Home About us Contact
|
Home About us Contact | ||
|
|
||
Retention Rates (retention + rate)
Selected AbstractsLearning and Retention Rates after Training in Posterior Epistaxis ManagementACADEMIC EMERGENCY MEDICINE, Issue 11 2008Richard L. Lammers MD Abstract Objectives:, The objective of the study was to compare the learning and retention rates of resident physicians trained in posterior epistaxis management with nasal gauze packing on a simulation model following two training methods. Methods:, This was a prospective, repeated-measures study. An objective, criterion-referenced performance standard, consisting of the number of major steps completed in the proper sequence, and the number of minor steps completed within a specified time, was used by an evaluator to assess performances. Subjects underwent two pretraining assessments 1 week prior to and the day of training and then were randomized to one of two training methods: the traditional "observation" method or a "pause-and-perfect" method. After training, both groups repeated the procedure until meeting the performance standard. Subjects were retested 1 and 3 months after training. Results:, Twenty-eight subjects participated. Baseline performance measures were similar between groups and did not change prior to training. During performance testing, experimental subjects completed a greater percentage of major steps (84%) and minor steps (86%) in less time (25 minutes) than the controls (65 and 68%, in 35 minutes) during the first attempt. All subjects met the standard within three attempts. There were no differences in major and minor steps completed between the two groups at either 1 week or 3 months after training, but performance times were shorter in the experimental group. After 3 months, 13% of control and none of experimental subjects met the performance standard. Conclusions:, The pause-and-perfect training method produced more rapid progress toward a performance standard during the initial attempt and better performance times after 3 months than the traditional, observational training method. Without further practice, this skill deteriorated after 3 months with both methods of training. [source] HEPATITIS C AND ADDICTION: Retention rate and side effects in a prospective trial on hepatitis C treatment with pegylated interferon alpha-2a and ribavirin in opioid-dependent patientsADDICTION BIOLOGY, Issue 2 2009Nina Ebner ABSTRACT Hepatitis C viral (HCV) infection is present in 30 to 98% of intravenous drug users. Intravenous substance abuse represents the main route of HCV transmission in industrialized countries. A multi-centre, randomized, controlled, prospective study assessed sustained virological response (SVR), adverse events such as depressive episodes and retention rate of HCV treatment in opioid-dependent patients. Stabilized, opioid-dependent patients with chronic HCV infection (genotype 2 or 3) received pegylated interferon alpha-2a in combination with ribavirin 800 mg/day (Group A) or 400 mg/day (Group B). Participants were randomized, blocked and stratified by genotype and viral load. A standardized psychiatric assessment, Beck Depression Inventory (BDI) and Van Zerssen's list of complaints were administered at each study visit. In 31 months, 300 opioid-dependent patients were screened; 190 (63.3%) were hepatitis C antibody positive. According to study protocol, out of 75 ,potential-to-treat' patients with genotype 2 or 3, 17 stable patients (22.6%) were included in the study. All participants completed the study. Significant haemoglobin decreases occurred in both Groups A (P = 0.001) and B (P = 0.011). All the patients had an end-of-treatment (week 24) HCV RNA negativity. Fifteen (88.2%) achieved SVR at week 48. Overall, 52.9% developed depressive symptoms during treatment. Because of the prompt initiation of antidepressant medication at first appearance of depressive symptoms, no severe depressive episodes occurred. Our data show a high retention rate and reliability, and good viral response for both treatments. Hepatitis C treatment in stable opioid-dependent patients was efficacious, suggesting that addiction clinics can offer antiviral therapy in combination with agonistic treatment as part of multi-disciplinary treatment. [source] Partnership Between an Educational Institution and a Healthcare Agency,Lessons Learned: Part INURSING FORUM, Issue 3 2009Loucine M. Huckabay RN PURPOSE., The purpose of this paper is to provide a model of a partnership program between a major educational institution and a large community medical center that has become a win,win situation for both, which enabled the former to double its undergraduate nursing (BSN) program when it was on the verge of reducing enrollments by 33% because of repeated financial cuts, and a healthcare agency (HCA) to find a creative way of hiring BSN-educated registered nurses in perpetuity, thus reducing their $2 million a month recruitment expenses. PROCESS., This was a 5-year, $15 million partnership between California State University, Long Beach, School of Nursing and Long Beach Memorial Medical Center/Miller Children's Hospital. The HCA contributed the $10 million in funds and in in-kind contributions in the form of facilities and adjunct clinical professors, and the university contributed the $5 million, all in in-kind contribution by doubling the lecture classes without additional cost. The project started in the spring of 2004. CONCLUSION., To date, eight groups have graduated from this program for a total of 288 additional BSN graduates. Retention rate has been a minimum of 95%. Over 95% of the graduates have been hired by the participating HCA. Indeed, it has been a win,win situation for both. [source] Effective Methods to Improve Recruitment and Retention in School-Based Substance Use Prevention StudiesJOURNAL OF SCHOOL HEALTH, Issue 9 2009Jean-Marie Bruzzese PhD ABSTRACT BACKGROUND: Poor recruitment and high attrition may invalidate results of research studies. This paper describes successful recruitment and retention strategies in a school-based substance use prevention trial and explores factors associated with intervention attendance and retention. METHODS: A total of 384 parent-child dyads from 15 schools in the New York Metropolitan area participated in a control trial, testing the efficacy of parent-training to prevent youth substance use. Assessments were completed immediately post-intervention and 6-, 12-, and 24-month postintervention. Logistic regression analyses were used to determine which familial and study characteristics predicted attendance in the intervention and retention by parents and youth. RESULTS: 84% of intervention parents attended 4 of the 5 workshops; 83% of control parents attended their single workshop. Intervention attendance was predicted by parent job status, but this was not significant after controlling for other family factors. Retention rates ranged from 87% to 91% over the 2 years. No family characteristics predicted retention, but time since baseline and attendance at treatment workshops and the control workshop did. For children, age at baseline and ethnicity predicted retention, but this did not remain significant in the adjusted model. CONCLUSION: Intervention attendance was high and retention rates far exceeded the minimum standard of 70% retention in behavioral studies. Recruitment and retention strategies were effective for different family constellations. Efforts to maximize participation in both treatment and control interventions are critical to retention in longitudinal trials. [source] Retention rates of new antiepileptic drugs in localization-related epilepsy: a single-center studyACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009J. Peltola Objectives,,, We evaluated long-term retention rates of newer antiepileptic drugs (AED) in adults with localization-related epilepsy retrospectively. Methods,,, We estimated retention rates by Kaplan,Meier method in all 222 patients (age , 16) with localization-related epilepsy exposed to new AED at the Tampere University Hospital. Results,,, There were 141 patients exposed to lamotrigine, 78 to levetiracetam, 97 to topiramate, 68 to gabapentin, and 69 to tiagabine. Three-year retention rate for lamotrigine was 73.5%, levetiracetam 65.4%, topiramate 64.2%, gabapentin 41.7%, and tiagabine 38.2%. The most common cause for withdrawal of these AED was lack of efficacy. Conclusions,,, Our study suggests that there are clinically significant differences among gabapentin, lamotrigine, levetiracetam, tiagabine, and topiramate as treatment for focal epilepsy in everyday practice. Gabapentin and tiagabine seem to be less useful than the other three AED. Furthermore, our study supports the value of retention rate studies in assessing outcome of the drugs in clinical practice. [source] Long-term assessment of oxcarbazepine in a naturalistic setting: a retrospective studyACTA NEUROLOGICA SCANDINAVICA, Issue 5 2008U. Seneviratne Background,,, New antiepileptics seem to be better tolerated by patients. The retention rate of an antiepileptic would be a useful indicator of its practical usefulness. Aims,,, To assess the long-term outcome of oxcarbazepine (OXC) in a naturalistic setting by determining the retention rate. Methods,,, This is a retrospective study. All epilepsy patients treated with OXC at a tertiary care epilepsy center during a period of 3.5 years were included in this study. Retention rates of OXC at 1 and 3 years were estimated for each cohort group using Kaplan,Meier estimates and corresponding 95% confidence intervals. Results,,, A total of 98 patients were studied. OXC was used as monotherapy in 14 (14.3%) and as add-on therapy in 84 (85.7%). The mean daily dose was 947 ± 492 mg and 60% received ,900 mg/day. Using the Kaplan,Meier survival analysis, the retention rates of OXC at 1 and 3 years were estimated to be 0.853 (0.749,0.956) and 0.737 (0.570,0.904), respectively. Conclusions,,, OXC is well tolerated by patients as both monotherapy and add-on therapy. [source] GASTRIC FUNDIC VARICES: HEMODYNAMICS AND NON-SURGICAL TREATMENTDIGESTIVE ENDOSCOPY, Issue 3 2005Seishu Hayashi The hemodynamics and non-surgical treatment of gastric fundic varices (FV) are reviewed. FV are more frequently supplied by the short and posterior gastric veins than esophageal varices (EV), and are formed mostly by large spontaneous shunts in which the gastric or splenic vein is continuous with the left renal vein via the inferior phrenic veins and the suprarenal vein (so-called gastric-renal shunt). Concomitant collaterals such as EV, para-esophageal vein, and para-umbilical vein were also observed in nearly 60% of FV. Endoscopic injection sclerotherapy (EIS) with Histoacryl is thought to be the most approved treatment for hemorrhage from FV, but repeated treatment for residual FV and care for ensuing hepatic failure are required. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a notable interventional radiological procedure specially developed for the elective or prophylactic treatment of FV. If the procedure is technically successful, long-term eradication of treated FV is found in most patients without recurrence. B-RTO includes another significance, obliteration of the unified portal-systemic shunt. Follow-up abdominal CT scan revealed a high incidence of long-term obliteration of the gastric-renal shunt after B-RTO. Benefits such as elevation of serum albumin, improvement in 15-min retention rate of indocyanine green, decrease in blood ammonia levels, and improvement of encephalopathy are sometimes observed. [source] Prognostic Factors Affecting Long-Term Retention of Topiramate in Patients with Chronic EpilepsyEPILEPSIA, Issue 3 2000S. D. Lhatoo Summary: Purpose: To determine the long-term retention rate of topiramate (TPM) therapy in patients with chronic epilepsy and to identify the relevant prognostic factors that influence retention. Methods: All patients with chronic epilepsy (n = 393) prescribed TPM between October 1, 1995, and December 31, 1998, at a tertiary referral centre for epilepsy were analysed. The retention rate for TPM was calculated by using Kaplan-Meier survival analysis, and the prognostic factors influencing retention were analysed by using Cox regression. Results: Of patients prescribed TPM, 30% continued taking the drug beyond 3 years. Discontinuation was mainly due to adverse events and lack of efficacy. Use of more than one new concurrent antiepileptic drug (AED) and lower maximal daily doses were more likely to result in treatment discontinuation due to adverse events. Older age at onset of epilepsy, a history of having previously taken more than one new AED [lamotrigine (LTG), gabapentin (GBP), or vigabatrin (VGB)], and lower maximal daily doses were more likely to lead to discontinuation due to lack of efficacy. Conclusions: A third of patients with chronic epilepsy started on TPM therapy will continue on treatment for >3 years. Absence of learning disabilities, late age at onset of seizures, previous use of more than one new AED, two or more concurrent AED use, and low maximal daily doses of TPM are more likely to result in discontinuation of medication. These factors should be taken into account when considering the use of TPM for the treatment of chronic epilepsy. [source] Hepatic phenylalanine metabolism measured by the [13C]phenylalanine breath testEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 4 2001T. Kobayashi Background The amino acid clearance test including phenylalanine is known to reflect liver functional reserve, which correlates with surgical outcome; however, the procedure is not clinically useful because of its laborious and time-consuming nature. This study evaluates whether phenylalanine oxidation capacity measured by a breath test could reflect liver functional reserve. Design We determined phenylalanine oxidation capacity in 42 subjects using the l -[1- 13C]phenylalanine breath test (PBT). The 13CO2 breath enrichment was measured at 10-min intervals for 120 min after oral administration of 100 mg of l -[1- 13C]phenylalanine. Subjects were divided into the following three groups according to their plasma retention rate of indocyanine green at 15 min (ICG R15): Group I (ICG R15 <,10%), Group II (ICG R15 10,20%), and Group III (ICG R15 >,20%). First, we determined the parameters of the phenylalanine oxidation capacity that differentiated these groups and then, using these parameters, we compared the PBT with the ICG clearance test, Child,Pugh classification score and standard liver blood tests. Results The %13C dose h,1 at 30 min and cumulative excretion at 80 min were significantly different among the three groups (P < 0·05). These two parameters significantly correlated with the ICG R15, Child,Pugh classification score (P < 0·0001) and results of standard liver blood tests (P < 0·05). Conclusions Phenylalanine oxidation capacity measured by the PBT was reduced according to the severity of liver injury assessed by the ICG clearance test, Child,Pugh classification, and standard liver blood tests. These results indicate that the PBT can be used as a noninvasive method to determine liver functional reserve. [source] CLINICAL STUDY: Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trialADDICTION BIOLOGY, Issue 2 2009Paolo Mannelli ABSTRACT Although current treatments for opioid detoxification are not always effective, medical detoxification remains a required step before long-term interventions. The use of opioid antagonist medications to improve detoxification has produced inconsistent results. Very low dose naltrexone (VLNTX) was recently found to reduce opioid tolerance and dependence in animal and clinical studies. We decided to evaluate safety and efficacy of VLNTX adjunct to methadone in reducing withdrawal during detoxification. In a multi-center, double-blind, randomized study at community treatment programs, where most detoxifications are performed, 174 opioid-dependent subjects received NTX 0.125 mg, 0.250 mg or placebo daily for 6 days, together with methadone in tapering doses. VLNTX-treated individuals reported attenuated withdrawal symptoms [F = 7.24 (2,170); P = 0.001] and reduced craving [F = 3.73 (2,107); P = 0.03]. Treatment effects were more pronounced at discharge and were not accompanied by a significantly higher retention rate. There were no group differences in use of adjuvant medications and no treatment-related adverse events. Further studies should explore the use of VLNTX, combined with full and partial opioid agonist medications, in detoxification and long-term treatment of opioid dependence. [source] HEPATITIS C AND ADDICTION: Retention rate and side effects in a prospective trial on hepatitis C treatment with pegylated interferon alpha-2a and ribavirin in opioid-dependent patientsADDICTION BIOLOGY, Issue 2 2009Nina Ebner ABSTRACT Hepatitis C viral (HCV) infection is present in 30 to 98% of intravenous drug users. Intravenous substance abuse represents the main route of HCV transmission in industrialized countries. A multi-centre, randomized, controlled, prospective study assessed sustained virological response (SVR), adverse events such as depressive episodes and retention rate of HCV treatment in opioid-dependent patients. Stabilized, opioid-dependent patients with chronic HCV infection (genotype 2 or 3) received pegylated interferon alpha-2a in combination with ribavirin 800 mg/day (Group A) or 400 mg/day (Group B). Participants were randomized, blocked and stratified by genotype and viral load. A standardized psychiatric assessment, Beck Depression Inventory (BDI) and Van Zerssen's list of complaints were administered at each study visit. In 31 months, 300 opioid-dependent patients were screened; 190 (63.3%) were hepatitis C antibody positive. According to study protocol, out of 75 ,potential-to-treat' patients with genotype 2 or 3, 17 stable patients (22.6%) were included in the study. All participants completed the study. Significant haemoglobin decreases occurred in both Groups A (P = 0.001) and B (P = 0.011). All the patients had an end-of-treatment (week 24) HCV RNA negativity. Fifteen (88.2%) achieved SVR at week 48. Overall, 52.9% developed depressive symptoms during treatment. Because of the prompt initiation of antidepressant medication at first appearance of depressive symptoms, no severe depressive episodes occurred. Our data show a high retention rate and reliability, and good viral response for both treatments. Hepatitis C treatment in stable opioid-dependent patients was efficacious, suggesting that addiction clinics can offer antiviral therapy in combination with agonistic treatment as part of multi-disciplinary treatment. [source] Transport and settlement of organic matter in small streamsFRESHWATER BIOLOGY, Issue 2 2010TRENT M. HOOVER Summary 1.,After it enters streams, terrestrially derived organic matter (OM) rapidly absorbs water. Using field and laboratory experiments, we examined how this process affected the buoyancy, settling velocity, transport distance and retention locations of four types of organic matter typically found in Pacific coastal streams (,flexible' red alder leaves and three ,stiff' particle types , Douglas-fir needles, red cedar fronds and Douglas-fir branch pieces). 2.,Immersion in water rapidly changed the physical characteristics of alder leaves, Douglas-fir needles and red cedar fronds, which all reached constant still-water settling velocities after only a few days of soaking. In contrast, the settling velocity of branch pieces continued to increase for 13 days, eventually reaching much higher values than any other OM type. Dried alder leaves became negatively buoyant after only two days of immersion, while other types took substantially longer (up to 24 days) before the specific gravity of all particles was >1. 3.,We released saturated OM particles in an experimental channel and found that all particle types travelled further in a fast, shallow ,riffle' than a slow, deep ,pool'. Comparisons with a passive settlement null model indicated that leaves were retained more rapidly than expected in the riffle (by large protruding stones), while the three stiff particle types travelled further than expected (probably due to turbulent suspension) and were retained when they settled in deeper water between larger stones. In pools, passive settlement appeared to dominate the retention of all OM types, with leaves travelling furthest. 4.,These retention patterns corresponded well with those observed when saturated OM particles collected in the field were released in two pools and two riffles in a second-order coastal stream. 5.,When the experimental channel and in-stream data were combined, the retention rates of the three stiff OM types were closely related to calculated Rouse numbers (Rouse number = particle settling velocity/shear velocity), whereas the retention rate of alder leaves was not. This suggests that different physical mechanisms are responsible for the retention of leaves and stiff OM types in shallow streams. [source] Clinical and Professional Role Development Among Experienced Pediatric Nurses: The Pediatric Medical Nursing Certificate ProgramJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 4 2004Louise D. Jakubik ISSUES AND PURPOSE. The development of a multiunit-based certificate program to promote retention by increasing experienced pediatric nurses' knowledge, skills, and professional role development through a blend of didactic, clinical, and mentoring components. CONCLUSIONS. The certificate group demonstrated an increase in knowledge and skill, advanced leadership role acquisition, promotion, certification, and graduate school matriculation, and achieved a 95% retention rate within the organization. PRACTICE IMPLICATIONS. With support from management and multidisciplinary team members, a certificate program like this can be implemented in a variety of settings and specialties. [source] Growth and Bone Mineral Accretion During Puberty in Chinese Girls: A Five-Year Longitudinal Study,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2008Kun Zhu Abstract There are few longitudinal data on bone development during puberty in children with low calcium intake. This 5-yr longitudinal study showed that, in Chinese girls, the mean apparent calcium retention efficiency during puberty was 40.9%, PHV occurred at 3,0 yr before menarche, and peak bone mineral accretion occurred 1 yr later than PHV. Chinese girls have high calcium retention efficiency during puberty. Introduction: There are few longitudinal data on bone development during puberty in children with low dietary calcium intake. The aim of this study was to examine the rate of growth and bone mineral accretion and study the predictors of total body BMC during puberty in a 5-yr longitudinal study with Chinese girls. Materials and Methods: Ninety-two girls, 9.5,10.5 yr of age at baseline, from the unsupplemented control group of a school milk intervention trial were included in this analysis. Data on anthropometric measurements, total body BMC as assessed by DXA, and calcium intake as assessed by a 3-day food record were obtained at baseline and 1, 2, 4, and 5 yr. Results: The mean age of menarche was 12.1 ± 1.0 yr. The mean annual rate of bone mineral accretion was 197.4 g/yr during the follow-up period, representing a calcium accretion rate of 162.3 mg/d. This calcium retention rate and the average dietary calcium intake of 444.1 mg/d gave an apparent calcium retention efficiency of 40.9%. Peak height velocity (PHV) occurred at 3,0 yr before menarche. Peak bone mineral accretion occurred 1 yr later than PHV. There was a decrease in size-corrected BMD in the year before menarche. In the linear mixed-effects model analysis containing body size and lifestyle factors, we found that height, body weight, and calcium intake were significant independent predictors of total body BMC. Conclusions: Chinese girls with low habitual dietary calcium intake have high calcium retention efficiency during puberty. Because calcium intake is a significant predictor of total body BMC, increasing dietary calcium intake may have beneficial effects on bone mineral accretion in these girls. [source] A Prospective Ten-Year Clinical Trial of Porcelain VeneersJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 2 2006Article first published online: 25 APR 200 abstract Objective:, The purpose of this prospective clinical study was to evaluate the performance of porcelain veneers after 5 and 10 years of clinical service. Materials and Methods:, A single experienced clinician placed 87 porcelain veneers in 25 patients in 1990 and 1991. The teeth included maxillary central incisors to first premolars. As described in the 5-year report of this study, preparations included a chamfer margin, 0.3 to 0.7 mm labial enamel reduction, and incisal edge coverage. A single laboratory technician fabricated the veneers using feldspathic porcelain on refractory dies. Internal surfaces were etched with 5% hydrofluoric acid and silanated. Teeth were isolated with a rubber dam prior to veneer placement. All veneers were bonded with a light-activated resin cement. Patients were recalled at 5 to 6 years and at 10 years after initial veneer placement. Two evaluators examined each veneer for retention, fractures, color match, surface roughness, marginal adaptation, leakage, recurrent caries, pulp vitality, and patient satisfaction. Marginal adaptation was assessed further using scanning electron microscopy to examine epoxy replicas. Results:, Five years after placement, all 87 veneers remained in place and had "perfect" color match and surface smoothness. Four veneers had fractures, but only one of those required repair. Ninety-nine percent of the veneers had clinically acceptable marginal adaptation, although just 14% of the veneers had "perfect" marginal adaptation at all margins. One had clinically unacceptable staining from leakage. Recurrent caries was present at the proximal margin of two veneers. At the 10-year evaluation, which had a 93% recall rate, color match and surface roughness remained optimal. Thirteen of 22 patients were very satisfied with the esthetic result, whereas 7 complained of minor esthetic problems. The fracture rate increased substantially, to 34% at the 10-year recall. However, only 11% of the fractures were clinically unacceptable. None of the veneers had debonded, but the percentage of veneers with "perfect" marginal adaptation had declined to only 4%. Leakage was now evident around two-thirds of the veneers, and eight restorations had recurrent caries. Conclusion:, Porcelain veneers are a reliable and effective means for conservative esthetic treatment of anterior teeth in the long term. After 10 years of clinical service, esthetic results remained good, patient satisfaction was high, and the retention rate was excellent. The number of irreparable fractures was low. Appropriate preparation design, occlusion, and use of adhesive materials contribute to the ultimate outcome. [source] Prediction of posthepatectomy hepatic functional reserve by serum hyaluronateBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2009S. Yachida Background: Serum hyaluronate can be used as an index of hepatic sinusoidal endothelial cell function and hepatic fibrosis. This study was designed to clarify the clinical significance of the serum hyaluronate level as a parameter of functional reserve. Methods: The study included 283 patients undergoing hepatectomy. Liver function parameters were examined before surgery and compared with outcomes. Patients were retrospectively grouped according to the presence or absence of postoperative hepatic dysfunction. Results: Preoperative serum hyaluronate levels were significantly raised in parallel with the degree of severity of the underlying chronic liver disease. Regression analysis revealed serum hyaluronate level to be an independent predictor of portal hypertension. In 131 patients undergoing major hepatectomy, preoperative hyaluronate levels were significantly higher in patients with poor outcome. Multivariable logistic regression analysis demonstrated serum hyaluronate and total bilirubin levels to be independent variables associated with postoperative hepatic dysfunction. Patients with high indocyanine green retention rate at 15 min (over 15 per cent) showed significantly higher morbidity and mortality rates when their serum hyaluronate levels were over 180 ng/ml. Conclusion: Serum hyaluronate is a simple clinical marker for portal venous pressure and a reliable auxiliary parameter of hepatic functional reserve in combination with other liver function tests. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Long-term levetiracetam treatment in patients with epilepsy: 3-year follow upACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010R. Kuba Kuba R, Novotná I, Brázdil M, Ko,varová J, Tyrlíková I, Mastík J, Rektor I. Long-term levetiracetam treatment in patients with epilepsy: 3-year follow up. Acta Neurol Scand: 2010: 121: 83,88. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To assess the long-term efficacy and tolerability of levetiracetam in routine clinical practice. Materials and methods,,, We retrospectively analysed 218 patients, mostly adults, presenting mostly with localisation-related epilepsy, treated with levetiracetam as adjunctive therapy or monotherapy for up to 36 months. The primary points evaluated were: long-term retention rate, reasons for discontinuing levetiracetam and the percentage of seizure-free patients. Results,,, The retention rate at 6, 12, 24 and 36 months following the commencement of levetiracetam treatment was 91.7, 75.2, 60.1 and 53.7% respectively. Sixty-seven (30.7%) patients discontinued levetiracetam treatment. During the clinical audit evaluation period, surgical resection or implantation of VNS was performed in 31 (14.3%) patients. In 53 of the 67 patients (79.1%), the treatment was discontinued due to lack of efficacy; in 14 patients (20.9%) treatment was discontinued due to adverse events. In total, 24 of 218 patients (11.0%) were seizure-free for 36 months. Conclusions,,, Levetiracetam is an effective and well-tolerated option for long-term treatment of epilepsy in adults. [source] Retention rates of new antiepileptic drugs in localization-related epilepsy: a single-center studyACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009J. Peltola Objectives,,, We evaluated long-term retention rates of newer antiepileptic drugs (AED) in adults with localization-related epilepsy retrospectively. Methods,,, We estimated retention rates by Kaplan,Meier method in all 222 patients (age , 16) with localization-related epilepsy exposed to new AED at the Tampere University Hospital. Results,,, There were 141 patients exposed to lamotrigine, 78 to levetiracetam, 97 to topiramate, 68 to gabapentin, and 69 to tiagabine. Three-year retention rate for lamotrigine was 73.5%, levetiracetam 65.4%, topiramate 64.2%, gabapentin 41.7%, and tiagabine 38.2%. The most common cause for withdrawal of these AED was lack of efficacy. Conclusions,,, Our study suggests that there are clinically significant differences among gabapentin, lamotrigine, levetiracetam, tiagabine, and topiramate as treatment for focal epilepsy in everyday practice. Gabapentin and tiagabine seem to be less useful than the other three AED. Furthermore, our study supports the value of retention rate studies in assessing outcome of the drugs in clinical practice. [source] Long-term assessment of oxcarbazepine in a naturalistic setting: a retrospective studyACTA NEUROLOGICA SCANDINAVICA, Issue 5 2008U. Seneviratne Background,,, New antiepileptics seem to be better tolerated by patients. The retention rate of an antiepileptic would be a useful indicator of its practical usefulness. Aims,,, To assess the long-term outcome of oxcarbazepine (OXC) in a naturalistic setting by determining the retention rate. Methods,,, This is a retrospective study. All epilepsy patients treated with OXC at a tertiary care epilepsy center during a period of 3.5 years were included in this study. Retention rates of OXC at 1 and 3 years were estimated for each cohort group using Kaplan,Meier estimates and corresponding 95% confidence intervals. Results,,, A total of 98 patients were studied. OXC was used as monotherapy in 14 (14.3%) and as add-on therapy in 84 (85.7%). The mean daily dose was 947 ± 492 mg and 60% received ,900 mg/day. Using the Kaplan,Meier survival analysis, the retention rates of OXC at 1 and 3 years were estimated to be 0.853 (0.749,0.956) and 0.737 (0.570,0.904), respectively. Conclusions,,, OXC is well tolerated by patients as both monotherapy and add-on therapy. [source] Comparison of the efficacy and tolerability of new antiepileptic drugs: what can we learn from long-term studies?ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2006G. Zaccara Objective,,, A review of long-term open-label studies was performed with the aim of detecting differences in efficacy and/or tolerability of new antiepileptic drugs (AEDs). Methods,,, From more than 500 open studies conducted to evaluate the efficacy and tolerability of gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), pregabalin (PGB), tiagabine (TGB), topiramate (TPM) or zonisamide (ZNS), we selected all studies that reported or allowed us to calculate the number of patients who achieved seizure freedom for 6 months and/or the number of patients withdrawing for adverse effects and/or the number or percentage of patients continuing treatment after 1 year. Results,,, No studies were found in which this information was available for OXC, PGB, TGB or ZNS. The number of patients who achieved seizure freedom for 6 months was reported in four studies each for GBP and TPM, five studies for LTG, and eight studies for LEV. The best efficacy profile using this end point was found for LEV, followed by TPM, LTG, and GBP. Twenty-two studies reported the number of patients withdrawing due to adverse effects. LEV was the best-tolerated AED, a little ahead of LTG, and significantly better than GBP or TPM . TPM was by far the least well-tolerated drug. Information concerning patients continuing treatment after 1 year was reported in two GBP studies, two TPM studies, six LEV studies and five LTG studies. GBP had a very low retention rate (between 20% and 25% of patients continued the drug), while TPM and LTG had a retention rate of 40,60% and LEV had a retention rate of 60,75%. Conclusion,,, One limitation of these rankings is that their statistical value is limited because of the indirect nature of the comparisons. Anyhow, this review covers the main studies published thus far on this subject and provides full updated information on the current literature about these drugs. [source] Retention of resin-based pit and fissure sealants: a systematic reviewCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2006Michčle Muller-Bolla Abstract,,, The aim of the present study was to perform a systematic review on the retention of resin-based sealants (RBSs) according to the material used and the clinical procedure. An electronic search in MEDLINE, EMBASE, Cochrane library and SCOPUS was completed by a hand search in conference proceedings. One hundred and twenty-four studies were identified, 31 of which were included. The retention rate of auto-polymerized and light-cured RBSs did not differ significantly. Light-cured RBSs had a significantly higher retention rate than fluoride-containing light-cured RBSs at 48 months (RR = 0.80, 95% CI: 0.72,0.89) and more. Concerning the clinical procedure, the scarcity of well-conducted studies made judgement difficult, except for the isolation stage. If using a rubber dam did not affect retention of auto-polymerized RBSs, it did for fluoride-containing light-cured RBSs (RR = 2.03, 95% CI: 1.51,2.73). [source] Tagging effects on three non-native fish species in England (Lepomis gibbosus, Pseudorasbora parva, Sander lucioperca) and of native Salmo truttaECOLOGY OF FRESHWATER FISH, Issue 2 2009S. Stak Abstract,,, To address the dearth of information on tagging effects and long-term survivorship of tagged fish in native and introduced species, laboratory and field investigations were undertaken on three non-native fish species (pumpkinseed Lepomis gibbosus; topmouth gudgeon Pseudorasbora parva; pikeperch Sander lucioperca) tagged with coded-wire (CW), passive integrated transponder (PIT), radio (RT) telemetry and/or acoustic tags (AT), with survivorship of native brown trout (Salmo trutta) examined in the field. Laboratory results revealed high survivorship following tag attachment/insertion and resumption of feeding within 24,48 h of tagging (all mortalities could be attributed to an unrelated outbreak of fungal infection), with retention rates being high in both pumpkinseed and pikeperch but low in topmouth gudgeon (excluded from field studies). In the field, short-term post-operation survival was high in pikeperch, pumpkinseed and brown trout. In pumpkinseed and trout, 100% of RT fish survived a 24,30 day tracking study, with 60% and 80%, respectively, recaptured alive at least 3 months post-tagging. Of PIT tagged pumpkinseed, 44% were recaptured (after 6,18 months), with small-sized, CW-tagged fish (0.38 g weight) captured up to 1 year after tagging. In pikeperch, all AT fish except one (the smallest specimen) survived their full expected tracking period (i.e. tag life) , the single lost specimen survived at least half of its expected tracking period (i.e. 6 month battery life). Overall, the tagging methods used were highly effective in pumpkinseed and pikeperch, showing good retention and survival, but PIT tagging of topmouth gudgeon was plagued by low survivorship and tag rejection. [source] Opioid agonist pharmacotherapy in New South Wales from 1985 to 2006: patient characteristics and patterns and predictors of treatment retentionADDICTION, Issue 8 2009Lucy Burns ABSTRACT Aims The aims of this study were to: examine the number and characteristics of patients entering and re-entering opioid replacement treatment between 1985 and 2006, to examine select demographic and treatment correlates of leaving treatment between 1985 and 2000, and to compare retention rates in methadone and buprenorphine maintenance treatment from 2001 to 2006. Design A retrospective cohort study using register data from the Pharmaceutical Drugs of Addiction System. Setting Opioid substitution treatment in New South Wales (NSW), Australia. Participants A total of n = 42 690 individuals prescribed opioid replacement treatment between 1985 and 2006 in NSW. Measurements Client characteristics over time, retention in days in first treatment episode, number of episodes of treatment and proportion switching medication. Findings Overall, younger individuals were significantly more likely to leave their first treatment episode than older individuals. In 2001,06, after controlling for age, sex and first administration point, the hazard of leaving treatment was 1.9 times for those on buprenorphine relative to those on methadone. Retention in treatment varied somewhat across historical time, with those entering during 1995,2000 more likely to leave at an earlier stage than those who entered before that time. Conclusions Retention in treatment appears to fluctuate in inverse proportion to the availability of heroin. Individuals in contemporary treatment are older users with a lengthy treatment history. This study has provided population-level evidence to suggest that retention in methadone and buprenorphine differ in routine clinical practice. Future work might investigate ways in which patient adherence and retention may be improved. [source] A numerical study of inferred rockfish (Sebastes spp.) larval dispersal along the central California coastFISHERIES OCEANOGRAPHY, Issue 1 2010CHRISTINE H. PETERSEN Abstract Successful recruitment of marine fishes depends on survival during early life-history stages, which is influenced by oceanic advection due to its impact on coastal trophodynamics and transport processes. Here we evaluate the influence of ocean circulation on the dispersal of rockfish (Sebastes spp.) larvae along the central California coast using an implementation of the Regional Ocean Modeling System, driven at the surface by output from the Coupled Ocean Atmosphere Mesoscale Prediction System. Thousands of floats simulating rockfish larval propagules, constrained to follow fixed depths, were released over a broad coastal area at 2-day intervals, and transported by simulated ocean currents at depths of 1, 7, 20, 40, and 70 m. Trajectory statistics are averaged across the 4-yr period from January 2000 through December 2003 to reveal mean trajectory direction, net displacement, fractional cross-shore loss, and duration of retention for different seasons. On average, near-surface propagules originating nearshore are transported offshore during the upwelling season, whereas deeper propagules move alongshore to the north. This vertical shear vanishes during winter, with most floats moving alongshore to the north, regardless of depth. After 35 days in the water column, typical transport distances were ,50 km for floats remaining nearshore and ,150 km for floats over the midshelf and slope. Implications for performance of marine reserves for rockfish conservation are discussed. Our results also provide evidence for a strong semiannual pattern of coastal retention rates, with high export of near-surface drifters during the upwelling season. In contrast, high rates of shelf retention occurred for releases at 20 m and deeper during summer, and at all depths during winter. [source] Transport and settlement of organic matter in small streamsFRESHWATER BIOLOGY, Issue 2 2010TRENT M. HOOVER Summary 1.,After it enters streams, terrestrially derived organic matter (OM) rapidly absorbs water. Using field and laboratory experiments, we examined how this process affected the buoyancy, settling velocity, transport distance and retention locations of four types of organic matter typically found in Pacific coastal streams (,flexible' red alder leaves and three ,stiff' particle types , Douglas-fir needles, red cedar fronds and Douglas-fir branch pieces). 2.,Immersion in water rapidly changed the physical characteristics of alder leaves, Douglas-fir needles and red cedar fronds, which all reached constant still-water settling velocities after only a few days of soaking. In contrast, the settling velocity of branch pieces continued to increase for 13 days, eventually reaching much higher values than any other OM type. Dried alder leaves became negatively buoyant after only two days of immersion, while other types took substantially longer (up to 24 days) before the specific gravity of all particles was >1. 3.,We released saturated OM particles in an experimental channel and found that all particle types travelled further in a fast, shallow ,riffle' than a slow, deep ,pool'. Comparisons with a passive settlement null model indicated that leaves were retained more rapidly than expected in the riffle (by large protruding stones), while the three stiff particle types travelled further than expected (probably due to turbulent suspension) and were retained when they settled in deeper water between larger stones. In pools, passive settlement appeared to dominate the retention of all OM types, with leaves travelling furthest. 4.,These retention patterns corresponded well with those observed when saturated OM particles collected in the field were released in two pools and two riffles in a second-order coastal stream. 5.,When the experimental channel and in-stream data were combined, the retention rates of the three stiff OM types were closely related to calculated Rouse numbers (Rouse number = particle settling velocity/shear velocity), whereas the retention rate of alder leaves was not. This suggests that different physical mechanisms are responsible for the retention of leaves and stiff OM types in shallow streams. [source] Women's Scientific Employment and Family Formation: A Longitudinal PerspectiveGENDER, WORK & ORGANISATION, Issue 6 2008Louisa Blackwell We focus here on the retention of highly qualified women scientists in science-based employment in England and Wales. Using linked Census records from the Longitudinal Study 1971,1991 we show that women's education and employment rates in science, engineering and technology increased somewhat, although some fields show persistently low representation. We then compare retention in employing women with health-related degrees with that of women with degrees in science, engineering and technology, showing that the latter group has markedly lower retention rates. Those who stay on in science-based employment have children later than other types of graduate and their rates of non-motherhood are higher. Four-fifths of women in health-related occupations were mothers, compared to only two-fifths in science, engineering and technology. Our findings have implications for policymakers who wish to make best use of the knowledge base: attention should be paid to retention, as well as the more usual focus on qualifications and recruitment. The findings also suggest the potential for institutionally based theories to explain why highly qualified women have such low retention rates in science-based employment. [source] Fluoride pit and fissure sealants: a reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2000Tonia L. Morphis There are two methods of fluoride incorporation into fissure sealants. In the first method, fluoride is added to the unpolymerized resin in the form of a soluble fluoride salt that releases fluoride ions by dissolution, following sealant application. In the second method, an organic fluoride compound is chemically bound to the resin and the fluoride is released by exchange with other ions (anion exchange system). This report reviews the literature on the effectiveness of all the fluoride-releasing sealants ,commercial and experimental , that have been prepared using either the former or the latter method of fluoride incorporation. There is evidence for equal retention rates to conventional sealants and for ex vivo fluoride release and reduced enamel demineralization. However, further research is necessary to ensure the clinical longevity of fluoride sealant retention and to establish the objective of greater caries inhibition through the fluoride released in saliva and enamel. [source] Evaluation of VIE and PIT tagging methods for juvenile cyprinid fishesJOURNAL OF APPLIED ICHTHYOLOGY, Issue 4 2009J. D. Bolland Summary Retention and mortality associated with visible implant elastomer (VIE) and passive integrated transponder (PIT) tagged juvenile chub [Leuciscus cephalus (L.)], dace [Leuciscus leuciscus (L.)] and roach [Rutilus rutilus (L.)] were evaluated. PIT tag retention (96.6,100%) was higher than VIE over the 6-month duration of the experiment. VIE retention was significantly better in the head (96.3,98.8%) than in the fins (78.8,90.9%) the first month after tagging, but the opposite was found after 6 months (head = 21.5,57.5%; fins = 77.2,88.8%). Survival was not significantly different from controls for any treatment, except dace tagged with 23-mm PIT (significantly influenced by mass of fish at tagging) and sham PIT tagged dace, because of initial losses. PIT tags are recommended as the most suitable method for tagging individual juvenile chub, dace and roach based on high retention and survival. VIE implantation in the head (studies < 30 days) and fins (studies > 30 days) could provide a cheap, batch-marking alternative, provided retention rates are monitored. [source] Do school accountability systems make it more difficult for low-performing schools to attract and retain high-quality teachers?JOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 2 2004Charles T. Clotfelter Administrative data from North Carolina are used to explore the extent to which that state's relatively sophisticated school-based accountability system has exacerbated the challenges that schools serving low-performing students face in retaining and attracting high-quality teachers. Most clear are the adverse effects on retention rates, and hence on teacher turnover, in such schools. Less clear is the extent to which that higher turnover has translated into a decline in the average qualifications of the teachers in the low-performing schools. Other states with more primitive accountability systems can expect even greater adverse effects on teacher turnover in low-performing schools. © 2004 by the Association for Public Policy Analysis and Management. [source] Maximizing follow-up in longitudinal studies of traumatized populationsJOURNAL OF TRAUMATIC STRESS, Issue 6 2006Christy K. Scott Although longitudinal research is essential in understanding the nature and course of posttraumatic mental health problems, high rates of attrition often threaten the internal validity of such studies and make results hard to interpret. C. K. Scott (2004) developed an approach to minimizing attrition in longitudinal studies that consistently yielded retention rates in excess of 90% through to 2-year follow-up. In this article, the authors discuss the interface between trauma exposure and participation in longitudinal research, before describing in detail a model to address those effects. The effectiveness of the model is examined with reference to traumatic stress in a large community sample (N = 887) with eight waves of data over 2 years. [source] | |||||||||||||||||||