Home About us Contact
|
Home About us Contact | ||
|
|
||
Screening Results (screening + result)
Selected AbstractsRapid Emergency Department Intervention for Older People Reduces Risk of Functional Decline: Results of a Multicenter Randomized TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2001DrPH, Jane McCusker MD OBJECTIVES: To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes. DESIGN: Controlled trial, randomized by day of ED visit, with follow-up at 1 and 4 months. SETTING: Four university-affiliated hospitals in Montreal. PARTICIPANTS: Patients age 65 and older expected to be released from the ED to the community with a score of 2 or more on the Identification of Seniors At Risk (ISAR) screening tool and their primary family caregivers. One hundred seventy-eight were randomized to the intervention, 210 to usual care. INTERVENTION: The intervention consisted of disclosure of results of the ISAR screen, a brief standardized nursing assessment in the ED, notification of the primary care physician and home care providers, and other referrals as needed. The control group received usual care, without disclosure of the screening result. MEASUREMENTS: Patient outcomes assessed at 4 months after enrollment included functional decline (increased dependence on the Older American Resources and Services activities of daily living scale or death) and depressive symptoms (as assessed by the short Geriatric Depression Scale). Caregiver outcomes, also assessed at baseline and 4 months, included the physical and mental summary scales of the Medical Outcomes Study Short Form-36. Patient and caregiver satisfaction with care were assessed 1 month after enrollment. RESULTS: The intervention increased the rate of referral to the primary care physician and to home care services. The intervention was associated with a significantly reduced rate of functional decline at 4 months, in both unadjusted (odds ratio (OR) = 0.60, 95% confidence interval (CI) = 0.36,0.99) and adjusted (OR = 0.53, 95% CI = 0.31,0.91) analyses. There was no intervention effect on patient depressive symptoms, caregiver outcomes, or satisfaction with care. CONCLUSION: A two-stage ED intervention, consisting of screening with the ISAR tool followed by a brief, standardized nursing assessment and referral to primary and home care services, significantly reduced the rate of subsequent functional decline. J Am Geriatr Soc 49:1272,1281, 2001. [source] Prenatal screening for Down syndrome: the problem of recurrent false-positivesPRENATAL DIAGNOSIS, Issue 5 2004Nicholas J. Wald Abstract Objectives It has been reported that, in prenatal screening programmes for Down syndrome, women who have false-positive results in one pregnancy have an increased risk of a false-positive result in a subsequent pregnancy. We examined the effect of this in the screening programme conducted from the Wolfson Institute of Preventive Medicine with a view to determining the magnitude of the effect, and to describe a method of avoiding the problem. Methods Six thousand four hundred and forty-eight women were identified who had had two singleton pregnancies without Down syndrome in the screening programme based at the Wolfson Institute of Preventive Medicine, in which both pregnancies were screened using a Quadruple test (maternal age with alphafetoprotein (AFP), unconjugated oestriol (uE3), total or free ,-human chorionic gonadotrophin (hCG) and either free ,-hCG or inhibin-A as the fourth serum marker). Results Among women who had a false-positive result in their initial pregnancy, the false-positive rate in the subsequent pregnancy was high: 20% (46/229), about three times higher than both the overall observed false-positive rate (6.6%), and the expected false-positive rate, in subsequent pregnancies that were false,positive in their initial pregnancy (7.5%) (p < 0.001). This arises because serum marker levels in one pregnancy are associated with the levels in a subsequent pregnancy. Using the slope (the regression coefficient b) of each marker level in a subsequent pregnancy regressed on the value in the first pregnancy, it is possible to adjust all marker values in a subsequent pregnancy to allow for the higher-than-expected false-positive rate. This can be done by dividing the observed MoM value for each marker by the ,expected' MoM, which is the MoM value in a previous pregnancy raised to the power b. Conclusions If a woman has had a false-positive result in one pregnancy, she is much more likely to have a false-positive screening result in a subsequent pregnancy than women in general. The problem can be avoided by adjusting the serum markers in all women who have been screened in a previous pregnancy and who have not had a previous pregnancy with Down syndrome. Copyright © 2004 John Wiley & Sons, Ltd. [source] Predictors of breast cancer-related distress following mammography screening in younger women on a family history breast screening programmePSYCHO-ONCOLOGY, Issue 12 2008K. Brain Abstract Objective: This longitudinal study investigated pre-screening factors that predicted breast cancer-specific distress among 1286 women who were undergoing annual mammography screening as part of a UK programme for younger women (i.e., under 50) with a family history of breast cancer. Methods: Women completed questionnaires one month prior to screening, and one and six months after receiving screening results. Factors measured were breast cancer worry, perceived risk, cognitive appraisals, coping, dispositional optimism, and background variables relating to screening history and family history. Results: Pre-screening cancer worry was the most important predictor of subsequent worry, explaining 56/61% and 54/57% of the variance at one and six months follow-up, respectively. Other salient pre-screening predictors included high perceived risk of breast cancer, appraisals of high relevance and threat associated with the family history, and low perceived ability to cope emotionally. Women who had previously been part of the screening programme and those with a relative who had recently died from breast cancer were also vulnerable to longer-term distress. A false positive screening result, pessimistic personality, and coping efforts relating to religion and substance use predicted outcomes of screening at one month follow-up, but were not predictive in the longer-term. Conclusion: Early intervention to ameliorate high levels of cancer-related distress and negative appraisals would benefit some women as they progress through the familial breast screening programme. Copyright © 2008 John Wiley & Sons, Ltd. [source] Universal newborn screening and adverse medical outcomes: A historical noteDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 4 2006Jeffrey P. Brosco Abstract Universal newborn screening programs for metabolic disorders are typically described as a triumph of medicine and public policy in the US over the last 50 years. Advances in science and technology, including the Human Genome Project, offer the opportunity to expand universal newborn screening programs to include many additional metabolic and genetic conditions. Although the benefits of such screening programs appear to outweigh their costs, some critics have claimed that historical examples of inadvertent harm ensuing from false-positive screening results and subsequent inappropriate medical treatment should make us wary of expanding universal newborn screening. In this essay, we report the results of a review of the published literature to assess whether the extension of screening from at risk populations to all newborns led to substantial morbidity and mortality from misguided medical treatment. We provide a historical overview of universal newborn screening programs in the United States, and then focus on six early NBS programs: congenital hypothyroidism, phenylketonuria, congenital adrenal hyperplasia, galactosemia, sickle cell disease, and maple syrup urine disease. Our comprehensive search of published sources did not reveal a widespread problem of harm ensuing from medical treatment of children with false positive screening test results. © 2006 Wiley-Liss, Inc. MRDD Research Reviews 2006;12:262,269. [source] Iron Chloride/4-Acetamido-TEMPO/Sodium Nitrite-Catalyzed Aerobic Oxidation of Primary Alcohols to the AldehydesADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 1 2010Weili Yin Abstract A variety of 4-substituted 2,2,6,6-tetramethylpiperidyl-1-oxy (TEMPO) derivatives has been screened for their ability in the oxidation of primary alcohols to the aldehydes with dioxygen under mild conditions. An evaluation of the efficiency of these 4-substituted TEMPO derivatives in the alcohol oxidation may allow an insight into the effect of the structural variations of TEMPO on the oxidation of alcohols, which should facilitate catalyst design and screening efforts. Based on the screening results of 4-substituted TEMPO derivatives, the catalyst comprised of 4-acetamido-TEMPO, iron chloride and sodium nitrite, has been developed for the highly efficient oxidation of a wide range of primary alcohols including primary aliphatic alcohols to the corresponding aldehydes under mild conditions. [source] Screening of Water Yam (Dioscorea alata L.) Genotypes for Reactions to Viruses in NigeriaJOURNAL OF PHYTOPATHOLOGY, Issue 11-12 2006B. O. Odu Abstract Studies were made to identify sources of resistance to yam viruses in Dioscorea alata. Forty genotypes of D. alata were evaluated in both the field and in the screenhouse for reactions to the yam viruses: Yam mosaic virus (YMV), genus Potyvirus; Dioscorea alata virus (DAV), genus Potyvirus; Cucumber mosaic virus (CMV), genus Cucumovirus; and Dioscorea alata bacilliform virus (DaBV), genus Badnavirus. The D. alata genotypes were planted in the field and subsequently scored for virus symptom severity. All the genotypes were also planted in an insect-proofed screenhouse, and challenged mechanically and by vectors for susceptibility to each of the viruses. Analysis of variance (anova) of the symptom severity scores showed that the genotypes responded differently (P < 0.01) to virus disease in the field. Field evaluation also showed that TDa 291 (a landrace genotype from Puerto Rico), TDa 87/01091, TDa 96-4, TDa 95-163 and TDa 289 from Nigeria, and TDa 95-25 (a landrace genotype from Ghana), had a low virus disease symptom rating. Overall screening results showed that two D. alata genotypes (TDa 289 and TDa 291) are good sources of resistance to YMV, DAV and CMV, and that they are tolerant to DaBV. [source] Optimization of the nitroxide-mediated radical polymerization conditions for styrene and tert -butyl acrylate in an automated parallel synthesizerJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 21 2006C. Remzi Becer Abstract Automated parallel synthesizers provide fast and comparable screening of different polymerization parameters under similar conditions. In addition, these robotic systems eliminate handling errors, which may affect the results of a kinetic experiment more than the effect of an important parameter. The polymerization temperature and N,N - tert -butyl- N -[1,-diethylphosphono-2,2,-dimethylpropyl]nitroxide concentration were optimized for the homopolymerization of both styrene and tert -butyl acrylate to improve the control over the polymerization while reasonable polymerization rates were retained. Subsequently, polystyrene and poly(tert -butyl acrylate) macro initiators were synthesized according to the knowledge obtained from the screening results. These macroinitiators were used for the preparation of block copolymers consisting of styrene and tert -butyl acrylate. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 6202,6213, 2006 [source] A hybrid method for simulation factor screeningNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 1 2010Hua Shen Abstract Factor screening is performed to eliminate unimportant factors so that the remaining important factors can be more thoroughly studied in later experiments. Controlled sequential bifurcation (CSB) and controlled sequential factorial design (CSFD) are two new screening methods for discrete-event simulations. Both methods use hypothesis testing procedures to control the Type I Error and power of the screening results. The scenarios for which each method is most efficient are complementary. This study proposes a two-stage hybrid approach that combines CSFD and an improved CSB called CSB-X. In Phase 1, a prescreening procedure will estimate each effect and determine whether CSB-X or CSFD will be used for further screening. In Phase 2, CSB-X and CSFD are performed separately based on the assignment of Phase 1. The new method usually has the same error control as CSB-X and CSFD. The efficiency, on the other hand, is usually much better than either component method. © 2009 Wiley Periodicals, Inc. Naval Research Logistics, 2010 [source] Screening for glucose-6-phosphate dehydrogenase deficiency using a modified formazan method: A pilot study on Filipino male newbornsPEDIATRICS INTERNATIONAL, Issue 1 2003CARMENCITA PADILLA AbstractBackground: Glucose-6-phosphate dehydrogenase (G6PD) deficiency has increased prevalence rates in tropical Africa, tropical and subtropical Asia and some parts of the Mediterranean. Earlier studies on G6PD deficiency in the Philippines have shown prevalence rates of 4.5% to 25.7%. Methods: In the present study, 3278 male newborns were screened for G6PD deficiency using the modified formazan method, a simple screening procedure affordable in the setting of a developing country. Subjects with positive screening results were recalled for confirmatory testing using a commercial assay kit for quantitative enzyme determination. Results: Of the 3278 boys studied, 186 revealed positive screening results. Of the 186, 65 boys had confirmatory testing. Of these 65 boys, 45 were confirmed to have G6PD deficiency and 20 had normal results. This study reveals an incidence of G6PD deficiency of 3.9% among male Filipinos. Conclusion: This study recommends the inclusion of G6PD deficiency in the panel of disorders for newborn screening among Filipino newborns. [source] Ovarian carcinoma screening in women at intermediate riskCANCER, Issue 2 2005Impact on quality of life, need for invasive follow-up Abstract BACKGROUND Women with family histories suggestive of an increased risk of ovarian carcinoma who have not had a deleterious BRCA1 or BRCA2 mutation identified are commonly suggested to consider ovarian carcinoma screening with transvaginal ultrasound and/or assessment of CA 125 levels. Limited information is available regarding the impact of this approach on either quality of life (QOL) or need for invasive follow-up in this group of women. METHODS From November 1999 to October 2002, 184 women at intermediate risk of ovarian carcinoma were enrolled in a prospective study. Participants were screened with twice yearly transvaginal ultrasound and CA 125 assessments. Impact on QOL was measured using the Mental Component Summary (MCS) score of the Medical Outcomes Studies Short Form-36. Need for invasive follow-up was determined by questionnaire and medical record review. RESULTS In the current study, 135 participants underwent , 1 follow-up assessment. During a mean of 19.8 months of follow-up, 12.9% of ultrasounds and 3.8% of CA 125 assessments were abnormal. The authors reported that 38.5% of participants had , 1 abnormal ovarian screen that required a short interval follow-up. Because of either abnormal bleeding or ultrasound abnormalities, 24% of participants underwent , 1 endometrial sampling. Controlling for a history of breast carcinoma and menopausal status, abnormal ovarian screening results were associated with a decrease in MCS score (P = 0.034), whereas the need for endometrial sampling was not (P = 0.87). CONCLUSIONS Ovarian carcinoma screening in women at intermediate risk was associated with a substantial rate of abnormal screen results, endometrial sampling, and in women with abnormal ovarian screening findings, a decrease in MCS scores. These findings may have important implications for women considering ovarian carcinoma screening and for the design of future ovarian carcinoma screening trials. Cancer 2005. © 2005 American Cancer Society. [source] Inconclusive Cystic Fibrosis neonatal screening results: long-term psychosocial effects on parentsACTA PAEDIATRICA, Issue 12 2009Sandra Perobelli Abstract Aim:, Cystic Fibrosis (CF) Newborn Screening occasionally identifies neonates where a CF diagnosis can neither be confirmed nor excluded. To assess how parents of these infants cope with this ambiguous situation. Methods:, Parents of 11 children with Ambiguous Diagnosis (group AD) were compared with parents of 11 children diagnosed with CF through neonatal screening [group Cystic Fibrosis Diagnosis (CFD)] and with parents of 11 Healthy Control children (group HC) matched for gender and age. Results:, The emotional reaction to the inconclusive result was less pronounced in AD than in CFD (p = 0.003), and AD parents considered their infants as healthy as controls. Parents' anxiety about their child's health is stronger in CFD than in AD (p < 0.05) and HC (p < 0.001). Long-term emotional distress was rated similarly in AD and CFD, and greater than in HC (p = 0.0003). The parent/child relationship was less influenced in AD than in the CF group (p = 0.03). Seven AD and CFD parents changed their family planning projects. Conclusion:, Inconclusive neonatal screening results appear to be understood and associated with lower anxiety levels than CF diagnosis. Concern about the child's health is similar to healthy controls and lower than in parents of CF children. [source] | |||||||||||||