was conducted to evaluate self-management promotion educational program intervention efficiency among diabetic patients in Iran and health belief model (HBM) was applied as a theoretical framework. Materials and Methods: Overall, 120 Type 2 diabetic patients referred to rural health centers in Gachsaran, Iran participated in this study as randomly divided into intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to promotion self-management among diabetic patients. Cross-tabulation and t-test by using SPSS statistical package, version 16 was used for the statistical analysis. Results: Mean age was 55.07 years (SD = 9.94, range: 30-70). Our result shows significant improvements in average response for susceptibility, severity, benefit and self-management among intervention group. Additionally, after intervention, average response of the barrier to self-management was decreased among intervention group. Conclusion: Our result showed education program based on HBM was improve of self-management and seems implementing these programs can be effective in the and prevention of diabetes complications. PMID:24741654

A Clinical Evaluation of the Competing Sources of Input Hypothesis

PubMed Central

Leonard, Laurence B.; Bredin-Oja, Shelley L.; Deevy, Patricia

2017-01-01

Purpose Our purpose was to test the competing sources of input (CSI) hypothesis by evaluating an intervention based on its principles. This hypothesis proposes that children's use of main verbs without tense is the result of their treating certain sentence types in the input (e.g., Was she laughing ?) as models for declaratives (e.g., She laughing). Method Twenty preschoolers with specific language impairment were randomly assigned to receive either a CSI-based intervention or a more traditional intervention that lacked the novel CSI features. The auxiliary is and the third-person singular suffix –s were directly treated over a 16-week period. Past tense –ed was monitored as a control. Results The CSI-based group exhibited greater improvements in use of is than did the traditional group (d = 1.31), providing strong support for the CSI hypothesis. There were no significant between-groups differences in the production of the third-person singular suffix –s or the control (–ed), however. Conclusions The group differences in the effects on the 2 treated morphemes may be due to differences in their distribution in interrogatives and declaratives (e.g., Is he hiding/He is hiding vs. Does he hide/He hide s). Refinements in the intervention could address this issue and lead to more general effects across morphemes. PMID:28114610

Tear Film Osmolarity in Subjects with Acute Allergic Rhinoconjunctivitis

PubMed Central

NITODA, EIRINI; LAVARIS, ANASTASIOS; LAIOS, KONSTANTINOS; ANDROUDI, SOPHIA; KALOGEROPOULOS, CHRIS D; TSATSOS, MICHAEL; DAMASKOS, CHRISTOS; GARMPIS, NIKOLAOS; MOSCHOS, MARILITA M

2018-01-01

Background/Aim: Acute allergic rhinoconjuctivitis is the most common form of ocular allergies. The pathogenetic mechanisms are based on an immunoglobulin E (IgE)-mediated hypersensitivity reaction. On the other hand, tear osmolarity has been suggested to be an index of ocular surface damage and inflammation. These data were the motive to investigate the levels of tear osmolarity in subjects with acute allergic rhinoconjuctivitis, before and after administration of artificial tears. Patients and Methods: Forty-five subjects with acute allergic rhinoconjuctivitis were randomly divided into three groups, based on the type of artificial tears that they received: Group A (Thera tears), Group B (Wet therapy) and Group C (Tears Naturale free). The eye drops were administered six times a day for 60 days and all subjects underwent grading of subjective symptoms and clinical examination at baseline and at the end of the treatment. Results: The diagnosis of severe eye disease, which was based on ocular surface disease index (OSDI; Allergan, Inc, Irvine, CA, USA) and tear osmolarity values, concerned all patients at baseline. Although the administration of artificial tears significantly ameliorated the symptoms and the ocular variables in all groups, the results were better in the first group. Tear osmolarity was strongly and negatively correlated with tear film breakup time (BUT) and Schirmer I test at 2 months. Contrariwise, symptoms were eliminated, when tear osmolarity was decreased. Conclusion: Acute allergic rhinoconjuctivitis is characterized by tear hyperosmolarity, which can be rehabilitated with the administration of hypotonic artificial tears. PMID:29475928

Comparison Between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing

PubMed Central

Ridderstråle, Martin

2017-01-01

Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. Conclusions: We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point. PMID:28366085

The use of telehealth (text messaging and video communications) in patients with cystic fibrosis: A pilot study.

PubMed

Gur, Michal; Nir, Vered; Teleshov, Anna; Bar-Yoseph, Ronen; Manor, Eynav; Diab, Gizelle; Bentur, Lea

2017-05-01

Background Poor communications between cystic fibrosis (CF) patients and health-care providers may result in gaps in knowledge and misconceptions about medication usage, and can lead to poor adherence. We aimed to assess the feasibility of using WhatsApp and Skype to improve communications. Methods This single-centre pilot study included CF patients who were older than eight years of age assigned to two groups: one without intervention (control group), and one with intervention. Each patient from the intervention group received Skype-based online video chats and WhatsApp messages from members of the multidisciplinary CF team. CF questionnaires, revised (CFQ-R) scores, knowledge and adherence based on CF My Way and patients satisfaction were evaluated before and after three months. Feasibility was assessed by session attendance, acceptability and satisfaction survey. Descriptive analysis and paired and non-paired t-tests were used as applicable. Results Eighteen patients were recruited to this feasibility study (nine in each group). Each intervention group participant had between four and six Skype video chats and received 22-45 WhatsApp messages. In this small study, CFQ-R scores, knowledge, adherence and patient satisfaction were similar in both groups before and after the three-month intervention. Conclusions A telehealth-based approach, using Skype video chats and WhatsApp messages, was feasible and acceptable in this pilot study. A larger and longer multi-centre study is warranted to examine the efficacy of these interventions to improve knowledge, adherence and communication.

Surgical wound management made easier and more cost-effective.

PubMed

Akagi, Ichiro; Furukawa, Kiyonori; Miyashita, Masao; Kiyama, Teruo; Matsuda, Akihisa; Nomura, Tsutomu; Makino, Hiroshi; Hagiwara, Nobutoshi; Takahashi, Ken; Uchida, Eiji

2012-07-01

Evidence-based guidelines for the prevention of surgical site infection (SSI) have been published by the U.S. Centers for Disease Control and Prevention (CDC). According to these guidelines, a wound should usually be covered with a sterile dressing for 24 to 48 h when a surgical incision is closed primarily. However, it is not recommended that an incision be covered by a dressing beyond 48 h. In this study, patients were stratified into two groups for analysis: patients whose surgical wound was sterilized and whose gauze was changed once daily until postoperative day 7 (7POD; group A); and patients whose surgical wound was sterilized and whose gauze was changed once daily until 2POD (group B). We evaluated the incidence of SSI, nursing hours and cost implications. The results showed that there was no significant difference in SSI occurrence between the two groups (group A, 10% vs. group B, 7.3%). By contrast, the average nursing time differed by 2.8 min (group A, 3.8 min vs. group B, 0.9 min). The material costs per patient were also reduced by $14.70 (group A, $61.80 vs. group B, $47.10). In conclusion, we applied our knowledge of the evidence-based CDC guidelines to determine whether 48-h wound management can be made easier, more uniform and more cost-effective compared to conventional wound management. The results of the present study showed that surgical wound management methods can be more convenient and inexpensive.

A Coast Mountains provenance for the Valdez and Orca groups, southern Alaska, based on Nd, Sr, and Pb isotopic evidence

USGS Publications Warehouse

Farmer, G.L.; Ayuso, R.; Plafker, G.

1993-01-01

Nd, Sr, and Pb isotopic data were obtained for fourteen fine- to coarse-grained samples of accreted flysch of the Late Cretaceous and early Tertiary Valdez and Orca Groups in southern Alaska to determine the flysch provenance. Argillites and greywackes from the Orca Group, as well as compositionally similar but higher metamorphic grade rocks from the Valdez Group, show a restricted range of correlated ??{lunate}Nd ( -0.6 to -3.8) and 87Sr 86Sr (0.7060-0.7080) at the time of sediment deposition ( ??? 50 Ma). Pb isotopic compositions also vary over a narrow range ( 206Pb 204Pb = 19.138-19.395, 207Pb 204Pb = 15.593-15.703, 208Pb 204Pb = 38.677-39.209), and in the Orca Group the samples generally become more radiogenic with decreasing ??{lunate}Nd and increasing 87Sr 86Sr. All samples have similar trace element compositions characterized by moderate light rare earth element enrichments, and low ratios of high field strength elements to large ion lithophile elements. Based on petrographic, geochemical, and isotopic data the sedimentary rocks are interpreted to have been derived largely from a Phanerozoic continental margin arc complex characterized by igneous rocks with ??{lunate}Nd values between 0 and -5. The latter conclusion is supported by the ??{lunate}Nd values of a tonalite clast and a rhyodacite clast in the Orca Group (??{lunate}Nd = -4.9 and -0.9, respectively). However, trondjemitic clasts in the Orca Group have significantly lower ??{lunate}Nd ( ??? -10) and require a derivation of a portion of the flysch from Precambrian crustal sources. The Nd, Sr, and Pb isotopic compositions of both the Valdez and Orca Groups overlap the values determined for intrusive igneous rocks exposed within the northern portion of the Late Cretaceous to early Tertiary Coast Mountains Plutonic Complex in western British Columbia and equivalent rocks in southeastern Alaska. The isotopic data support previous conclusions based on geologic studies which suggest that the flysch was shed from this portion of the batholith, and from overlying continental margin arc-related volcanic rocks, following its rapid uplift in the Late Cretaceous and early Tertiary. The Precambrian crustal material present in the flysch may have been derived from Late Proterozoic or older metasedimentary and metaigneous rocks now exposed along the western margin of the Coast Mountains Plutonic Complex. ?? 1993.

Fuzzy logic and causal reasoning with an 'n' of 1 for diagnosis and treatment of the stroke patient.

PubMed

Helgason, Cathy M; Jobe, Thomas H

2004-03-01

The current scientific model for clinical decision-making is founded on binary or Aristotelian logic, classical set theory and probability-based statistics. Evidence-based medicine has been established as the basis for clinical recommendations. There is a problem with this scientific model when the physician must diagnose and treat the individual patient. The problem is a paradox, which is that the scientific model of evidence-based medicine is based upon a hypothesis aimed at the group and therefore, any conclusions cannot be extrapolated but to a degree to the individual patient. This extrapolation is dependent upon the expertise of the physician. A fuzzy logic multivalued-based scientific model allows this expertise to be numerically represented and solves the clinical paradox of evidence-based medicine.

Long Duration Exposure Facility Mini-Data Base User`s Guide: Macintosh version. (Diskette)

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

Bohnhoff-Hlavacek, G.; Pippin, H.G.; Dursch, H.W.

1995-04-01

One of the objectives of the LDEF Special Investigation Group (SIG) was to develop a LDEF data base that identifies the experiment objectives and hardware flown, summarizes results and conclusions, and provides a system analysis overview, including spacecraft design guidelines and space environmental effects. Compiling the information into an easily accessible data base format, and making it available to the space community was a major task accomplished by the System and Materials SIG effort beginning in 1981. Included in this document is a short user`s manual for the LDEF Mini-Data Bases. The user`s manual contains pertinent examples from the datamore » base on specifically how to access and work with the LDEF information. Accompanying this document are the mini-data bases on disk.« less

In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer

PubMed Central

Kwon, Hye Youn; Kim, Im-kyung; Kang, Jeonghyun; Sohn, Seung-Kook; Lee, Kang Young

2016-01-01

Purpose We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer. Materials and Methods Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls. Results Among the 86 enrolled patients who underwent radical surgery followed by fluorouracil-based adjuvant chemotherapy, recurrence was found in 11 patients (12.7%). The CDR ≥ 20% group was associated with better disease-free survival than the CDR < 20% group (89.4% vs. 70.1%, p=0.027). Multivariate analysis showed that CDR < 20% and T4 stage were poor prognostic factors for disease-free survival after fluorouracil-based adjuvant chemotherapy. Conclusion In stage II colorectal cancer, the in vitro ATP-CRA may be useful in identifying patients likely to benefit from fluorouracil-based adjuvant chemotherapy. PMID:26511802

Breakfast skipping and breakfast type are associated with daily nutrient intakes and metabolic syndrome in Korean adults

PubMed Central

Chung, Sang-Jin; Lee, Yoonna; Lee, Seokhwa

2015-01-01

BACKGROUND/OBJECTIVES Emerging evidence shows that eating breakfast and breakfast types may be associated with health outcomes and dietary intakes in various populations. The aim of this study was to investigate the association between breakfast types in Korean adults with their daily nutrient intakes and health outcomes. SUBJECTS/METHODS A total of 11,801 20- to 64-year-old adults (age 42.9 ± 11.8 yrs [mean ± standard error of the mean]; male 41.1%, female 58.9%) in 2007-2009 Korean National Health and Nutrition Survey data were divided into 5 groups based on breakfast types in a 24-hr dietary recall: rice with 3 or more side dishes (Rice3+, 35.3%), rice with 0-2 side dishes (Rice0-2, 34.73%), noodles (1.56%), bread and cereal (6.56%), and breakfast skipping (21.63%). Daily nutrient intakes and the risk of metabolic syndrome were compared among five groups. RESULTS Compared with Korean Recommended Nutrient Intake levels, the breakfast-skipping group showed the lowest intake level in most nutrients, whereas the Rice3+ group showed the highest. Fat intake was higher in the bread and noodle groups than in the other groups. When compared with the Rice3+ group, the odds ratios for the risk of obesity and metabolic syndrome were increased in the breakfast skipping, Rice0-2, and noodle groups after controlling for confounding variables. CONCLUSIONS The rice-based breakfast group showed better nutritional status and health outcomes when eating with 3 or more side dishes. Nutrition education is needed to emphasize both the potential advantage of the rice-based, traditional Korean diet in terms of nutritional content and the importance of food diversity. PMID:26060541

Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

PubMed Central

Ismail, Suriani; Shamsuddin, Khadijah; Latiff, Khalib A.; Saad, Hazizi A.; Majid, Latifah A.; Othman, Fadlan M.

2015-01-01

Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients. PMID:25685394

Impact of type of calcineurin inhibitor on post-transplant tuberculosis: Single-center study from India.

PubMed

Agarwal, Sanjay K; Bhowmik, Dipankar; Mahajan, Sandeep; Bagchi, Soumita

2017-02-01

Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipients. Immunosuppressive drugs are one of the most important risk factor for post-transplant tuberculosis (PTTB). A paucity of data exists about the impact of the type of calcineurin inhibitor on PTTB. In this retrospective study, all adult patients on calcineurin inhibitor-based immunosuppression were included. Patients receiving TB chemoprophylaxis were excluded. Diabetes, duration of dialysis, hepatitis B and C, past treated TB, induction therapy, type of antimetabolite, acute rejection, new onset of diabetes after renal transplantation (RT) (NODAT) and cytomegalovirus (CMV) were analyzed in tacrolimus (Tac) and cyclosporine (CsA) groups. Primary outcome was incidence of TB and secondary outcomes were timeline of development of TB after RT and pattern of TB in the two groups. Of the 1664 patients included, 582 patients received CsA-based immunosuppression while 1082 received Tac-based immunosuppression. Duration of dialysis, positive tuberculin skin test, use of induction, mycophenolate mofetil use, CMV infection, and NODAT were significantly more, and hepatitis B infection, past treated TB, and acute rejection episodes were significantly less in the Tac group. At the end of follow-up, incidence of TB in the Tac group was significantly less than in the CsA group (6.1% vs 19.9%, P<.001). Mean time for development of TB after RT was similar in both the groups and nodal and disseminated TB were more common in the Tac group. In conclusion, our study shows that use of Tac as compared to CsA significantly decreases incidence of PTTB. Time of infection since transplant was similar in both the groups. However, nodal and disseminated TB were more common in the Tac group. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perinatal Risks in "Late Motherhood" Defined Based On Parity and Preterm Birth Rate - an Analysis of the German Perinatal Survey (20th Communication).

PubMed

Schure, V; Voigt, M; Schild, R L; Hesse, V; Carstensen, M; Schneider, K T M; Straube, S

2012-01-01

Aim: "Late motherhood" is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what "late motherhood" associated with "high risk" is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998-2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of "late" mothers (with high preterm birth rates) with "control" groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the "control" group included women aged 22-26 (27-31; 29-33) years. Women in the "late motherhood" group were aged > 33 (> 35; > 38) years. Results: The "late motherhood" groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the "control" group, but only in 84.5 % (90 %; 90.4 %) in the "late motherhood" group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the "control" group, but only in 51.4 % (72.2 %; 76.4 %) in the "late motherhood" group. Five-minute APGAR scores were likewise worse for neonates of "late" mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: "Late motherhood" that is associated with greater perinatal risks can be defined based on parity and preterm birth rate.

Effect of Virtual Reality on Cognition in Stroke Patients

PubMed Central

Kim, Bo Ryun; Kim, Lee Suk; Park, Ji Young

2011-01-01

Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. Results The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Conclusion Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients. PMID:22506159

A randomized controlled trial to increase information, motivation, and behavioral skills in Ugandan adolescents

PubMed Central

Ybarra, Michele L.; Korchmaros, Josephine D.; Prescott, Tonya L.; Birungi, Ruth

2015-01-01

Background One in twenty-five Ugandan adolescents is HIV positive. Purpose Examine the impact of an Internet-based HIV prevention program on Information-Motivation-Behavior Skills Model-related constructs. Methods Three hundred and sixty-six sexually experienced and inexperienced students 12-18+ years-old in Mbarara, Uganda were randomly assigned to: the five-lesson CyberSenga program or treatment-as-usual. Half of the intervention participants were further randomized to a booster session. Assessments were collected at three and six months post-baseline. Results Participants’ HIV-related information improved over time at a greater rate for the intervention groups compared to the control group. Motivation for condom use changed to a greater degree over time for the intervention group – especially those in the intervention+booster group - compared to the control group. Behavioral skills for condom use, and motivation and behavioral skills for abstinence were statistically similar over time for both groups. Conclusions CyberSenga improves HIV preventive information and motivation to use condoms. PMID:25633626

Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)

PubMed Central

McNaughton, Amanda; Aldington, Sarah; Williams, Gayle; Levack, William M M

2016-01-01

Objective To explore the ways in which participation in a community singing group contributed to the health and well-being of patients with chronic obstructive pulmonary disease (COPD). Design Qualitative description, based on transcripts from individual interviews and a focus group meeting with people with COPD participating in the singing group, regarding their experience. Setting Urban community, Wellington, New Zealand. Participants 23 people (13 women and 10 men), 51–91 years with COPD (21) or interstitial lung disease (2). Results The weekly singing group was a well-attended activity, with self-reported benefits to health and well-being. 4 key themes were identified: being in the ‘right space’, connection, purpose and growth, and participation in a meaningful physical activity. Conclusions This study helps us to better understand how participation in a community singing group can benefit the health and well-being of patients with COPD. Trial registration number ACTRN12615000736549; Results. PMID:27650768

The effects of prone bridge exercise on trunk muscle thickness in chronic low back pain patients.

PubMed

Kong, Yong-Soo; Lee, Woo-Jin; Park, Seol; Jang, Gwon-Uk

2015-07-01

[Purpose] This study aimed to investigate the effects of prone bridge exercise on trunk muscle thickness. [Subjects and Methods] Thirty-seven chronic low back pain patients participated in this study. Each participant was randomly assigned to one of three exercise groups, namely, a prone bridge exercise group, supine bridge exercise on a Swiss ball group, and supine bridge exercise group. The thicknesses of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) were measured using ultrasound. [Results] After eight weeks of training, the three groups showed significant increases in the thicknesses of the TrA, IO, and EO. Among the groups, TrA and IO showed significantly different muscle thicknesses. [Conclusion] The prone bridge exercise significantly affected the thicknesses of the TrA, IO, and EO unlike the supine bridge exercises. Based on the results of this study, the prone bridge exercise is a more effective method to improve trunk stability than conventional supine bridge exercises.

Comparing the epistemological underpinnings of students' and scientists' reasoning about conclusions

NASA Astrophysics Data System (ADS)

Hogan, Kathleen; Maglienti, Mark

2001-08-01

This study examined the criteria that middle school students, nonscientist adults, technicians, and scientists used to rate the validity of conclusions drawn by hypothetical students from a set of evidence. The groups' criteria for evaluating conclusions were considered to be dimensions of their epistemological frameworks regarding how knowledge claims are justified, and as such are integral to their scientific reasoning. Quantitative and qualitative analyses revealed that the responses of students and nonscientists differed from the responses of technicians and scientists, with the major difference being the groups' relative emphasis on criteria of empirical consistency or plausibility of the conclusions. We argue that the sources of the groups' differing epistemic criteria rest in their different spheres of cultural practice, and explore implications of this perspective for science teaching and learning.

Impact of an engineering design-based curriculum compared to an inquiry-based curriculum on fifth graders' content learning of simple machines

NASA Astrophysics Data System (ADS)

Marulcu, Ismail; Barnett, Michael

2016-01-01

Background: Elementary Science Education is struggling with multiple challenges. National and State test results confirm the need for deeper understanding in elementary science education. Moreover, national policy statements and researchers call for increased exposure to engineering and technology in elementary science education. The basic motivation of this study is to suggest a solution to both improving elementary science education and increasing exposure to engineering and technology in it. Purpose/Hypothesis: This mixed-method study examined the impact of an engineering design-based curriculum compared to an inquiry-based curriculum on fifth graders' content learning of simple machines. We hypothesize that the LEGO-engineering design unit is as successful as the inquiry-based unit in terms of students' science content learning of simple machines. Design/Method: We used a mixed-methods approach to investigate our research questions; we compared the control and the experimental groups' scores from the tests and interviews by using Analysis of Covariance (ANCOVA) and compared each group's pre- and post-scores by using paired t-tests. Results: Our findings from the paired t-tests show that both the experimental and comparison groups significantly improved their scores from the pre-test to post-test on the multiple-choice, open-ended, and interview items. Moreover, ANCOVA results show that students in the experimental group, who learned simple machines with the design-based unit, performed significantly better on the interview questions. Conclusions: Our analyses revealed that the design-based Design a people mover: Simple machines unit was, if not better, as successful as the inquiry-based FOSS Levers and pulleys unit in terms of students' science content learning.

Delivery System Integration and Health Care Spending and Quality for Medicare Beneficiaries

PubMed Central

McWilliams, J. Michael; Chernew, Michael E.; Zaslavsky, Alan M.; Hamed, Pasha; Landon, Bruce E.

2013-01-01

Background The Medicare accountable care organization (ACO) programs rely on delivery system integration and provider risk sharing to lower spending while improving quality of care. Methods Using 2009 Medicare claims and linked American Medical Association Group Practice data, we assigned 4.29 million beneficiaries to provider groups based on primary care use. We categorized group size according to eligibility thresholds for the Shared Savings (≥5,000 assigned beneficiaries) and Pioneer (≥15,000) ACO programs and distinguished hospital-based from independent groups. We compared spending and quality of care between larger and smaller provider groups and examined how size-related differences varied by 2 factors considered central to ACO performance: group primary care orientation (measured by the primary care share of large groups’ specialty mix) and provider risk sharing (measured by county health maintenance organization penetration and its relationship to financial risk accepted by different group types for managed care patients). Spending and quality of care measures included total medical spending, spending by type of service, 5 process measures of quality, and 30-day readmissions, all adjusted for sociodemographic and clinical characteristics. Results Compared with smaller groups, larger hospital-based groups had higher total per-beneficiary spending in 2009 (mean difference: +$849), higher 30-day readmission rates (+1.3% percentage points), and similar performance on 4 of 5 process measures of quality. In contrast, larger independent physician groups performed better than smaller groups on all process measures and exhibited significantly lower per-beneficiary spending in counties where risk sharing by these groups was more common (−$426). Among all groups sufficiently large to participate in ACO programs, a strong primary care orientation was associated with lower spending, fewer readmissions, and better quality of diabetes care. Conclusions Spending was lower and quality of care better for Medicare beneficiaries served by larger independent physician groups with strong primary care orientations in environments where providers accepted greater risk. PMID:23780467

Advancing the evidence base in cancer: psychosocial multicenter trials

PubMed Central

2012-01-01

Background The diagnosis and treatment of cancer is associated with significant distress and psychosocial morbidity. Although psychosocial interventions have been developed in an attempt to improve psychosocial outcomes in cancer patients and survivors, there is continued debate about whether there is adequate high-level evidence to establish the effectiveness of these interventions. The evidence base is limited as a result of numerous challenges faced by those attempting to conduct psychosocial intervention trials within the health system. Barriers include insufficient participant recruitment, difficulty generalizing from single-trial studies, difficulty in building and managing research teams with multidisciplinary expertise, lack of research design expertise and a lack of incentives for researchers conducting intervention research. To strengthen the evidence base, more intervention studies employing methodologically rigorous research designs are necessary. Methods In order to advance the evidence base of interventions designed to improve psychosocial outcomes for cancer patients and survivors, we propose the formation of a collaborative trials group that conducts multicenter trials to test the effectiveness of such interventions. Results Establishment of such a group would improve the quality of the evidence base in psychosocial research in cancer patients, by increasing support for conducting intervention research and providing intervention research training opportunities. A multidisciplinary collaborative group conducting multicenter trials would have the capacity to overcome many of the barriers that currently exist. Conclusions A stronger evidence base is necessary to identify effective psychosocial interventions for cancer patients. The proposed formation of a psycho-oncology collaborative trials group that conducts multicenter trials to test the effectiveness of psychosocial interventions would assist in achieving this outcome. PMID:22992443

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

PubMed

Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

2018-04-27

BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). CONCLUSIONS Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Effect of two laser photobiomodulation application protocols on the viability of random skin flap in rats

NASA Astrophysics Data System (ADS)

Martignago, C. C. S. M.; Tim, C. R.; Assis, L.; Neve, L. M. G.; Bossini, P. S.; Renno, A. C.; Avó, L. R. S.; Liebano, R. E.; Parizotto, N. A.

2018-02-01

Objective: to identify the best low intensity laser photobiomodulation application site to increase the viability of the cutaneous flap in rats. Methods: 18 male rats (Rattus norvegicus: var. Albinus, Rodentia Mammalia) were randomly distributed into 3 groups (n = 6). Group I (GI) was submitted to simulated laser photobiomodulation, group II (GII) was submitted to the laser photobiomodulation at three points in the flap cranial base, and group III (GIII) was submitted to laser photobiomodulation at twelve points distributed along the flap. All groups were irradiated with an Indium, Galium, Aluminum and Phosphorus diode laser (InGaAlP), 660 nm, with power of 50 mW, total energy of 12 J in continuous emission mode. The treatment started immediately after performing the cranial base random skin flap (dimension of 10X4 cm2 ) and reapplied every 24 hours, with a total of 5 applications. The animals were euthanized after the evaluation of the percentage of necrosis area and the material was collected for histological analysis on the 7th postoperative day. Results: GII animals presented a statistically significant decrease for the necrosis area when compared to the other groups, and a statistically significant increase in the quantification of collagen when compared to the control. We did not observe a statistical difference between the TGFβ and FGF expression in the different groups evaluated. Conclusion: the application of laser photobiomodulation at three points of the flap cranial base was more effective than at twelve points regarding the reduction of necrosis area.

Effect of Group Mindfulness-Based Stress-Reduction Program and Conscious Yoga on Lifestyle, Coping Strategies, and Systolic and Diastolic Blood Pressures in Patients with Hypertension

PubMed Central

Nejati, Somayeh; Zahiroddin, Alireza; Afrookhteh, Gita; Rahmani, Soheila; Hoveida, Shahrzad

2015-01-01

Background: Healthy lifestyle and ineffective coping strategies are deemed significant variables among patients with hypertension. This study attempted to determine the status of these variables following intervention via the mindfulness-based stress-reduction program (MBSRP) in patients with hypertension. Method: This study was a randomized clinical trial. The study sample, consisting of 30 patients referring to the Hypertension Clinic of Imam Hossein Hospital in 2013, was assigned either to the intervention (recipient of the MBSRP and conscious yoga) or to the control group (recipient of yoga training). The intervention group had 8 training sessions over 8 weeks. Lifestyle and coping strategies as well as blood pressure were measured in the intervention group before intervention and then immediately thereafter and at 2 months' follow-up and were compared to those in the control group at the same time points. Result: The mean age of the patients in the intervention (40% women) and control (53% women) groups was 43.66 ± 5.14 and 43.13 ± 5.04 years, respectively. The results showed that the mean scores of lifestyle (p value < 0.05), emotion-focused coping strategies (p value < 0.001), problem-focused coping strategies (p value < 0.001), diastolic blood pressure (p value < 0.001), and systolic blood pressure (p value < 0.001) were significantly different between the intervention and control groups after the intervention. Conclusion: Applying an intervention based on the MBSRP may further improve the lifestyle and coping strategies of patients with hypertension. PMID:26697087

Effectiveness of Relapse Prevention Cognitive-Behavioral Model in Opioid-Dependent Patients Participating in the Methadone Maintenance Treatment in Iran

PubMed Central

PASHAEI, Tahereh; SHOJAEIZADEH, Davoud; RAHIMI FOROUSHANI, Abbas; GHAZITABATABAE, Mahmoud; MOEENI, Maryam; RAJATI, Fatemeh; M RAZZAGHI, Emran

2013-01-01

Background: To evaluate the effectiveness of a relapse prevention cognitive-behavioral model, based on Marlatt treatment approach, in Opioid-dependent patients participating in the Methadone Maintenance Treatment (MMT) in Iran. Methods: The study consisted of 92 individuals treated with methadone in Iranian National Center of Addiction Studies (INCAS). Participants were randomized into two groups: educational intervention group (N=46) and control group (N=46). The intervention was comprised of 10 weekly 90 minute sessions, done during a period of 2.5 months based on the most high risk situations determined using Inventory Drug Taking Situation instrument. Relapse was defined as not showing up for MMT, drug use for at least 5 continuous days, and a positive urinary morphine test. Results: While, only 36.4% of the intervention group relapsed into drug use, 63.6% of the control group relapsed. The result of the logistic regressions showed that the odd ratio of the variable of intervention program for the entire follow up period was 0.43 (P<0.01). Further, the odd ratio of this variable in one month, three months, and 195 days after the therapy were 0.48 (P<.03), 0.31 (P<.02), and 0.13 (P<.02) respectively that revealed that on average, the probability of relapse among individuals in the intervention group was lower than patients in control group Conclusion: Relapse prevention model based on Marlatt treatment approach has an effective role in decreasing relapse rate. This model can be introduced as a complementary therapy in patients treated with methadone maintenance. PMID:26056645

Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents

PubMed Central

Killion, Cheryl M.; Andrisin, Sharon; Lissemore, Frances; Primm, Tonia; Olayinka, Oluwatomisin; Borawski, Elaine A.

2017-01-01

Abstract Background: Focus groups are often used to involve families as codesigners of weight management interventions. Focus groups, however, are seldom designed to elicit families' strengths and positive experiences. The purpose of this study was to describe the use of the Appreciative Inquiry process in the conduct of focus groups to engage families in the design of a weight management intervention for adolescents. Methods: A convenience sample of 44 parents (84% female; 82% minority) of adolescent children with a BMI ≥ 85th percentile, who were in the 6th–8th grade in a large urban school, participated in focus groups designed to elicit family-positive experiences and strengths regarding healthy living. A structured set of questions based on the Appreciative Inquiry process was used in the focus groups. Analyses consisted of the constant comparative method to generate themes. Results: Parent-positive perceptions regarding their family's healthy living habits were reflected in five themes: (1) Having healthy children is a joy; (2) Becoming healthy is a process; (3) Engaging in healthy habits is a family affair; (4) Good health habits can be achieved despite obstacles; and (5) School, community, and social factors contribute to their family's health habits. Parents generated ideas to improve their families' health. Conclusions: Focus groups based on the Appreciative Inquiry process were found to be a useful approach to discover features that are important to low-income, urban-living parents to include in an adolescent weight management program. Recommendations for designing and conducting focus groups based on the Appreciative Inquiry process are provided. PMID:28187267

Reflections and Conclusions on the Work Developed by the Group of Teaching Innovation in Electronics at the University of Valladolid

ERIC Educational Resources Information Center

Herrero, Luis Carlos; Pardo, Fernando; Fernando, María Luisa; González, María Luisa

2011-01-01

We hereby present the main conclusions and perspectives obtained by the Group of Teaching Innovation in Electronics (Grupo de Innovación Docente en Electrónica, GIDEN) of the University of Valladolid (UVa) with regard to its main areas of work. This group comprises teachers of the "Specialty in Industrial Electronics" degree, and the…

Job titles classified into socioeconomic and occupational groups identify subjects with increased risk for respiratory symptoms independent of occupational exposure to vapour, gas, dust, or fumes.

PubMed

Schyllert, Christian; Andersson, Martin; Hedman, Linnea; Ekström, Magnus; Backman, Helena; Lindberg, Anne; Rönmark, Eva

2018-01-01

Objectives : To evaluate the ability of three different job title classification systems to identify subjects at risk for respiratory symptoms and asthma by also taking the effect of exposure to vapours, gas, dust, and fumes (VGDF) into account. Background : Respiratory symptoms and asthma may be caused by occupational factors. There are different ways to classify occupational exposure. In this study, self-reported occupational exposure to vapours, gas, dust and fumes was used as well as job titles classifed into occupational and socioeconomic Groups according to three different systems. Design: This was a large population-based study of adults aged 30-69 years in Northern Sweden ( n  = 9,992, 50% women). Information on job titles, VGDF-exposure, smoking habits, asthma and respiratory symptoms was collected by a postal survey. Job titles were used for classification into socioeconomic and occupational groups based on three classification systems; Socioeconomic classification (SEI), the Nordic Occupations Classification 1983 (NYK), and the Swedish Standard Classification of Occupations 2012 (SSYK). Associations were analysed by multivariable logistic regression. Results : Occupational exposure to VGDF was a risk factor for all respiratory symptoms and asthma (odds ratios (ORs) 1.3-2.4). Productive cough was associated with the socioeconomic groups of manual workers (ORs 1.5-2.1) and non-manual employees (ORs 1.6-1.9). These groups include occupations such as construction and transportation workers, service workers, nurses, teachers and administration clerks which by the SSYK classification were associated with productive cough (ORs 2.4-3.7). Recurrent wheeze was significantly associated with the SEI group manual workers (ORs 1.5-1.7). After adjustment for also VGDF, productive cough remained significantly associated with the SEI groups manual workers in service and non-manual employees, and the SSYK-occupational groups administration, service, and elementary occupations. Conclusions : In this cross-sectional study, two of the three different classification systems, SSYK and SEI gave similar results and identified groups with increased risk for respiratory symptoms while NYK did not give conclusive results. Furthermore, several associations were independent of exposure to VGDF indicating that also other job-related factors than VGDF are of importance.

Applications of Infrared and Raman Spectroscopies to Probiotic Investigation

PubMed Central

Santos, Mauricio I.; Gerbino, Esteban; Tymczyszyn, Elizabeth; Gomez-Zavaglia, Andrea

2015-01-01

In this review, we overview the most important contributions of vibrational spectroscopy based techniques in the study of probiotics and lactic acid bacteria. First, we briefly introduce the fundamentals of these techniques, together with the main multivariate analytical tools used for spectral interpretation. Then, four main groups of applications are reported: (a) bacterial taxonomy (Subsection 4.1); (b) bacterial preservation (Subsection 4.2); (c) monitoring processes involving lactic acid bacteria and probiotics (Subsection 4.3); (d) imaging-based applications (Subsection 4.4). A final conclusion, underlying the potentialities of these techniques, is presented. PMID:28231205

[Consensus document on continuous subcutaneous insulin infusion (CSII) treatment in paediatrics with type I diabetes].

PubMed

Barrio Castellanos, R; García Cuartero, B; Gómez Gila, A; González Casado, I; Hermoso López, F; Luzuriaga Tomás, C; Oyarzabal Irigoyen, M; Rica Etxebarria, I; Rodríguez Rigual, M; Torres Lacruz, M

2010-05-01

This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence base on the international consensus and consensual answers to these questions for the participants. Copyright 2009 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Clinical efficacy of fidarestat, a novel aldose reductase inhibitor, for diabetic peripheral neuropathy: a 52-week multicenter placebo-controlled double-blind parallel group study.

PubMed

Hotta, N; Toyota, T; Matsuoka, K; Shigeta, Y; Kikkawa, R; Kaneko, T; Takahashi, A; Sugimura, K; Koike, Y; Ishii, J; Sakamoto, N

2001-10-01

The purpose of this study was to evaluate the efficacy of fidarestat, a novel aldose reductase (AR) inhibitor, in a double-blind placebo controlled study in patients with type 1 and type 2 diabetes and associated peripheral neuropathy. A total of 279 patients with diabetic neuropathy were treated with placebo or fidarestat at a daily dose of 1 mg for 52 weeks. The efficacy evaluation was based on change in electrophysiological measurements of median and tibial motor nerve conduction velocity, F-wave minimum latency, F-wave conduction velocity (FCV), and median sensory nerve conduction velocity (forearm and distal), as well as an assessment of subjective symptoms. Over the course of the study, five of the eight electrophysiological measures assessed showed significant improvement from baseline in the fidarestat-treated group, whereas no measure showed significant deterioration. In contrast, in the placebo group, no electrophysiological measure was improved, and one measure significantly deteriorated (i.e., median nerve FCV). At the study conclusion, the fidarestat-treated group was significantly improved compared with the placebo group in two electrophysiological measures (i.e., median nerve FCV and minimal latency). Subjective symptoms (including numbness, spontaneous pain, sensation of rigidity, paresthesia in the sole upon walking, heaviness in the foot, and hypesthesia) benefited from fidarestat treatment, and all were significantly improved in the treated versus placebo group at the study conclusion. At the dose used, fidarestat was well tolerated, with an adverse event profile that did not significantly differ from that seen in the placebo group. The effects of fidarestat-treatment on nerve conduction and the subjective symptoms of diabetic neuropathy provide evidence that this treatment alters the progression of diabetic neuropathy.

Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies

PubMed Central

Vissenberg, C; Stronks, K; Nijpels, G; Uitewaal, P J M; Middelkoop, B J C; Kohinor, M J E; Hartman, M A; Nierkens, V

2016-01-01

Objective There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences hindering DSM (eg, peer pressure, social norms) in patients living in deprived neighbourhoods. Through a qualitative process evaluation, this paper aims to study whether this intervention changed social support and social influences, and which elements of the intervention contributed to this. Methods The intervention group (IG) was compared with a standard group-based educational intervention (control group, CG). 27 qualitative in-depth interviews with participants (multiethnic sample) and 24 interviews with group leaders were conducted. Interviews were coded and analysed using MAXQDA according to framework analysis. Results Patients in the IG experienced more emotional support from group members and more instrumental and appraisal support from relatives than those in the CG. Also, they were better able to recognise and cope with influences that hinder their DSM, exhibited more positive norms towards DSM and increased their priority regarding DSM and their adherence. Finally, the engagement in DSM by relatives of participants increased. Creating trust between group members, skills training, practising together and actively involving relatives through action plans contributed to these changes. Conclusions A group-based intervention aimed at creating trust, practising together and involving relatives has the potential to increase social support and diminish social influences hindering DSM in socioeconomically deprived patients with diabetes. Promising elements of the intervention were skills training and providing feedback using role-playing exercises in group sessions with patients, as well as the involvement of patients' significant others in self-management tasks, and actively involving them in making an action plan for self-management. These positive results justify the value of further evaluating the effectiveness of this intervention in a larger sample. Trial registration number NTR1886, Results. PMID:27075842

Transportation accident scenarios for commercial spent fuel

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

Wilmot, E L

1981-02-01

A spectrum of high severity, low probability, transportation accident scenarios involving commercial spent fuel is presented together with mechanisms, pathways and quantities of material that might be released from spent fuel to the environment. These scenarios are based on conclusions from a workshop, conducted in May 1980 to discuss transportation accident scenarios, in which a group of experts reviewed and critiqued available literature relating to spent fuel behavior and cask response in accidents.

Center for Army Leadership’s Response to Empirically Based Leadership

DTIC Science & Technology

2013-02-01

account for considerably less variability in leadership outcomes than do behaviors. Background. The introduction of McDonald’s paper questions...ethical or moral rea- soning. The developers of LRM and FM 6-22 are in complete alignment with McDonald’s conclusions Figure 1 Study competency...ideas of leadership as social phenomena within and across groups. McDonald’s paper and the referenced book offer concepts that are not fully

Highly branched polyethylenes as lubricant viscosity and friction modifiers

DOE PAGES

Robinson, Joshua W.; Zhou, Yan; Qu, Jun; ...

2016-10-08

A series of highly branched polyethylene (BPE) were prepared and evaluated in a Group I base oil as potential viscosity and friction modifiers. The performance of these BPEs supports the expected dual functionality. Changes in polarity, topology, and molecular weight of the BPEs showed significant effects on the lubricants' performance with respect to viscosity index and friction reduction. In conclusion, this study provides scientific insights into polymer design for future lubricant development activities.

Variables related to tobacco use among young adults: are there differences between males and females?

PubMed

Pederson, Linda L; Koval, John J; Chan, Stella S H; Zhang, Xiaohe

2007-02-01

We sought to determine the association of four categories (chunks) of variables: (1) demographic characteristics, (2) family and friends smoking and other drug use, (3) psychosocial factors and attitude, and (4) lifestyle factors to current smoking as compared to never smoking among Canadian young adults. A cohort of 1270 young adults, followed for 10 years, completed a self-administered questionnaire. In multivariable analyses, the best final model for both genders did not include the psychosocial and attitudinal categories, but did contain variables in the demographic, family and friends, and lifestyle categories. Interventions for reducing smoking among young adults may be similar for males and females, a conclusion that differs from conclusions based on findings from younger age groups.

Transcatheter Arterial Embolization of Renal VX-2 Carcinoma: Ethiodol-Ethanol Capillary Embolization Combined with Carboplatin

PubMed Central

Choi, Byung Gil; Van Pelt, Carolyn S.; Wright, Kenneth C.

2007-01-01

Objective We wanted to determine whether transcatheter Ethiodol-based capillary embolization in combination with carboplatin could improve the efficiency of a 1:1 Ethiodol-ethanol mixture (EEM) to ablate kidneys that been inoculated with VX-2 carcinoma. Materials and Methods The right kidney in 34 New Zealand white rabbits were inoculated with fresh VX-2 tumor fragments. One week later, the kidneys were subjected to transarterial treatment (4-5 rabbits/group): Saline infusion (Group 1); carboplatin infusion (5 or 10 mg, Groups 2A and 2B); carboplatin-Ethiodol (CE) alone (Group 3) and followed by main renal artery occlusion with ethanol (RAO) (Group 4); carboplatin-EEM (C-EEM) followed by RAO (Group 5); carboplatin infusion followed by EEM plus RAO (Group 6); and EEM followed by RAO (Group 7). The animals were followed for up to 3-weeks. The treated kidneys were evaluated angiographically and macroscopically. The kidneys that showed successful embolization macroscopically were entirely cut into serial sections, and these were examined microscopically. Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections. Results The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1). Kidneys from Groups 4-7 demonstrated macroscopically successful embolization with histologically proven complete renal parenchyma infarction; however, some residual tumor was evident in all but one animal. Conclusion None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone. PMID:17420631

Study of phase clustering method for analyzing large volumes of meteorological observation data

NASA Astrophysics Data System (ADS)

Volkov, Yu. V.; Krutikov, V. A.; Botygin, I. A.; Sherstnev, V. S.; Sherstneva, A. I.

2017-11-01

The article describes an iterative parallel phase grouping algorithm for temperature field classification. The algorithm is based on modified method of structure forming by using analytic signal. The developed method allows to solve tasks of climate classification as well as climatic zoning for any time or spatial scale. When used to surface temperature measurement series, the developed algorithm allows to find climatic structures with correlated changes of temperature field, to make conclusion on climate uniformity in a given area and to overview climate changes over time by analyzing offset in type groups. The information on climate type groups specific for selected geographical areas is expanded by genetic scheme of class distribution depending on change in mutual correlation level between ground temperature monthly average.

Integrating Ultrasound Teaching into Preclinical Problem-based Learning

PubMed Central

Tshibwabwa, Eli Tumba; Cannon, Jenifer; Rice, James; Kawooya, Michael G; Sanii, Reza; Mallin, Robert

2016-01-01

Objectives: The aim is to provide students in the preclinical with ultrasound image interpretation skills. Research question: Are students in smaller groups with access to a combination of lectures and hands-on patient contact most likely to have better ultrasound image interpretation skills, than students in larger groups with only interactive didactic lectures? Methodology: First-year students at the preclinical Program of the College of Medicine, participated in two 2-h introductory interactive ultrasound sessions. The study comprised two cohorts: 2012/2013 students, who were offered large group teaching (LGT) sessions (control group), and 2013/2014 students, who received the intervention in small group learning problem-based learning (PBL) sessions (experimental group). The overall learning objectives were identical for both groups. The success of the module was evaluated using pre- and post-tests as well as students’ feedback. Results: The students in the experimental group showed significantly higher scores in interpretations of images than those in the control group. The experimental group showed achievement of learning outcomes along with higher levels of satisfaction with the module compared to the latter. Conclusion: Posttest knowledge of the basics of ultrasound improved significantly over the pretest in the experimental group. In addition, students’ overall satisfaction of the ultrasound module was shown to be higher for the PBL compared to the LGT groups. Small groups in an interactive and PBL setting along with opportunities for hands-on practice and simultaneous visualization of findings on a high definition screen should enhance preclinical student learning of the basics of ultrasound. Despite the potential of ultrasound as a clinical, teaching and learning tool for students in the preclinical years, standardized recommendations have yet to be created regarding its integration into the curricula within academic institutions and clinical medicine. The interactive and PBL is here to stay at the college of medicine. Further research would be carried out to see if this trend persists in the upcoming vertical system-based curriculum of the college of medicine. PMID:27833780

Immediate Effects of Ankle Balance Taping with Kinesiology Tape for Amateur Soccer Players with Lateral Ankle Sprain: A Randomized Cross-Over Design

PubMed Central

Kim, Myoung Kwon; Shin, Young Jun

2017-01-01

Background The objective of this study was to investigate the immediate effect on gait function when ankle balance taping is applied to amateur soccer players with lateral ankle sprain. Material/Methods A cross-over randomized design was used. Twenty-two soccer players with an ankle sprain underwent 3 interventions in a random order. Subjects were randomly assigned to ankle balance taping, placebo taping, and no taping groups. The assessment was performed using the GAITRite portable walkway system, which records the location and timing of each footfall during ambulation. Results Significant differences were found in the velocity, step length, stride length, and H-H base support among the 3 different taping methods (p<0.05). The ankle balance taping group showed significantly greater velocity, step length, and stride length in comparison to the placebo and no taping group. The ankle balance taping group showed a statistically significant decrease (p<0.05) in the H-H base support compared to the placebo and no taping groups, and the placebo group showed significantly greater velocity in comparison to the no taping group (p<0.05). Conclusions We conclude that ankle balance taping that uses kinesiology tape instantly increased the walking ability of amateur soccer players with lateral ankle sprain. Therefore, ankle balance taping is a useful alternative to prevent and treat ankle sprain of soccer players. PMID:29158472

Effect of music intervention on the cognitive and depression status of senior apartment residents in Taiwan

PubMed Central

Tai, Shu-Yu; Wang, Ling-Chun; Yang, Yuan-Han

2015-01-01

Objective To identify the effect of music intervention on cognitive function and depression status of residents in senior citizen apartments based on the existing evidence regarding music therapy. Methods An experimental study was conducted from November 2008 to December 2009. Sixty healthy senior apartment residents over 65 years of age were recruited and separated into two groups. According to their opinion, 41 took part in the music intervention group and 19 in the comparison group. The music intervention involved Buddhist hymns. The short-term effects were evaluated based on the measurement of cognitive function and depression level using the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale-short form (GDS-SF) at the baseline, 1 month, and 4 months. Results The means of the initial and the 1-month MMSE and GDS-SF scores did not differ between the two groups. The 4-month MMSE score significantly declined compared with the initial level in the comparison group, whereas no significant change was observed in the experimental group. Moreover, the 4-month GDS-SF score significantly improved in both groups compared with the initial level. Conclusion Music intervention may postpone cognitive decline in healthy residents preferring Buddhist hymns in the senior citizen apartments in 4 months follow-up, and intense contact with participants may improve their mood status. PMID:26109859

Effectiveness of a Dissonance-Based Eating Disorder Prevention Program for Ethnic Groups in Two Randomized Controlled Trials

PubMed Central

Stice, Eric; Marti, C. Nathan; Cheng, Zhen Hadassah

2014-01-01

Objective As young women from certain ethnic minority groups have reported less pursuit of the thin ideal and body dissatisfaction than European American young women we tested whether a dissonance-based prevention program designed to reduce thin-ideal internalization among women with body dissatisfaction is less effective for the former relative to the later groups. We also tested whether intervention effects are larger when participants from minority groups worked with a facilitator matched versus not matched on ethnicity. Method In Study 1, 426 female undergraduates (M age = 21.6, SD = 5.6) were randomized to clinician-led Body Project groups or an educational control group. In Study 2, 189 female undergraduates were randomized to peer-led Body Project groups or a waitlist control condition. Results Although there was some variation in risk factor scores across ethnic groups, ethnic minority participants did not demonstrate consistently higher or lower risk relative to European American participants. Intervention effects did not significantly differ for participants from minority groups versus European American participants in either trial. There was no evidence that effects were significantly larger when minority participants and facilitators were matched on ethnicity. Conclusions Results suggest that the Body Project is similarly effective for African American, Asian American, European American, and Hispanic female college students, and when participants and facilitators are matched or not on minority ethnicity status, implying that this prevention program can be broadly disseminated in this population. PMID:24655465

The base number of ‘loxoscaphoid’ Asplenium species and its implication for cytoevolution in Aspleniaceae

PubMed Central

Bellefroid, Elke; Rambe, S. Khadijah; Leroux, Olivier; Viane, Ronald L. L.

2010-01-01

Background and Aims ‘Loxoscaphoid’ Asplenium species are morphologically a remarkably distinct group of Aspleniaceae. Except for two preliminary chromosome counts of Asplenium theciferum, the cytology of this group of species has, however, been largely unstudied. Methods Chromosome counts were obtained by acetocarmine squash preparations of one mitotic cell and several meiotic cells. Relative DNA content of gametophytic and sporophytic cells was determined by flow cytometry. The phylogenetic placement of A. loxoscaphoides, A. rutifolium s.l. and A. theciferum s.l. was investigated through an analysis of rbcL sequences. Key Results The dysploid base number is reported to be x = 35 in Asplenium centrafricanum, A. loxoscaphoides, A. sertularioides and A. theciferum. Analysis of rbcL sequences confirms that ‘loxoscaphoids’ nest robustly within Asplenium. Several high ploidy levels exceeding the tetraploid level were found in A. theciferum s.l. and A. rutifolium s.l. All taxa proved to be sexual. Conclusions Four base numbers are known at present for Aspleniaceae: x = 39, 38, 36 and 35. The dysploid base number x = 35 found in the ‘loxoscaphoid’ Asplenium spp. sheds a novel light on the cytoevolution of the whole family. We postulate a recurrent descending dysploid evolution within Aspleniaceae, leading to speciation at the (sub)generic and species/group level. PMID:20498038

Video-based sexually transmitted disease patient education: its impact on condom acquisition.

PubMed Central

O'Donnell, L N; Doval, A S; Duran, R; O'Donnell, C

1995-01-01

OBJECTIVES. This study assessed the impact of video-based educational interventions on condom acquisition among men and women seeking services at a large sexually transmitted disease clinic in the South Bronx, New York. METHODS. During 1992, 3348 African American and Hispanic patients were enrolled in a clinical trial of video-based interventions designed to promote safer sex behaviors, including increased condom use. Patients were assigned to one of three groups: control, video, or video plus interactive group discussion. Subjects were given a coupon to redeem for free condoms at a pharmacy several blocks from the clinic. Rates of condom acquisition were assessed by level of intervention. RESULTS. In comparison with a control group, subjects who viewed videos were significantly more likely to redeem coupons for condoms (21.2% redemption rate vs 27.6%). However, participation in interactive sessions after video viewing augmented the positive effects of video viewing alone (27.6% redemption rate vs 36.9%). Gender and ethnicity were significantly associated with outcomes. CONCLUSIONS. The condom acquisition are almost doubled with the use of culturally appropriate, video-based interventions. Designed to present minimal disruption to clinical services, these interventions can be implemented in clinics servicing at-risk men and women. Images FIGURE 1 PMID:7762716

Comparative performance of novel self-sampling methods in detecting high-risk human papillomavirus in 30,130 women not attending cervical screening.

PubMed

Bosgraaf, Remko P; Verhoef, Viola M J; Massuger, Leon F A G; Siebers, Albert G; Bulten, Johan; de Kuyper-de Ridder, Gabriëlle M; Meijer, Chris J M; Snijders, Peter J F; Heideman, Daniëlle A M; IntHout, Joanna; van Kemenade, Folkert J; Melchers, Willem J G; Bekkers, Ruud L M

2015-02-01

We determined whether the participation rate for a brush-based cervicovaginal self-sampling device is noninferior to the participation rate for a lavage-based one for testing for hrHPV (high-risk human papillomavirus). Additionally, positivity rates for hrHPV, the detection rates for cervical intraepithelial neoplasia grades 2 and 3 or worse (CIN2+/3+), and user comfort were compared. A total of 35,477 non-responders of the regular cervical screening program aged 33-63 years were invited to participate. Eligible women (n = 30,130) were randomly assigned to receive either a brush-based or a lavage-based device, and a questionnaire for reporting user convenience. Self-sampling responders testing hrHPV-positive were invited for a physician-taken sample for cytology; triage-positive women were referred for colposcopy. A total of 5,218 women participated in the brush-based sampling group (34.6%) and 4809 women in the lavage-based group (31.9%), i.e. an absolute difference of 2.7% (95%CI 1.8-4.2). The hrHPV-positivity rates in the two groups were identical (8.3%, relative risk (RR) 0.99, 95%CI 0.87-1.13). The detection of CIN2+ and CIN3+ in the brush group (2.0% for CIN2+; 1.3% for CIN3+) was similar to that in the lavage group (1.9% for CIN2+; 1.0% for CIN3+) with a cumulative RR of 1.01, 95%CI 0.83-1.24 for CIN2+ and 1.25, 95%CI 0.92-1.70 for CIN3+. The two self-sampling devices performed similarly in user comfort. In conclusion, offering a brush-based device to non-responders is noninferior to offering a lavage-based device in terms of participation. The two self-sampling methods are equally effective in detecting hrHPV, CIN2+/CIN3+ and are both well accepted. © 2014 UICC.

The Effectiveness and Cost-Effectiveness of Web-Based and Home-Based Postnatal Psychoeducational Interventions for First-Time Mothers: Randomized Controlled Trial Protocol

PubMed Central

Chong, Yap-Seng; Jiao, Nana; Luo, Nan

2018-01-01

Background In addition to recuperating from the physical and emotional demands of childbirth, first-time mothers are met with demands of adapting to their social roles while picking up new skills to take care of their newborn. Mothers may not feel adequately prepared for parenthood if they are situated in an unsupported environment. Postnatal psychoeducational interventions have been shown to be useful and can offer a cost-effective solution for improving maternal outcomes. Objective The objective of this study was to examine the effectiveness and cost-effectiveness of Web-based and home-based postnatal psychoeducational programs for first-time mothers on maternal outcomes. Methods A randomized controlled three-group pre- and posttests experimental design is proposed. This study plans to recruit 204 first-time mothers on their day of discharge from a public tertiary hospital in Singapore. Eligible first-time mothers will be randomly allocated to either a Web-based psychoeducation group, a home-based psychoeducation group, or a control group receiving standard care. The outcomes include maternal parental self-efficacy, social support, psychological well-being (anxiety and postnatal depression), and cost evaluation. Data will be collected at baseline, 1 month, 3 months, and 6 months post-delivery. Results The recruitment (n=204) commenced in October 2016 and was completed in February 2017, with 68 mothers in each group. The 6-month follow-up data collection was completed in August 2017. Conclusions This study may identify an effective and cost-effective Web-based postnatal psychoeducational program to improve first-time mothers’ health outcomes. The provision of a widely-accessed Web-based postnatal psychoeducational program will eventually lead to more positive postnatal experiences for first-time mothers and positively influence their future birth plans. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 45202278; http://www.isrctn.com/ISRCTN45202278 (Archived by WebCite at http://www.webcitation.org/6whx0pQ2F). PMID:29386175

Development and Validation of a Job Exposure Matrix for Physical Risk Factors in Low Back Pain

PubMed Central

Solovieva, Svetlana; Pehkonen, Irmeli; Kausto, Johanna; Miranda, Helena; Shiri, Rahman; Kauppinen, Timo; Heliövaara, Markku; Burdorf, Alex; Husgafvel-Pursiainen, Kirsti; Viikari-Juntura, Eira

2012-01-01

Objectives The aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP). Materials and Methods We utilized two large Finnish population surveys, one to construct the JEM and another to test matrix validity. The exposure axis of the matrix included exposures relevant to LBP (heavy physical work, heavy lifting, awkward trunk posture and whole body vibration) and exposures that increase the biomechanical load on the low back (arm elevation) or those that in combination with other known risk factors could be related to LBP (kneeling or squatting). Job titles with similar work tasks and exposures were grouped. Exposure information was based on face-to-face interviews. Validity of the matrix was explored by comparing the JEM (group-based) binary measures with individual-based measures. The predictive validity of the matrix against LBP was evaluated by comparing the associations of the group-based (JEM) exposures with those of individual-based exposures. Results The matrix includes 348 job titles, representing 81% of all Finnish job titles in the early 2000s. The specificity of the constructed matrix was good, especially in women. The validity measured with kappa-statistic ranged from good to poor, being fair for most exposures. In men, all group-based (JEM) exposures were statistically significantly associated with one-month prevalence of LBP. In women, four out of six group-based exposures showed an association with LBP. Conclusions The gender-specific JEM for physical exposures showed relatively high specificity without compromising sensitivity. The matrix can therefore be considered as a valid instrument for exposure assessment in large-scale epidemiological studies, when more precise but more labour-intensive methods are not feasible. Although the matrix was based on Finnish data we foresee that it could be applicable, with some modifications, in other countries with a similar level of technology. PMID:23152793

Sodium Peroxide Dihydrate or Sodium Superoxide: The Importance of the Cell Configuration for Sodium-Oxygen Batteries

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

Bi, Xuanxuan; Wang, Rongyue; Ma, Lu

In sodium–oxygen (Na–O2) batteries, multiple discharge products have been observed by different research groups. Given the fact that different materials, gas supplies, and cell configurations are used by different groups, it is a great challenge to draw a clear conclusion on the formation of the different products. Here, two different cell setups are used to investigate the cell chemistries of Na–O2 batteries. With the same materials and gas supplies, a peroxide-based product is observed in a glass chamber cell and a superoxide-based product is observed in a stainless-steel cell. Ex situ high-energy X-ray diffraction (HEXRD) and Raman spectroscopy are performedmore » to investigate the structure and composition of the product. In addition, in situ XRD is used to investigate the structure evolution of the peroxide-based product. The findings highlight the importance of the cell design and emphasize the critical environment of the formation of the discharge products of Na–O2 batteries.« less

[Health promotion: a relevant concept for a management and organizational dynamics tool in the restructuring of a geriatric hospital].

PubMed

Chatot-Henry, Didier; Chatot-Henry, Carole; Courcier, Dominique

2014-01-01

The financial difficulties encountered by Martinique hospitals has led to restructuring of the territory's medical project with the merger of three healthcare facilities. These new constraints impacting the work environment with organizational consequences in services. A management experiment was attempted in a geriatric day care hospital based on the use of health promotion concepts. After an overview of the unit's activity based on the perceptions of staff, patients and private physicians, a one-day research-action structural seminar was organized. Group dynamics, unit functioning, shared values, success factors, and improvement strategies were discussed. This seminar resulted in the development of a business model based on five values (respect, professionalism, cohesion, empathy, communication). Three operational working groups were established to implement the conclusions of the seminar in the unit. This experiment focused on an alternative approach to the management of small health care services by the use of health promotion.

Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study

PubMed Central

Chung, Peter Chi-Ho; Chen, Hsiu-Pin; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

2016-01-01

Purpose The purpose of this study was to assess whether preoperative chronic renal failure (CRF) affects the rates of postoperative complications and survival after liver transplantation. Methods This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF. Results The overall estimated survival rate of liver transplantation recipients (LTRs) with preoperative CRF was significantly lower than that of patients without preoperative CRF (P=0.0085). There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF. Conclusion These findings suggest that LTRs with preoperative CRF have a higher rate of mortality. PMID:28008264

The Effects of School-Based Maum Meditation Program on the Self-Esteem and School Adjustment in Primary School Students

PubMed Central

Yoo, Yang Gyeong; Lee, In Soo

2013-01-01

Self-esteem and school adjustment of children in the lower grades of primary school, the beginning stage of school life, have a close relationship with development of personality, mental health and characters of children. Therefore, the present study aimed to verify the effect of school-based Maum Meditation program on children in the lower grades of primary school, as a personality education program. The result showed that the experimental group with application of Maum Meditation program had significant improvements in self-esteem and school adjustment, compared to the control group without the application. In conclusion, since the study provides significant evidence that the intervention of Maum Meditation program had positive effects on self-esteem and school adjustment of children in the early stage of primary school, it is suggested to actively employ Maum Meditation as a school-based meditation program for mental health promotion of children in the early school ages, the stage of formation of personalities and habits. PMID:23777717

THE EFFECTS OF COMPUTER-BASED FIRE SAFETY TRAINING ON THE KNOWLEDGE, ATTITUDES, AND PRACTICES OF CAREGIVERS

PubMed Central

Harrington, Susan S.; Walker, Bonnie L.

2010-01-01

Background Older adults in small residential board and care facilities are at a particularly high risk of fire death and injury because of their characteristics and environment. Methods The authors investigated computer-based instruction as a way to teach fire emergency planning to owners, operators, and staff of small residential board and care facilities. Participants (N = 59) were randomly assigned to a treatment or control group. Results Study participants who completed the training significantly improved their scores from pre- to posttest when compared to a control group. Participants indicated on the course evaluation that the computers were easy to use for training (97%) and that they would like to use computers for future training courses (97%). Conclusions This study demonstrates the potential for using interactive computer-based training as a viable alternative to instructor-led training to meet the fire safety training needs of owners, operators, and staff of small board and care facilities for the elderly. PMID:19263929

Report-reading patterns of technical managers and nonmanagers

NASA Technical Reports Server (NTRS)

Pinelli, T. E.; Cordle, V. M.; Glassman, M.; Vondran, R. F., Jr.

1984-01-01

A survey to determine the review and reading processes used by technical managers and nonmanagers indicates that the summary, abstract, conclusion, title page, and introduction are the components used most frequently by both groups to decide whether to read a NASA technical report. In the review process, significantly more managers than nonmanagers use the summary and conclusion, whereas significantly more nonmanagers use the abstract and title page. The most common sequence of review consists of the title page, abstract, and summary, in that order, for both groups. In the reading process, the conclusion, results and discussion, and summary are the components read by the highest percentage of both groups.

Participants’ Perceptions of a Group Based Program Incorporating Hands-On Meal Preparation and Pedometer-Based Self-Monitoring in Type 2 Diabetes

PubMed Central

Dasgupta, Kaberi; Jarvandi, Soghra; De Civita, Mirella; Pillay, Sabrina; Hajna, Samantha; Gougeon, Rejeanne; Bader, Abeer; Da Costa, Deborah

2014-01-01

Background Nutrition education (portion sizes, balanced meals) is a cornerstone of diabetes management; however, moving from information to behavior change is challenging. Through a single arm intervention study, we recently demonstrated that combining education with group-based meal preparation training has measureable effects on weight, eating behaviour, and glycemic control in adults with type 2 diabetes. In the present study, we conducted an in-depth examination of participants’ perceptions of this strategy, through focus group discussion, to delineate effective elements of the strategy from participants’ perspectives. Methods Participants who had completed the nutrition education/meal preparation training program were invited to attend one of four focus group discussions. These were led by experienced facilitators and guided by questions addressing experiences during the intervention and their perceived impact. Audiotapes were transcribed and qualitative content analysis of transcripts was performed. We report herein themes that achieved saturation across the four discussions. Results Twenty-nine (80.6%, 29/36) attended a focus group discussion. The program elements perceived as effective by participants included the hands-on interactive learning approach to meal preparation, the grocery store tour, pedometer-based self-monitoring, experiencing the link between food consumption/physical activity and glucose changes during the program, and peer support. Discussants reported changes in eating and walking behaviour, greater confidence in ability to self-manage diabetes, reductions in glucose levels and/or need for glucose-lowering medications, and, in some cases, weight loss. Family members and friends were facilitators for some and barriers for others in terms of achieving health behavior changes. Conclusions Among adults with type 2 diabetes, a group based program that included hands-on meal preparation and pedometer-based self-monitoring was perceived as effective in conveying information, developing skills, building confidence, and changing health behaviors. PMID:25536068

Serum Neutrophil Gelatinase-Associated Lipocalin and Urinary Kidney Injury Molecule-1 as Potential Biomarkers of Subclinical Nephrotoxicity After Gadolinium-Based and Iodinated-Based Contrast Media Exposure in Pediatric Patients with Normal Kidney Function

PubMed Central

Spasojević-Dimitrijeva, Brankica; Kotur-Stevuljević, Jelena; Đukić, Milan; Paripović, Dušan; Miloševski-Lomić, Gordana; Spasojević-Kalimanovska, Vesna; Pavićević, Polina; Mitrović, Jadranka; Kostić, Mirjana

2017-01-01

Background New renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) show promise in early diagnosis of contrast media induced acute kidney injury (CI-AKI). The purpose of our study was to compare the subclinical nephrotoxicity (a condition without changes in standard renal biomarkers) of gadolinium-based contrast media (Gd-DTPA, gadopentetate dimeglumine) and iodinated-based contrast media (iopromide) in pediatric patients with normal kidney function. Material/Methods The first group (n=58) of patients included in the study were undergoing angiography with iopromide, and the second group (n=65) were undergoing magnetic resonance (MR) angiography/urography with Gd-DTPA administration. The concentrations of NGAL and KIM-1 were measured four times in the urine (pre-contrast, then at four hours, 24 hours, and 48 hours after contrast administration), and serum NGAL was measured at 0 (baseline), 24 hours, and 48 hours after contrast exposure. Results After 24 hours, serum NGAL increase of ≥25% was noticed in 32.6% of the patients in the iopromide group and in 25.45% of the patients in the gadolinium group, with significantly higher average percent of this increase in first group (62.23% vs. 36.44%, p=0.002). In the Gd-DTPA group, we observed a statistically significant increase in urinary KIM-1 24 hours after the procedure. Normalized urinary KIM-1, 24 hours after contrast exposure, was a better predictive factor for CI-AKI than other biomarkers (AUC 0.757, cut off 214 pg/mg, sensitivity 83.3%, specificity 54.2%, p=0.035). Conclusions In children with normal renal function, exposure to iodinated-based and gadolinium-based media might lead to subclinical nephrotoxicity, which could be detected using serum NGAL and urinary KIM-1. PMID:28874655

Evaluation of an Affordable Wireless Node Sensor (Mote69) Designed for Internet of Thing (IoT) Device

NASA Astrophysics Data System (ADS)

Ruhiyat, Z. F.; Somantri, Y.; Wahyudin, D.; Hakim, D. L.

2018-02-01

This research aims to determine the student’s response to the implementation of Internet of Things (IoT) device based on RFM69, called Mote69, for practical work of Aircraft Electronic Circuits and Controllers. Participants in this study were students of a vocational high school of Aircraft Electronics which consisted of three groups. The first group is the students who have grades above the average class. The second group is the students who have grade the average class. The third group is the students who have grades below the average class. The research phase consisted of (1). Observation and Assessment of Empirical Issues; (2). Testing of Media Feasibility and Research Instruments; (3). Accumulate and Processing of Field Data; and (4). Results and Data Conclusions. The result of media feasibility showed that Mote69 is appropriate to be used in practical work of Aircraft Electronic Circuits and Controllers subject.

Profile changes after conventional and chin shield genioplasty

PubMed Central

Singh, Stuti; Mehrotra, Divya; Mohammad, S.

2014-01-01

Introduction The aim of this study was to compare the profile changes after conventional and chin shield genioplasty. Material and method 20 patients with retruded chin were randomly allocated to two different groups. The experimental group had chin shield osteotomy with interposition of hydroxyapatite collagen graft soaked in platelet rich plasma, while the controls had a conventional genioplasty. The outcome variables evaluated were lip seal, chin thickness, mandibular base length, SNB, labiomental angle, anterior lower facial height, transverse chin shift, and complications. Results There was an increase in chin thickness among all, but a significant increase in anterior lower facial height was seen in the experimental group only. There was no statistically significant difference in satisfaction score in both groups. Conclusion Chin shield genioplasty provides horizontal as well as vertical lengthening of chin without deepening of the mentolabial fold. Hydroxyapatite collagen bone graft and platelet rich plasma promote healing, induce bone formation and reduce bone resorption. PMID:25737921

Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey

PubMed Central

Kachan, Diana; Olano, Henry; Tannenbaum, Stacey L.; Annane, Debra W.; Mehta, Ashwin; Arheart, Kristopher L.; Fleming, Lora E.; McClure, Laura A.; Lee, David J.

2017-01-01

Introduction Mindfulness-based practices can improve workers’ health and reduce employers’ costs by ameliorating the negative effect of stress on workers’ health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. Methods We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Results Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21–0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54–0.74) than among white-collar workers. Conclusion Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs. PMID:28055821

Theoretical assumptions of Maffesoli's sensitivity and Problem-Based Learning in Nursing Education1

PubMed Central

Rodríguez-Borrego, María-Aurora; Nitschke, Rosane Gonçalves; do Prado, Marta Lenise; Martini, Jussara Gue; Guerra-Martín, María-Dolores; González-Galán, Carmen

2014-01-01

Objective understand the everyday and the imaginary of Nursing students in their knowledge socialization process through the Problem-Based Learning (PBL) strategy. Method Action Research, involving 86 students from the second year of an undergraduate Nursing program in Spain. A Critical Incident Questionnaire and Group interview were used. Thematic/categorical analysis, triangulation of researchers, subjects and techniques. Results the students signal the need to have a view from within, reinforcing the criticism against the schematic dualism; PBL allows one to learn how to be with the other, with his mechanical and organic solidarity; the feeling together, with its emphasis on learning to work in group and wanting to be close to the person taking care. Conclusions The great contradictions the protagonists of the process, that is, the students experience seem to express that group learning is not a form of gaining knowledge, as it makes them lose time to study. The daily, the execution time and the imaginary of how learning should be do not seem to have an intersection point in the use of Problem-Based Learning. The importance of focusing on the daily and the imaginary should be reinforced when we consider nursing education. PMID:25029064

Acupuncture to Reduce HIV-Associated Inflammation

PubMed Central

Swanson, Barbara; Keithley, Joyce K.; Johnson, Angela; Fogg, Louis; Adeyemi, Oluwatoyin; Sha, Beverly E.; Snell, Kimberly A.

2015-01-01

Background. HIV infection is associated with systemic inflammation that can increase risk for cardiovascular events. Acupuncture has been shown to have immunomodulatory effects and to improve symptoms in persons with inflammatory conditions. Objective. To test the anti-inflammatory effects of an acupuncture protocol that targets the cholinergic anti-inflammatory pathway (CAIP), a neural mechanism whose activation has been shown to reduce the release of proinflammatory cytokines, in persons with HIV-associated inflammation. Design, Setting, Participants, and Interventions. Double-blind, placebo-controlled clinical trial conducted in an outpatient clinic located in a medically underserved urban neighborhood. Twenty-five clinically-stable HIV-infected persons on antiretroviral therapy were randomized to receive once weekly CAIP-based acupuncture or sham acupuncture. Main Outcome Measures. Outcomes included plasma concentrations of high sensitivity C-reactive protein and D-dimer and fasting lipids. Results. Twenty-five participants completed the protocol (treatment group n = 12, control group n = 13). No adverse events related to the acupuncture protocol were observed. Compared to baseline values, the two groups did not significantly differ in any outcome measures at the end of the acupuncture protocol. Conclusions. CAIP-based acupuncture did not favorably modulate inflammatory or lipid parameters. Additional studies are warranted of CAIP-based protocols of different frequencies/durations. PMID:25922615

Large calf circumference indicates non-sarcopenia despite body mass

PubMed Central

Kusaka, Satomi; Takahashi, Tetsuya; Hiyama, Yoshinori; Kusumoto, Yasuaki; Tsuchiya, Junko; Umeda, Masaru

2017-01-01

[Purpose] The purpose of this study is to evaluate the applicability of the calf circumference as a tool for screening sarcopenia. [Subjects and Methods] One hundred sixteen community-dwelling elderly females were enrolled. Calf circumference of the dominant leg was measured using a plastic measuring tape. Subjects were divided into 3 groups based on body mass index (BMI); subjects with the values for BMI <18.5 kg/m2; those with BMI 18.5 to 25.0; those with BMI ≥25.0 kg/m2. Positive predictive value and negative predictive value of sarcopenia were calculated based on the obtained cut off values of calf circumference and the diagnosis of sarcopenia in each group. [Results] Prevalence rate of sarcopenia was 9.4% (n=10). Cut off value of the calf circumference was 32.8 cm (sensitivity: 73.0%, specificity: 80.0%, AUC: 0.792). Each BMI group showed high negative predictive value of sarcopenia based on the calf circumference cut off value of 32.8 cm. [Conclusion] These results suggested that to identify non-sarcopenia by larger calf circumference is more reasonable and useful than to identify sarcopenia due to the smaller calf circumference regardless of BMI. PMID:29200625

The Effectiveness of a Web-Based Computer-Tailored Intervention on Workplace Sitting: A Randomized Controlled Trial

PubMed Central

De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

2016-01-01

Background Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. Objective The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Methods Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. Results The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: P<.001), sitting at work (time × group: P<.001), and leisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition were superior to the generic and control conditions. Trial Registration Clinicaltrials.gov NCT02672215; http://clinicaltrials.gov/ct2/show/NCT02672215 (Archived by WebCite at http://www.webcitation.org/6glPFBLWv) PMID:27245789

[Effect of high frequency electrotherapy on caspase-3 and ultra microstructure of hippocampus in rats following cerebral ischemia/reperfusion].

PubMed

Fan, Yongmei; Wang, Rumi; Zhang, Changjie; Peng, Wenna; Yin, Jing; Hu, Zhiping

2017-01-28

To investigate the effect of high frequency electrotherapy (HFE) on rat hippocampus after cerebral ischemia/reperfusion (I/R).
 Methods: A rat model of cerebral I/R injury was established. The rats were randomly divided into a sham group, an I/R group and an HFE group. The HFE group received thearapy daily for different sessions for 1, 3, 7 d. Neuronal deficit score,neuron ultra microstructure in the hippocampus and caspase-3 protein expression were measured on 1 st, 3 th and 7th d.
 Results: Compared with the I/R group, the HFE group showed the decreased neurological deficit scores, with significant differences between the 2 groups (P<0.05). The injury in HFE group was reduced compared with that in the I/R group based on the electron microscope test, with significant difference. Caspase-3 protein in brain tissue in the HFE group also downregulated compared with that in the I/R group (P<0.05).
 Conclusion: High frequency electrotherapy can improve neural function, suppress caspase-3 expression and apoptosis in nerve cells and improve the ultra microstructure of neurons, displaying a protective effect on cerebral I/R injury in rats.

A personality-based latent class typology of outpatients with major depressive disorder: association with symptomatology, prescription pattern and social function.

PubMed

Hori, Hiroaki; Teraishi, Toshiya; Nagashima, Anna; Koga, Norie; Ota, Miho; Hattori, Kotaro; Kim, Yoshiharu; Higuchi, Teruhiko; Kunugi, Hiroshi

2017-08-01

While major depressive disorder (MDD) is considered to be a heterogeneous disorder, the nature of the heterogeneity remains unclear. Studies have attempted to classify patients with MDD using latent variable techniques, yet the empirical approaches to symptom-based subtyping of MDD have not provided conclusive evidence. Here we aimed to identify homogeneous classes of MDD based on personality traits, using a latent profile analysis. We studied 238 outpatients with DSM-IV MDD recruited from our specialized depression outpatient clinic and assessed their dimensional personality traits with the Temperament and Character Inventory. Latent profile analysis was conducted with 7 dimensions of the Temperament and Character Inventory as indicators. Relationships of the identified classes with symptomatology, prescription pattern, and social function were then examined. The latent profile analysis indicated that a 3-class solution best fit the data. Of the sample, 46.2% was classified into a "neurotic" group characterized by high harm avoidance and low self-directedness; 30.3% into an "adaptive" group characterized by high self-directedness and cooperativeness; and 23.5% into a "socially-detached" group characterized by low reward dependence and cooperativeness and high self-transcendence. The 2 maladaptive groups, namely neurotic and socially-detached groups, demonstrated unique patterns of symptom expression, different classes of psychotropic medication use, and lower social functioning. Generalizability of the findings was limited since our patients were recruited from the specialized depression outpatient clinic. Our personality-based latent profile analysis identified clinically meaningful 3 MDD groups that were markedly different in their personality profiles associated with distinct symptomatology and functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

McMaster PLUS: A Cluster Randomized Clinical Trial of an Intervention to Accelerate Clinical Use of Evidence-based Information from Digital Libraries

PubMed Central

Haynes, R. Brian; Holland, Jennifer; Cotoi, Chris; McKinlay, R. James; Wilczynski, Nancy L.; Walters, Leslie A.; Jedras, Dawn; Parrish, Rick; McKibbon, K. Ann; Garg, Amit; Walter, Stephen D.

2006-01-01

Background Physicians have difficulty keeping up with new evidence from medical research. Methods We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point. Results Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group’s usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI −23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups. Conclusion A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians. PMID:16929034

The Effect of Different Chemical Surface Treatments of Denture Teeth on Shear Bond Strength: A Comparative Study

PubMed Central

Palekar, Umesh; Awinashe, Vaibav; Mishra, Sunil Kumar; Kawadkar, Abhishek; Rahangdale, Tripti

2014-01-01

Background: The development of better cross linked acrylic resin teeth has solved the problems related to wearing and discoloration of acrylic teeth. The same cross linking at ridge lap region acts as a double edge sword as it weakens the bond between denture base and tooth. Aim of Study: The purpose of study was to evaluate the effect of surface treatment on the bond strength of resin teeth to denture base resin using monomethyl methacrylate monomer and dichloromethane with no surface treatment acting as control. Settings and Design:Denture base cylinder samples in wax (n=180) were made with maxillary central incisor attached at 450 (JIST 6506). These samples were randomly and equally divided into three groups of 60 each. These specimens were then flasked, dewaxed as per the standard protocol. Materials and Methods: Before acrylization, ridge lap area was treated as follows: Group A- no surface treatment act as control, Group B treated with monomethyl methacrylate monomer, Group C treated with dichloromethane. Digitally controlled acryliser was used for acrylization as per manufacturer’s instructions and shear bond strength was tested on Universal Testing Machine (Servo Hydraulic, 50kN High Strain, BISS Research). Statistical Analysis used: Result was statistically analyzed with One-way analysis of variance (ANOVA) and Post-hoc ANOVA Tukey’s HSD test at 5% level of significance. Results: The application of dichloromethane showed increased bond strength between cross linked acrylic resin teeth and heat cure denture base resin followed by monomethyl methacrylate monomer and control group. Conclusion: The application of dichloromethane on the ridge lap surface of the resin teeth before packing of the dough into the mold significantly increased the bond strength between cross linked acrylic resin teeth and heat cure denture base resin. PMID:25121057

A Custom Made Intrinsic Silicone Shade Guide for Indian Population

PubMed Central

Behanam, Mohammed; Ahila, S.C.; Jei, J. Brintha

2016-01-01

Introduction Replication of natural skin colour in maxillofacial prosthesis has been traditionally done using trial and error method, as concrete shade guides are unavailable till date. Hence a novel custom made intrinsic silicone shade guide has been attempted for Indian population. Aim Reconstruction of maxillofacial defects is challenging, as achieving an aesthetic result is not always easy. A concoction of a novel intrinsic silicone shade guide was contemplated for the study and its reproducibility in clinical practice was analysed. Materials and Methods Medical grade room temperature vulcanising silicone was used for the fabrication of shade tabs. The shade guide consisted of three main groups I, II and III which were divided based upon the hues yellow, red and blue respectively. Five distinct intrinsic pigments were added in definite proportions to subdivide each group of different values from lighter to darker shades. A total number of 15 circular shade tabs comprised the guide. To validate the usage of the guide, visual assessment of colour matching was done by four investigators to investigate the consent of perfect colour correspondence. Data was statistically analysed using kappa coefficients. Results The kappa values were found to be 0.47 to 0.78 for yellow based group I, 0.13 to 0.65 for red based group II, and 0.07 to 0.36 for blue based group III. This revealed that the shade tabs of yellow and red based hues matched well and showed a statistically good colour matching. Conclusion This intrinsic silicone shade guide can be effectively utilised for fabrication of maxillofacial prosthesis with silicone in Indian population. A transparent colour formula with definite proportioning of intrinsic pigments is provided for obtaining an aesthetic match to skin tone. PMID:27190946

Effects of online group exercises for older adults on physical, psychological and social wellbeing: a randomized pilot trial.

PubMed

Baez, Marcos; Khaghani Far, Iman; Ibarra, Francisco; Ferron, Michela; Didino, Daniele; Casati, Fabio

2017-01-01

Intervention programs to promote physical activity in older adults, either in group or home settings, have shown equivalent health outcomes but different results when considering adherence. Group-based interventions seem to achieve higher participation in the long-term. However, there are many factors that can make of group exercises a challenging setting for older adults. A major one, due to the heterogeneity of this particular population, is the difference in the level of skills. In this paper we report on the physical, psychological and social wellbeing outcomes of a technology-based intervention that enable online group exercises in older adults with different levels of skills. A total of 37 older adults between 65 and 87 years old followed a personalized exercise program based on the OTAGO program for fall prevention, for a period of eight weeks. Participants could join online group exercises using a tablet-based application. Participants were assigned either to the Control group, representing the traditional individual home-based training program, or the Social group, representing the online group exercising. Pre- and post- measurements were taken to analyze the physical, psychological and social wellbeing outcomes. After the eight-weeks training program there were improvements in both the Social and Control groups in terms of physical outcomes, given the high level of adherence of both groups. Considering the baseline measures, however, the results suggest that while in the Control group fitter individuals tended to adhere more to the training, this was not the case for the Social group, where the initial level had no effect on adherence. For psychological outcomes there were improvements on both groups, regardless of the application used. There was no significant difference between groups in social wellbeing outcomes, both groups seeing a decrease in loneliness despite the presence of social features in the Social group. However, online social interactions have shown to be correlated to the decrease in loneliness in the Social group. The results indicate that technology-supported online group-exercising which conceals individual differences in physical skills is effective in motivating and enabling individuals who are less fit to train as much as fitter individuals. This not only indicates the feasibility of training together despite differences in physical skills but also suggests that online exercise might reduce the effect of skills on adherence in a social context. However, results from this pilot are limited to a small sample size and therefore are not conclusive. Longer term interventions with more participants are instead recommended to assess impacts on wellbeing and behavior change.

Method variation in the impact of missing data on response shift detection.

PubMed

Schwartz, Carolyn E; Sajobi, Tolulope T; Verdam, Mathilde G E; Sebille, Veronique; Lix, Lisa M; Guilleux, Alice; Sprangers, Mirjam A G

2015-03-01

Missing data due to attrition or item non-response can result in biased estimates and loss of power in longitudinal quality-of-life (QOL) research. The impact of missing data on response shift (RS) detection is relatively unknown. This overview article synthesizes the findings of three methods tested in this special section regarding the impact of missing data patterns on RS detection in incomplete longitudinal data. The RS detection methods investigated include: (1) Relative importance analysis to detect reprioritization RS in stroke caregivers; (2) Oort's structural equation modeling (SEM) to detect recalibration, reprioritization, and reconceptualization RS in cancer patients; and (3) Rasch-based item-response theory-based (IRT) models as compared to SEM models to detect recalibration and reprioritization RS in hospitalized chronic disease patients. Each method dealt with missing data differently, either with imputation (1), attrition-based multi-group analysis (2), or probabilistic analysis that is robust to missingness due to the specific objectivity property (3). Relative importance analyses were sensitive to the type and amount of missing data and imputation method, with multiple imputation showing the largest RS effects. The attrition-based multi-group SEM revealed differential effects of both the changes in health-related QOL and the occurrence of response shift by attrition stratum, and enabled a more complete interpretation of findings. The IRT RS algorithm found evidence of small recalibration and reprioritization effects in General Health, whereas SEM mostly evidenced small recalibration effects. These differences may be due to differences between the two methods in handling of missing data. Missing data imputation techniques result in different conclusions about the presence of reprioritization RS using the relative importance method, while the attrition-based SEM approach highlighted different recalibration and reprioritization RS effects by attrition group. The IRT analyses detected more recalibration and reprioritization RS effects than SEM, presumably due to IRT's robustness to missing data. Future research should apply simulation techniques in order to make conclusive statements about the impacts of missing data according to the type and amount of RS.

Effects of a Prototype Internet Dissonance-Based Eating Disorder Prevention Program at 1- and 2-Year Follow-up

PubMed Central

Stice, Eric; Durant, Shelley; Rohde, Paul; Shaw, Heather

2014-01-01

Objective A group-based eating disorder prevention program wherein young women explore the costs of pursuing the thin ideal reduces eating disorder risk factors and symptoms. However, it can be challenging to identify school clinicians to effectively deliver the intervention. The present study compares the effects of a new Internet-based version of this prevention program, which could facilitate dissemination, to the group-based program and to educational video and educational brochure control conditions at 1- and 2-year follow-up. Method Female college students with body dissatisfaction (N = 107; M age = 21.6 SD = 6.6) were randomized to these four conditions. Results Internet participants showed reductions in eating disorder risk factors and symptoms relative to the two control conditions at 1- and 2-year follow-up (M d = .34 and .17 respectively), but the effects were smaller than parallel comparisons for the group participants (M d = .48 and .43 respectively). Yet the Internet intervention produced large weight gain prevention effects relative to the two control conditions at 1- and 2-year follow-up (M d = .80 and .73 respectively), which were larger than the parallel effects for the group intervention (M d = .19 and .47 respectively). Conclusions Although the effects for the Internet versus group intervention were similar at posttest, results suggest that the effects faded more quickly for the Internet intervention. However, the Internet intervention produced large weight gain prevention effects, implying that it might be useful for simultaneously preventing eating disordered behavior and unhealthy weight gain. PMID:25020152

Essential pediatric hypertension: defining the educational needs of primary care pediatricians

PubMed Central

2014-01-01

Background In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. Methods We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. Results Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. Conclusions There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN. PMID:25063988

EFFECT OF EUGENOL-BASED ENDODONTIC SEALER ON THE ADHESION OF INTRARADICULAR POSTS CEMENTED AFTER DIFFERENT PERIODS

PubMed Central

Dias, Larissa Lustosa Lima; Giovani, Alessandro Rogério; Sousa, Yara Teresinha Corrêa Silva; Vansan, Luiz Pascoal; Alfredo, Edson; Sousa-Neto, Manoel Damião; Paulino, Silvana Maria

2009-01-01

Objective: This study evaluated in vitro the influence of an eugenol-based sealer (EndoFill) on the retention of stainless steel prefabricated posts cemented with zinc phosphate and resin-based (Panavia F) cements after different periods of root canal obturation, using the pull-out test. Material and methods: Sixty upper canines were decoronated and the roots were embedded in resin blocks. The specimens were distributed into 3 groups, according to the period elapsed between canal obturation and post cementation: Group I - immediately; Group II - 72 h and Group III - 4 months. The groups were subdivided according to the type of cement used for post cementation: A - zinc phosphate and B - Panavia F. Following the experimental periods, specimens were subjected to pull- out test in an Instron machine with application of tensile force at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal were recorded (kN) and means were subjected to statistical analysis by 2-way ANOVA and Tukey-Kramer test (α=0.001) Results: There were statistically significant differences (p<0.01) between the posts cemented with zinc phosphate cement (0.2112 kN) and Panavia F (0.0501 kN). However, no statistically significant differences (p>0.05) were found between the three post cementation periods, regardless of the cement. Conclusions: It was concluded that the eugenol-based sealer influenced the tensile strength of the posts cemented with the resin cement, but had no influence on the time waited between root canal obturation and post space preparation/post cementation. PMID:20027430

Cost Analysis of a Home-Based Nurse Care Coordination Program

PubMed Central

Marek, Karen Dorman; Stetzer, Frank; Adams, Scott J; Bub, Linda Denison; Schlidt, Andrea; Colorafi, Karen Jiggins

2014-01-01

Objectives To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost. Design Randomized, controlled, three-arm longitudinal study. Setting Participant homes in a large Midwestern urban area. Participants Older adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414). Intervention A team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group. Measurements To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files. Results Ordinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P = .11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P = .06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group. Conclusion Nurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention. PMID:25482242

Cost-effectiveness of a distance lifestyle counselling programme among overweight employees from a company perspective, ALIFE@Work: a randomized controlled trial.

PubMed

Gussenhoven, A H M; van Wier, M F; Bosmans, J E; Dekkers, J C; van Mechelen, W

2013-01-01

The objective of this study was to determine whether a lifestyle intervention with individual counselling was cost-effective for reducing body weight compared with usual care from a company perspective. Overweight employees were recruited and randomly assigned to the intervention groups, either phone or Internet, or the control group. The intervention was based on a cognitive behavioural approach and addressed physical activity and diet. Self-reported body weight was collected at baseline and 12 months follow-up. Intervention costs and costs of sick leave days based on gross and net lost productivity days (GLPDs/NLPDs) obtained from the participating companies were calculated. Missing data were imputed using multiple imputation techniques. Uncertainty surrounding the differences in costs and the incremental cost-effectiveness ratios (ICER) was estimated by bootstrapping techniques, and presented on cost-effectiveness planes and cost-effectiveness acceptability curves. No statistically significant differences in total costs were found between the intervention groups and control group, though mean total costs in both intervention groups tended to be higher than those in the control group. The ICER of the Internet group compared with the control group was €59 per kilogram of weight loss based on GLPD costs. The probability of cost effectiveness of the Internet intervention was 45% at a willingness-to-pay of €0 per extra kilogram weight loss and 75% at a willingness-to-pay of €1500 per extra kilogram body weight loss. Comparable results were found for the phone intervention. The intervention was not cost effective in comparison with usual care from the company perspective. Due to the large amount of missing data, it is not possible to draw firm conclusions.

Effectiveness of breastfeeding education on the weight of child and self-efficacy of mothers – 2011

PubMed Central

Kamran, Aziz; Shrifirad, Gholamreza; Mirkarimi, Seyed Kamal; Farahani, Abbas

2012-01-01

Background: Breastfeeding is the most natural and essential way for feeding newborn babies. This is an ideal approach for physical and emotional development of babies, as well as for the recovery of mothers. This study was aimed to determine the effect of breastfeeding education based on the health belief model (HBM) toward primiparous women. Materials and Methods: In a case–control group, quasi-experimental study, 88 subjects were allocated in control and experimental groups. Subjects who were assigned to the experimental group were provided a program consisting of group education based on HBM during their prenatal period. Instrument for data gathering was made by the researchers and standard questionnaire from Dennis and Faux for Breastfeeding Self-efficacy Scale (BSES). Baseline interviews were conducted before delivery and follow-up visits were conducted after 30 days and at the fourth month after delivery. Data were analyzed using SPSS (version 16) with c2, independent sample t-tests, and paired t-test. Results: Mean age of pregnant women who participated in the study was 22 ± 3.29 years. After the program, the experimental group had significantly better scores in terms of self-efficacy, knowledge, and attitude scores statistically. In the fourth month, the mean of child weight in the experimental group was significantly higher than that of the control group (P=0.001) and exclusive breastfeeding was significantly higher than in the control group (P=0.007). Conclusion: Prenatal education in this study based on HBM was successful, and knowledge, attitude, self-efficacy, and related indicators improved. The necessity of producing standard education package and education of pregnant mothers, especially in their first pregnancy, by health professionals is perceived. PMID:23555114

Pancreatic Proteolytic Enzyme Therapy Compared With Gemcitabine-Based Chemotherapy for the Treatment of Pancreatic Cancer

PubMed Central

Chabot, John A.; Tsai, Wei-Yann; Fine, Robert L.; Chen, Chunxia; Kumah, Carolyn K.; Antman, Karen A.; Grann, Victor R.

2010-01-01

Purpose Conventional medicine has had little to offer patients with inoperable pancreatic adenocarcinoma; thus, many patients seek alternative treatments. The National Cancer Institute, in 1998, sponsored a randomized, phase III, controlled trial of proteolytic enzyme therapy versus chemotherapy. Because most eligible patients refused random assignment, the trial was changed in 2001 to a controlled, observational study. Methods All patients were seen by one of the investigators at Columbia University, and patients who received enzyme therapy were seen by the participating alternative practitioner. Of 55 patients who had inoperable pancreatic cancer, 23 elected gemcitabine-based chemotherapy, and 32 elected enzyme treatment, which included pancreatic enzymes, nutritional supplements, detoxification, and an organic diet. Primary and secondary outcomes were overall survival and quality of life, respectively. Results At enrollment, the treatment groups had no statistically significant differences in patient characteristics, pathology, quality of life, or clinically meaningful laboratory values. Kaplan-Meier analysis found a 9.7-month difference in median survival between the chemotherapy group (median survival, 14 months) and enzyme treatment groups (median survival, 4.3 months) and found an adjusted-mortality hazard ratio of the enzyme group compared with the chemotherapy group of 6.96 (P < .001). At 1 year, 56% of chemotherapy-group patients were alive, and 16% of enzyme-therapy patients were alive. The quality of life ratings were better in the chemotherapy group than in the enzyme-treated group (P < .01). Conclusion Among patients who have pancreatic cancer, those who chose gemcitabine-based chemotherapy survived more than three times as long (14.0 v 4.3 months) and had better quality of life than those who chose proteolytic enzyme treatment. PMID:19687327

Evaluation of Transtheoretical Model-Based Family Education Among Females of Zahedan (Southeast of Iran)

PubMed Central

Kamalikhah, Tahereh; Rakhshani, Fatemeh; Rahmati Najarkolaei, Fatemeh; Gholian Avval, Mehdi

2015-01-01

Background: It cannot be denied that many improvements in female and child health have been achieved worldwide through international family planning programs. More than half of the females (57%) with unintended pregnancy admitted that they had not used birth control the month before conception. Objectives: The aim of this study was to promote family planning practice among females of Zahedan (southeast of Iran) through the transtheoretical model (TTM). Patients and Methods: The current quasi-experimental study was conducted on 96 eligible females, who were allocated either to the case or the control group and were selected from homes in the border of Zahedan city (southeast of Iran) during 2010. Convenience sampling by door-to-door visits was used for finding eligible cases. A TTM-based self-administrated family planning questionnaire was used for data collection. Participants in the intervention group received education in two groups, based on their stage of change: precontemplation, contemplation, preparation, action, maintenance, and all groups were followed for three months. Results: The result of the chi-square test did not show any significant difference in the stage of change: precontemplation, contemplation, preparation, action, maintenance before education between the control and intervention groups (P = 0.55). After education, subjects in the intervention group moved forward through stage of change and got at least one step closer to the family planning behavior., with this change being significant (P < 0.001), while the movement of participants through stage of change not being significant in control group (P = 1). The results of statistical tests illustrated that the mean knowledge of the intervention group was 7.5 ± 7.1 versus 0.5 ± 4 for the control group (P < 0.001), mean of attitude of the intervention group was 5.5 ± 5.41 versus 0.09 ± 2.04 for the control group (P < 0.001), and practicing family planning methods (P < 0.007) in the intervention group was higher than the control group after education based on TTM. Conclusions: According to this study, the educational plan based on TTM was effective in changing knowledge, attitude, and practice and directing females towards taking action. Moreover, self-efficacy, perceived barriers and benefits are factors that affect the use of family planning methods. PMID:26568846

Yoga based cardiac rehabilitation after coronary artery bypass surgery: One-year results on LVEF, lipid profile and psychological states – A randomized controlled study

PubMed Central

Raghuram, Nagarathna; Parachuri, Venkateshwara Rao; Swarnagowri, M.V.; Babu, Suresh; Chaku, Ritu; Kulkarni, Ravi; Bhuyan, Bhagavan; Bhargav, Hemant; Nagendra, Hongasandra Ramarao

2014-01-01

Objective To compare the long term effects of yoga based cardiac rehabilitation program with only physiotherapy based program as an add-on to conventional rehabilitation after coronary artery bypass grafting (CABG) on risk factors. Methods In this single blind prospective randomized parallel two armed active control study, 1026 patients posted for CABG at Narayana Hrudayalaya Institute of Cardiac Sciences, Bengaluru (India) were screened. Of these, 250 male participants (35–65 years) who satisfied the selection criteria and consented were randomized into two groups. Within and between group comparisons were done at three points of follow up (i.e. 6th week, 6th month, and 12th month) by using Wilcoxon's signed ranks test and Mann Whitney U test respectively. Results Yoga group had significantly (p = 0.001, Mann Whitney) better improvement in LVEF than control group in those with abnormal baseline EF (<53%) after 1 year. There was a better reduction in BMI in the yoga group (p = 0.038, between groups) in those with high baseline BMI (≥23) after 12 months. Yoga group showed significant (p = 0.008, Wilcoxon's) reduction in blood glucose at one year in those with high baseline FBS ≥110 mg/dl. There was significantly better improvement in yoga than the control group in HDL (p = 0.003), LDL (p = 0.01) and VLDL (p = 0.03) in those with abnormal baseline values. There was significantly better improvement (p = 0.02, between groups) in positive affect in yoga group. Within Yoga group, there was significant decrease in perceived stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.001), and negative affect (p = 0.03) while in the control group there was reduction (p = 0.003) only in scores on anxiety. Conclusion Addition of yoga based relaxation to conventional post-CABG cardiac rehabilitation helps in better management of risk factors in those with abnormal baseline values and may help in preventing recurrence. PMID:25443601

Comparative evaluation of border molding, using two different techniques in maxillary edentulous arches - An in vivo study

PubMed Central

Yarapatineni, Rameshbabu; Vilekar, Abhishek; Kumar, J Phani; Kumar, G Ajay; Aravind, Prasad; Kumar, P Anil

2013-01-01

Background: This study was undertaken to compare the retention between sectional border molding using low fusing greenstick compound and single step border molding using condensation silicone (putty) impression material in three stages- A. Immediately following border molding, B. After final impression and C. With the finished permanent denture base. Materials & Methods: In this study evaluation of retentive values of sectional border molding (Group I) (custom impression trays border molded with green stick compound ) and single step border molding (Group II) ( border molding with condensation silicone (putty) impression material ). In both techniques definitive wash impression were made with light body condensation silicone and permanent denture base with heat cure polymerization resin. Results: Group II was significantly higher (mean=8011.43) than Group I (mean=5777.43) in test-A. The t-value (1.5883) infers that there was significant difference between Group I and Group II (p =0.15). Group I was significantly higher (mean=6718.57) than Group II (mean=5224.29) in test -B. The t-value (1.6909) infers that there was significant difference between Group I and Group II (p=0.17). Group II was higher (mean=4025.14) than Group I (mean=3835.07) in test -C. The t-value was 0.1239. But it was found to be statistically insignificant (p=0.005). Conclusion: Within the limitation of this clinical study border molding custom tray with low fusing green stick compound provided similar retention as compared to custom impression tray with condensation silicone in permanent denture base. How to cite this article: Yarapatineni R, Vilekar A, Kumar JP, Kumar GA, Aravind P, Kumar PA. Comparative evaluation of border molding, using two different techniques in maxillary edentulous arches - An in vivo study. J Int Oral Health 2013; 5(6):82-7 . PMID:24453450

Extended follow-up of the CYCLOFA-LUNE trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide or on cyclosporine A.

PubMed

Závada, J; Sinikka Pesicková, S; Rysavá, R; Horák, P; Hrncír, Z; Lukác, J; Rovensky, J; Vítová, J; Havrda, M; Rychlík, I; Böhmova, J; Vlasáková, V; Slatinská, J; Zadrazil, J; Olejárová, M; Tegzova, D; Tesar, V

2014-01-01

Objective To evaluate the extended follow-up of the CYCLOFA-LUNE trial, a randomized prospective trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide (CPH) or cyclosporine A (CyA). Patients and methods Data for kidney function and adverse events were collected by a cross-sectional survey for 38 of 40 patients initially randomized in the CYCLOFA-LUNE trial. Results The median follow-up time was 7.7 years (range 5.0-10.3). Rates of renal impairment and end-stage renal disease, adverse events (death, cardiovascular event, tumor, premature menopause) did not differ between the CPH and CyA group, nor did mean serum creatinine, 24 h proteinuria and SLICC damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. Conclusion An immunosuppressive regimen based on CyA achieved similar clinical results to that based on CPH in the very long term.

Gameplay as a Source of Intrinsic Motivation in a Randomized Controlled Trial of Auditory Training for Tinnitus

PubMed Central

Hoare, Derek J.; Van Labeke, Nicolas; McCormack, Abby; Sereda, Magdalena; Smith, Sandra; Taher, Hala Al; Kowalkowski, Victoria L.; Sharples, Mike; Hall, Deborah A.

2014-01-01

Background Previous studies of frequency discrimination training (FDT) for tinnitus used repetitive task-based training programmes relying on extrinsic factors to motivate participation. Studies reported limited improvement in tinnitus symptoms. Purpose To evaluate FDT exploiting intrinsic motivations by integrating training with computer-gameplay. Methods Sixty participants were randomly assigned to train on either a conventional task-based training, or one of two interactive game-based training platforms over six weeks. Outcomes included assessment of motivation, tinnitus handicap, and performance on tests of attention. Results Participants reported greater intrinsic motivation to train on the interactive game-based platforms, yet compliance of all three groups was similar (∼70%) and changes in self-reported tinnitus severity were not significant. There was no difference between groups in terms of change in tinnitus severity or performance on measures of attention. Conclusion FDT can be integrated within an intrinsically motivating game. Whilst this may improve participant experience, in this instance it did not translate to additional compliance or therapeutic benefit. Trial Registration ClinicalTrials.gov NCT02095262 PMID:25215617

The Japan Lung Cancer Society–Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations in radiotherapy for lung cancer

PubMed Central

Itazawa, Tomoko; Tamaki, Yukihisa; Komiyama, Takafumi; Nishimura, Yasumasa; Nakayama, Yuko; Ito, Hiroyuki; Ohde, Yasuhisa; Kusumoto, Masahiko; Sakai, Shuji; Suzuki, Kenji; Watanabe, Hirokazu; Asamura, Hisao

2017-01-01

The purpose of this study was to develop a consensus-based computed tomographic (CT) atlas that defines lymph node stations in radiotherapy for lung cancer based on the lymph node map of the International Association for the Study of Lung Cancer (IASLC). A project group in the Japanese Radiation Oncology Study Group (JROSG) initially prepared a draft of the atlas in which lymph node Stations 1–11 were illustrated on axial CT images. Subsequently, a joint committee of the Japan Lung Cancer Society (JLCS) and the Japanese Society for Radiation Oncology (JASTRO) was formulated to revise this draft. The committee consisted of four radiation oncologists, four thoracic surgeons and three thoracic radiologists. The draft prepared by the JROSG project group was intensively reviewed and discussed at four meetings of the committee over several months. Finally, we proposed definitions for the regional lymph node stations and the consensus-based CT atlas. This atlas was approved by the Board of Directors of JLCS and JASTRO. This resulted in the first official CT atlas for defining regional lymph node stations in radiotherapy for lung cancer authorized by the JLCS and JASTRO. In conclusion, the JLCS–JASTRO consensus-based CT atlas, which conforms to the IASLC lymph node map, was established. PMID:27609192

The effects of team-based learning techniques on nursing students’ perception of the psycho-social climate of the classroom

PubMed Central

Koohestani, Hamid Reza; Baghcheghi, Nayereh

2016-01-01

Background: Team-based learning is a structured type of cooperative learning that is becoming increasingly more popular in nursing education. This study compares levels of nursing students’ perception of the psychosocial climate of the classroom between conventional lecture group and team-based learning group. Methods: In a quasi-experimental study with pretest-posttest design 38 nursing students of second year participated. One half of the 16 sessions of cardiovascular disease nursing course sessions was taught by lectures and the second half with team-based learning. The modified college and university classroom environment inventory (CUCEI) was used to measure the perception of classroom environment. This was completed after the final lecture and TBL sessions. Results: Results revealed a significant difference in the mean scores of psycho-social climate for the TBL method (Mean (SD): 179.8(8.27)) versus the mean score for the lecture method (Mean (SD): 154.213.44)). Also, the results showed significant differences between the two groups in the innovation (p<0.001), student cohesiveness (p=0.01), cooperation (p<0.001) and equity (p= 0.03) sub-scales scores (p<0.05). Conclusion: This study provides evidence that team-based learning does have a positive effect on nursing students’ perceptions of their psycho-social climate of the classroom. PMID:28210602

Applying Intervention Mapping to develop a community-based intervention aimed at improved psychological and social well-being of unmarried teenage mothers in Uganda.

PubMed

Leerlooijer, Joanne N; Kok, Gerjo; Weyusya, Joseph; Bos, Arjan E R; Ruiter, Robert A C; Rijsdijk, Liesbeth E; Nshakira, Nathan; Bartholomew, Leona K

2014-08-01

Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried teenage mothers in rural Uganda. We used Intervention Mapping (IM) for systematically developing a theory and evidence-based comprehensive health promotion programme. A planning group consisting of community leaders, teenage mothers, staff of a community-based organization and a health promotion professional was involved in the six steps of IM: needs assessment, programme objectives, methods and applications, intervention design, planning for adoption and implementation and planning for evaluation. The programme includes five intervention components: community awareness raising, teenage mother support groups, formal education and income generation, counselling, and advocacy. The intervention components are based on a variety of theoretical methods, including entertainment education, persuasive communication, mobilization of social networks and social action. In conclusion, IM facilitated the planning group to structure the iterative, bottom-up, participatory design of the project in a real-life setting and to use evidence and theory. The article provides suggestions for the planning of support interventions for unmarried teenage mothers. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Safety and efficacy of stenting nonthrombotic iliac vein lesions in octogenarians and nonagenarians in an office setting.

PubMed

Kibrik, Pavel; Eisenberg, Justin; Alsheekh, Ahmad; Rizvi, Syed Ali; Aurshina, Afsha; Marks, Natalie; Hingorani, Anil; Ascher, Enrico

2018-02-01

Objectives Treatment options for venous insufficiency are rapidly evolving in the office setting and include venography, intravascular ultrasound, and venous stenting. Non-thrombotic iliac vein lesions assessment and treatment in an office setting is currently an area of interest. The purpose of this study is to demonstrate the safety and efficacy of evaluating non-thrombotic iliac vein lesion with this office-based procedure in octogenarians and nonagenarians. Methods From January 2012 through December 2013, 300 non-thrombotic iliac vein lesion limbs in 192 patients with venous insufficiency ≥80 years old were evaluated for non-thrombotic iliac vein lesion. Patients were evaluated and treated with venography, intravascular ultrasound, and stent placement for significant lesions demonstrated by greater than 50% diameter or cross-sectional area reduction. Group 1: 168 of these patients were octogenarians; female/male ratio was 1.75:1, bilateral in 89/168 patients (53%), left sided in 131/259 limbs (51%), right sided in 128 limbs (49%), average age 83.5 ± 2.6 years (range 80-89) compared to Group 2: 24 nonagenarians; female/male was 3:1, bilateral in 17/24 patients (70%), left sided in 20/41 limbs (49%), right sided in 21/41 limbs (51%), average age 92.9 ± 2.2 years (range 90-99). Stent related outcomes were evaluated with communication to the patient within 24 h to assess post-procedure pain followed by serial iliocaval ultrasonography. Results Out of the 300 limbs evaluated, in Group 1, 86% of limbs had stents placed compared to 90% in Group 2 and 11% of both groups had two stents placed. Overall improvement in pain, edema, and ulcers was reported in 147 (59%) of octogenarians and 24 (65%) of nonagenarians. There were no surgical site infections, pseudo-aneurysms, arteriovenous fistulas, or femoral artery injuries. No patients required transfusion within three days post-operatively and there were no 30-day mortalities in both sets of patients. Conclusions Our results demonstrate that there is no statistical difference in the outcome of performing venography, intravascular ultrasound, and stent placement in an office-based setting in octogenarians and nonagenarians. Both groups maintained a similar safety profile with low morbidity and mortality. In conclusion, we believe that the treatment of non-thrombotic iliac vein lesion in an office-based setting is safe and efficacious in both groups.

Learning from Simple Ebooks, Online Cases or Classroom Teaching When Acquiring Complex Knowledge. A Randomized Controlled Trial in Respiratory Physiology and Pulmonology

PubMed Central

Worm, Bjarne Skjødt

2013-01-01

Background and Aims E-learning is developing fast because of the rapid increased use of smartphones, tablets and portable computers. We might not think of it as e-learning, but today many new e-books are in fact very complex electronic teaching platforms. It is generally accepted that e-learning is as effective as classroom teaching methods, but little is known about its value in relaying contents of different levels of complexity to students. We set out to investigate e-learning effects on simple recall and complex problem-solving compared to classroom teaching. Methods 63 nurses specializing in anesthesiology were evenly randomized into three groups. They were given internet-based knowledge tests before and after attending a teaching module about respiratory physiology and pulmonology. The three groups was either an e-learning group with eBook teaching material, an e-learning group with case-based teaching or a group with face-to-face case-based classroom teaching. After the module the students were required to answer a post-test. Time spent and the number of logged into the system was also measured. Results For simple recall, all methods were equally effective. For problem-solving, the eCase group achieved a comparable knowledge level to classroom teaching, while textbook learning was inferior to both (p<0.01). The textbook group also spent the least amount of time on acquiring knowledge (33 minutes, p<0.001), while the eCase group spent significantly more time on the subject (53 minutes, p<0.001) and logged into the system significantly more (2.8 vs 1.6, p<0.001). Conclusions E-learning based cases are an effective tool for teaching complex knowledge and problem-solving ability, but future studies using higher-level e-learning are encouraged.Simple recall skills, however, do not require any particular learning method. PMID:24039917

The Distressed Brain: A Group Blind Source Separation Analysis on Tinnitus

PubMed Central

De Ridder, Dirk; Vanneste, Sven; Congedo, Marco

2011-01-01

Background Tinnitus, the perception of a sound without an external sound source, can lead to variable amounts of distress. Methodology In a group of tinnitus patients with variable amounts of tinnitus related distress, as measured by the Tinnitus Questionnaire (TQ), an electroencephalography (EEG) is performed, evaluating the patients' resting state electrical brain activity. This resting state electrical activity is compared with a control group and between patients with low (N = 30) and high distress (N = 25). The groups are homogeneous for tinnitus type, tinnitus duration or tinnitus laterality. A group blind source separation (BSS) analysis is performed using a large normative sample (N = 84), generating seven normative components to which high and low tinnitus patients are compared. A correlation analysis of the obtained normative components' relative power and distress is performed. Furthermore, the functional connectivity as reflected by lagged phase synchronization is analyzed between the brain areas defined by the components. Finally, a group BSS analysis on the Tinnitus group as a whole is performed. Conclusions Tinnitus can be characterized by at least four BSS components, two of which are posterior cingulate based, one based on the subgenual anterior cingulate and one based on the parahippocampus. Only the subgenual component correlates with distress. When performed on a normative sample, group BSS reveals that distress is characterized by two anterior cingulate based components. Spectral analysis of these components demonstrates that distress in tinnitus is related to alpha and beta changes in a network consisting of the subgenual anterior cingulate cortex extending to the pregenual and dorsal anterior cingulate cortex as well as the ventromedial prefrontal cortex/orbitofrontal cortex, insula, and parahippocampus. This network overlaps partially with brain areas implicated in distress in patients suffering from pain, functional somatic syndromes and posttraumatic stress disorder, and might therefore represent a specific distress network. PMID:21998628

Symptoms Associated With Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorders in School-Aged Children Prenatally Exposed to Substances

PubMed Central

Sandtorv, Lisbeth Beate; Fevang, Silje Katrine Elgen; Nilsen, Sondre Aasen; Bøe, Tormod; Gjestad, Rolf; Haugland, Siren; Elgen, Irene Bircow

2018-01-01

Prenatal exposure to substances may influence a child’s neurodevelopment and impact on subsequent mental health. In a hospital-based population of school-aged children prenatally exposed to opiates and a number of illicit substances (n = 57), we evaluated mental health symptoms associated with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) using the Swanson, Nolan, and Pelham Questionnaire, revision IV (SNAP-IV) and the Autism Spectrum Screening Questionnaire (ASSQ) and compared the scores to a reference group which comprised children from the population-based Bergen Child Study (n = 171). Prenatally exposed children had significantly higher SNAP-IV scores associated with ADHD symptoms in both areas of inattention and hyperactivity/impulsivity and also reported a higher ASSQ score related to an increased number of symptoms associated with ASD, compared with the reference group. Of tested predictors of mental health outcomes in the exposed group, the intelligence quotient was a strong predictor of most mental health outcomes, and neonatal abstinence syndrome was a predictor of inattention. In conclusion, prenatally exposed children had more mental health symptoms associated with ADHD and ASD, compared with the reference group. PMID:29618930

Knowledge Gains Following a Child Sexual Abuse Prevention Program Among Urban Students: A Cluster-Randomized Evaluation

PubMed Central

Dauber, Sarah; Tully, Brenda A.; Hamilton, Paige; Smith, Michael J.; Freeman, Katherine

2015-01-01

Objectives. We evaluated a school-based child sexual abuse (CSA) prevention program, Safe Touches, in a low–socioeconomic status, racially diverse sample. Methods. Participants were 492 second- and third-grade students at 6 public elementary schools in New York City. The study period spanned fall 2012 through summer 2014. We cluster-randomized classrooms to the Safe Touches intervention or control groups and assessed outcomes with the Children’s Knowledge of Abuse Questionnaire. Hierarchical models tested change in children’s knowledge of inappropriate and appropriate touch. Results. The intervention group showed significantly greater improvement than the control group on knowledge of inappropriate touch. Children in second grade and children in schools with a greater proportion of students in general (vs special) education showed greater gains than other participants in knowledge of inappropriate touch. We observed no significant change in knowledge of appropriate touch among control or intervention groups. Conclusions. Young children benefited from a school-based, 1-time CSA prevention program. Future research should explore the efficacy of CSA prevention programs with children before the second grade to determine optimal age for participation. PMID:25973809

SU-F-T-250: What Does It Take to Correctly Assess the High Failure Modes of an Advanced Radiotherapy Procedure Such as Stereotactic Body Radiation Therapy?

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

Han, D; Vile, D; Rosu, M

Purpose: Assess the correct implementation of risk-based methodology of TG 100 to optimize quality management and patient safety procedures for Stereotactic Body Radiation Therapy. Methods: A detailed process map of SBRT treatment procedure was generated by a team of three physicists with varying clinical experience at our institution to assess the potential high-risk failure modes. The probabilities of occurrence (O), severity (S) and detectability (D) for potential failure mode in each step of the process map were assigned by these individuals independently on the scale from1 to 10. The risk priority numbers (RPN) were computed and analyzed. The highest 30more » potential modes from each physicist’s analysis were then compared. Results: The RPN values assessed by the three physicists ranged from 30 to 300. The magnitudes of the RPN values from each physicist were different, and there was no concordance in the highest RPN values recorded by three physicists independently. The 10 highest RPN values belonged to sub steps of CT simulation, contouring and delivery in the SBRT process map. For these 10 highest RPN values, at least two physicists, irrespective of their length of experience had concordance but no general conclusions emerged. Conclusion: This study clearly shows that the risk-based assessment of a clinical process map requires great deal of preparation, group discussions, and participation by all stakeholders. One group albeit physicists cannot effectively implement risk-based methodology proposed by TG100. It should be a team effort in which the physicists can certainly play the leading role. This also corroborates TG100 recommendation that risk-based assessment of clinical processes is a multidisciplinary team effort.« less

Changing Names with Changed Address: Integrated Taxonomy and Species Delimitation in the Holarctic Colymbetes paykulli Group (Coleoptera: Dytiscidae)

PubMed Central

Drotz, Marcus K.; Brodin, Tomas; Nilsson, Anders N.

2015-01-01

Species delimitation of geographically isolated forms is a long-standing problem in less studied insect groups. Often taxonomic decisions are based directly on morphologic variation, and lack a discussion regarding sample size and the efficiency of migration barriers or dispersal/migration capacity of the studied species. These problems are here exemplified in a water beetle complex from the Bering Sea region that separates North America from Eurasia. Only a few sampled specimens occur from this particular area and they are mostly found in museum and private collections. Here we utilize the theory of integrated taxonomy to discuss the speciation of the Holarctic Colymbetes paykulli water beetle complex, which historically has included up to five species of which today only two are recognized. Three delimitation methods are used; landmark based morphometry of body shape, variation in reticulation patterns of the pronotum exo-skeleton and sequence variation of the partial mitochondrial gene Cyt b. Our conclusion is that the Palearctic and Nearctic populations of C. paykulli are given the status of separate species, based on the fact that all methods showed significant separation between populations. As a consequence the name of the Palearctic species is C. paykulli Erichson and the Nearctic species should be known as C. longulus LeConte. There is no clear support for delineation between Palearctic and Nearctic populations of C. dahuricus based on mtDNA. However, significant difference in size and reticulation patterns from the two regions is shown. The combined conclusion is that the C. dahuricus complex needs a more thorough investigation to fully disentangle its taxonomic status. Therefore it is here still regarded as a Holarctic species. This study highlights the importance to study several diagnosable characters that has the potential to discriminate evolutionary lineage during speciation. PMID:26619278

Lessons Learned: Cultural and linguistic enhancement of surveys through community-based participatory research

PubMed Central

Formea, Christine M.; Mohamed, Ahmed A.; Hassan, Abdullahi; Osman, Ahmed; Weis, Jennifer A.; Sia, Irene G.; Wieland, Mark L.

2014-01-01

Background Surveys are frequently implemented in community-based participatory research (CBPR), but adaptation and translation of surveys can be logistically and methodologically challenging when working with immigrant and refugee populations. Objective To describe a process of participatory survey adaptation and translation. Methods Within an established CBPR partnership, a survey about diabetes was adapted for health literacy and local relevance and then translated through a process of forward translation, group deliberation, and back translation. Lessons Learned The group deliberation process was the most time-intensive and important component of the process. The process enhanced community ownership of the larger project while maximizing local applicability of the product. Conclusions A participatory process of survey adaptation and translation resulted in significant revisions to approximate semantic, cultural, and conceptual equivalence with the original surveys. This approach is likely to enhance community acceptance of the survey instrument during the implementation phase. PMID:25435559

Issues and Challenges in the Design of Culturally Adapted Evidence-Based Interventions

PubMed Central

Castro, Felipe González; Barrera, Manuel; Holleran Steiker, Lori K.

2014-01-01

This article examines issues and challenges in the design of cultural adaptations that are developed from an original evidence-based intervention (EBI). Recently emerging multistep frameworks or stage models are examined, as these can systematically guide the development of culturally adapted EBIs. Critical issues are also presented regarding whether and how such adaptations may be conducted, and empirical evidence is presented regarding the effectiveness of such cultural adaptations. Recent evidence suggests that these cultural adaptations are effective when applied with certain subcultural groups, although they are less effective when applied with other subcultural groups. Generally, current evidence regarding the effectiveness of cultural adaptations is promising but mixed. Further research is needed to obtain more definitive conclusions regarding the efficacy and effectiveness of culturally adapted EBIs. Directions for future research and recommendations are presented to guide the development of a new generation of culturally adapted EBIs. PMID:20192800

The State as Community in Community-based Participatory Research

PubMed Central

Goold, Susan Dorr; Rowe, Zachary; Szymecko, Lisa; Coombe, Chris; Danis, Marion; Hammad, Adnan; Calhoun, Karen; Salman, Cengiz

2017-01-01

Background Community-based participatory research (CBPR) typically defines communities by geography, ethnicity, shared health needs, or some combination. Objectives We describe a CBPR project aiming to engage diverse minority and underserved communities throughout Michigan in deliberations about health research priorities. Methods A Steering Committee (SC) with 15 members from minority and underserved communities, and 4 members from research organizations led the project, with the help of regional advisory groups (RAGs) formed at the SC’s request. Evaluation of the SC used questionnaires, focused group discussion, and review of SC meetings to describe engagement, partnership, and communication. Lessons Learned An academic-community partnership with a diverse, dispersed and broadly defined community found value in RAGs, dedicated academic staff, face-to-face meetings, varied communication modalities, capacity building tailored to varying levels of CBPR experience, and ongoing evaluation. Conclusions A geographically and culturally diverse partnership presents challenges and opportunities in representativeness, relationship building, capacity building, and communication. PMID:28569676

Improving Foster Parent Engagement: Using Qualitative Methods to Guide Tailoring of Evidence-based Engagement Strategies

PubMed Central

Conover, Kate L.; Cox, Julia Revillion

2014-01-01

Objective This qualitative study examined applicability and need for tailoring of an evidence-based engagement intervention, combined with Trauma-focused Cognitive Behavioral Therapy, for foster parents. Method Qualitative methods were used, including individual interviews with participating foster parents (N = 7), review of interview findings with an independent group of foster parents (N = 5), and review of the combined foster parent findings by child welfare caseworkers (N = 5), an important stakeholder group. Results The engagement intervention, with its primary focus on perceptual barriers (e.g., past experiences with mental health), was relevant for the foster care population. However, the study identified areas for tailoring to better recognize and address the unique needs and situation of foster parents as substitute caregivers. Conclusions Perceptually-focused engagement interventions may have broad applicability to a range of populations, including foster parents, with the potential for improving caregiver participation in children’s mental health services. PMID:24611600

Age estimation of living Indian individuals based on aspartic acid racemization from tooth biopsy specimen

PubMed Central

Rastogi, Manu; Logani, Ajay; Shah, Naseem; Kumar, Abhishek; Arora, Saurabh

2017-01-01

Background: Age estimation in living individuals is imperative to amicably settle civil and criminal disputes. A biochemical method based on amino acid racemization was evaluated for age estimation of living Indian individuals. Design: Caries-free maxillary/mandibular premolar teeth (n = 90) were collected from participants with age proof documents and divided into predefined nine age groups. Materials and Methods: Dentine biopsy from the labial aspect of the tooth crown was taken with an indigenously developed microtrephine. The samples were processed and subjected to gas chromatography. Dextrorotatory:levorotatory ratios were calculated, and a regression equation was formulated. Results: Across all age groups, an error of 0 ± 4 years between protein racemization age and chronological age was observed. Conclusion: Aspartic acid racemization from dentine biopsy samples could be a viable and accurate technique for age estimation of living individuals who have attained a state of skeletal maturity. PMID:29263613

Randomized Placebo-Controlled Double-Blind Clinical Trial of Cannabis-Based Medicinal Product (Sativex) in Painful Diabetic Neuropathy

PubMed Central

Selvarajah, Dinesh; Gandhi, Rajiv; Emery, Celia J.; Tesfaye, Solomon

2010-01-01

OBJECTIVE To assess the efficacy of Sativex, a cannabis-based medicinal extract, as adjuvant treatment in painful diabetic peripheral neuropathy (DPN). RESEARCH DESIGN AND METHODS In this randomized controlled trial, 30 subjects with painful DPN received daily Sativex or placebo. The primary outcome measure was change in mean daily pain scores, and secondary outcome measures included quality-of-life assessments. RESULTS There was significant improvement in pain scores in both groups, but mean change between groups was not significant. There were no significant differences in secondary outcome measures. Patients with depression had significantly greater baseline pain scores that improved regardless of intervention. CONCLUSIONS This first-ever trial assessing the efficacy of cannabis has shown it to be no more efficacious than placebo in painful DPN. Depression was a major confounder and may have important implications for future trials on painful DPN. PMID:19808912

Implications of Posttraumatic Stress Among Military-Affiliated and Civilian Students

PubMed Central

Barry, Adam E.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.

2012-01-01

Objectives Determine whether posttraumatic stress symptoms (PTS) are associated with problem drinking and alcohol-related consequences, as well as academic correlates among military-affiliated and civilian students. Participants Final sample (n = 248) included 78 combat exposed student service members/veterans, 53 non-combat exposed student service members/veterans, 38 ROTC students, and 79 civilian students. Method Self-report data was collected spring 2011 via a web-based survey measuring PTS, problem drinking, alcohol-related consequences, GPA, educational self-efficacy, academic amotivation and persistence. Results Military students exposed to combat-related trauma reported significantly greater PTS symptoms than other military and civilian groups. PTS symptoms were associated with problem drinking and alcohol-related consequences for all groups, yet unrelated to academic correlates among those exposed to combat-related trauma. Conclusions This study adds to the scant literature base exploring the unique characteristics of student service members/veterans in higher education. PMID:23157198

Introductory Statistics Students' Conceptual Understanding of Study Design and Conclusions

NASA Astrophysics Data System (ADS)

Fry, Elizabeth Brondos

Recommended learning goals for students in introductory statistics courses include the ability to recognize and explain the key role of randomness in designing studies and in drawing conclusions from those studies involving generalizations to a population or causal claims (GAISE College Report ASA Revision Committee, 2016). The purpose of this study was to explore introductory statistics students' understanding of the distinct roles that random sampling and random assignment play in study design and the conclusions that can be made from each. A study design unit lasting two and a half weeks was designed and implemented in four sections of an undergraduate introductory statistics course based on modeling and simulation. The research question that this study attempted to answer is: How does introductory statistics students' conceptual understanding of study design and conclusions (in particular, unbiased estimation and establishing causation) change after participating in a learning intervention designed to promote conceptual change in these areas? In order to answer this research question, a forced-choice assessment called the Inferences from Design Assessment (IDEA) was developed as a pretest and posttest, along with two open-ended assignments, a group quiz and a lab assignment. Quantitative analysis of IDEA results and qualitative analysis of the group quiz and lab assignment revealed that overall, students' mastery of study design concepts significantly increased after the unit, and the great majority of students successfully made the appropriate connections between random sampling and generalization, and between random assignment and causal claims. However, a small, but noticeable portion of students continued to demonstrate misunderstandings, such as confusion between random sampling and random assignment.

Three treatments for bilingual children with primary language impairment: Examining cross-linguistic and cross-domain effects

PubMed Central

Ebert, Kerry Danahy; Kohnert, Kathryn; Pham, Giang; Disher, Jill Rentmeester; Payesteh, Bita

2014-01-01

Purpose This study examines the absolute and relative effects of three different treatment programs for school-aged bilingual children with primary or specific language impairment (PLI). It serves to expand the evidence base on which service providers can base treatment decisions. It also explores hypothesized relations between languages and cognition in bilinguals with PLI. Method Fifty-nine school-aged Spanish-English bilingual children with PLI were assigned to receive nonlinguistic cognitive processing, English, bilingual (Spanish-English), or deferred treatment. Participants in each of the three active treatments received treatment administered by nationally certified speech-language pathologists. Pre- and post-treatment assessments measured change in nonlinguistic cognitive processing, English, and Spanish skills, and analyses examined change within and across both treatment groups and skill domains. Results All active treatment groups made significant pre- to post-treatment improvement on multiple outcome measures. There were fewer significant changes in Spanish than in English across groups. Between group comparisons indicate that the active treatment groups generally outperformed the deferred treatment control, reaching statistical significance for two tasks. Conclusions Results provide insight into cross-language transfer in bilingual children and advance understanding of the general PLI profile with respect to relationships between basic cognitive processing and higher level language skills. PMID:23900032

Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions

PubMed Central

Sonmez, Hayriye; Sari, Saziye

2016-01-01

Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing. PMID:27957486

Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions.

PubMed

Arikan, Volkan; Sonmez, Hayriye; Sari, Saziye

2016-01-01

Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing.

Effect of maltitol-containing chewing gum use on the composition of dental plaque microbiota in subjects with active dental caries.

PubMed

Prosdocimi, Erica M; Kistler, James O; Moazzez, Rebecca; Thabuis, Clementine; Perreau, Caroline; Wade, William G

2017-01-01

Background : Sugar alcohols such as xylitol are incorporated in a number of oral hygiene products for their anti-cariogenic properties while chewing gum is known to be beneficial to oral hygiene. Objective : The aim of this study was to determine the composition of the dental plaque microbiota in patients with active caries before and after using a chewing gum supplemented with maltitol. Design : Forty subjects with active caries were randomly allocated to chew maltitol gum or gum base for two weeks. A healthy control group used gum base for two weeks. Plaque samples were collected before and after treatment and the microbiota analysed by pyrosequencing of 16S rRNA genes. Results : A total of 773,547 sequences were obtained from 117 samples. There was no difference in structure of the bacterial communities between groups (AMOVA). There was a significant difference in community membership between groups, (AMOVA, p=0.009). There was a significant difference between the control group after treatment and the maltitol patient group after treatment (p<0.001). A. naeslundii HOT-176 and Actinomyces HOT-169 were significantly reduced following use of maltitol chewing gum in patients. Conclusions : This study has shown that chewing gum containing maltitol had minor effects on the composition of the plaque microbiome.

Prediction/discussion-based learning cycle versus conceptual change text: comparative effects on students' understanding of genetics

NASA Astrophysics Data System (ADS)

khawaldeh, Salem A. Al

2013-07-01

Background and purpose: The purpose of this study was to investigate the comparative effects of a prediction/discussion-based learning cycle (HPD-LC), conceptual change text (CCT) and traditional instruction on 10th grade students' understanding of genetics concepts. Sample: Participants were 112 10th basic grade male students in three classes of the same school located in an urban area. The three classes taught by the same biology teacher were randomly assigned as a prediction/discussion-based learning cycle class (n = 39), conceptual change text class (n = 37) and traditional class (n = 36). Design and method: A quasi-experimental research design of pre-test-post-test non-equivalent control group was adopted. Participants completed the Genetics Concept Test as pre-test-post-test, to examine the effects of instructional strategies on their genetics understanding. Pre-test scores and Test of Logical Thinking scores were used as covariates. Results: The analysis of covariance showed a statistically significant difference between the experimental and control groups in the favor of experimental groups after treatment. However, no statistically significant difference between the experimental groups (HPD-LC versus CCT instruction) was found. Conclusions: Overall, the findings of this study support the use of the prediction/discussion-based learning cycle and conceptual change text in both research and teaching. The findings may be useful for improving classroom practices in teaching science concepts and for the development of suitable materials promoting students' understanding of science.

Ethics of Health Research in Communities: Perspectives From the Southwestern United States

PubMed Central

Williams, Robert L.; Willging, Cathleen E.; Quintero, Gilbert; Kalishman, Summers; Sussman, Andrew L.; Freeman, William L.

2010-01-01

PURPOSE The increasing attention paid to community-based research highlights the question of whether human research protections focused on the individual are adequate to safeguard communities. We conducted a study to explore how community members perceive low-risk health research, the adequacy of human research protection processes, and the ethical conduct of community-based research. METHODS Eighteen focus groups were conducted among rural and urban Hispanic and Native American communities in New Mexico using a semistructured guide. Group transcriptions were analyzed using iterative readings and coding, with review of the analytic summary by group members. RESULTS Although participants recognized the value of health research, many also identified several adverse effects of research in their communities, including social (community and individual labeling, stigmatization, and discrimination) and economic (community job losses, increased insurance rates, and loss of community income). A lack of community beneficence was emphasized by participants who spoke of researchers who fail to communicate results adequately or assist with follow-through. Many group members did not believe current human research and data privacy processes were adequate to protect or assist communities. CONCLUSIONS Ethical review of community-based health research should apply the Belmont principles to communities. Researchers should adopt additional approaches to community-based research by engaging communities as active partners throughout the research process, focusing on community priorities, and taking extra precautions to assure individual and community privacy. Plans for meaningful dissemination of results to communities should be part of the research design. PMID:20843885

Assessment formats in dental medicine: An overview

PubMed Central

Gerhard-Szep, Susanne; Güntsch, Arndt; Pospiech, Peter; Söhnel, Andreas; Scheutzel, Petra; Wassmann, Torsten; Zahn, Tugba

2016-01-01

Aim: At the annual meeting of German dentists in Frankfurt am Main in 2013, the Working Group for the Advancement of Dental Education (AKWLZ) initiated an interdisciplinary working group to address assessments in dental education. This paper presents an overview of the current work being done by this working group, some of whose members are also actively involved in the German Association for Medical Education's (GMA) working group for dental education. The aim is to present a summary of the current state of research on this topic for all those who participate in the design, administration and evaluation of university-specific assessments in dentistry. Method: Based on systematic literature research, the testing scenarios listed in the National Competency-based Catalogue of Learning Objectives (NKLZ) have been compiled and presented in tables according to assessment value. Results: Different assessment scenarios are described briefly in table form addressing validity (V), reliability (R), acceptance (A), cost (C), feasibility (F), and the influence on teaching and learning (EI) as presented in the current literature. Infoboxes were deliberately chosen to allow readers quick access to the information and to facilitate comparisons between the various assessment formats. Following each description is a list summarizing the uses in dental and medical education. Conclusion: This overview provides a summary of competency-based testing formats. It is meant to have a formative effect on dental and medical schools and provide support for developing workplace-based strategies in dental education for learning, teaching and testing in the future. PMID:27579365

The Alignment and Blending of Payment Incentives within Physician Organizations

PubMed Central

Robinson, James C; Shortell, Stephen M; Li, Rui; Casalino, Lawrence P; Rundall, Thomas

2004-01-01

Objective To analyze the blend of retrospective (fee-for-service, productivity-based salary) and prospective (capitation, nonproductivity-based salary) methods for compensating individual physicians within medical groups and independent practice associations (IPAs) and the influence of managed care on the compensation blend used by these physician organizations. Data Sources Of the 1,587 medical groups and IPAs with 20 or more physicians in the United States, 1,104 responded to a one-hour telephone survey, with 627 providing detailed information on physician payment methods. Study Design We calculated the distribution of compensation methods for primary care and specialty physicians, separately, in both medical groups and IPAs. Multivariate regression methods were used to analyze the influence of market and organizational factors on the payment method developed by physician organizations for individual physicians. Principal Findings Within physician organizations, approximately one-quarter of physicians are paid on a purely retrospective (fee-for-service) basis, approximately one-quarter are paid on a purely prospective (capitation, nonproductivity-based salary) basis, and approximately one-half on blends of retrospective and prospective methods. Medical groups and IPAs in heavily penetrated managed care markets are significantly less likely to pay their individual physicians based on fee-for-service than are organizations in less heavily penetrated markets. Conclusions Physician organizations rely on a wide range of prospective, retrospective, and blended payment methods and seek to align the incentives faced by individual physicians with the market incentives faced by the physician organization. PMID:15333124

Blended learning approach improves teaching in a problem-based learning environment in orthopedics - a pilot study

PubMed Central

2014-01-01

Background While e-learning is enjoying increasing popularity as adjunct in modern teaching, studies on this topic should shift from mere evaluation of students’ satisfaction towards assessing its benefits on enhancement of knowledge and skills. This pilot study aimed to detect the teaching effects of a blended learning program on students of orthopedics and traumatology in the context of a problem-based learning environment. Methods The project NESTOR (network for students in traumatology and orthopedics) was offered to students in a problem-based learning course. Participants completed written tests before and directly after the course, followed by a final written test and an objective structured clinical examination (OSCE) as well as an evaluation questionnaire at the end of the semester. Results were compared within the group of NESTOR users and non-users and between these two groups. Results Participants (n = 53) rated their experiences very positively. An enhancement in knowledge was found directly after the course and at the final written test for both groups (p < 0.001). NESTOR users scored higher than non-users in the post-tests, while the OSCE revealed no differences between the groups. Conclusions This pilot study showed a positive effect of the blended learning approach on knowledge enhancement and satisfaction of participating students. However, it will be an aim for the future to further explore the chances of this approach and internet-based technologies for possibilities to improve also practical examination skills. PMID:24690365

School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009–2014

PubMed Central

Msakni, Zineb; Zammit, Nawel; Bhiri, Sana; Harrabi, Imed; Boughammoura, Lamia; Slama, Slim; Larbi, Chaieb; Ghannem, Hassen

2015-01-01

Introduction Combating obesity at an early age, by improving physical activity and nutrition-related behaviors, is vital to the prevention of more critical health concerns in adulthood. This intervention study evaluated the effectiveness of a school-based component of a community behavioral intervention on overweight and obesity rates of adolescents in Sousse, Tunisia. Methods A quasi-experimental school-based intervention was conducted with an intervention group (in Sousse Jawhara and Sousse Riadh) and a control group (in Sousse Msaken). The intervention (which was a physical activity and nutrition program) lasted 3 years, with data at preintervention collected during the 2009–2010 school year and at postintervention collected during the 2013–2014 school year. Descriptive statistics and multivariate analysis were used to determine the effect of the intervention on risk of excess weight. Results Results showed a significant increase in fruit and vegetable intake by the intervention group (P = .04). The intervention group had an increase in students in the normal weight category (P = .03) and a decrease in students in the overweight category (P = .03).The intervention effect was a protective factor against excess weight for the participating schoolchildren (OR, 0.84; P = .02). Conclusion This study showed that a school-based intervention is successful in increasing healthy dietary habits and in reducing risk of excess weight. It also showed the importance of a multisectoral approach to provide an environment conducive to healthy behaviors for adolescents. PMID:26402050

Long Duration Exposure Facility mini-data base user`s guide: IBM-compatible PC computer version. (Diskette)

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

Bohnhoff-Hlavacek, G.; Pippin, G.; Dursch, H.

1995-04-01

One of the objectives of the LDEF Special Investigation Group (SIG) was to develop a LDEF data base that identifies the experiment objectives and hardware flown, summarizes results and conclusions, and provides a system analysis overview which would include spacecraft design guidelines and space environmental effects. Compiling this information into an easily accessible data base format and making it available to the space community was a major task accomplished by the System and Materials SIG effort beginning in 1991. Included in this document is a short user`s manual for the LDEF Mini-Data Bases. The user`s manual contains pertinent examples frommore » the data base on specifically how to access and work with the LDEF information. Accompanying this document are the mini-data bases on disk.« less

Prefrontal cortex dysfunction and 'Jumping to Conclusions': bias or deficit?

PubMed

Lunt, Laura; Bramham, Jessica; Morris, Robin G; Bullock, Peter R; Selway, Richard P; Xenitidis, Kiriakos; David, Anthony S

2012-03-01

The 'beads task' is used to measure the cognitive basis of delusions, namely the 'Jumping to Conclusions' (JTC) reasoning bias. However, it is not clear whether the task merely taps executive dysfunction - known to be impaired in patients with schizophrenia - such as planning and resistance to impulse. To study this, 19 individuals with neurosurgical excisions to the prefrontal cortex, 21 unmedicated adults with Attention Deficit Hyperactivity Disorder (ADHD), and 25 healthy controls completed two conditions of the beads task, in addition to tests of memory and executive function as well as control tests of probabilistic reasoning ability. The results indicated that the prefrontal lobe group (in particular, those with left-sided lesions) demonstrated a JTC bias relative to the ADHD and control groups. Further exploratory analyses indicated that JTC on the beads task was associated with poorer performance in certain executive domains. The results are discussed in terms of the executive demands of the beads task and possible implications for the model of psychotic delusions based on the JTC bias. ©2011 The British Psychological Society.

Isolated development of inner (wall) caries like lesions in a bacterial-based in vitro model.

PubMed

Diercke, K; Lussi, A; Kersten, T; Seemann, R

2009-12-01

The study conducted in a bacterial-based in vitro caries model aimed to determine whether typical inner secondary caries lesions can be detected at cavity walls of restorations with selected gap widths when the development of outer lesions is inhibited. Sixty bovine tooth specimens were randomly assigned to the following groups: test group 50 (TG50; gap, 50 microm), test group 100 (TG100; gap, 100 microm), test group 250 (TG250; gap, 250 microm) and a control group (CG; gap, 250 microm). The outer tooth surface of the test group specimens was covered with an acid-resistant varnish to inhibit the development of an outer caries lesion. After incubation in the caries model, the area of demineralization at the cavity wall was determined by confocal laser scanning microscopy. All test group specimens demonstrated only wall lesions. The CG specimens developed outer and wall lesions. The TG250 specimens showed significantly less wall lesion area compared to the CG (p < 0.05). In the test groups, a statistically significant increase (p < 0.05) in lesion area could be detected in enamel between TG50 and TG250 and in dentine between TG50 and TG100. In conclusion, the inner wall lesions of secondary caries can develop without the presence of outer lesions and therefore can be regarded as an entity on their own. The extent of independently developed wall lesions increased with gap width in the present setting.

Effects of Nursing Care Based on Watson's Theory of Human Caring on Anxiety, Distress, And Coping, When Infertility Treatment Fails: A Randomized Controlled Trial.

PubMed

Durgun Ozan, Yeter; Okumuş, Hülya

2017-06-01

Introduction: The failure of infertility treatment leads to individual, familial, and social problems. The objective of this study was to evaluate the effectiveness of the nursing care program based on Watson's "Theory of Human Caring" on anxiety and distress caused by coping when the treatment fails. Methods: This study randomized controlled trial study was conducted from April to November 2012, with 86 Turkish women with infertility (intervention group: 45, control group: 41). Follow-up of 32 infertile women, who failed infertility treatment from intervention group, and 35 infertile women, who failed infertility treatment from control group, continued for another four weeks. Data were collected through Spiel Berger's State/Trait Anxiety Inventory, Distress Scale, and Ways of Coping Questionnaire. The analyses of data were conducted using SPSS ver 13. Results: The intervention and control groups significantly differed in terms of anxiety, distress, and coping levels. The intervention group's mean anxiety score decreased by thirteen points and distress by fourteen points (in a positive direction). The intervention group's mean positive coping style score increased. Whereas a negative increase was observed in the control group's values depending on the failure of the treatment. Conclusion: Watson's theory of human caring is recommended as a guide to nursing patients with infertility treatment to decrease levels of anxiety and distress, and to increase the positive coping style among infertile women.

Wound healing activity of Sida cordifolia Linn. in rats

PubMed Central

Pawar, Rajesh S.; Chaurasiya, Pradeep K.; Rajak, Harish; Singour, Pradeep K.; Toppo, Fedelic Ashish; Jain, Ankit

2013-01-01

Introduction: The present study provides a scientific evaluation for the wound healing potential of ethanolic (EtOH) extract of Sida cordifolia Linn. (SCL) plant. Materials and Methods: Excision, incision and burn wounds were inflicted upon three groups of six rats each. Group I was assigned as control (ointment base). Group II was treated with 10% EtOH extract ointment. Group III was treated with standard silver sulfadiazine (0.01%) cream. The parameters observed were percentage of wound contraction, epithelialization period, hydroxyproline content, tensile strength including histopathological studies. Result: It was noted that the effect produced by the ethanolic extract of SCL ointment showed significant (P < 0.01) healing in all wound models when compared with the control group. All parameters such as wound contraction, epithelialization period, hydroxyproline content, tensile strength and histopathological studies showed significant (P < 0.01) changes when compared with the control. Conclusion: The ethanolic extract ointment of SCL effectively stimulates wound contraction; increases tensile strength of excision, incision and burn wounds. PMID:24130382

Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

PubMed Central

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

2016-01-01

Background Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. Method In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Main Outcome Measures Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. Results We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. Conclusion The results suggest that occupational therapy using the ADOC for older residents might be effective and cost-effective. We also found that conducting an RCT in the occupational therapy setting is feasible. Trial Registration UMIN Clinical Trials Registry UMIN000012994 PMID:26930191

Jamaican Mothers’ Influences of Adolescent Girls’ Sexual Beliefs and Behaviors

PubMed Central

Hutchinson, M. Katherine; Kahwa, Eulalia; Waldron, Norman; Brown, Cerese Hepburn; Hamilton, Pansy I.; Hewitt, Hermi H.; Aiken, Joyette; Cederbaum, Julie; Alter, Emily; Jemmott, Loretta Sweet

2012-01-01

Purpose The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters’ sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. Design Focus groups were conducted with 46 14- to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. Findings Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers’ and daughters’ reports were consistent; both groups identified positive and negative influences within each category. Conclusions Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. Clinical Relevance In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design. PMID:22339731

An Internet-based program for depressive symptoms using human and automated support: a randomized controlled trial

PubMed Central

Mira, Adriana; Bretón-López, Juana; García-Palacios, Azucena; Quero, Soledad; Baños, Rosa María; Botella, Cristina

2017-01-01

Purpose The purpose of this study was to analyze the efficacy of an Internet-based program for depressive symptoms using automated support by information and communication technologies (ICTs) and human support. Patients and methods An Internet-based program was used to teach adaptive ways to cope with depressive symptoms and daily problems. A total of 124 participants who were experiencing at least one stressful event that caused interference in their lives, many of whom had clinically significant depressive symptoms, were randomly assigned into either an intervention group with ICT support (automated mobile phone messages, automated emails, and continued feedback through the program); an intervention group with ICT support plus human support (brief weekly support phone call without clinical content); or a waiting-list control. At pre-, post-, and 12-month follow-up, they completed depression, anxiety, positive and negative effect, and perceived stress measures. Results were analyzed using both intention-to-treat and completers data. The majority were women (67.7%), with a mean age of 35.6 years (standard deviation =9.7). Results The analysis showed that the two intervention groups improved significantly pre- to posttreatment, compared with the control group. Furthermore, improvements were maintained at the 12-month follow-up. Adherence and satisfaction with the program was high in both conditions. Conclusion The Internet-based program was effective and well accepted, with and without human support, showing that ICT-based automated support may be useful. It is essential to continue to study other ICT strategies for providing support. PMID:28408833

Pilot Randomized Controlled Trial of a Mindfulness-Based Group Intervention in Adolescent Girls at Risk for Type 2 Diabetes with Depressive Symptoms

PubMed Central

Shomaker, Lauren B.; Bruggink, Stephanie; Pivarunas, Bernadette; Skoranski, Amanda; Foss, Jillian; Chaffin, Ella; Dalager, Stephanie; Annameier, Shelly; Quaglia, Jordan; Brown, Kirk Warren; Broderick, Patricia; Bell, Christopher

2017-01-01

Objective (1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Design and setting Parallel-group, randomized controlled pilot trial conducted at a university. Participants Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Interventions Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Main outcome measures Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Results Most adolescents attended ≥80% sessions (mindfulness:92% versus cognitive-behavioral:87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). Conclusions A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. PMID:28619307

A Randomized Trial of a Web-based Intervention to Improve Migraine Self-Management and Coping

PubMed Central

Bromberg, Jonas; Wood, Mollie E.; Black, Ryan A.; Surette, Daniel A.; Zacharoff, Kevin L.; Chiauzzi, Emil J.

2011-01-01

Objective Test the clinical efficacy of a web-based intervention designed to increase patient self-efficacy to perform headache self-management activities and symptom management strategies; and reduce migraine-related psychological distress. Background In spite of their demonstrated efficacy, behavioral interventions are used infrequently as an adjunct in medical treatment of migraine. Little clinical attention is paid to the behavioral factors that can help manage migraine more effectively, improve the quality of care, and improve quality of life. Access to evidenced-based, tailored, behavioral treatment is limited for many people with migraine. Design The study is a parallel group design with two conditions, (1) an experimental group exposed to the web intervention, and (2) a no-treatment control group that was not exposed to the intervention. Assessments for both groups were conducted at baseline (T1), 1-month (T2), 3-months (T3), and 6-months (T4). Results Compared to controls, participants in the experimental group reported significantly: increased headache self-efficacy, increased use of relaxation, increased use of social support, decreased pain catastrophizing, decreased depression, and decreased stress. The hypothesis that the intervention would reduce pain could not be tested. Conclusions Demonstrated increases in self-efficacy to perform headache self-management, increased use of positive symptom management strategies, and reported decreased migraine-related depression and stress, suggest that the intervention may be a useful behavioral adjunct to a comprehensive medical approach to managing migraine. PMID:22413151

Workplace learning through peer groups in medical school clerkships.

PubMed

Chou, Calvin L; Teherani, Arianne; Masters, Dylan E; Vener, Margo; Wamsley, Maria; Poncelet, Ann

2014-01-01

Purpose When medical students move from the classroom into clinical practice environments, their roles and learning challenges shift dramatically from a formal curricular approach to a workplace learning model. Continuity among peers during clinical clerkships may play an important role in this different mode of learning. We explored students' perceptions about how they achieved workplace learning in the context of intentionally formed or ad hoc peer groups. Method We invited students in clerkship program models with continuity (CMCs) and in traditional block clerkships (BCs) to complete a survey about peer relationships with open-ended questions based on a workplace learning framework, including themes of workplace-based relationships, the nature of work practices, and selection of tasks and activities. We conducted qualitative content analysis to characterize students' experiences. Results In both BCs and CMCs, peer groups provided rich resources, including anticipatory guidance about clinical expectations of students, best practices in interacting with patients and supervisors, helpful advice in transitioning between rotations, and information about implicit rules of clerkships. Students also used each other as benchmarks for gauging strengths and deficits in their own knowledge and skills. Conclusions Students achieve many aspects of workplace learning in clerkships through formal or informal workplace-based peer groups. In these groups, peers provide accessible, real-time, and relevant resources to help each other navigate transitions, clarify roles and tasks, manage interpersonal challenges, and decrease isolation. Medical schools can support effective workplace learning for medical students by incorporating continuity with peers in the main clinical clerkship year.

The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression

PubMed Central

2011-01-01

Background Although numerous efficacy studies in recent years have found internet-based interventions for depression to be effective, there has been scant consideration of therapeutic process factors in the online setting. In face-to face therapy, the quality of the working alliance explains variance in treatment outcome. However, little is yet known about the impact of the working alliance in internet-based interventions, particularly as compared with face-to-face therapy. Methods This study explored the working alliance between client and therapist in the middle and at the end of a cognitive-behavioral intervention for depression. The participants were randomized to an internet-based treatment group (n = 25) or face-to-face group (n = 28). Both groups received the same cognitive behavioral therapy over an 8-week timeframe. Participants completed the Beck Depression Inventory (BDI) post-treatment and the Working Alliance Inventory at mid- and post- treatment. Therapists completed the therapist version of the Working Alliance Inventory at post-treatment. Results With the exception of therapists' ratings of the tasks subscale, which were significantly higher in the online group, the two groups' ratings of the working alliance did not differ significantly. Further, significant correlations were found between clients' ratings of the working alliance and therapy outcome at post-treatment in the online group and at both mid- and post-treatment in the face-to-face group. Correlation analysis revealed that the working alliance ratings did not significantly predict the BDI residual gain score in either group. Conclusions Contrary to what might have been expected, the working alliance in the online group was comparable to that in the face-to-face group. However, the results showed no significant relations between the BDI residual gain score and the working alliance ratings in either group. Trial registration ACTRN12611000563965 PMID:22145768

Leader behaviors, group cohesion, and participation in a walking group program

PubMed Central

Izumi, Betty T.; Schulz, Amy J.; Mentz, Graciela; Israel, Barbara A.; Sand, Sharon L.; Reyes, Angela G.; Hoston, Bernadine; Richardson, Dawn; Gamboa, Cindy; Rowe, Zachary; Diaz, Goya

2015-01-01

Background Fewer than half of all U.S. adults meet the 2008 Physical Activity Guidelines. Leader behaviors and group cohesion have been associated with increased participation or adherence in sports team and exercise class settings. Physical activity interventions in community settings that encompass these factors may enhance intervention adherence. Purpose To examine the impact of Community Health Promoter leader behaviors and group cohesion on participation in a walking group intervention among racially/ethnically diverse adults in low-to-moderate income communities in Detroit, Mich. Design Data for the current study were drawn from the Walk Your Heart to Health (WYHH) data set. WYHH was a multi-site cluster randomized controlled study with a lagged intervention and outcome measurements at baseline, four, eight, and 32 weeks. Pooled survey data from both intervention arms is used for the current study. Data were analyzed between August 2013 and October 2014. Setting/participants A total of 603 non-Hispanic Black, non-Hispanic White, and Hispanic adults across five cohorts that began the 32-week WYHH intervention between March 2009 and October 2011. Intervention A 32-week long walking group program hosted by community- and faith-based organizations and facilitated by Community Health Promoters. Walking groups met three times per week for 90-minutes per session. To promote participation in or adherence to WYHH, Community Health Promoters used evidence-based strategies to facilitate group cohesion. Group members assumed increasing leadership responsibility for facilitating sessions over time. Main outcome measures Participation in WYHH as measured by consistency of attendance. Results Community Health Promoter leader behaviors were positively associated with participation in WYHH. Social but not task cohesion was significantly associated with consistent participation. Social cohesion may mediate the relationship between leader behaviors and walking group participation. Conclusions Providing leaders with training to build socially cohesive groups may help motivate individuals to continue participation in community-based physical activity programs. PMID:26094226

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis

PubMed Central

Ranganathan, Hemalatha; Ganapathy, Dhanraj M.; Jain, Ashish R.

2017-01-01

Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups. PMID:28839415

Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy.

PubMed

Cho, Chunhee; Hwang, Wonjeong; Hwang, Sujin; Chung, Yijung

2016-03-01

Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy (CP). Virtual reality-based rehabilitation therapy is effective in motivating children with CP. This study investigated the effects of treadmill training with virtual reality on gait, balance, muscular strength, and gross motor function in children with CP. Eighteen children with spastic CP were randomly divided into the virtual reality treadmill training (VRTT) group (9 subjects, mean age, 10.2 years) and treadmill training (TT) group (9 subjects, mean age, 9.4 years). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. Muscle strength was assessed using a digitalized manual muscle tester. Gross motor function was assessed using the Gross Motor Functional Measure (GMFM). Balance was assessed using the Pediatric Balance Scale (PBS). Gait speed was assessed using the 10-meter walk test (10MWT), and gait endurance was assessed using the 2-minute walk test (2MWT). After training, gait and balance was improved in the VRTT compared to the TT group (P < 0.05). Muscular strength was significantly greater in the VRTT group than the TT group, except for right hamstring strength. The improvements in GMFM (standing) and PBS scores were greater in the VRTT group than the TT group (P < 0.05). Furthermore, the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group (P < 0.05). In conclusion, VRTT programs are effective for improving gait, balance, muscular strength, and gross motor function in children with CP.

Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

PubMed

Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

2015-05-01

Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis. © 2014 Japanese Teratology Society.

Balint 2.0: A virtual Balint group for doctors around the world.

PubMed

Nease, Donald E; Lichtenstein, Albert; Pinho-Costa, Luis; Hoedebecke, Kyle

2018-05-01

Objective Balint groups have shown promise in addressing clinician-patient relationships, clinician burnout, referral practices, and psychological mindedness. However, their traditional format of in-person sessions limits their ability to meet the needs of clinicians practicing in locations without trained Balint leaders. We report on a pilot of an international, internet-based Balint group in collaboration between the World Organization of Family Doctors regional Young Doctors Movements and the International Balint Federation. Method Balint 2.0 arose through interest of the Young Doctors Movements leadership, who approached the International Balint Federation for assistance. Initial discussions and some trialing of videoconference platforms led to monthly group meetings over the internet. Surveys evaluated each individual session as well as quarterly progress of the group. Survey items were borrowed from existing surveys in use by the American and German Balint Societies. Results Session surveys demonstrated the effectiveness of the videoconferencing platform for convening a Balint group, with a majority of participants expressing agreement with survey items evaluating each session. Quarterly survey responses were more positive reflecting agreement with outcomes seen from in-person Balint groups. Conclusions The Balint 2.0 pilot has demonstrated the ability of a Balint group to successfully convene over the internet and reach the common outcomes of a Balint group meeting in-person. The Young Doctors Movements and International Balint Federation plan to expand this work based on this successful pilot. We hope that others may also be able to build on this success with the result that Balint groups are available to clinicians in areas where they might not otherwise be accessible.

SU43. The Effect of Implementation Intention on Different Types of Prospective Memory Performance in Patients With Schizophrenia

PubMed Central

Wang, Ya; Liu, Lu-lu; Gan, Ming-yuan; Tan, Shu-ping; Shum, David; Chan, Raymond

2017-01-01

Abstract Background: Prospective memory (PM) refers to remembering to execute a planned intention in the future, which can been divided as event-based PM (focal, nonfocal) and time-based PM according to the nature of the cue. Focal event-based PM, where the ongoing task requires processing of the characteristics of PM cues, has been found to be benefited from implementation intention (II, ie, an encoding strategy in the format of “if I see X, then I will do Y”). However, to date, it is unclear whether implementation intention can produce a positive effect on nonfocal event-based PM (where the ongoing task is irrelevant with the PM cues) and time-based PM. Moreover, patients with schizophrenia (SCZ) were found to have impairments in these types of PM, and few studies have been conducted to examine the effect of II on these types of PM. This study investigated whether (and how) implementation intention can improve nonfocal event-based PM and time-based PM performance in patients with SCZ. Methods: Forty-two patients with SCZ and 42 healthy control participants were administered both computerized nonfocal event-based PM task and time-based PM task. Patients and healthy controls were further randomly allocated to implementation intention condition (N = 21) and typical instruction condition (N = 21). Results: Patients with SCZ in the implementation intention group showed higher PM accuracy than the typical instruction group in both nonfocal event-based PM task (0.51 ± 0.32 vs 0.19 ± 0.29, t(40) = 3.39, P = .002) and time-based PM task (0.72 ± 0.31 vs 0.39 ± 0.40, t(40) = 2.98, P = .005). Similarly, healthy controls in the II group also showed better PM performance than the typical instruction group in both tasks (all P’s < 0.05). Time check frequency of time-based PM task in the II group of all the participants was significantly higher than the typical instruction group. Conclusion: Implementation intention is an effective strategy for improving different types of PM performance in patients with schizophrenia and can be applied for clinical settings.

Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review

PubMed Central

Nancarrow, Susan; Dart, Jared; Gray, Leonard; Parkinson, Lynne

2018-01-01

Background Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. Objective The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional–led group videoconferencing to provide education or social support or both, into the home setting. Methods Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. Results Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to replicate group processes such as bonding and cohesiveness. Similar outcomes were reported for those comparing face-to-face groups and videoconference groups. Conclusions Groups delivered by videoconference are feasible and potentially can improve the accessibility of group interventions. This may be particularly useful for those who live in rural areas, have limited mobility, are socially isolated, or fear meeting new people. Outcomes are similar to in-person groups, but future research on facilitation process in videoconferencing-mediated groups and large-scale studies are required to develop the evidence base. PMID:29396387

Cost-effectiveness analysis of hypertension treatment: controlled release nifedipine and candesartan low-dose combination therapy in patients with essential hypertension--the Nifedipine and Candesartan Combination (NICE-Combi) Study.

PubMed

Fujikawa, Keita; Hasebe, Naoyuki; Kikuchi, Kenjiro

2005-07-01

Societal interest in pharmaco-economic analysis is increasing in Japan. In this study, the cost-effectiveness of low-dose combination therapy with controlled release nifedipine plus candesartan and up-titrated monotherapy with candesartan was estimated, based on the results of the NICE-Combi study. The NICE-Combi study was a double-blind, parallel arm, randomized clinical trial to compare the efficacy of low-dose combination therapy of controlled release nifedipine (20 mg/day) plus candesartan (8 mg/day) vs. up-titrated monotherapy of candesartan (12 mg/day) on blood pressure control in Japanese patients with mild to severe essential hypertension who were not sufficiently controlled by the conventional dose of candesartan (8 mg/ day). The incremental cost effectiveness of each cohort during the 8-week randomization period was compared, from the perspective of a third-party payer (i.e., insurers). The average total cost per patient was 29,943 Japanese yen for the combination therapy group and 33,182 Japanese yen for the candesartan monotherapy group, while the rate of achievement of the target blood pressure was significantly higher in the combination therapy group than in the up-titrated monotherapy group. In the combination therapy group, higher efficacy and lower incremental treatment cost ("Dominance") were observed when compared to the monotherapy group. The sensitivity analyses also supported the results. In conclusion, these results suggest that combination therapy with controlled release nifedipine and low-dose candesartan (8 mg) is "dominant" to up-titrated candesartan monotherapy for the management of essential hypertension. This conclusion was robust to sensitivity analysis.

Efficacy of an Experiential, Dissonance-Based Smoking Intervention for College Students Delivered via the Internet

PubMed Central

Simmons, Vani Nath; Heckman, Bryan W.; Fink, Angelina C.; Small, Brent J.; Brandon, Thomas H.

2015-01-01

Objective College represents a window of opportunity to reach the sizeable number of cigarette smokers who are vulnerable to lifelong smoking. The underutilization of typical cessation programs suggests the need for novel and more engaging approaches for reaching college smokers. The aim of the present study was to test the efficacy of a dissonance-enhancing, Web-based experiential intervention for increasing smoking cessation motivation and behavior. Method We used a 4-arm, randomized design to examine the efficacy of a Web-based, experiential smoking intervention (Web-Smoke). The control conditions included a didactic smoking intervention (Didactic), a group-based experiential intervention (Group), and a Web-based nutrition experiential intervention (Web-Nutrition). We recruited 341 college smokers. Primary outcomes were motivation to quit, assessed immediately postintervention, and smoking abstinence at 1 and 6 months following the intervention. Results As hypothesized, the Web-Smoke intervention was more effective than control groups in increasing motivation to quit. At 6-month follow-up, the Web-Smoke intervention produced higher rates of smoking cessation than the Web-Nutrition control intervention. Daily smoking moderated intervention outcomes. Among daily smokers, the Web-Smoke intervention produced greater abstinence rates than both the Web-Nutrition and Didactic control conditions. Conclusion Findings demonstrate the efficacy of a theory-based intervention delivered over the Internet for increasing motivation to quit and smoking abstinence among college smokers. The intervention has potential for translation and implementation as a secondary prevention strategy for college-aged smokers. PMID:23668667

Torque-onset determination: Unintended consequences of the threshold method.

PubMed

Dotan, Raffy; Jenkins, Glenn; O'Brien, Thomas D; Hansen, Steve; Falk, Bareket

2016-12-01

Compared with visual torque-onset-detection (TOD), threshold-based TOD produces onset bias, which increases with lower torques or rates of torque development (RTD). To compare the effects of differential TOD-bias on common contractile parameters in two torque-disparate groups. Fifteen boys and 12 men performed maximal, explosive, isometric knee-extensions. Torque and EMG were recorded for each contraction. Best contractions were selected by peak torque (MVC) and peak RTD. Visual-TOD-based torque-time traces, electromechanical delays (EMD), and times to peak RTD (tRTD) were compared with corresponding data derived from fixed 4-Nm- and relative 5%MVC-thresholds. The 5%MVC TOD-biases were similar for boys and men, but the corresponding 4-Nm-based biases were markedly different (40.3±14.1 vs. 18.4±7.1ms, respectively; p<0.001). Boys-men EMD differences were most affected, increasing from 5.0ms (visual) to 26.9ms (4Nm; p<0.01). Men's visually-based torque kinetics tended to be faster than the boys' (NS), but the 4-Nm-based kinetics erroneously depicted the boys as being much faster to any given %MVC (p<0.001). When comparing contractile properties of dissimilar groups, e.g., children vs. adults, threshold-based TOD methods can misrepresent reality and lead to erroneous conclusions. Relative-thresholds (e.g., 5% MVC) still introduce error, but group-comparisons are not confounded. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of aerobic training on hot flushes and quality of life—a randomized controlled trial

PubMed Central

Luoto, Riitta; Moilanen, Jaana; Heinonen, Reetta; Mikkola, Tomi; Raitanen, Jani; Tomas, Eija; Ojala, Katriina; Mansikkamäai, Kirsi; Nygård, Clas-Håkan

2012-01-01

Background and objective. To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life. Design. A randomized controlled trial. Participants and setting. Symptomatic, sedentary women (n = 176), 43–63 years, no current use of hormone therapy. Intervention. Unsupervised aerobic training for 50 minutes four times per week during 6 months. Outcomes. Hot flushes as measured with Women's Health Questionnaire (WHQ) and Health-Related Quality of Life (HRQoL, SF-36), daily reported hot flushes on phone-based diary, cardiorespiratory fitness (CRF), and body composition. Results. Intervention group had larger decrease in the frequency of night-time hot flushes based on phone diary (P for month X group = 0.012), but not on WHQ scale. Intervention group had less depressed mood (P= 0.01) than control women according to change in WHQ score. Changes in WHQ score in depressed mood (P = 0.03) and menstrual symptoms (P=0.01) in the intervention group were significantly dependent on frequency of training sessions. HRQoL was improved among the intervention group women in physical functioning (P= 0.049) and physical role limitation (P= 0.017). CRF improved (P= 0.008), and lean muscle mass increased (P= 0.046) significantly in the intervention group as compared to controls. Conclusions. Aerobic training may decrease the frequency of hot flushes and improve quality of life among slightly overweight women. PMID:21639722

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults

PubMed Central

Fong, Shirley S.M.; Ng, Shamay S.M.; Cheng, Yoyo T.Y.; Zhang, Joni; Chung, Louisa M.Y.; Chow, Gary C.C.; Chak, Yvonne T.C.; Chan, Ivy K.Y.; Macfarlane, Duncan J.

2016-01-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants’ physical activity was evaluated using the International Physical Activity Questionnaire–Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results. PMID:27313391

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Zhang, Joni; Chung, Louisa M Y; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Macfarlane, Duncan J

2016-05-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.

Clinical usefulness of brain-computer interface-controlled functional electrical stimulation for improving brain activity in children with spastic cerebral palsy: a pilot randomized controlled trial.

PubMed

Kim, Tae-Woo; Lee, Byoung-Hee

2016-09-01

[Purpose] Evaluating the effect of brain-computer interface (BCI)-based functional electrical stimulation (FES) training on brain activity in children with spastic cerebral palsy (CP) was the aim of this study. [Subjects and Methods] Subjects were randomized into a BCI-FES group (n=9) and a functional electrical stimulation (FES) control group (n=9). Subjects in the BCI-FES group received wrist and hand extension training with FES for 30 minutes per day, 5 times per week for 6 weeks under the BCI-based program. The FES group received wrist and hand extension training with FES for the same amount of time. Sensorimotor rhythms (SMR) and middle beta waves (M-beta) were measured in frontopolar regions 1 and 2 (Fp1, Fp2) to determine the effects of BCI-FES training. [Results] Significant improvements in the SMR and M-beta of Fp1 and Fp2 were seen in the BCI-FES group. In contrast, significant improvement was only seen in the SMR and M-beta of Fp2 in the control group. [Conclusion] The results of the present study suggest that BCI-controlled FES training may be helpful in improving brain activity in patients with cerebral palsy and may be applied as effectively as traditional FES training.

A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia

PubMed Central

Sampalli, Tara; Berlasso, Elizabeth; Fox, Roy; Petter, Mark

2009-01-01

Background: The objective of this study was to examine the effect of a mindfulness-based stress reduction (MBSR) program on women diagnosed with conditions such as multiple chemical sensitivity (MCS), chronic fatigue syndrome (CFS), and fibromyalgia (FM). Methods: The intervention group underwent a 10-week MBSR program. Symptoms Checklist Inventory (SCL-90R) was used as outcome measure and was administered before the start of the program (pre-), immediately upon completion (post-) and at three-month follow-up. Women on the wait list to receive treatment at the Nova Scotia Environmental Health Centre were used as control subjects for the study. Results: A total of 50 participants in the intervention group and 26 in the wait-list controls group were recruited for this study. Global scores in the intervention group reached statistical significance pre-post (<0.0001) and at pre-follow-up (<0.0001) while the global scores in the control group remained the same. Five of nine and eight of nine subscales of the SCL-90R showed improvement of statistical significance in MBSR group following treatment and at three-month follow-up. Conclusions: The study showed the importance of complementary interventions such as MBSR techniques in the reduction of psychological distress in women with chronic conditions. PMID:21197347

Preliminary study of urine metabolism in type two diabetic patients based on GC-MS

PubMed Central

Zhang, Ning; Geng, Fang; Hu, Zhong-Hua; Liu, Bin; Wang, Ye-Qiu; Liu, Jun-Cen; Qi, Yong-Hua; Li, Li-Jing

2016-01-01

Objective: Comparative study of type 2 diabetes and healthy controls by metabolomics methods to explore the pathogenesis of Type II diabetes. Methods: Gas chromatography - mass spectrometry (GC-MS) with a variety of multivariate statistical analysis methods to the healthy control group 58 cases, 68 cases of Type II diabetes group were analyzed. Chromatographic conditions: DB-5MS column; the carrier gas He; flow rate of 1 mL·min-1, the injection volume 1 uL; split ratio is 100: 1. MS conditions: electron impact (EI) ion source, an auxiliary temperature of 280°C, the ion source 230°C, quadrupole 150°C; mass scan range 30~600 mAu. Results: Established analytical method based on urine metabolomics GC-MS of Type II diabetes, determine the urine succinic acid, L-leucine, L-isoleucine, tyrosine, slanine, acetoace acid, mannose, L-isoleucine, L-threonine, Phenylalanine, fructose, D-glucose, palmi acid, oleic acid and arachidonic acid were significantly were significantly changed. Conclusion: Based on metabolomics of GC-MS detection and analysis metabolites can be found differences between type 2 diabetes and healthy control group, PCA diagram can effectively distinguish Type II diabetes and healthy control group, with load diagrams and PLS-DA VIP value metabolite screening, the resulting differences in metabolic pathways involved metabolites, including amino acid metabolism, lipid metabolism, glucose metabolism and energy metabolism. PMID:27508010

Knowing the ABCs: A Comparative Effectiveness Study of Two Methods of Diabetes Education

PubMed Central

Naik, Aanand D.; Teal, Cayla R.; Rodriguez, Elisa; Haidet, Paul

2011-01-01

Objective To test an active-learning, empowerment approach to teaching patients about the “diabetes ABCs” (hemoglobin A1C, systolic blood pressure, and low density lipoprotein cholesterol). Methods 84 (97%) diabetic patients who participated in a randomized effectiveness trial of two clinic-based group educational methods and completed a post-intervention assessment. The empowerment arm participated in a group session that incorporated two educational innovations (a conceptual metaphor to foster understanding, and team-based learning methods to foster active learning). The traditional diabetes education arm received a didactic group session focused on self-management and educational materials about the diabetes ABCs. Participants in both arms received individual review of their current ABC values. Results A questionnaire evaluated knowledge, understanding, and recall of the diabetes ABCs was administered three months after enrollment in the study. At three months, participants in the empowerment group demonstrated greater understanding of the diabetes ABCs (P<.0001), greater knowledge of their own values (P<.0001), and greater knowledge of guideline-derived target goals for the ABCs compared with participants in the traditional arm (P<.0001). Conclusion An active-learning, empowerment-based approach applied to diabetes education can lead to greater understanding and knowledge retention. Practice Implications An empowerment approach to education can facilitate informed, activated patients and increase performance of self-management behaviors. PMID:21300516

Randomised controlled trial on the effectiveness of home-based walking exercise on anxiety, depression and cancer-related symptoms in patients with lung cancer

PubMed Central

Chen, H-M; Tsai, C-M; Wu, Y-C; Lin, K-C; Lin, C-C

2015-01-01

Background: Although exercise has been addressed as an adjuvant treatment for anxiety, depression and cancer-related symptoms, limited studies have evaluated the effectiveness of exercise in patients with lung cancer. Methods: We recruited 116 patients from a medical centre in northern Taiwan, and randomly assigned them to either a walking-exercise group (n=58) or a usual-care group (n=58). We conducted a 12-week exercise programme that comprised home-based, moderate-intensity walking for 40 min per day, 3 days per week, and weekly exercise counselling. The outcome measures included the Hospital Anxiety and Depression Scale and the Taiwanese version of the MD Anderson Symptom Inventory. Results: We analysed the effects of the exercise programme on anxiety, depression and cancer-related symptoms by using a generalised estimating equation method. The exercise group patients exhibited significant improvements in their anxiety levels over time (P=0.009 and 0.006 in the third and sixth months, respectively) and depression (P=0.00006 and 0.004 in the third and sixth months, respectively) than did the usual-care group patients. Conclusions: The home-based walking exercise programme is a feasible and effective intervention method for managing anxiety and depression in lung cancer survivors and can be considered as an essential component of lung cancer rehabilitation. PMID:25490525

Risk strata-based therapy and outcome in stage Ib-IIa carcinoma cervix: single-centre ten-year experience.

PubMed

Kundargi, Rajshekar S; Guruprasad, B; Rathod, Praveen Shankar; Shakuntala, Pn; Shobha, K; Pallavi, Vr; Uma Devi, K; Bafna, Ud

2013-01-01

To review the outcome of stage (Ib, IIa), cervical cancer patients were primarily treated with radical hysterectomy and risk-based postoperative therapy. Between January 2001 and December 2011, 601 cases underwent surgery followed by tailored therapy. Patients were classified into low risk (pelvic lymph node negative, tumour less than 4 cm, no evidence of lympho-vascular invasion, less than one-third of thickness of surgical stoma involved), intermediate risk (positive lympho-vascular space invasion, tumour size more than 4 cm, and deep invasion of cervical stroma), and high risk (pelvic lymph node involved, positive parametrial, or vaginal margins) groups. Postoperative adju-vant therapy in the form of radiotherapy alone to those with intermediate risk and chemo-radiotherapy to those with high risk was given to patients. The median follow-up was 60 months. The majority of patients had intermediate risk. The overall event-free survival (EFS) at five years was 74.37%, with EFS of 86.5% in those from the low-risk group, 73% in those from the intermediate-risk group, and 64% in those from the high-risk group. In conclusion, risk strata-based adjuvant postoperative therapy is able to provide a favourable outcome in patients with stage Ib-IIa cervical cancer with a nearly 11% improvement in survival compared with historical control.

Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism?

PubMed Central

Kuijpers, Karlijn F.

2008-01-01

Background Although several studies have reported positive effects of mindfulness-based stress reduction (MBSR) intervention on psychological well-being, it is not known whether these effects are attributable to a change in mindfulness. Purpose The aim of this study is to compare the effects of MBSR to a waiting-list control condition in a randomized controlled trial while examining potentially mediating effects of mindfulness. Methods Forty women and 20 men from the community with symptoms of distress (mean age 43.6 years, SD = 10.1) were randomized into a group receiving MBSR or a waiting-list control group. Before and after the intervention period, questionnaires were completed on psychological well-being, quality of life, and mindfulness. Results Repeated measures multiple analysis of variance (MANCOVAs) showed that, compared with the control group, the intervention resulted in significantly stronger reductions of perceived stress (p = 0.016) and vital exhaustion (p = 0.001) and stronger elevations of positive affect (p = 0.006), quality of life (p = .009), as well as mindfulness (p = 0.001). When mindfulness was included as a covariate in the MANCOVA, the group effects on perceived stress and quality of life were reduced to nonsignificance. Conclusion Increased mindfulness may, at least partially, mediate the positive effects of mindfulness-based stress reduction intervention. PMID:18535870

Brief Report: Adapting an In-Person Patient-Caregiver Communication Intervention to a Tailored Web-Based Format

PubMed Central

Zulman, Donna M.; Schafenacker, Ann; Barr, Kathryn L.C.; Moore, Ian T.; Fisher, Jake; McCurdy, Kathryn; Derry, Holly A.; Saunders, Edward W.; An, Lawrence C.; Northouse, Laurel

2011-01-01

Background Interventions that target cancer patients and their caregivers have been shown to improve communication, support, and emotional well-being. Objective To adapt an in-person communication intervention for cancer patients and caregivers to a web-based format, and to examine the usability and acceptability of the web-based program among representative users. Methods A tailored, interactive web-based communication program for cancer patients and their family caregivers was developed based on an existing in-person, nurse-delivered intervention. The development process involved: 1) building a multidisciplinary team of content and web design experts, 2) combining key components of the in-person intervention with the unique tailoring and interactive features of a web-based platform, and 3) conducting focus groups and usability testing to obtain feedback from representative program users at multiple time points. Results Four focus groups with 2 to 3 patient-caregiver pairs per group (n = 22 total participants) and two iterations of usability testing with 4 patient-caregiver pairs per session (n = 16 total participants) were conducted. Response to the program's structure, design, and content was favorable, even among users who were older or had limited computer and internet experience. The program received high ratings for ease of use and overall usability (mean System Usability Score of 89.5 out of 100). Conclusions Many elements of a nurse-delivered patient-caregiver intervention can be successfully adapted to a web-based format. A multidisciplinary design team and an iterative evaluation process with representative users were instrumental in the development of a usable and well-received web-based program. PMID:21830255

Effects of bite-jumping appliances on mandibular advancement in growing rats: A radiographic study

PubMed Central

Oksayan, Ridvan; Sokucu, Oral; Ucuncu, Neslihan

2014-01-01

Objective: The aim was to evaluate the effects of the use of mandibular advancement appliances on mandibular growth in growing rats. Materials and Methods: Twenty-four 8-week-old male Wistar albino rats were randomly divided into two experimental groups (12 rats each): Group I was a control group, and Group II was the mandibular advancement appliance group. A functional bite-jumping appliance was used in Group II to promote mandibular advancement. Anatomical changes in the condyle and mandible were evaluated by comparing radiographic results from before and after the study, with angular and linear measurements. Friedman and Mann-Whitney U-tests were used in statistical analysis. Results: According to the radiographic results, the growth of mandibles and condyles in Group II was significantly greater than with the length of the condylar process (A-B) and distance from condyle to menton (A-D) variables (P < 0.05). In addition, Group I showed greater mandibular base growth than did Group II (P < 0.05). Conclusions: We conclude that the use of an intraoral bite-jumping appliance can stimulate condylar growth and increase sagittal mandibular advancement in growing rats. PMID:25202205

Morphology and luminosity segregation of galaxies in nearby loose groups

NASA Astrophysics Data System (ADS)

Girardi, M.; Rigoni, E.; Mardirossian, F.; Mezzetti, M.

2003-08-01

We study morphology and luminosity segregation of galaxies in loose groups. We analyze the two catalogs of groups identified in the Nearby Optical Galaxy (NOG) sample, by means of hierarchical and percolation ``friends-of-friends'' methods (HG and PG catalogs, respectively). In the first part of our analysis we consider 387 and 436 groups of HG and PG and compare morphology- (luminosity-) weighted to unweighted group properties: velocity dispersion, mean pairwise distance, and mean groupcentric distance of member galaxies. The second part of our analysis is based on two ensemble systems, one for each catalog, built by suitably combining together galaxies of all groups (1584 and 1882 galaxies for HG and PG groups). We find that earlier-type (brighter) galaxies are more clustered and lie closer to the group centers, both in position and in velocity, than later-type (fainter) galaxies. Spatial segregations are stronger than kinematical segregations. These effects are generally detected at the >˜ 3-sigma level. Luminosity segregation is shown to be independent of morphology segregation. Our main conclusions are strengthened by the detection of segregation in both hierarchical and percolation catalogs. Our results agree with a continuum of segregation properties of galaxies in systems, from low-mass groups to massive clusters.

The demand control model and circadian saliva cortisol variations in a Swedish population based sample (The PART study)

PubMed Central

Alderling, Magnus; Theorell, Töres; de la Torre, Bartolomé; Lundberg, Ingvar

2006-01-01

Background Previous studies of the relationship between job strain and blood or saliva cortisol levels have been small and based on selected occupational groups. Our aim was to examine the association between job strain and saliva cortisol levels in a population-based study in which a number of potential confounders could be adjusted for. Methods The material derives from a population-based study in Stockholm on mental health and its potential determinants. Two data collections were performed three years apart with more than 8500 subjects responding to a questionnaire in both waves. In this paper our analyses are based on 529 individuals who held a job, participated in both waves as well as in an interview linked to the second wave. They gave saliva samples at awakening, half an hour later, at lunchtime and before going to bed on a weekday in close connection with the interview. Job control and job demands were assessed from the questionnaire in the second wave. Mixed models were used to analyse the association between the demand control model and saliva cortisol. Results Women in low strain jobs (high control and low demands) had significantly lower cortisol levels half an hour after awakening than women in high strain (low control and high demands), active (high control and high demands) or passive jobs (low control and low demands). There were no significant differences between the groups during other parts of the day and furthermore there was no difference between the job strain, active and passive groups. For men, no differences were found between demand control groups. Conclusion This population-based study, on a relatively large sample, weakly support the hypothesis that the demand control model is associated with saliva cortisol concentrations. PMID:17129377

What interventions increase commuter cycling? A systematic review

PubMed Central

Stewart, Glenn; Anokye, Nana Kwame; Pokhrel, Subhash

2015-01-01

Objective To identify interventions that will increase commuter cycling. Setting All settings where commuter cycling might take place. Participants Adults (aged 18+) in any country. Interventions Individual, group or environmental interventions including policies and infrastructure. Primary and secondary outcome measures A wide range of ‘changes in commuter cycling’ indicators, including frequency of cycling, change in workforce commuting mode, change in commuting population transport mode, use of infrastructure by defined populations and population modal shift. Results 12 studies from 6 countries (6 from the UK, 2 from Australia, 1 each from Sweden, Ireland, New Zealand and the USA) met the inclusion criteria. Of those, 2 studies were randomised control trials and the remainder preintervention and postintervention studies. The majority of studies (n=7) evaluated individual-based or group-based interventions and the rest environmental interventions. Individual-based or group-based interventions in 6/7 studies were found to increase commuter cycling of which the effect was significant in only 3/6 studies. Environmental interventions, however, had small but positive effects in much larger but more difficult to define populations. Almost all studies had substantial loss to follow-up. Conclusions Despite commuter cycling prevalence varying widely between countries, robust evidence of what interventions will increase commuter cycling in low cycling prevalence nations is sparse. Wider environmental interventions that make cycling conducive appear to reach out to hard to define but larger populations. This could mean that environmental interventions, despite their small positive effects, have greater public health significance than individual-based or group-based measures because those interventions encourage a larger number of people to integrate physical activity into their everyday lives. PMID:26275902

Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions

PubMed Central

2013-01-01

Background Sexual and other forms of gender-based violence are common in conflict settings and are known risk factors for mental health and psychosocial wellbeing. We present findings from a systematic review of the academic and grey literature focused on the effectiveness of mental health and psychosocial support interventions for populations exposed to sexual and other forms of gender-based violence in the context of armed conflicts. Methods We searched the Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PubMed/ Medline, psycINFO, and PILOTS, as well as grey literature to search for evaluations of interventions, without date limitations. Results Out of 5,684 returned records 189 full text papers were assessed for eligibility. Seven studies met inclusion criteria: 1 non-randomized controlled study; 3 non-controlled pre- post-test designs; 1 retrospective cohort with a matched comparison group; and 2 case studies. Studies were conducted in West and Central Africa; Albania; UK and USA, included female participants, and focused on individual and group counseling; combined psychological, medical, social and economic interventions; and cognitive behavioral therapy (two single case studies). Conclusions The seven studies, while very limited, tentatively suggest beneficial effects of mental health and psychosocial interventions for this population, and show feasibility of evaluation and implementation of such interventions in real-life settings through partnerships with humanitarian organizations. Robust conclusions on the effectiveness of particular approaches are not possible on the basis of current evidence. More rigorous research is urgently needed. PMID:23915821

Problem-based learning using patient-simulated videos showing daily life for a comprehensive clinical approach

PubMed Central

Ohira, Yoshiyuki; Uehara, Takanori; Noda, Kazutaka; Suzuki, Shingo; Shikino, Kiyoshi; Kajiwara, Hideki; Kondo, Takeshi; Hirota, Yusuke; Ikusaka, Masatomi

2017-01-01

Objectives We examined whether problem-based learning tutorials using patient-simulated videos showing daily life are more practical for clinical learning, compared with traditional paper-based problem-based learning, for the consideration rate of psychosocial issues and the recall rate for experienced learning. Methods Twenty-two groups with 120 fifth-year students were each assigned paper-based problem-based learning and video-based problem-based learning using patient-simulated videos. We compared target achievement rates in questionnaires using the Wilcoxon signed-rank test and discussion contents diversity using the Mann-Whitney U test. A follow-up survey used a chi-square test to measure students’ recall of cases in three categories: video, paper, and non-experienced. Results Video-based problem-based learning displayed significantly higher achievement rates for imagining authentic patients (p=0.001), incorporating a comprehensive approach including psychosocial aspects (p<0.001), and satisfaction with sessions (p=0.001). No significant differences existed in the discussion contents diversity regarding the International Classification of Primary Care Second Edition codes and chapter types or in the rate of psychological codes. In a follow-up survey comparing video and paper groups to non-experienced groups, the rates were higher for video (χ2=24.319, p<0.001) and paper (χ2=11.134, p=0.001). Although the video rate tended to be higher than the paper rate, no significant difference was found between the two. Conclusions Patient-simulated videos showing daily life facilitate imagining true patients and support a comprehensive approach that fosters better memory. The clinical patient-simulated video method is more practical and clinical problem-based tutorials can be implemented if we create patient-simulated videos for each symptom as teaching materials.  PMID:28245193

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke

PubMed Central

Lee, Myung Mo; Lee, Kyeong Jin

2018-01-01

Background Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. Material/Methods Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. Results At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). Conclusions Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs. PMID:29702630

Effectiveness of Placebo Therapy for Maintaining Masking in a Clinical Trial of Vergence/Accommodative Therapy

PubMed Central

Kulp, Marjean; Mitchell, G. Lynn; Borsting, Eric; Scheiman, Mitchell; Cotter, Susan; Rouse, Michael; Tamkins, Susanna; Mohney, Brian G.; Toole, Andrew; Reuter, Kathleen

2009-01-01

Purpose To evaluate the effectiveness of the Convergence Insufficiency Treatment Trial (CITT) placebo therapy program in maintaining masking of patients randomized to the office-based treatment arms, determine whether demographic variables affect masking, and determine whether perception of assigned treatment group was associated with treatment outcome or adherence to treatment. Methods Patients (n = 221, ages, 9–17 years) were randomized to one of four treatment groups, two of which were office-based and masked to treatment (n = 114). The placebo therapy program was designed to appear to be real vergence/accommodative therapy, without stimulating vergence, accommodation, or fine saccades (beyond levels of daily visual activities). After treatment, patients in the office-based groups were asked whether they thought they had received real or placebo therapy and how confident they were in their answers. Results Ninety-three percent of patients assigned to real therapy and 85% assigned to placebo therapy thought they were in the real therapy group (P = 0.17). No significant differences were found between the two groups in adherence to the therapy (P ≥ 0.22 for all comparisons). The percentage of patients who thought they were assigned to real therapy did not differ by age, sex, race, or ethnicity (P > 0.30 for all comparisons). No association was found between patients' perception of group assignment and symptoms or signs at outcome (P ≥ 0.38 for all comparisons). Conclusions The CITT placebo therapy program was effective in maintaining patient masking in this study and therefore may have potential for use in future clinical trials using vergence/accommodative therapy. Masking was not affected by demographic variables. Perception of group assignment was not related to symptoms or signs at outcome (ClinicalTrials.gov number, NCT00338611). PMID:19151384

An Internet-based program for depression using activity and physiological sensors: efficacy, expectations, satisfaction, and ease of use

PubMed Central

Botella, Cristina; Mira, Adriana; Moragrega, Inés; García-Palacios, Azucena; Bretón-López, Juana; Castilla, Diana; Riera López del Amo, Antonio; Soler, Carla; Molinari, Guadalupe; Quero, Soledad; Guillén-Botella, Verónica; Miralles, Ignacio; Nebot, Sara; Serrano, Berenice; Majoe, Dennis; Alcañiz, Mariano; Baños, Rosa María

2016-01-01

Purpose Computerized cognitive behavioral therapy (CCBT) has been shown to be efficacious. Moreover, CCBT can be enhanced by using physiological and activity sensors, but there is no evidence about the acceptability of all these tools. The objective of this study is to examine the efficacy, expectations, satisfaction, and ease of use of an Internet-based CCBT program for preventing depression, with and without sensors (electroencephalography, electrocardiograhpy ECG, and actigraphy), in a high-risk population (unemployed men). Patients and methods Sixty participants at risk of depression (unemployed men) were randomly assigned to three experimental conditions: 1) intervention program (N=22), 2) intervention program plus sensors (N=19), and 3) control group (N=19). Participants completed depression, anxiety, positive and negative affect, and perceived stress measures. Furthermore, they also completed the measures for expectation, satisfaction, and the ease of use of the program. Results Results showed that the two intervention groups improved significantly more than the control group on the clinical variables, and the improvements were greater in the group that used sensors than in the group that did not use them. Furthermore, participants in both intervention groups scored high on expectations and satisfaction with the CCBT program (with and without sensors). The mean score for usability was 88 out of 100 (standard deviation =12.32). No significant differences were found between groups on any of these variables. Conclusion This is the first study to analyze the efficacy, expectations, satisfaction, and ease of use of an Internet-based program using physiological and activity sensors. These results suggest that an Internet program for depression with or without physiological and activity sensors is effective, satisfactory, and easy to use. PMID:27042067

The residual monomer content and mechanical properties of CAD\\CAM resins used in the fabrication of complete dentures as compared to heat cured resins

PubMed Central

Ayman, Al-Dharrab

2017-01-01

Background The utilization of computer-assisted designing and computer-assisted milling CAD\\CAM resins in the fabrication of removable prostheses is a modern-day concept that offers many advantages over the use of the traditional polymethylmethacrylate (PMMA). Aim This study instigated some of the mechanical properties of CAD\\CAM denture base resin including the amount of residual monomer. Methods This study was conducted at the Faculty of Dentistry, King Abdulaziz University from October 2016 to February 2017. A total of seventy rectangular specimens were fabricated (group A: 35 heat-cured PMMA and group B: 35 CAD/CAM pre-polymerized acrylic resin blocks). The flexural strength and surface hardness were tested while the residual monomer content at baseline, two-day and seven-day intervals was estimated using gas chromatography (GC). Means and standard deviations were determined for each group as well as independent-samples t-test and ANOVA with repeated measures for comparison between the groups and subgroups of varying time intervals. Results Heat cured PMMA (A), displayed higher flexural strength and low value flexural modulus compared to CAD/CAM acrylic resin denture base material (B). Student t-test indicated highly significant differences (p<0.001) of the flexural strength (t=37.911) and flexural modulus (t=88.559). The surface hardness of group (B) was significantly higher compared to group (A) as indicated by the t-test (t=20.430). Higher release of the monomer content was detected by GC in group (A) at different time intervals with a statistically significant difference (p<0.001) in residual monomer content. Conclusion CAD/CAM resin may be considered suitable for use in the construction of denture bases. PMID:28894533

The Efficacy of Internet-based Cognitive Behavioral Therapy on the Anxiety Disorders among Adolescent Girls.

PubMed

Karbasi, Afsaneh; Haratian, Azadeh

2018-01-01

The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8-12 and 5-10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT) in treating the anxiety disorders among adolescent females. The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another ( P < 0.001). This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms' scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT.

A Comparison between Shear Bond Strength of VMK Master Porcelain with Three Base-metal Alloys (Ni-cr-T3, VeraBond, Super Cast) and One Noble Alloy (X-33) in Metal-ceramic Restorations

PubMed Central

Ahmadzadeh, A; Neshati, A; Mousavi, N; Epakchi, S; Dabaghi Tabriz, F; Sarbazi, AH

2013-01-01

Statement of Problem: The increase in the use of metal-ceramic restorations and a high prevalence of porcelain chipping entails introducing an alloy which is more compatible with porcelain and causes a stronger bond between the two. This study is to compare shear bond strength of three base-metal alloys and one noble alloy with the commonly used VMK Master Porcelain. Materials and Method: Three different groups of base-metal alloys (Ni-cr-T3, Super Cast, and VeraBond) and one group of noble alloy (X-33) were selected. Each group consisted of 15 alloy samples. All groups went through the casting process and change from wax pattern into metal disks. The VMK Master Porcelain was then fired on each group. All the specimens were put in the UTM; a shear force was loaded until a fracture occurred and the fracture force was consequently recorded. The data were analyzed by SPSS Version 16 and One-Way ANOVA was run to compare the shear strength between the groups. Furthermore, the groups were compared two-by-two by adopting Tukey test. Results: The findings of this study revealed shear bond strength of Ni-Cr-T3 alloy was higher than the three other alloys (94 MPa or 330 N). Super Cast alloy had the second greatest shear bond strength (80. 87Mpa or 283.87 N). Both VeraBond (69.66 MPa or 245 N) and x-33 alloys (66.53 MPa or 234 N) took the third place. Conclusion: Ni-Cr-T3 with VMK Master Porcelain has the greatest shear bond strength. Therefore, employment of this low-cost alloy is recommended in metal-ceramic restorations. PMID:24724144

Drug Craving Terminology among Opiate Dependents; A Mixed Method Study

PubMed Central

Maarefvand, Masoomeh; Ghiasvand, Hamid Reza

2013-01-01

Objective Drug craving is defined as an urge to continue substance abuse. Drug dependents use different terms to express their subjective feeling of craving. This study was an attempt to generate an understanding of craving terminology among different groups of Persian speaking Iranian opiate dependents. Method Terms used for the meaning of drug craving were listed by 36 ex-opiate dependents in focus group discussion meetings in the first phase of the study. These terms were composed from Craving Terms Questionnaire. In the second phase, 120 subjects in 3 groups of opiate dependents and a group of Current Opiate Abusers rated usage frequency of each term in the questionnaire under a Twelve-Step Program, Methadone Maintenance, and Other Abstinence-based Programs. Results Eighty nine terms were categorized in stimulation and triggering, attention bias and obsession, decision making difficulty, information processing impairment, withdrawal induction, drug euphoric experience, mental urge, motor control problem, negative valancing and stigmatizing. Terms for the three categories of mental urge, attention bias and obsession and motor control problem were used more than others. Patients in Methadone Maintenance Treatment (MMT) group used different categories of craving terms in comparison to other groups. Abstinent cases reported higher total score for craving terms in comparison to other groups in Twelve-Step Program and other abstinence-based programs. Conclusion Each craving-related term is associated with some aspects of the multidimensional concept of craving. A drug-craving thesaurus could provide a better understanding of craving nature from a drug dependent point of view. There are differences among abstinence vs. maintenance based treated opiate dependents in using craving terms. Addiction therapists will benefit from accessing drug dependents’ lexicon to assess and create therapeutic alliance with their clients. PMID:24130609

Definition of the thermographic regions of interest in cycling by using a factor analysis

NASA Astrophysics Data System (ADS)

Priego Quesada, Jose Ignacio; Lucas-Cuevas, Angel Gabriel; Salvador Palmer, Rosario; Pérez-Soriano, Pedro; Cibrián Ortiz de Anda, Rosa M.^a.

2016-03-01

Research in exercise physiology using infrared thermography has increased in the last years. However, the definition of the Regions of Interest (ROIs) varies strongly between studies. Therefore, the aim of this study was to use a factor analysis approach to define highly correlated groups of thermographic ROIs during a cycling test. Factor analyses were performed based on the moment of measurement and on the variation of skin temperatures as a result of the cycling exercise. 19 male participants cycled during 45 min at 50% of their individual peak power output with a cadence of 90 rpm. Infrared thermography was used to measure skin temperatures in sixteen ROIs of the trunk and lower limbs at three moments: before, immediately after and 10 min after the cycling test. Factor analyses were used to identify groups of ROIs based on the skin absolute temperatures at each moment of measurement as well as on skin temperature variations between moments. All the factor analyses performed for each moment and skin temperature variation explained more than the 80% of the variance. Different groups of ROIs were obtained when the analysis was based on the moment of measurement or on the effect of exercise on the skin temperature. Furthermore, some ROIs were grouped in the same way in both analyses (e.g. the ROIs of the trunk), whereas other regions (legs and their joints) were grouped differently in each analysis. Differences between groups of ROIs are related to their tissue composition, muscular activity and capacity of sweating. In conclusion, the resultant groups of ROIs were coherent and could help researchers to define the ROIs in future thermal studies.

The amelioration of plasma lipids by Korean traditional confectionery in middle-aged women: A cross-over study with western cookie

PubMed Central

Hong, Sun Hee; Kim, Mijeong; Woo, Minji; Noh, Jeong Sook; Lee, JaeHwan; Chung, Lana

2016-01-01

BACKGROUND/OBJECTIVES The purpose of this study was to examine whether plasma lipid profiles are affected differently by snack kinds with equal calorific values. SUBJECTS/METHODS We compared a Korean traditional confectionery (dasik) with Western confectionery (cookie) in this regard. Controlled cross-over study consisted of two 3-week snack intake phases and for separating, a 2-week washout period (3–2–3) was carried out with 30 healthy women aged between 40-59 years old. Brown rice based Korean traditional confectionery and wheat flour based Western confectionery were used. The participants consumed either dasik or cookie every day for 3 weeks, providing 93 kcal a day. RESULTS The total cholesterol (TC) in the dasik group had decreased significantly after 3 weeks (P < 0.05). Furthermore, in the dasik group, reduction in TC and low-density lipoprotein-cholesterol were greater than those in the cookie group (P < 0.05). CONCLUSIONS Prioritizing functional snacks like dasik improves plasma lipid profiles; this may be useful information for individuals who cannot refrain from snacking. PMID:27909556

One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy

PubMed Central

Grecco, Marcus Vinicius; Brech, Guilherme Carlos; Greve, Júlia Maria D'Andrea

2013-01-01

OBJECTIVE: To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up. METHOD: This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6±11.8 years (range: 25-68 years), 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly. RESULTS: At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster. CONCLUSION: Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment. PMID:24037003

Effect of Infrared Radiation on the Healing of Diabetic Foot Ulcer

PubMed Central

Hakim, Ashrafalsadat; Sadeghi Moghadam, Ali; Shariati, Abdalali; karimi, Hamid; Haghighizadeh, Mohamad Hossien

2016-01-01

Background Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications. Objectives This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer. Patients and Methods This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale). Sample size was determined based on relevant studies of the recent decade. Patients were classified into the intervention and control groups (n = 25 in each group) in terms of age, gender, degree of ulcer, ulcer site and body mass index. In this study, work progress was evaluated according to the checklist of diabetic foot ulcer healing evaluation. Results The results of the current study showed that there was a statistically significant difference in healing ulcers (P < 0.05) and mean healing time (P < 0.05) between the two groups. Conclusions Using the infrared plus routine dressing is more effective than using merely routine dressing. PMID:27942260

[The risk of manual handling loads in the hotel sector].

PubMed

Muraca, G; Martino, L Barbaro; Abbate, A; De Pasquale, D; Barbuzza, O; Brecciaroli, R

2007-01-01

The aim of our study is to evaluate the manual handling risk and the incidence of muscle-skeletal pathologies in the hotel compartment. Our study is conducted on 264 workers of the hotel compartment. The sample is divided on the base of the working turn in the following groups: porter (both to the plans and in the kitchen); waiters to the plans; services (gardeners and workers). The duties have been valued according to the method NIOSH. The presence of muscle-skeletal pathologies has been verified on the base to the accused symptomology, and on the presence of clinical objectivity and to the reports of checks. The data has been compared to a control group. The application of the NIOSH method has showed for each working profile an elevated synthetic index, > 3, and for porter the index is 5. The clinical data has shown an elevated incidence of pathologies of the spine, especially lumbar spine, with a high prevalence in the group of male porters. In conclusion we believe that the manual handling represents a particularly remarkable risk for the workers in the hotel compartment.

Femtosecond Pulse Characterization as Applied to One-Dimensional Photonic Band Edge Structures

NASA Technical Reports Server (NTRS)

Fork, Richard L.; Gamble, Lisa J.; Diffey, William M.

1999-01-01

The ability to control the group velocity and phase of an optical pulse is important to many current active areas of research. Electronically addressable one-dimensional photonic crystals are an attractive candidate to achieve this control. This report details work done toward the characterization of photonic crystals and improvement of the characterization technique. As part of the work, the spectral dependence of the group delay imparted by a GaAs/AlAs photonic crystal was characterized. Also, a first generation an electrically addressable photonic crystal was tested for the ability to electronically control the group delay. The measurement technique, using 100 femtosecond continuum pulses was improved to yield high spectral resolution (1.7 nanometers) and concurrently with high temporal resolution (tens of femtoseconds). Conclusions and recommendations based upon the work done are also presented.

Cyber-Neuropsychology: application of new technologies in neuropsychological evaluation.

PubMed

Bernardo-Ramos, Mercedes; Franco-Martín, Manuel A; Soto-Pérez, Felipe

2012-01-01

Neuropsychological evaluation deals with the study of cerebral functioning through the persons' performance. It makes it possible to collaborate the clinical diagnosis and to provide information on deficit and skills. Specialized care in rural environments is uncommon, and often means impossibility to access some services. This study has aimed to evaluate the possibility of using neuropsychological evaluation by internet videoconferences. Our research was based on the traditional and online application of the SCIP-S to 30 subjects who were diagnosed with schizophrenia. The 30 subjects were randomly divided into two groups (Group A and B). Both groups underwent the two conditions inversely. The results show some differences and similarities when the results in both types of applications SCIP-S are compared. In conclusion, cyber-neuropsychology is possible and may be a complement and alternative to traditional assessment when they cannot develop.

Accuracy of Rapid Tests for Malaria and Treatment Outcomes for Malaria and Non-Malaria Cases among Under-Five Children in Rural Ghana

PubMed Central

Baiden, Frank; Webster, Jayne; Tivura, Mathilda; Delimini, Rupert; Berko, Yvonne; Amenga-Etego, Seeba; Agyeman-Budu, Akua; Karikari, Akosua B.; Bruce, Jane; Owusu-Agyei, Seth; Chandramohan, Daniel

2012-01-01

Background WHO now recommends test-based management of malaria across all transmission settings. The accuracy of rapid diagnostic test (RDT) and the outcome of treatment based on the result of tests will influence acceptability of and adherence to the new guidelines. Method We conducted a study at the Kintampo hospital in rural Ghana to evaluate the performance of CareStart, a HRP-2 based RDT, using microscopy as reference. We applied IMCI treatment guidelines, restricted ACT to RDT-positive children and followed-up both RDT-positive (malaria) and RDT-negative (non-malaria) cases over 28 days. Results 436 children were enrolled in the RDT evaluation and 391 (children with haemoglobin >8.0 gm/dl) were followed-up to assess treatment outcomes. Mean age was 25.4 months (s.d. 14.6). Sensitivity and specificity of the RDT were 100.0% and 73.0% respectively. Over the follow-up period, 32 (18.5%) RDT-negative children converted to positive, with 7 (4.0%) of them presenting with fever. More children in the non-malaria group made unscheduled visits than children in the malaria group (13.3% versus 7.7%) On all scheduled follow-up visits, proportion of children having a temperature higher than that recorded on day 0 was higher in the non-malaria group compared to the malaria group. Reports of unfavourable treatment outcomes by caregivers were higher among the non-malaria group than the malaria group. Conclusions The RDT had good sensitivity and specificity. However a minority of children who will not receive ACT based on RDT results may develop clinical malaria within a short period in high transmission settings. This could undermine caregivers' and health workers' confidence in the new guidelines. Improving the quality of management of non-malarial febrile illnesses should be a priority in the era of test-based management of malaria. Trial Registration ClinicalTrials.gov NCT00832754 PMID:22514617

A Comparison Between Phone-Based Psychotherapy With and Without Text Messaging Support In Between Sessions for Crisis Patients

PubMed Central

2014-01-01

Background Few studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation. Objective The intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises. Methods Over a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only. Results A total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3). Conclusions Both groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing the clinical impact of the tailored text messages, and utilizing designs with additional power to test for between-group effects. PMID:25295667

Effect of metal conditioner on bonding of porcelain to cobalt-chromium alloy

PubMed Central

Kajihara, Yutaro; Takenouchi, Yoshihisa; Tanaka, Takuo; Suzuki, Shiro; Minami, Hiroyuki

2016-01-01

PURPOSE The purpose of this study was to evaluate the efficacy of two different metal conditioners for non-precious metal alloys for the bonding of porcelain to a cobalt-chromium (Co-Cr) alloy. MATERIALS AND METHODS Disk-shaped specimens (2.5×10.0 mm) were cast with Co-Cr alloy and used as adherend materials. The bonding surfaces were polished with a 600-grid silicon carbide paper and airborne-particle abraded using 110 µm alumina particles. Bonding specimens were fabricated by applying and firing either of the metal conditioners on the airborne-particle abraded surface, followed by firing porcelain into 5 mm in diameter and 3 mm in height. Specimens without metal conditioner were also fabricated. Shear bond strength for each group (n=8) were measured and compared (α=.05). Sectional view of bonding interface was observed by SEM. EDS analysis was performed to determine the chemical elements of metal conditioners and to determine the failure modes after shear test. RESULTS There were significant differences among three groups, and two metal conditioner-applied groups showed significantly higher values compared to the non-metal conditioner group. The SEM observation of the sectional view at bonding interface revealed loose contact at porcelain-alloy surface for non-metal conditioner group, however, close contact at both alloy-metal conditioner and metal conditioner-porcelain interfaces for both metal conditioner-applied groups. All the specimens showed mixed failures. EDS analysis showed that one metal conditioner was Si-based material, and another was Ti-based material. Si-based metal conditioner showed higher bond strengths compared to the Ti-based metal conditioner, but exhibited more porous failure surface failure. CONCLUSION Based on the results of this study, it can be stated that the application of metal conditioner is recommended for the bonding of porcelain to cobalt-chromium alloys. PMID:26949481

Peer Group Self-Identification as a Predictor of Relational and Physical Aggression Among High School Students

PubMed Central

Pokhrel, Pallav; Sussman, Steven; Black, David; Sun, Ping

2011-01-01

BACKGROUND Adolescent peer group self-identification refers to adolescents’ affiliation with reputation-based peer groups such as “Goths” or “Jocks.” These groups tend to vary on normative characteristics, including the group members’ attitudes and behaviors. This article examined whether adolescents’ baseline peer group self-identification predicted their self-reported relational and physical aggression 1 year later. METHODS Self-report data were collected from 1614 students from 9 regular and 9 continuation (alternative) high schools in Southern California, at baseline and 1-year follow-up. Subjects’ mean baseline age was 15.21 years (SD = 1.18) and 51.6% of the subjects were female. RESULTS Findings indicated that compared with self-identified “Regular” or “Normal” students, adolescents who identified with high-risk peer groups (eg, “Druggies,” “Goths”) tended to report higher relational and physical aggression 1 year later, controlling for baseline aggression and demographic variables. In addition, adolescents’ self-identification with high-status peer groups (eg, “Jocks,” “Populars”) was predictive of higher relational aggression 1 year later. Gender and school type (ie, regular vs continuation) were not found to moderate these effects. CONCLUSIONS It appears that peer group self-identification is a salient predictor of physical and relational aggression across gender and school type. Adolescents who identify with high-risk peer groups tend to report higher levels of physical as well as relational aggression in the future. In addition, adolescents who affiliate with elite groups tend to become more relationally aggressive over time. School-based prevention programs targeting aggression may benefit from addressing the impacts of peer group self-identification on adolescents’ aggressive behavior. PMID:20529198

Design and feasibility testing of a novel group intervention for young women who binge drink in groups

PubMed Central

Crombie, Iain K.; Swanson, Vivien; Dimova, Elena D.; Melson, Ambrose J.; Fraser, Tracey M.; Barbour, Rosaline; Rice, Peter M.; Allan, Sheila

2018-01-01

Background Young women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods. Methods Friendship groups of women aged 18–35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. Results The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%. Conclusions This study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial. PMID:29494683

Effect of diabetes mellitus on walking distance parameters after supervised exercise therapy for intermittent claudication: A systematic review.

PubMed

Hageman, David; Gommans, Lindy Nm; Scheltinga, Marc Rm; Teijink, Joep Aw

2017-02-01

Some believe that certain patients with intermittent claudication may be unsuitable for supervised exercise therapy (SET), based on the presence of comorbidities and the possibly increased risks. We conducted a systematic review (MEDLINE, EMBASE and CENTRAL) to summarize evidence on the potential influence of diabetes mellitus (DM) on the response to SET. Randomized and nonrandomized studies that investigated the effect of DM on walking distance after SET in patients with IC were included. Considered outcome measures were maximal, pain-free and functional walking distance (MWD, PFWD and FWD). Three articles met the inclusion criteria ( n = 845). In one study, MWD was 111 meters (128%) longer in the non-DM group compared to the DM group after 3 months of follow-up ( p = 0.056). In a second study, the non-DM group demonstrated a significant increase in PFWD (114 meters, p ⩽ 0.05) after 3 months of follow-up, whereas there was no statistically significant increase for the DM group (54 meters). On the contrary, the largest study of this review did not demonstrate any adverse effect of DM on MWD and FWD after SET. In conclusion, the data evaluating the effects of DM on SET were inadequate to determine if DM impairs the exercise response. While trends in the data do not suggest an impairment, they are not conclusive. Practitioners should consider this limitation when making clinical decisions.

Cost-Effectiveness Analysis of Primary Arthrodesis Versus Open Reduction Internal Fixation for Primarily Ligamentous Lisfranc Injuries.

PubMed

Albright, Rachel H; Haller, Sarah; Klein, Erin; Baker, Jeffrey R; Weil, Lowell; Weil, Lowell S; Fleischer, Adam E

The purpose of the present study was to determine whether surgical intervention with open reduction internal fixation (ORIF) or primary arthrodesis (PA) for Lisfranc injuries is more cost effective. We conducted a formal cost-effectiveness analysis using a Markov model and decision tree to explore the healthcare costs and health outcomes associated with a scenario of ORIF versus PA for 45 years postoperatively. The outcomes assessed included long-term costs, quality-adjusted life-years (QALYs), and incremental cost per QALY gained. The costs were evaluated from the healthcare system perspective and are expressed in U.S. dollars at a 2017 price base. ORIF was always associated with greater costs compared with PA and was less effective in the long term. When calculating the cost required to gain 1 additional QALY, the PA group cost $1429/QALY and the ORIF group cost $3958/QALY. The group undergoing PA overall spent, on average, $43,192 less than the ORIF group, and PA was overall a more effective technique. Strong dominance compared with ORIF was demonstrated in multiple scenarios, and the model's conclusions were unchanged in the sensitivity analysis even after varying the key assumptions. ORIF failed to show functional or financial benefits. In conclusion, from a healthcare system's standpoint, PA would clearly be the preferred treatment strategy for predominantly ligamentous Lisfranc injuries and dislocations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Prevalence of unprotected anal intercourse in men who have sex with men recruited online versus offline: a meta-analysis

PubMed Central

2014-01-01

Background Men who have sex with men (MSM) are a high risk population for human immunodeficiency virus (HIV) infection. Our study aims to find whether MSM who were recruited online had a higher prevalence of self-reported unprotected anal intercourse (UAI) than those who were recruited offline. Methods A meta-analysis was conducted from the results of published studies. The analysis was stratified by the participants’ geographic location, the sample size and the date of the last reported UAI. Results Based on fourteen studies, MSM who were recruited online (online-based group) reported that 33.9% (5,961/17,580) of them had UAI versus 24.9% (2,700/10,853) of MSM who were recruited offline (offline-based group). The results showed that it is more likely for an online-based MSM group to have UAI with male partners than an offline-based MSM group [odds ratio (OR) = 1.35, 95% CI = 1.13-1.62, P < 0.01]. The subgroup analysis results also showed that the prevalence of UAI was higher in the European subsample (OR = 1.38, 95% CI = 1.17-1.63, P < 0.01) and in sample sizes of more than 500 individuals (OR = 1.32, 95% CI = 1.09-1.61, P < 0.01) in the online group compared to the offline group. The prevalence of UAI was also significantly higher when the time of the last UAI was during the last 3 or more months (OR = 1.40, 95% CI = 1.13-1.74, P < 0.05) in the online group compared to the offline group. A sensitivity analysis was used to test the reliability of the results, and it reported that the results remained unchanged and had the same estimates after deleting any one of the included studies. Conclusions A substantial percentage of MSM were recruited online, and they were more inclined to engage in UAI than MSM who were recruited offline. Targeted interventions of HIV prevention programs or services are recommended when designing preventive interventions to be delivered via the Internet. PMID:24885058

The effect of morphometric atlas selection on multi-atlas-based automatic brachial plexus segmentation.

PubMed

Van de Velde, Joris; Wouters, Johan; Vercauteren, Tom; De Gersem, Werner; Achten, Eric; De Neve, Wilfried; Van Hoof, Tom

2015-12-23

The present study aimed to measure the effect of a morphometric atlas selection strategy on the accuracy of multi-atlas-based BP autosegmentation using the commercially available software package ADMIRE® and to determine the optimal number of selected atlases to use. Autosegmentation accuracy was measured by comparing all generated automatic BP segmentations with anatomically validated gold standard segmentations that were developed using cadavers. Twelve cadaver computed tomography (CT) atlases were included in the study. One atlas was selected as a patient in ADMIRE®, and multi-atlas-based BP autosegmentation was first performed with a group of morphometrically preselected atlases. In this group, the atlases were selected on the basis of similarity in the shoulder protraction position with the patient. The number of selected atlases used started at two and increased up to eight. Subsequently, a group of randomly chosen, non-selected atlases were taken. In this second group, every possible combination of 2 to 8 random atlases was used for multi-atlas-based BP autosegmentation. For both groups, the average Dice similarity coefficient (DSC), Jaccard index (JI) and Inclusion index (INI) were calculated, measuring the similarity of the generated automatic BP segmentations and the gold standard segmentation. Similarity indices of both groups were compared using an independent sample t-test, and the optimal number of selected atlases was investigated using an equivalence trial. For each number of atlases, average similarity indices of the morphometrically selected atlas group were significantly higher than the random group (p < 0,05). In this study, the highest similarity indices were achieved using multi-atlas autosegmentation with 6 selected atlases (average DSC = 0,598; average JI = 0,434; average INI = 0,733). Morphometric atlas selection on the basis of the protraction position of the patient significantly improves multi-atlas-based BP autosegmentation accuracy. In this study, the optimal number of selected atlases used was six, but for definitive conclusions about the optimal number of atlases and to improve the autosegmentation accuracy for clinical use, more atlases need to be included.

The use of a magnesium-based bone adhesive for flexor tendon-to-bone healing

PubMed Central

Stavros, Thomopoulos; Emmanouil, Zampiakis; Rosalina, Das; Hyun-Min, Kim; J., Silva, Matthew; Necat, Havlioglu; H., Gelberman, Richard

2010-01-01

Purpose Our previous studies in a canine animal model demonstrated that the flexor tendon-to-bone insertion site has a poor capacity to heal. Magnesium based adhesives have the potential to improve tendon-to-bone healing. Therefore, we hypothesized that magnesium based bone adhesive (MBA) will improve the tendon-to-bone biomechanical properties initially and in the early period after repair. Methods Flexor digitorum profundus tendons were injured and repaired into bone tunnels in the distal phalanges of dogs. The bone tunnels were either filled with MBA prior to completing the repair or left empty (CTL). Histologic appearance, tensile properties, range of motion, and bone density were examined at time zero and 21 days after the repair. Results There was no histologic evidence of acute inflammation. There appeared to be more mast cells in the MBA group than in the CTL group. Chronic inflammatory infiltrate and fibrosis was slightly higher in the MBA group compared to the CTL group. Tensile properties at time zero were significantly higher in the MBA group compared to the CTL group. However, tensile properties were significantly lower in the MBA group compared to the CTL group at 21 days. Range of motion and bone density were significantly lower in the MBA and CTL groups compared to normal (i.e., uninjured) at 21 days; no differences were seen when comparing MBA to CTL. Conclusions We found that the initial biomechanical properties of flexor tendon-to-bone repairs can be improved with MBA. However, MBA use in vivo led to a decrease in the biomechanical properties of the repair. There was no effect of MBA on bone density or range of motion in the early period after repair. Our histologic analysis suggests that the poor healing in the MBA group may have been due to an allergic response or to increased chronic inflammation due to the foreign material. PMID:19643291

A community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson disease

PubMed Central

Foster, Erin R.; Golden, Laura; Duncan, Ryan P.; Earhart, Gammon M.

2012-01-01

Objective To determine the effect of a 12-month community-based tango dance program on activity participation among individuals with Parkinson disease (PD). Design Randomized controlled trial with assessment at baseline, 3, 6, and 12 months. Setting The intervention was administered in the community; assessments were completed in a university laboratory. Participants Sixty-two volunteers with PD enrolled in the study and were randomized to treatment group. Ten participants did not receive the allocated intervention, so the final analyzed sample included 52 participants. Intervention Participants were randomly assigned to the Tango group, which involved 12 months of twice weekly Argentine tango dance classes, or to the no intervention Control group (n = 26 per group). Main Outcome Measures Current, new and retained participation in instrumental, leisure and social activities as measured by the Activity Card Sort (with the “dance” activity removed). Results Total Current participation in the Tango group was higher at 3, 6, and 12 months compared to baseline (ps ≤ 0.008), while the Control group did not change (ps ≥ 0.11). Total Activity Retention (since onset of PD) in the Tango group increased from 77% to 90% (p = 0.006) over the course of the study, whereas the Control group remained around 80% (p = 0.60). These patterns were similar in the separate activity domains. The Tango group gained a significant number of New Social activities (p = 0.003), but the Control group did not (p = 0.71). Conclusions Individuals with PD who participated in a community-based Argentine tango class reported increased participation in complex daily activities, recovery of activities lost since the onset of PD, and engagement in new activities. Incorporating dance into the clinical management of PD may benefit participation and subsequently quality of life for this population. PMID:22902795

A Field Test of a Web-Based Workplace Health Promotion Program to Improve Dietary Practices, Reduce Stress, and Increase Physical Activity: Randomized Controlled Trial

PubMed Central

Billings, Douglas W; Hersch, Rebekah K; Back, Anita S; Hendrickson, April

2007-01-01

Background Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet. Objective The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity. Methods Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests. Results Retention rates were good for both groups—85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F1,415 = 7.104, P = .008) and Dietary Stage of Change (F1,408 = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F2,203 = 5.270, P = .003), Attitudes Toward a Healthful Diet (F2,204 = 2.585, P = .045), and Dietary Stage of Change (F2,200 = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F1,410 = 9.808, P = .002). Conclusions The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition. PMID:17581811

Evaluating team-based, lecture-based, and hybrid learning methods for neurology clerkship in China: a method-comparison study

PubMed Central

2014-01-01

Background Neurology is complex, abstract, and difficult for students to learn. However, a good learning method for neurology clerkship training is required to help students quickly develop strong clinical thinking as well as problem-solving skills. Both the traditional lecture-based learning (LBL) and the relatively new team-based learning (TBL) methods have inherent strengths and weaknesses when applied to neurology clerkship education. However, the strengths of each method may complement the weaknesses of the other. Combining TBL with LBL may produce better learning outcomes than TBL or LBL alone. We propose a hybrid method (TBL + LBL) and designed an experiment to compare the learning outcomes with those of pure LBL and pure TBL. Methods One hundred twenty-seven fourth-year medical students attended a two-week neurology clerkship program organized by the Department of Neurology, Sun Yat-Sen Memorial Hospital. All of the students were from Grade 2007, Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-Sen University. These students were assigned to one of three groups randomly: Group A (TBL + LBL, with 41 students), Group B (LBL, with 43 students), and Group C (TBL, with 43 students). The learning outcomes were evaluated by a questionnaire and two tests covering basic knowledge of neurology and clinical practice. Results The practice test scores of Group A were similar to those of Group B, but significantly higher than those of Group C. The theoretical test scores and the total scores of Group A were significantly higher than those of Groups B and C. In addition, 100% of the students in Group A were satisfied with the combination of TBL + LBL. Conclusions Our results support our proposal that the combination of TBL + LBL is acceptable to students and produces better learning outcomes than either method alone in neurology clerkships. In addition, the proposed hybrid method may also be suited for other medical clerkships that require students to absorb a large amount of abstract and complex course materials in a short period, such as pediatrics and internal medicine clerkships. PMID:24884854

GOLD Stage and Treatment in COPD: A 500 Patient Point Prevalence Study.

PubMed

Safka, Katherine A; Wald, Joshua; Wang, Hongyu; McIvor, Luke; McIvor, Andrew

2016-12-22

Background and Objective: The Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines recommend using a combination of spirometry, symptoms and exacerbation history to classify patients into 4 categories (A, B, C, D) to guide treatment decisions along with a stepwise increase in therapy. Our objectives were to identify the GOLD stage of patients in respiratory outpatient clinics and assess how treatment compares to guideline recommendations. Methods: This was a point prevalence study using a convenience sample of 500 patients with chronic obstructive pulmonary disease (COPD) from a single tertiary care outpatient respiratory clinic. Results: Patients' GOLD classification was determined based on symptoms (modified Medical Research Council [mMRC] dyspnea scale, COPD Assessment Test [CAT]), spirometry and self-reported exacerbation history. A total of 8.2% of patients were in the GOLD group A, 28.3% in group B, 4.2% in group C and 59.2% in group D. Conclusions: In this 500 patient point prevalence study we report a low proportion of patients in GOLD group C and a high level of inhaled corticosteroids (ICS)/ long-acting beta2-agonist (LABA) and triple therapy use throughout all GOLD categories. Clinical Implications: The GOLD guidelines have attempted to provide direction to practitioners by grouping patients into 4 groups based on symptoms and exacerbations however, the low prevalence of GOLD group C may indicate that not all of these groupings are clinically relevant. Future research is needed to better identify clinically relevant phenotypes that predict benefit from ICS and methods to promote guideline concordant management in COPD.

The Effect of Gap Angle on Tensile Strength of Preceramic Base Metal Solder Joints

PubMed Central

Fattahi, Farnaz; Hashemi Ardakani, Zahra; Hashemi Ardakani, Maryam

2015-01-01

Statement of the Problem Soldering is a process commonly used in fabricating dental prosthesis. Since most soldered prosthesis fail at the solder joints; the joint strength is of utmost importance. Purpose The purpose of this study was to evaluate the effect of gap angle on the tensile strength of base metal solder joints. Materials and Method A total number of 40 Ni-Cr samples were fabricated according to ADA/ISO 9693 specifications for tensile test. Samples were cut at the midpoint of the bar, and were placed at the considered angles by employing an explicitly designed device. They were divided into 4 groups regarding the gap angle; Group C (control group) with parallel gap on steady distance of 0.2mm, Group 1: 10°, Group 2: 20°, and Group3: 30° gap angles. When soldered, the specimens were all tested for tensile strength using a universal testing machine at a cross-head speed of 0.5 mm/min with a preload of 10N. Kruskal-Wallis H test was used to compare tensile strength among the groups (p< 0.05). Results The mean tensile strength values obtained from the study groups were respectively 307.84, 391.50, 365.18, and 368.86 MPa. The tensile strength was not statistically different among the four groups in general (p≤ 0.490). Conclusion Making the gap angular at the solder joints and the subsequent unsteady increase of the gap distance would not change the tensile strength of the joint. PMID:26636118

Comparing the Use of an Online Expert Health Network against Common Information Sources to Answer Health Questions

PubMed Central

Lenderink, Annet F; van Dijk, Frank JH; Hulshof, Carel TJ

2012-01-01

Background Many workers have questions about occupational safety and health (OSH). It is unknown whether workers are able to find correct, evidence-based answers to OSH questions when they use common information sources, such as websites, or whether they would benefit from using an easily accessible, free-of-charge online network of OSH experts providing advice. Objective To assess the rate of correct, evidence-based answers to OSH questions in a group of workers who used an online network of OSH experts (intervention group) compared with a group of workers who used common information sources (control group). Methods In a quasi-experimental study, workers in the intervention and control groups were randomly offered 2 questions from a pool of 16 standardized OSH questions. Both questions were sent by mail to all participants, who had 3 weeks to answer them. The intervention group was instructed to use only the online network ArboAntwoord, a network of about 80 OSH experts, to solve the questions. The control group was instructed that they could use all information sources available to them. To assess answer correctness as the main study outcome, 16 standardized correct model answers were constructed with the help of reviewers who performed literature searches. Subsequently, the answers provided by all participants in the intervention (n = 94 answers) and control groups (n = 124 answers) were blinded and compared with the correct model answers on the degree of correctness. Results Of the 94 answers given by participants in the intervention group, 58 were correct (62%), compared with 24 of the 124 answers (19%) in the control group, who mainly used informational websites found via Google. The difference between the 2 groups was significant (rate difference = 43%, 95% confidence interval [CI] 30%–54%). Additional analysis showed that the rate of correct main conclusions of the answers was 85 of 94 answers (90%) in the intervention group and 75 of 124 answers (61%) in the control group (rate difference = 29%, 95% CI 19%–40%). Remarkably, we could not identify differences between workers who provided correct answers and workers who did not on how they experienced the credibility, completeness, and applicability of the information found (P > .05). Conclusions Workers are often unable to find correct answers to OSH questions when using common information sources, generally informational websites. Because workers frequently misjudge the quality of the information they find, other strategies are required to assist workers in finding correct answers. Expert advice provided through an online expert network can be effective for this purpose. As many people experience difficulties in finding correct answers to their health questions, expert networks may be an attractive new source of information for health fields in general. PMID:22356848

Effects of asymptomatic Giardia intestinalis infection on carbohydrate absorption in well-nourished Mexican children.

PubMed

Moya-Camarena, Silvia Y; Sotelo, Norberto; Valencia, Mauro E

2002-03-01

The aim of this study was to evaluate carbohydrate absorption in well-nourished children with asymptomatic giardiasis. Two groups were selected based on results of stool examination of 211 children attending pre-school centers in Hermosillo, Sonora, Mexico: a control group of six non-infected children, and an infected group of seven children harboring Giardia intestinalis, without gastrointestinal symptoms of disease. Carbohydrate absorption was determined in the control group, before and after drug therapy in the infected group by the hydrogen breath test. Hydrogen production after lactose ingestion was higher in children with giardiasis compared with control group and after anti-parasite treatment; however, hydrogen production was not high enough to classify children as lactose malabsorbers by the cut-off criteria. Similar results were obtained for xylose absorption. None of the children had hydrogen increments high enough to be considered xylose malabsorbers. In conclusion, children asymptomatically infected with G. intestinalis showed significantly higher hydrogen production. However, the biological relevance is questionable since they did not exceed cut-off criteria to classify them as carbohydrate malabsorbers.

Effect of propofol versus sodium thiopental on electroconvulsive therapy in major depressive disorder: a randomized double-blind controlled clinical trial.

PubMed

Purtuloğlu, Tark; Özdemir, Barbaros; Erdem, Murat; Deniz, Süleyman; Balkç, Adem; Ünlü, Gazi; Öznur, Taner

2013-03-01

To compare propofol and sodium thiopental as anesthetic agents for electroconvulsive therapy (ECT) in major depression with respect to clinical effect. Participants were composed of 96 patients with depression who were administered either propofol or sodium thiopental as an anesthetic agent for bilateral ECT. The Hamilton Depression Rating Scale was administered at baseline and after 6 treatments. Algorithm-based charge dosing was used. There was a statistically significant difference between the groups regarding postintervention Hamilton Depression Rating Scale score. The preintervention mean (SD) scores in the propofol group and the sodium thiopental group were 37.3 (2.2) and 36.7 (1.2), respectively. The postintervention mean (SD) scores in the propofol group and the sodium thiopental group were 10.7 (1.8) and 13.4 (3.3), respectively. No correlation was found between clinical response and age, weight, and body mass index. There was no association between the groups' seizure time and duration of recovery. In conclusion, propofol may improve major depressive disorder more than sodium thiopental in patients who are receiving ECT.

Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

PubMed Central

Eek, Frida; Merlo, Juan; Gerdtham, Ulf; Lithman, Thor

2009-01-01

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group. PMID:19936124

Multifactorial Analysis of Mortality in Screening Detected Lung Cancer.

PubMed

Digumarthy, Subba R; De Man, Ruben; Canellas, Rodrigo; Otrakji, Alexi; Wang, Ge; Kalra, Mannudeep K

2018-01-01

We hypothesized that severity of coronary artery calcification (CAC), emphysema, muscle mass, and fat attenuation can help predict mortality in patients with lung cancer participating in the National Lung Screening Trial (NLST). Following regulatory approval from the Cancer Data Access System (CDAS), all patients diagnosed with lung cancer at the time of the screening study were identified. These subjects were classified into two groups: survivors and nonsurvivors at the conclusion of the NLST trial. These groups were matched based on their age, gender, body mass index (BMI), smoking history, lung cancer stage, and survival time. CAC, emphysema, muscle mass, and subcutaneous fat attenuation were quantified on baseline low-dose chest CT (LDCT) for all patients in both groups. Nonsurvivor group had significantly greater CAC, decreased muscle mass, and higher fat attenuation compared to the survivor group ( p < 0.01). No significant difference in severity of emphysema was noted between the two groups ( p > 0.1). We thus conclude that it is possible to create a quantitative prediction model for lung cancer mortality for subjects with lung cancer detected on screening low-dose CT (LDCT).

Efficacy of ProTaper Retreatment System in Root Canals Obturated with Gutta-Percha Using Two Different Sealers and GuttaFlow

PubMed Central

Siotia, Jaya; Acharya, Shashi Rashmi; Gupta, Sunil Kumar

2011-01-01

Objective. To compare the efficacy of ProTaper retreatment files in removing three different obturating materials. Study Design. Forty-five human, single-rooted premolars were divided into three experimental groups. Group 1 was obturated with gutta-percha and AH Plus sealer, Group 2 was obturated with gutta-percha and zinc oxide eugenol sealer, and Group 3 was obturated with GuttaFlow. Retreatment was done using the ProTaper universal rotary retreatment files. Root halves were visualized using magnifying loops at 3X magnification and optical stereomicroscope at 10X magnification. Images were analyzed using AutoCAD 2004 software to calculate area of the remaining debris in the canal. For statistical analysis were used variance test and ANOVA. Results. Total debris/canal area ratio between the three groups showed a statistically significant difference (P < 0.001). Conclusion. ProTaper retreatment system did not produce completely clean canals in any of the groups. However, it had the best efficacy towards removing silicon based obturating material GuttaFlow. PMID:22114598

Advanced Age: Is It an Indication or Contraindication for Laparoscopic Ventral Hernia Repair?

PubMed Central

Elgamal, Mohamed H.; Mancl, Tara B.; Norman, Earl; Boros, Michael J.

2008-01-01

Introduction: Ventral hernias are common surgical problems in the geriatric population. Although ventral hernias are electively repaired in younger patients, the safety and efficacy of elective laparoscopic hernia repair in the geriatric age group is not well documented in the literature. Methods: A review of 155 patients undergoing laparoscopic ventral hernia repair was undertaken. The patients were classified according to their age into 2 groups, Group A (n=126) for those who are ≤65 years old and Group B (n=29) for those who are >65 years old. The patient demographics, comorbidities, hernia characteristics, and operative and postoperative data were compared. Results: Younger patients were found to have a significantly increased BMI, while the older group had an increased number of comorbidities. No difference was found in the complication or recurrence rates between the 2 groups. Conclusion: Elective laparoscopic ventral hernia repair in senior citizens is safe and feasible in our experience. We believe that the decision to perform an elective hernia repair in this patient population should be based on the general condition of the patient rather than the patient's chronological age. PMID:18402738

The perceived impact of the group practice model on enhancing interpersonal skills of predoctoral dental students

PubMed Central

Errante, Margaret R; Gill, Gurjinder S; Rodriguez, Tobias E

2018-01-01

Purpose The purpose of this study was to assess if a clinical group practice model has an impact on enhancing the interpersonal skills of predoctoral dental students, what factors may influence the development of these skills, and what, if any, are innovative and technological solutions that can potentially influence interpersonal skills in predoctoral dental students. Methods This study surveyed the faculty responsible for teaching the dental students in a recently developed group practice model. Out of 18 eligible group practice leaders at one US dental school, 17 respondents (94.4%) completed the survey. In addition, this study asked the faculty to provide qualitative response and recommendations to improve interpersonal skills. Based on the feedback, a focus group was conducted to explore opportunities to further enhance the skills. Results The results of the study suggest that the group practice model has a positive and distinct impact on the development of overall interpersonal skills for students. Further research suggests that the greatest impacted areas of personal development are critical thinking skills and teamwork. However, as a way to make the model more effectual, most faculty suggested the need for additional time, for both students and faculty. To some extent, using technology and innovative teaching pedagogies could potentially address the challenge of limited time. Conclusion Based on the results of the survey, one may conclude that with adequate design and conditions, the group practice model can have a positive effect on the interpersonal skills of its students. PMID:29720884

Comparison of brain connectivity between Internet gambling disorder and Internet gaming disorder: A preliminary study.

PubMed

Bae, Sujin; Han, Doug Hyun; Jung, Jaebum; Nam, Ki Chun; Renshaw, Perry F

2017-12-01

Background and aims Given the similarities in clinical symptoms, Internet gaming disorder (IGD) is thought to be diagnostically similar to Internet-based gambling disorder (ibGD). However, cognitive enhancement and educational use of Internet gaming suggest that the two disorders derive from different neurobiological mechanisms. The goal of this study was to compare subjects with ibGD to those with IGD. Methods Fifteen patients with IGD, 14 patients with ibGD, and 15 healthy control subjects were included in this study. Resting-state functional magnetic resonance imaging data for all participants were acquired using a 3.0 Tesla MRI scanner (Philips, Eindhoven, The Netherlands). Seed-based analyses, the three brain networks of default mode, cognitive control, and reward circuitry, were performed. Results Both IGD and ibGD groups demonstrated decreased functional connectivity (FC) within the default-mode network (DMN) (family-wise error p < .001) compared with healthy control subjects. However, the IGD group demonstrated increased FC within the cognitive network compared with both the ibGD (p < .01) and healthy control groups (p < .01). In contrast, the ibGD group demonstrated increased FC within the reward circuitry compared with both IGD (p < .01) and healthy control subjects (p < .01). Discussion and conclusions The IGD and ibGD groups shared the characteristic of decreased FC in the DMN. However, the IGD group demonstrated increased FC within the cognitive network compared with both ibGD and healthy comparison groups.

ITS2 data corroborate a monophyletic chlorophycean DO-group (Sphaeropleales)

PubMed Central

2008-01-01

Background Within Chlorophyceae the ITS2 secondary structure shows an unbranched helix I, except for the 'Hydrodictyon' and the 'Scenedesmus' clade having a ramified first helix. The latter two are classified within the Sphaeropleales, characterised by directly opposed basal bodies in their flagellar apparatuses (DO-group). Previous studies could not resolve the taxonomic position of the 'Sphaeroplea' clade within the Chlorophyceae without ambiguity and two pivotal questions remain open: (1) Is the DO-group monophyletic and (2) is a branched helix I an apomorphic feature of the DO-group? In the present study we analysed the secondary structure of three newly obtained ITS2 sequences classified within the 'Sphaeroplea' clade and resolved sphaeroplealean relationships by applying different phylogenetic approaches based on a combined sequence-structure alignment. Results The newly obtained ITS2 sequences of Ankyra judayi, Atractomorpha porcata and Sphaeroplea annulina of the 'Sphaeroplea' clade do not show any branching in the secondary structure of their helix I. All applied phylogenetic methods highly support the 'Sphaeroplea' clade as a sister group to the 'core Sphaeropleales'. Thus, the DO-group is monophyletic. Furthermore, based on characteristics in the sequence-structure alignment one is able to distinguish distinct lineages within the green algae. Conclusion In green algae, a branched helix I in the secondary structure of the ITS2 evolves past the 'Sphaeroplea' clade. A branched helix I is an apomorph characteristic within the monophyletic DO-group. Our results corroborate the fundamental relevance of including the secondary structure in sequence analysis and phylogenetics. PMID:18655698

Cytological Results of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules: Emphasis on Correlation with Sonographic Findings

PubMed Central

Lee, Mi-Jung; Hong, Soon Won; Chung, Woung Youn; Kwak, Jin Young; Kim, Min Jung

2011-01-01

Purpose To compare the cytological results of ultrasound-guided fine-needle aspiration (US-FNA) cytology of thyroid nodules to sonographic findings and determine whether US findings are helpful in the interpretation of cytological results. Materials and Methods Among the thyroid nodules that underwent US-FNA cytology, we included the 819 nodules which had a conclusive diagnosis. Final diagnosis was based on pathology from surgery, repeated FNA cytology or follow-up of more than one year. Cytological results were divided into five groups: benign, indeterminate (follicular or Hurthle cell neoplasm), suspicious for malignancy, malignant, and inadequate. US findings were categorized as benign or suspicious. Cytological results and US categories were analyzed. Results Final diagnosis was concluded upon in 819 nodules based on pathology (n=311), repeated FNA cytology (n=204) and follow-up (n=304), of which 634 were benign and 185 were malignant. There were 560 benign nodules, 141 malignant nodules, 49 nodules with inadequate results, 21 with indeterminate results, and 48 that were suspicious for malignancy. The positive and negative predictive values of the US categories were 59.1% and 97.0%, and those of the cytological results were 93.7% and 98.9%. The US categories were significantly correlated with final diagnosis in the benign (p=0.014) and suspicious for malignancy (p<0.001) cytological result groups, but not in the inadequate and indeterminate cytological results groups. The false positive and negative rates of cytological results were 1.9% and 3.2%. Conclusion Sonographic findings can be useful when used alongside cytological results, especially in nodules with cytological results that are benign or suspicious for malignancy. PMID:21786450

A prospective, randomized, double-blind, placebo-controlled parallel-group dual site trial to evaluate the effects of a Bacillus coagulans-based product on functional intestinal gas symptoms

PubMed Central

2009-01-01

Background This randomized double blind placebo controlled dual site clinical trial compared a probiotic dietary supplement to placebo regarding effects on gastrointestinal symptoms in adults with post-prandial intestinal gas-related symptoms (abdominal pain, distention, flatulence) but no gastrointestinal (GI) diagnoses to explain the symptoms. Methods Sixty-one adults were enrolled (age 36.5 ± 12.6 years; height 165.1 ± 9.2 cm; weight 75.4 ± 17.3 kg) and randomized to either Digestive Advantage™ Gas Defense Formula - (GanedenBC30 Bacillus coagulans GBI-30, 6086): n = 30; or Placebo: n = 31. Study subjects were evaluated every two weeks over a four-week period using validated questionnaires and standard biochemical safety testing. Outcome criteria of interest included change from baseline in Gastrointestinal Symptom Rating Scale (GSRS) abdominal pain, abdominal distention, flatus, and the Severity of Dyspepsia Assessment (SODA) bloating and gas subscores over four weeks of product use. Results Measured against the placebo, subjects in the probiotic group achieved significant improvements in GSRS abdominal pain subscore (p = 0.046) and the GSRS total score (p = 0.048), with a strong trend for improvement on the GSRS abdominal distension subscore (p = 0.061). A strong placebo effect was evident which could explain the lack of statistical significant differences between the groups for many of the efficacy variables. Conclusion In conclusion, the Bacillus coagulans-based product was effective in improving the quality of life and reducing gastrointestinal symptoms in adults with post prandial intestinal gas-related symptoms and no GI diagnoses. Trial Registration ClinicalTrials.gov Identifier: NCT00881322 PMID:19922649

An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia

PubMed Central

Hirano, Jinichi; Watanabe, Koichiro; Suzuki, Takefumi; Uchida, Hiroyuki; Den, Ryosuke; Kishimoto, Taishiro; Nagasawa, Takashi; Tomita, Yusuke; Hara, Koichiro; Ochi, Hiromi; Kobayashi, Yoshimi; Ishii, Mutsuko; Fujita, Akane; Kanai, Yoshihiko; Goto, Megumi; Hayashi, Hiromi; Inamura, Kanako; Ooshima, Fumiko; Sumida, Mariko; Ozawa, Tomoko; Sekigawa, Kayoko; Nagaoka, Maki; Yoshimura, Kae; Konishi, Mika; Inagaki, Ataru; Saito, Takuya; Motohashi, Nobutaka; Mimura, Masaru; Okubo, Yoshiro; Kato, Motoichiro

2013-01-01

Objective The use of an algorithm may facilitate measurement-based treatment and result in more rational therapy. We conducted a 1-year, open-label study to compare various outcomes of algorithm-based treatment (ALGO) for schizophrenia versus treatment-as-usual (TAU), for which evidence has been very scarce. Methods In ALGO, patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were treated with an algorithm consisting of a series of antipsychotic monotherapies that was guided by the total scores in the positive and negative syndrome scale (PANSS). When posttreatment PANSS total scores were above 70% of those at baseline in the first and second stages, or above 80% in the 3rd stage, patients proceeded to the next treatment stage with different antipsychotics. In contrast, TAU represented the best clinical judgment by treating psychiatrists. Results Forty-two patients (21 females, 39.0 ± 10.9 years-old) participated in this study. The baseline PANSS total score indicated the presence of severe psychopathology and was significantly higher in the ALGO group (n = 25; 106.9 ± 20.0) than in the TAU group (n = 17; 92.2 ± 18.3) (P = 0.021). As a result of treatment, there were no significant differences in the PANSS reduction rates, premature attrition rates, as well as in a variety of other clinical measures between the groups. Despite an effort to make each group unique in pharmacologic treatment, it was found that pharmacotherapy in the TAU group eventually became similar in quality to that of the ALGO group. Conclusion While the results need to be carefully interpreted in light of a hard-to-distinguish treatment manner between the two groups and more studies are necessary, algorithm-based antipsychotic treatments for schizophrenia compared well to treatment-as-usual in this study. PMID:24143104

Primary prevention of cardiovascular disease: a web‐based risk score for seven British black and minority ethnic groups

PubMed Central

Brindle, P; May, M; Gill, P; Cappuccio, F; D'Agostino, R; Fischbacher, C; Ebrahim, S

2006-01-01

Objective To recalibrate an existing Framingham risk score to produce a web‐based tool for estimating the 10‐year risk of coronary heart disease (CHD) and cardiovascular disease (CVD) in seven British black and minority ethnic groups. Design Risk prediction models were recalibrated against survey data on ethnic group risk factors and disease prevalence compared with the general population. Ethnic‐ and sex‐specific 10‐year risks of CHD and CVD, at the means of the risk factors for each ethnic group, were calculated from the product of the incidence rate in the general population and the prevalence ratios for each ethnic group. Setting Two community‐based surveys. Participants 3778 men and 4544 women, aged 35–54, from the Health Surveys for England 1998 and 1999 and the Wandsworth Heart and Stroke Study. Main outcome measures 10‐year risk of CHD and CVD. Results 10‐year risk of CHD and CVD for non‐smoking people aged 50 years with a systolic blood pressure of 130 mm Hg and a total cholesterol to high density lipoprotein cholesterol ratio of 4.2 was highest in men for those of Pakistani and Bangladeshi origin (CVD risk 12.6% and 12.8%, respectively). CHD risk in men with the same risk factor values was lowest in Caribbeans (2.8%) and CVD risk was lowest in Chinese (5.4%). Women of Pakistani origin were at highest risk and Chinese women at lowest risk for both outcomes with CVD risks of 6.6% and 1.2%, respectively. A web‐based risk calculator (ETHRISK) allows 10‐year risks to be estimated in routine primary care settings for relevant risk factor and ethnic group combinations. Conclusions In the absence of cohort studies in the UK that include significant numbers of black and minority ethnic groups, this risk score provides a pragmatic solution to including people from diverse ethnic backgrounds in the primary prevention of CVD. PMID:16762981