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Retrospective Assessment (retrospective + assessment)
Selected AbstractsLong-Term Results of Provox ActiValve, Solving the Problem of Frequent Candida- and "Underpressure"-Related Voice Prosthesis ReplacementsTHE LARYNGOSCOPE, Issue 2 2008Jessica Soolsma MSc Abstract Objectives: To assess the long-term results of the Provox ActiValve, a prosthesis for voice rehabilitation after total laryngectomy that was designed to lessen the need for frequent replacements caused by Candida and "underpressure." Patients and Methods: Retrospective assessment of device lifetime, indications for replacement, voice quality, and maintenance issues, measured by a structured trial specific questionnaire, in a cohort of 42 laryngectomized patients, experiencing a short Provox2 device lifetime (median, 21 days). Results: The median device lifetime of Provox ActiValve, replaced for leakage through the device and those still in situ at the date of data collection (N = 32), was 337 days (mean 376 days): a statistically significant 16-fold increase compared to the Provox2 prosthesis (P < .001). In 10 patients, replacement was fistula-related (median after 86 days): esophageal pouch (N = 4), fistula granulation (N = 3), extrusion of the device (N = 2), and periprosthetic leakage (N = 1). Eighty-six percent of the patients used a special lubricant to diminish "stickiness" of the valve. Provox ActiValve was preferred by 90% of the patients who completed the trial-specific questionnaire. Conclusions: For patients requiring frequent device-related replacements, Provox ActiValve, also long-term, provides a true solution and thereby is a valuable addition to prosthetic voice rehabilitation. [source] Quantifying carbon sequestration as a result of soil erosion and deposition: retrospective assessment using caesium-137 and carbon inventoriesGLOBAL CHANGE BIOLOGY, Issue 12 2007TIMOTHY ANDREW QUINE Abstract The role of soil erosion in the global carbon cycle remains a contested subject. A new approach to the retrospective derivation of erosion-induced quantitative fluxes of carbon between soil and atmosphere is presented and applied. The approach is based on the premise that soil redistribution perturbs the carbon cycle by driving disequilibrium between soil carbon content and input. This perturbation is examined by establishing the difference between measured carbon inventories and the inventories that would be found if input and content were in dynamic equilibrium. The carbon inventory of a profile in dynamic equilibrium is simulated by allowing lateral and vertical redistribution of carbon but treating all other profile inputs as equal to outputs. Caesium-137 is used to derive rates of vertical and lateral soil redistribution. Both point and field-scale estimates of carbon exchange with the atmosphere are derived using the approach for a field subject to mechanized agricultural in the United Kingdom. Sensitivity analysis is undertaken and demonstrates that the approach is robust. The results indicate that, despite a 15% decline in the carbon content of the cultivation layer of the eroded part of the field, this area has acted as a net sink of 11 ± 2 g C m,2 yr,1 over the last half century and that in the field as a whole, soil redistribution has driven a sink of 7 ± 2 g C m,2 yr,1 (6 ± 2 g C m,2 yr,1 if all eroded carbon transported beyond the field boundary is lost to the atmosphere) over the same period. This is the first empirical evidence for, and quantification of, dynamic replacement of eroded carbon. The relatively modest field-scale net sink is more consistent with the identification of erosion and deposition as a carbon sink than a carbon source. There is a clear need to assemble larger databases with which to evaluate critically the carbon sequestration potential of erosion and deposition in a variety of conditions of agricultural management, climate, relief, and soil type. In any case, this study demonstrated that the operation of erosion and deposition processes within the boundaries of agricultural fields must be understood as a key driver of the net carbon cycle consequences of cultivating land. [source] The cognitive decline scale of the psychogeriatric assessment scales (PAS): longitudinal data on its validityINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2001A.F. Jorm Abstract Objective The Cognitive Decline scale of the Psychogeriatric Assessment Scales (PAS), uses informant data to assess retrospectively change from earlier in life. Data from a 7,8-year longitudinal study were used to assess the validity of this scale against changes in cognitive performance and mortality. Design and measures PAS data were collected on three occasions, with gaps of 3.6 and 4.1 years between the waves. The Cognitive Decline score at Wave 3 was validated retrospectively against actual change on a brief test of current cognitive status (the PAS Cognitive Impairment scale) over the three waves, while the Cognitive Decline score at Wave 1 was assessed for predictive validity against future mortality and cognitive change. Setting A community survey in the Australian cities of Canberra and Queanbeyan. Participants Participants were aged 70+ at the beginning of the study. The sample size varied from 729 to 279, depending on the number of waves involved. Results Participants with scores of 4+ on the Cognitive Decline scale at Wave 3 showed substantial deterioration over the previous 7,8 years. Scores of 4+ at Wave 1 predicted mortality and further cognitive deterioration. Conclusions The Cognitive Decline scale allows a valid retrospective assessment of change and has predictive validity for subsequent cognitive deterioration and increased mortality. Copyright © 2001 John Wiley & Sons, Ltd. [source] Original Contribution: Hyperandrogenism does not predispose patients to photoepilatory treatment failure: a single-center reviewJOURNAL OF COSMETIC DERMATOLOGY, Issue 3 2010MSc Derm, Marisa Taylor MBBS Summary Studies have suggested that patients with PCOS tend to be more treatment resistant to light-mediated depilation compared with their non-PCOS counterparts. We conducted a retrospective assessment of 29 hirsute patients treated between January 2006 and February 2007 to assess whether those with unsatisfactory hair clearance after treatment with intense pulsed light (IPL) were predominantly hyperandrogenic. The number of IPL sessions was also recorded for those patients failing to improve on treatment. Seventy-six percent had satisfactory hair clearance where hyperandrogenic patients dominated. All patients required an average of six treatments before discharge. Eighty-eight percent of poor responders were normoandrogenic. Our hyperandrogenic cohort appeared more responsive to IPL than the normoandrogenic patients. From our observations, the presence of hyperandrogenism does not indicate treatment resistance. This standpoint is unique and warrants a randomized trial directly comparing the two groups to investigate whether a positive or negative relationship actually exists. [source] Tuberculids as sentinel lesions of tuberculous epididymo-orchitisJOURNAL OF CUTANEOUS PATHOLOGY, Issue 11 2007Pratistadevi K. Ramdial Background:, Tuberculids are rarely associated with male genital tract tuberculosis (TB). Tuberculous epididymo-orchitis (TBEO) has been associated rarely with papulonecrotic tuberculid (PNT) but not with erythema induratum (EI) or the simultaneous occurrence of different tuberculids. Methods:, A retrospective assessment of tuberculids that occurred with underlying TBEO was carried out. Results:, Five patients, four with one and one with two skin biopsies, with clinical diagnoses of PNT (two), EI (one), impetigo (two) and calf ulcer (one), formed the study cohort. Histopathological evaluation confirmed PNT and EI in four and two skin biopsies, respectively. Two patients who returned for follow-up were commenced on anti-tuberculous therapy. All patients sought medical attention 3,34 months later for tender right-sided (two) and left-sided (three) testicular masses. Orchidectomy was undertaken following a poor clinical response to empirical treatment with trimethoprim sulfamethoxazole. Pathological examination of the testis and epididymis confirmed TBEO. The patients were initiated on anti-tuberculous therapy. There was dramatic healing of the skin lesions. Conclusion:, Tuberculids are a sentinel cutaneous manifestation of visceral TB and a valuable external audit of treatment compliance and response. Heightened recognition of and more rigorous genitourinary tract investigation are necessary to identify occult or asymptomatic TBEO as the underlying cause of tuberculids. [source] NEEDLE-STICK INJURY: A NOVEL INTERVENTION TO REDUCE THE OCCUPATIONAL HEALTH AND SAFETY RISK IN THE HAEMODIALYSIS SETTINGJOURNAL OF RENAL CARE, Issue 3 2009BAppSci, Grad Dip Edu, Josephine Chow MBA SUMMARY Needle-stick injury (NSI) is a major occupational health and safety issue facing healthcare professionals. The administration of erythropoiesis-stimulating agents (ESA) in haemodialysis patients represents a major cause for injections. The purpose of this initiative was to familiarise nursing staff with needle-free administration of an ESA in haemodialysis patients to reduce the risk of NSI. Epoetin beta comes in a commercial presentation with a detached needle. Epoetin beta was administered to 10 haemodialysis patients via the venous bubble trap short line of the haemodialysis circuit. An audit was conducted that included a retrospective assessment of NSI for the previous six months; and a prospective assessment for eight weeks to assess whether there is a nursing staff preference for needle-free administration of ESA. There were no reports of NSI in the needle-free group. Haemoglobin levels were maintained. Ninety-one percent of the nursing staff preferred needle-free administration of ESA. In conclusion, the commercial presentation of epoetin beta with the detached needle presents an opportunity to reduce the potential risk of NSI in haemodialysis units. [source] Personality disorders in first-episode psychosis,PERSONALITY AND MENTAL HEALTH, Issue 4 2008Erik Simonsen The aim of the study was to determine the prevalence of personality disorders in the early course of first-episode psychosis and their likely presence in the premorbid period. Fifty-five patients were enrolled at baseline and premorbid function was evaluated by the Premorbid Adjustment Scale. Thirty-three of these of the patients were assessed at two-year follow-up for comorbid personality disorders by the Structured Clinical Interview for DSM-IV Personality Disorders and by the self-report instrument Millon Clinical Multiaxial Inventory-II. Half of the patients met the criteria of two or more personality disorders, while one-third of the patients did not fulfil the criteria for any personality disorder. The schizoid and the avoidant were the most frequent personality disorders and both were associated with social withdrawal during childhood and adolescence. The limitation of the study is the small sample, the retrospective assessment and a 40% attrition rate. The strengths are that it is a clinical epidemiological sample of first-episode psychotic patients and that different but complimentary measures of the personality disorders were used. Copyright © 2008 John Wiley & Sons, Ltd. [source] Daily assessment of coping in patients with gastrointestinal cancerPSYCHO-ONCOLOGY, Issue 1 2002Elisabet Wasteson Ninety-five patients with gastrointestinal (GI) cancer participated in a study concerning stressful events, coping and emotional well-being. Participants were either potentially cured (n=62) after radical surgery or non-cured (n=33). For a period of 1 week, close to being informed about their diagnosis, they performed daily recordings of stressful events, the distress occasioned by these events and their perception of control over them, coping, worry and happiness/sadness. Anxiety and depression were assessed by a single retrospective assessment at the end of the week (Hospital Anxiety and Depression (HAD) scale). The most commonly recorded stressful events were ,Somatic aspects' and ,Everyday concerns'. ,Somatic aspects', ,Social aspects' and ,Other consequences of the disease' were rated as most bothersome. Patients perceived that they had the highest degree of control over ,Returning home after hospital stay', whereas ,Contact with the medical services' was assigned low control. The most commonly used coping strategies were ,Acceptance' and ,Relaxation', and the least used was ,Religion'. Significant positive correlations between the occurrence of stressful events and the use of coping strategies were demonstrated between ,Somatic Aspects' and ,Acceptance'/,Direct Action', and between ,Social Aspects' and ,Seeking Social Support'. Daily assessment of stress-coping relationships represents a promising approach to the understanding of adaptation among cancer patients. Copyright © 2002 John Wiley & Sons, Ltd. [source] Australia's National Action Plan for Salinity and Water Quality: a retrospective assessment,AUSTRALIAN JOURNAL OF AGRICULTURAL & RESOURCE ECONOMICS, Issue 4 2010David J. Pannell Perceptions of a salinity ,crisis' in Australia around 2000 resulted in the establishment of a major national program that aimed to prevent, stabilize, and reverse trends in salinity. The National Action Plan for Salinity and Water Quality allocated A$1.4 billion of public funds to 1700 projects over 7 years. Here, we assess the performance of the program in relation to 12 features that we propose as being essential for programs that aim to address complex environmental problems. The features include use of technical information to guide investment prioritization, use of socio-economic information, effective integration of information for prioritization, selection of appropriate targets, choice of appropriate policy mechanisms, and provision of incentives and support to environmental managers to pursue environmental outcomes cost effectively. Our assessment reinforces findings from a number of public reviews that found serious weaknesses in the program. Overall, with a few exceptions, projects under the National Action Plan generated few worthwhile salinity mitigation benefits and will have little enduring benefit. This was readily foreseeable given attention to the scientific and economic knowledge of salinity available at the time the program was developed. [source] Pathways to cannabis abuse: a multi-stage model from cannabis availability, cannabis initiation and progression to abuseADDICTION, Issue 3 2009Nathan A. Gillespie ABSTRACT Aims Although previous twin studies have modeled the association between drug initiation and abuse, none has included the obvious risk factor of drug availability. Our aim is to determine whether the genetic and environmental risk factors for cannabis availability also generate variation in cannabis initiation and/or progression to DSM-IV symptoms of abuse. Design We used multi-stage modeling, also known as causal-common-contingent (CCC) analysis, to partition the genetic and environmental factors into common and stage-specific components. Participants This report is based on data collected from 1772 adult males from the Mid Atlantic Twin Registry. Measurements The twins participated in two structured interviews which included clinical and non-clinical measures of cannabis abuse as well as retrospective assessments of perceived cannabis availability between ages 8 and 25 years. Findings Cannabis availability explained almost all the shared environmental risks in cannabis initiation and abuse. The influence of availability on the symptoms of abuse was indirect and mediated entirely by cannabis initiation. Conclusion These findings have begun to elucidate the causal processes underlying the liability to drug use and abuse in terms of putative risk factors. Specifically, our results show that the latent shared environmental factors in cannabis initiation and abuse can be explained by measured aspects of the shared environment,those responsible for variation in cannabis availability. [source] | ||||||||||