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Completion Rates (completion + rate)
Selected AbstractsRandomized study of sertraline and low-dose amitriptyline in patients with Parkinson's disease and depression: Effect on quality of lifeMOVEMENT DISORDERS, Issue 8 2006Angelo Antonini MD Abstract We assessed the effect of 3-month treatment of sertraline (50 mg) or low-dose amitriptyline (25 mg) on depression and quality of life in 31 patients with Parkinson's disease in a prospective single-blind randomized study. Both drugs significantly reduced the Hamilton Depression Rating Scale (HDRS-17) score. Completion rate was 75% for sertraline (12 of 16) and 73% for amitriptyline (11 of 15). Responder rate (HDRS-17 score reduction , 50%) was 83.3% for sertraline and 72.7% for amitriptyline. Sertraline but not amitriptyline treatment determined a significant benefit on quality of life (PDQ-39 scale). We found no change in Unified Parkinson's Disease Rating Scale scores. However, the improvement in specific PDQ-39 subscores (mobility, activities of daily living, and stigma) suggests that depression affects patient self-perception of motor function and further emphasizes the need for its treatment. © 2006 Movement Disorder Society [source] A double-blind, randomized, parallel group study to compare the efficacy, safety and tolerability of slow-release oral morphine versus methadone in opioid-dependent in-patients willing to undergo detoxificationADDICTION, Issue 9 2009Ekkehard Madlung-Kratzer ABSTRACT Aims Evaluation of the efficacy and safety of slow-release oral morphine (SROM) compared with methadone for detoxification from methadone and SROM maintenance treatment. Design Randomized, double-blind, double-dummy, comparative multi-centre study with parallel groups. Setting Three psychiatric hospitals in Austria specializing in in-patient detoxification. Participants Male and female opioid dependents (age > 18 years) willing to undergo detoxification from maintenance therapy in order to reach abstinence. Interventions Abstinence was reached from maintenance treatment by tapered dose reduction of either SROM or methadone over a period of 16 days. Measurements Efficacy analyses were based on the number of patients per treatment group completing the study, as well as on the control of signs and symptoms of withdrawal [measured using Short Opioid Withdrawal Scale (SOWS)] and suppression of opiate craving. In addition, self-reported somatic and psychic symptoms (measured using Symptom Checklist SCL-90-R) were monitored. Findings Of the 208 patients enrolled into the study, 202 were eligible for analysis (SROM: n = 102, methadone: n = 100). Completion rates were 51% in the SROM group and 49% in the methadone group [difference between groups: 2%; 95% confidence interval (CI): ,12% to 16%]. The rate of discontinuation in the study was high mainly because of patients voluntarily withdrawing from treatment. No statistically significant differences between treatment groups were found in terms of signs and symptoms of opiate withdrawal, craving for opiates or self-reported symptoms. SROM and methadone were both well tolerated. Conclusions Detoxification from maintenance treatment with tapered dose reduction of SROM is non-inferior to methadone. [source] Agreement between dementia patient report and proxy reports using the Nottingham Health ProfileINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2004F. Boyer Abstract Objective The aim of the study was to examine the agreement between patient reports and their proxy reports (family and care provider proxies) on Health Status in a sample of patients with dementia. Method Ninety-nine patients with mild to moderate dementia and proxies completed the 38-item Nottingham Health Profile (NHP) questionnaire. Results Completion rates for the different NHP dimensions ranged from 78 to 90% for the dementia subjects. Inter-rater agreement between different proxies and subject was from moderate to good for physical assessment (ICCs from 0.54 to 0.78 for physical mobility scales). Patient/family proxy concordance was moderate to good for five out of six dimensions (physical mobility, social isolation, pain, energy, sleep) and poor for emotional reaction. Family proxies systematically reported lower functioning than did patients in the four subscales assessing: physical mobility (p,<,0.0001), energy (p,<,0.005), social isolation (p,<,0.01) and sleep (p,<,0.03). Care provider proxies only estimated physical mobility as lower (p,<,0.0001). Conclusion Age and physical status of the patient significantly affected agreement in patient-care provider proxy ratings. Thus, caution is appropriate when resorting to proxies to estimate the Health Status of a dementia patient. Copyright © 2004 John Wiley & Sons, Ltd. [source] Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida,PRENATAL DIAGNOSIS, Issue 9 2010Lily J. Tsai Abstract Objective To determine the completion rate of ultrasound surveys for aneuploidy markers by maternal body mass index (BMI). Methods A retrospective review of ultrasounds on midtrimester singleton pregnancies was performed. Subjects were grouped as normal, overweight (BMI 25,29.9 kg/m2), and obese: class I (30,34.9 kg/m2), class II (35,39.9 kg/m2), and class III (, 40 kg/m2). Examinations with visualization of at least seven of eight markers were considered complete. Results Of 14 353 ultrasounds reviewed, 5690 patients were eligible: 43% normal, 29% overweight, 27% obese. Completion rates differed significantly between groups (64% normal, 64% overweight, 61% class I, 55% class II, 47% class III, p < 0.001). The screen positive rates (,1 marker) differed significantly overall (16% normal, 13% overweight, 15% class I, 12% class II, 10% class III, p < 0.02), but not for complete examinations (p = 0.42). Conclusions Since completion rates for ultrasound aneuploidy screening are inversely related to maternal obesity, obese women are underscreened. Copyright © 2010 John Wiley & Sons, Ltd. [source] Improving Heart Failure Self-Management Support by Actively Engaging Out-of-Home Caregivers: Results of a Feasibility StudyCONGESTIVE HEART FAILURE, Issue 1 2008John D. Piette PhD The benefits of heart failure (HF) care management have been demonstrated, yet health systems are often unable to meet patients' needs for support between outpatient visits. Informal care provided by family or friends is a low-cost, and potentially effective, adjunct to care management services. The authors evaluated the feasibility of augmenting HF care management with weekly, automated assessment and behavior change calls to patients, feedback via the Internet to an out-of-home informal caregiver or CarePartner (CP), and faxes to the patient's health care team. The program included 52 HF patient-CP pairs participating for an average of 12 weeks. Patients completed 586 assessments (92% completion rate) and reported problems that might otherwise have gone unidentified. At follow-up, 75% had made changes in their self-care as a result of the intervention. The CP program may extend the impact of HF telemonitoring beyond what care management programs can realistically deliver. [source] Assessing competency in Dentoalveolar surgery: a 3-year study of cumulative experience in the undergraduate curriculumEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2007J. A. Durham Aim:, To assess and observe the development of competence in oral surgical skills during a 3-year undergraduate programme. Method:, Over a 3-year period 75 students were followed through from the beginning of their clinical course to their Bachelor of Dental Surgery graduation and their surgical experience monitored by the use of logbooks. Their development of competence was assessed objectively through structured assessments and subjectively by a single tutor responsible for each year. Assessments were made of their ability in exodontia, pre-surgical assessment and the surgical extraction of teeth/roots. Results:, Seventy-three students completed the course (97%). Successful completion rates for the objective testing were 100% for both exodontia and pre-surgical assessment. The surgical assessment, (surgical extraction of a tooth or root) had a successful completion rate of only 23% and the caseload for students was low with a mean of four teeth removed surgically upon graduation. Relationships were examined between total numbers of teeth extracted, total number of minor oral surgical procedures completed and the successful completion of the surgical competence assessment, but no significant relationships were found. Conclusions:, This study demonstrates that it is possible to achieve objectively measurable levels of competence in undergraduates undertaking oral surgery procedures. It is however, a labour and time intensive process and appropriate clinical and teaching resources are required. National co-operation towards agreed standardised competencies should be encouraged to allow data to be pooled and more powerful analyses to occur. [source] Long pediatric colonoscope versus intermediate length adult colonoscope for colonoscopyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt2 2008Yu-Hsi Hsieh Abstract Background:, Controversy exists on how the length and diameter of colonoscopes affect the quality of colonoscopy. The aim of this study was to compare a long pediatric colonoscope with an intermediate length adult colonoscope with regards to completion rate and cecal intubation time. Whether either scope may be more efficient in any subgroups was also investigated. Methods:, Asymptomatic patients admitted to the physical check-up department of Buddhist Dalin Tzu Chi General Hospital were included. A single endoscopist performed all of the colonoscopic examinations under sedation. Consecutive patients were randomized to undergo colonoscopy with either intermediate length adult colonoscope (CF-240I) or long pediatric colonoscope (PCF-240L). The success rate and time required to reach cecum were compared between the two groups. Results:, Between April 2005 and February 2006, a total of 918 patients were enrolled. Incomplete colonoscopy occurred in 21 (2.3%) cases (14 in the CF-240I group and seven in the PCF-240L group, P > 0.1). The overall cecal mean insertion time was 6.00 ± 3.66 min. There was no significant difference between the CF-240I and PCF 240L groups with regard to the cecal intubation rate (96.9% vs 98.5%, P = 0.18), the need for abdominal pressure (71.7% vs 73.4%, P = 0.55) and change of position (13.5% vs 11.5%, P = 0.37). However, the cecal intubation time was shorter in the CF-240I group (5.75 ± 3.18 vs 6.26 ± 3.30 min, P = 0.02). Subgroup analysis by sex, age, and body mass index showed comparable outcomes between the two groups except that the cecal intubation times were significantly shorter in the CF-240I group when only men (4.78 ± 2.57 vs 5.50 ± 2.93 min, P < 0.01) or those younger than 50 years (5.50 ± 2.90 vs 6.25 ± 3.68 min, P = 0.02) were considered. Conclusion:, Cecal intubation time is shorter in patients examined with an intermediate length adult colonoscope, mainly in the subgroups of men and those younger than 50 years of age. [source] Parents, infants and health care: Utilization of health services in the first 12 months of lifeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2003SR Goldfeld Objective: To describe patterns of health-service use in the first 12 months of life. Methods: In this prospective cohort study, 173 first-born infants and their families living in two middle socio-economic urban areas of Melbourne were enrolled consecutively when presenting for their initial maternal and child health nurse (MCHN) visit (at approximately 4 weeks of age). Families kept a daily ,health diary' for the entire 12-month period, recording use of all health services for their infant, and reasons for the contact. Results: There was an 87% completion rate of diaries. The mean number of visits to any health service, including medical, hospitals, MCHN services, pharmacists, allied health services and naturopaths, was 35.7 (95% CI 34.7,36.6) during the 12 months. Of these, 31% (mean 10.9 visits) were visits to a general practitioner (GP) and 41.5% (mean 14.3 visits) were visits to the MCHN. Infants' visits to the MCHN were far more frequent in the first 6 months of life compared with the second 6 months (10.3 vs 3.6, P < 0.001). Rates of GP use were constant over the same periods (5.3 vs 5.7, P = 0.8). Conclusions: In a universal health-care system, this high rate of health-service use equates to approximately one visit to a health service every 2 weeks in the first year of life. The majority of these visits appeared unrelated to illness. This previously undocumented data has implications for future integrated service delivery, health-professional training and policy development for this age group. [source] SBIRT Outcomes in Houston: Final Report on InSight, a Hospital District-Based Program for Patients at Risk for Alcohol or Drug Use ProblemsALCOHOLISM, Issue 8 2009The InSight Project Research Group Background:, Screening, Brief Intervention, and Referral to Treatment (SBIRT) services have been implemented as the standard of care for patients in the Harris County Hospital District (HCHD). The present analysis addresses alcohol and drug use for patients admitted over a 39-month period from July 1, 2005 through September 30, 2008. Methods:, Patients were screened for alcohol and drug use at medical admission. Those who were positive received further assessment and were transitioned to receive services as appropriate. A sample of consenting patients who were positive and received services was contacted at 6 months for a follow-up interview. Using an intent-to-treat (ITT) protocol, the analysis included all patients who were assigned for follow-up, including those with completed follow-ups as well as those who could not be contacted at follow-up. Patients not contacted at follow-up were assumed to have maintained their baseline drug and alcohol consumption levels. Results:, Of 59,760 patients who were screened by generalists (primarily nurses, physicians, and medical care technicians), 15,241 (26%) were positive and received further assessment and services. The 6-month follow-up interview completion rate was 66%. The ITT sample consisted of all 1,937 patients who were assigned for follow-up. There was an overall reduction in the number of patients reporting any days of heavy drinking from 70% at intake to 37% at 6-month follow-up and a reduction in the mean number of days of heavy drinking from 7.8 days at intake to 4.1 days at follow-up. The number of patients reporting any days of drug use was 82% at intake versus 33% at follow-up, and the mean number of days of drug use declined from 8.3 days at intake to 4.2 days at follow-up. Conclusions:, The results were consistent with but of greater magnitude than most other studies reporting positive outcomes for SBIRT patients. Drug use and heavy alcohol use were found to decrease substantially from admission to follow-up. This finding holds good for all levels of drug or alcohol misuse severity, with the highest severity patients showing the largest decreases. Future studies are needed to control for potential regression to the mean effects and to develop improved understanding of differences in outcomes by race/ethnicity. [source] Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, TennesseeALCOHOLISM, Issue 10 2008Michael S. Reich Background:, Alcoholics Anonymous (AA) members represent an important and relatively understudied population for improving our understanding of alcohol dependence recovery as over 1 million Americans participate in the program. Further insight into coffee and cigarette use by these individuals is necessary given AA members' apparent widespread consumption and the recognized health consequences and psychopharmacological actions of these substances. Methods:, Volunteers were sought from all open-AA meetings in Nashville, TN during the summer of 2007 to complete a questionnaire (n = 289, completion rate = 94.1%) including timeline followback for coffee, cigarette, and alcohol consumption; the Alcoholics Anonymous Affiliation Scale; coffee consumption and effects questions; the Fagerstrom Test for Nicotine Dependence (FTND); and the Smoking Effects Questionnaire. Results:, Mean (±SD) age of onset of alcohol consumption was 15.4 ± 4.2 years and mean lifetime alcohol consumption was 1026.0 ± 772.8 kg ethanol. Median declared alcohol abstinence was 2.1 years (range: 0 days to 41.1 years) and median lifetime AA attendance was 1000.0 meetings (range: 4 to 44,209 meetings); average AA affiliation score was 7.6 ± 1.5. Most (88.5%) individuals consumed coffee and approximately 33% of coffee consumers drank more than 4 cups per day (M = 3.9 ± 3.9). The most common self-reported reasons for coffee consumption and coffee-associated behavioral changes were related to stimulatory effects. More than half (56.9%) of individuals in AA smoked cigarettes. Of those who smoked, 78.7% consumed at least half a pack of cigarettes per day (M = 21.8 ± 12.3). Smokers' FTND scores were 5.8 ± 2.4; over 60% of smokers were highly or very highly dependent. Reduced negative affect was the most important subjective effect of smoking. Conclusions:, A greater proportion of AA participants drink coffee and smoke cigarettes in larger per capita amounts than observed in general U.S. populations. The effects of these products as described by AA participants suggest significant stimulation and negative affect reduction. Fundamental knowledge of the quantitative and qualitative aspects of coffee and cigarette consumption among AA members will enable future research to discern their impact on alcohol abstinence and recovery. [source] Response to pegylated interferon and ribavirin in Asian American patients with Chronic hepatitis C genotypes 1 vs 2/3 vs 6JOURNAL OF VIRAL HEPATITIS, Issue 10 2010N. H. Nguyen Summary., Chronic hepatitis C is generally underappreciated in Asian Americans, and most pivotal studies were conducted in western countries and only included a small numbers of Asian patients. Our goal was to examine and compare treatment outcomes in these patients with genotypes 1 vs 2/3 vs 6. We performed a retrospective cohort study of 167 consecutive treatment-naïve Asian American patients treated with pegylated interferon (PEG IFN) plus ribavirin (RBV) at two community clinics in Northern California from 12/00 to 1/08. Primary outcome was sustained virological response rate by intention-to-treat analysis. The overall completion rate was 76%, and treatment adherence (completion of ,75,80% PEG IFN + RBV dose for ,75,80% of intended duration) was 74%. Significant depression was noted in only 4% of patients. Sustained virologic response in patients with genotype 6 treated for 48 weeks was similar to that seen in those with genotype 2/3 (74%vs 75%, P = 0.89) and significantly higher than those with genotype 1 (74%vs 49%, P = 0.016). On multivariate analysis inclusive of sex, age, body mass index (,25 vs >25) and viral load, only treatment adherence and genotype (2/3 and 6 treated for 48 weeks) were found to be significant predictors of sustained virologic response. We conclude that significant depression is rare in Asian American patients (4%). Patients with genotype 6 treated for 48 weeks appear to have a similar treatment response rate as patients with genotype 2/3 and a significantly higher response rate than those with genotype 1. [source] Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida,PRENATAL DIAGNOSIS, Issue 9 2010Lily J. Tsai Abstract Objective To determine the completion rate of ultrasound surveys for aneuploidy markers by maternal body mass index (BMI). Methods A retrospective review of ultrasounds on midtrimester singleton pregnancies was performed. Subjects were grouped as normal, overweight (BMI 25,29.9 kg/m2), and obese: class I (30,34.9 kg/m2), class II (35,39.9 kg/m2), and class III (, 40 kg/m2). Examinations with visualization of at least seven of eight markers were considered complete. Results Of 14 353 ultrasounds reviewed, 5690 patients were eligible: 43% normal, 29% overweight, 27% obese. Completion rates differed significantly between groups (64% normal, 64% overweight, 61% class I, 55% class II, 47% class III, p < 0.001). The screen positive rates (,1 marker) differed significantly overall (16% normal, 13% overweight, 15% class I, 12% class II, 10% class III, p < 0.02), but not for complete examinations (p = 0.42). Conclusions Since completion rates for ultrasound aneuploidy screening are inversely related to maternal obesity, obese women are underscreened. Copyright © 2010 John Wiley & Sons, Ltd. [source] Meta-Analysis of Studies with Missing DataBIOMETRICS, Issue 2 2009Ying Yuan Summary Consider a meta-analysis of studies with varying proportions of patient-level missing data, and assume that each primary study has made certain missing data adjustments so that the reported estimates of treatment effect size and variance are valid. These estimates of treatment effects can be combined across studies by standard meta-analytic methods, employing a random-effects model to account for heterogeneity across studies. However, we note that a meta-analysis based on the standard random-effects model will lead to biased estimates when the attrition rates of primary studies depend on the size of the underlying study-level treatment effect. Perhaps ignorable within each study, these types of missing data are in fact not ignorable in a meta-analysis. We propose three methods to correct the bias resulting from such missing data in a meta-analysis: reweighting the DerSimonian,Laird estimate by the completion rate; incorporating the completion rate into a Bayesian random-effects model; and inference based on a Bayesian shared-parameter model that includes the completion rate. We illustrate these methods through a meta-analysis of 16 published randomized trials that examined combined pharmacotherapy and psychological treatment for depression. [source] Unmet education and training needs in adolescent health of health professionals in a UK children's hospitalACTA PAEDIATRICA, Issue 6 2006Janet E. McDonagh Abstract Aim: To determine the perceived education and training needs in adolescent health of health professionals. Design: Cross-sectional survey Setting and subjects: Hospital staff in a UK children's hospital. Outcome measures: perceived barriers, confidence, knowledge, skill and prior teaching in key adolescent health subject areas. Results: The hospital survey was completed by 159/1400 professionals representing a completion rate of 11%. Doctors and staff from ,Professions allied to medicine' rated ,lack of training', ,lack of teaching materials' and ,lack of community resources' as the main barriers to providing developmentally appropriate care. Sixty per cent of hospital respondents had received no prior specific training in adolescent health. All but four topics were perceived to be of very high or high importance by the majority of respondents (54,90%). Low scores in perceived knowledge, confidence and/or skill were reported in nine key subject areas (including adolescent mental health and substance use). Differences between doctors and professions allied to medicine were observed in a minority of areas. Conclusion: Unmet education and training needs of a range of professionals working in a paediatric setting were identified in key areas of adolescent health and they provide useful directions for the development of future multidisciplinary training programmes. [source] Use of intravenous steroids at induction of anaesthesia for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trialCLINICAL OTOLARYNGOLOGY, Issue 1 2006S. McKean Objective:, To assess the effectiveness of intravenous steroids at induction of anaesthetic to reduce post-operative nausea and vomiting and pain after adult tonsillectomy. Design:, Prospective, double-blind, randomized, placebo controlled trial, with ethical approval, following Consolidated Standards of Reporting Trials guidelines. Setting:, District General Hospital in Scotland, UK. Participants:, Seventy-two adults between 16 and 70 years, American Association of Anaethetists (ASA) 1, listed for elective tonsillectomy. Intervention:, Single dose of either 10 mg of dexamethasone or 2 mL of saline after induction with a consistent anaesthetic technique. Main outcome measures:, Patients filled in a visual analogue scale relating to pain and post-operative nausea and vomiting for the day of operation and 7 days after operation. The time to first ingestion of food and drink after operation was also noted. Results:, Data completion rate of 64% (46 of 72 patients enrolled). Statistically significant relative decrease (62%P = 0.001) in the incidence of post-operative nausea and vomiting was seen in those treated with dexamethasone. Statistically significant relative decrease (23%P = 0.016) in post-operative pain scores for the day of operation was seen in those treated with dexamethasone. Significant decrease (17.5%, P < 0.001) in mean pain score for seven post-operative days was seen in those treated with dexamethasone. No adverse effects were seen. Conclusions:, Dexamethasone given as a single dose of 10 mg at induction of anaesthesia for adult tonsillectomy is an effective, safe and inexpensive method for reducing morbidity in adult tonsillectomy. [source] The outcome of a rapid hepatitis B vaccination programme in a methadone treatment clinicADDICTION, Issue 2 2010Parameswaran Ramasamy ABSTRACT Aim Injecting drug users are a high-risk population for hepatitis B (HBV), but are difficult to engage in vaccination programmes. This study examines the completion rates of a HBV vaccination schedule and seroconversion in a group of patients in methadone maintenance treatment. Methods Patients at a public methadone maintenance programme in Sydney, Australia, were screened for viral hepatitis (hepatitis A, B and C) and offered a rapid HBV vaccination schedule (0, 1 and 2 months). Hepatitis B surface antibody (antiHBs) was retested on completion of the vaccination schedule. Results A total of 143 patients [71.3% male, mean age 33.1 (standard deviation ± 8.3)] enrolled in the project. Forty-nine per cent of patients were HAV antibody (Ab) positive, 81.1% hepatitis C virus (HCV) antibody (Ab) positive and 38.9% antiHBs positive. Exposure to multiple hepatitis viruses was common, with 24.5% testing positive for all three viruses. Seventy-three (83%) of the 88 antiHBs negative patients completed the vaccination schedule. Post-vaccination serology indicated a seroconversion rate of 75.4% (55 of 73) of completors, or 62.5% of eligible participants (55 of 88). Conclusion While there was a high rate of completion of the rapid vaccination schedule in this population, a moderate seroconversion rate was achieved. Further work is required to identify an optimal vaccination schedule in opioid substitution patients. [source] Critical issues in the treatment of hepatitis C virus infection in methadone maintenance patientsADDICTION, Issue 6 2008David M. Novick ABSTRACT Aims Hepatitis C virus (HCV) infection is a common chronic complication of injection drug use. Methadone maintenance programs contain large numbers of patients infected with HCV. This paper reviews HCV infection with emphasis on the medical care of HCV-infected, or HCV and human immunodeficiency virus co-infected, patients on methadone or buprenorphine maintenance. Methods Literature searches using PubMed, PsycINFO and SocINDEX were used to identify papers from 1990,present on antiviral therapy for HCV in methadone maintenance patients and on liver transplantation in methadone maintenance patients. Results Injection drug use is the most significant risk factor for HCV infection in most western countries. The prevalence of HCV antibody is high in injection drug users (53,96%) and in patients enrolled in methadone maintenance programs (67,96%). Studies of antiviral therapy for HCV in methadone maintenance patients show rates of sustained virological response (SVR), defined as negative HCV-RNA 24 weeks after the end of treatment, of 28,94%. In studies with contrast groups, no significant differences in SVR between methadone and contrast groups were found. Excellent completion rates of antiviral therapy (72,100%) were found in five of six studies. There are many barriers to methadone maintenance patients' receiving antiviral therapy, and research on overcoming barriers is discussed. Liver transplantation has been successful in methadone maintenance patients but has not been utilized widely. Conclusion High quality medical care for all aspects of HCV infection can be provided to methadone maintenance patients. The literature supports the effectiveness of such services, but the reality is that most patients do not receive them. [source] Assessing competency in Dentoalveolar surgery: a 3-year study of cumulative experience in the undergraduate curriculumEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2007J. A. Durham Aim:, To assess and observe the development of competence in oral surgical skills during a 3-year undergraduate programme. Method:, Over a 3-year period 75 students were followed through from the beginning of their clinical course to their Bachelor of Dental Surgery graduation and their surgical experience monitored by the use of logbooks. Their development of competence was assessed objectively through structured assessments and subjectively by a single tutor responsible for each year. Assessments were made of their ability in exodontia, pre-surgical assessment and the surgical extraction of teeth/roots. Results:, Seventy-three students completed the course (97%). Successful completion rates for the objective testing were 100% for both exodontia and pre-surgical assessment. The surgical assessment, (surgical extraction of a tooth or root) had a successful completion rate of only 23% and the caseload for students was low with a mean of four teeth removed surgically upon graduation. Relationships were examined between total numbers of teeth extracted, total number of minor oral surgical procedures completed and the successful completion of the surgical competence assessment, but no significant relationships were found. Conclusions:, This study demonstrates that it is possible to achieve objectively measurable levels of competence in undergraduates undertaking oral surgery procedures. It is however, a labour and time intensive process and appropriate clinical and teaching resources are required. National co-operation towards agreed standardised competencies should be encouraged to allow data to be pooled and more powerful analyses to occur. [source] Reversal of Fortunes or Continued Success?INTERNATIONAL MIGRATION REVIEW, Issue 2 2010Cohort Differences in Education, Earnings of Childhood Immigrants Using several years of Canadian census data, this study examines cohort differences in educational attainment and earnings among childhood immigrants who arrived in Canada between 1960 and 1989. Successive cohorts of childhood immigrants had increasingly higher university completion rates than their Canadian-born peers by age 25,34. We find that this lead was tempered by declining earnings of immigrant parents relative to Canadian-born parents, particularly among the 1980s cohort. Despite rising university completion rates, wages of male (but not female) childhood immigrants lagged behind those of their Canadian-born peers. This gap can be accounted for largely by the rising share of members of racial minority groups and the decreasing incidence of full-time employment. [source] Sampling for a longitudinal study of the careers of nurses qualifying from the English pre-registration Project 2000 diploma courseJOURNAL OF ADVANCED NURSING, Issue 4 2000Louise Marsland PhD BSc RMN Sampling for a longitudinal study of the careers of nurses qualifying from the English pre-registration Project 2000 diploma course This paper describes the processes involved in selecting a sample, from the eight English regional health authorities, of nurse qualifiers from all four branches of the Project 2000 pre-registration diploma course, for a longitudinal study of nurses' careers. A simple random sample was not feasible since accurate information about the population could not be obtained and the study design involved recruiting participants by personal visit. A multi-stage approach was therefore adopted in which ,college of nursing' was taken as the primary sampling unit. Sampling was further complicated by the fact that adult branch students could generally only be visited in larger groups than was ideal. Information obtained during pilot work about the accuracy of data about the population, course completion rates and the proportion of students who were likely to agree to participate was used to calculate required sampling fractions. The final sample was therefore a function of this information and the practicalities of recruiting nurses into the study. [source] A Comparison of Computerized and Pencil-and-Paper Tasks in Assessing Cognitive Function in Community-Dwelling Older People in the Newcastle 85+ Pilot StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2007Joanna Collerton MRCP OBJECTIVES: To compare the acceptability and feasibility of computerized and pencil-and-paper tests of cognitive function in 85-year-old people. DESIGN: Group comparison of participants randomly allocated to pencil-and-paper (Wechsler Adult Intelligence and Memory Scales) or computerized (Cognitive Drug Research) tests of verbal memory and attention. SETTING: The Newcastle 85+ Pilot Study was the precursor to the Newcastle 85+ Study a United Kingdom Medical Research Council/Biotechnology and Biological Sciences Research Council cohort study of health and aging in the oldest-old age group. PARTICIPANTS: Eighty-one community-dwelling individuals aged 85. MEASUREMENTS: Participant and researcher acceptability, completion rates, time taken, validity as cognitive measures, and psychometric utility. RESULTS: Participants randomized to computerized tests were less likely to rate the cognitive function tests as difficult (odds ratio (OR)=0.16, 95% confidence interval (CI)=0.07,0.39), stressful (OR=0.18, 95% CI=0.07,0.45), or unacceptable (OR=0.18, 95% CI=0.08,0.48) than those randomized to pencil-and-paper tests. Researchers were also less likely to rate participants as being distressed in the computer test group (OR=0.19, 95% CI=0.07,0.46). Pencil-and-paper tasks took participants less time to complete (mean±standard deviation 18±4 minutes vs 26±4 minutes) but had fewer participants who could complete all tasks (91% vs 100%). Both types of task were equally good measures of cognitive function. CONCLUSION: Computerized and pencil-and-paper tests are both feasible and useful means of assessing cognitive function in the oldest-old age group. Computerized tests are more acceptable to participants and administrators. [source] A bounds analysis of school completion rates in AustraliaJOURNAL OF APPLIED ECONOMETRICS, Issue 3 2008Tue Gørgens Official estimates of school completion rates in Australia increased in the 1980s, peaked in 1992, and fell immediately thereafter before stabilizing. The official estimates were a specific focus of Australian education policy. The decline caused concern at the time. We use data from the Australian Youth Survey (AYS) to gain insight into the behavior of the official estimates. The AYS suffers from nonrepresentativeness, attrition and nonresponse, which means that parameters of interest are not identified. Our bounds analysis is suggestive that school completion was overstated in the official estimates at their peak. Our analysis points to repetition as a key factor in inflating the official estimates. Copyright © 2008 John Wiley & Sons, Ltd. [source] When bonuses backfire: an inaction inertia analysis of procrastination induced by a missed opportunityJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 2 2008Thane S. Pittman Abstract An inaction inertia analysis of procrastination was used to generate the prediction that using bonuses to encourage early task completion will have two opposing effects, encouraging early task completion by some but also inducing procrastination for those who miss the bonus. Study 1 showed that the addition of bonuses for early completion produced both of these effects and also led to overall task completion rates that were either equal to (large bonus) or actually less than (medium and small bonuses) those obtained by simply establishing a completion deadline with no bonus. In Study 2, a lottery methodology was used to manipulate the size of a missed bonus for all participants. Even under these conditions of reduced personal responsibility the larger missed bonus led to increased procrastination as predicted by the inaction inertia analysis. Possible mediating processes based on anticipated regret and perceived fairness were discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Monitoring the care of lung cancer patients: linking audit and care pathwaysJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2001E. Kaltenthaler BSc Abstract Clinical audit plays an important role in monitoring the provision of care for patients whatever their condition. Care pathways define the steps and expected course of events in the care of patients with a specific clinical problem over a set time scale. This paper describes a study undertaken in a multisite cancer unit to develop a tool for monitoring the progress of lung cancer patients through a care pathway and auditing key standards within the pathway. Important issues associated with the development of this tool are highlighted. The process of developing this tool involved the following steps: a review of the literature dealing with the management of lung cancer patients; interviews with key personnel in primary, secondary, tertiary and palliative care; development of a paper-based series of forms representing key steps in the patient's care pathway; 3-month trial of the paper-based tool; analysis of completion rates and interviews with form users to evaluate effectiveness; and recommendations for creating an electronic record using the experience and lessons learned from the paper version. The paper forms developed through this multistage process were found to be acceptable to users and have the potential to provide accurate information at key points for audit throughout the patient's time within the health-care system for their lung cancer condition. The flexibility of this methodology allows it to be adapted readily to a variety of clinical situations and conditions. [source] Acupuncture for Alcohol Dependence: A Systematic ReviewALCOHOLISM, Issue 8 2009Seung-Hun Cho Background:, Acupuncture has been used in the treatment of substance-related disorders for the past 30 years. However, a systematic review to assess the effect of various types of acupuncture for alcohol dependence has not yet been performed. The present systematic review assessed the results of randomized controlled trials (RCTs). Methods:, Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched for RCTs of acupuncture for alcohol dependence up to June 2008 with no language restrictions. The methodological qualities of eligible studies were assessed using the criteria described in the Cochrane Handbook. Results:, Eleven studies, which comprised a total of 1,110 individual cases, were systematically reviewed. Only 2 of 11 trials reported satisfactorily all quality criteria. Four trials comparing acupuncture treatment and sham treatments reported data for alcohol craving. Three studies reported that there were no significant differences. Among 4 trials comparing acupuncture and no acupuncture with conventional therapies, 3 reported significant reductions. No differences between acupuncture and sham treatments were found for completion rates (Risk Ratio = 1.07, 95% confidence interval, CI = 0.91 to 1.25) or acupuncture and no acupuncture (Risk Ratio = 1.15, 95% CI = 0.79 to 1.67). Only 3 RCTs reported acupuncture-related adverse events, which were mostly minimal. Conclusions:, The results of the included studies were equivocal, and the poor methodological quality and the limited number of the trials do not allow any conclusion about the efficacy of acupuncture for treatment of alcohol dependence. More research and well-designed, rigorous, and large clinical trials are necessary to address these issues. [source] Treating Substance-Abusing Parents: A Study of the Pima County Family Drug Court ApproachJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2004JOSÉ B. ASHFORD ABSTRACT A geographical comparison-group design was used to examine the effectiveness of the Pima County (Arizona) Court Assisted Treatment Services (CATS) program and its drug court intervention. The study compared the summary statistics for the volunteers to the family drug court (n=33) with a treatment-refusal group (n=42) and a treatment-as-usual group (n=45) from a matched geographical area. The findings of this study indicate that the family drug court group had higher engagement and completion rates of residential treatment than was true of the other comparison groups. In addition, the volunteers to the family drug court group had fewer parental rights severed, a higher percentage of permanency decisions reached within one year, earlier permanency decisions, and a higher percentage of children placed with their parents. The implications of this study's findings for future evaluations of the components of a family drug court intervention are discussed. [source] Effects of Instruction in an Assignment Completion Strategy on the Homework Performance of Students with Learning Disabilities in General Education ClassesLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 1 2002Charles A. Hughes Homework is an important activity in the lives of school-aged children, including students with learning disabilities (LD). Characteristics often associated with LD (e.g., poor organizational skills) may adversely impact the rate and quality of homework completion. In this study, a multiple-probe across-students design (Horner & Baer, 1978) was used to evaluate the effects of instruction in a comprehensive, independent assignment completion strategy with regard to homework completion rates and the quality of products completed in response to assignments given in general education classrooms. Eight of nine students mastered use of the strategy, and their homework completion rates and the quality of their homework products improved. Associated with these improvements were increases in quarterly grades and teacher ratings of the quality of the assignments. Thus, direct instruction in a comprehensive strategy comprised of organizational behaviors can result in independent completion of more homework by students with LD. Nevertheless, instruction in organizational skills alone appears insufficient to produce a 100 percent submission rate: student motivation to complete assignments and mastery of the skills required, as well as the appropriateness of assignments for students, need to be addressed. [source] Optimal material control in an assembly system with component commonalityNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 5 2001Narendra Agrawal Abstract Allocation of scarce common components to finished product orders is central to the performance of assembly systems. Analysis of these systems is complex, however, when the product master schedule is subject to uncertainty. In this paper, we analyze the cost,service performance of a component inventory system with correlated finished product demands, where component allocation is based on a fair shares method. Such issuing policies are used commonly in practice. We quantify the impact of component stocking policies on finished product delays due to component shortages and on product order completion rates. These results are used to determine optimal base stock levels for components, subject to constraints on finished product service (order completion rates). Our methodology can help managers of assembly systems to (1) understand the impact of their inventory management decisions on customer service, (2) achieve cost reductions by optimizing their inventory investments, and (3) evaluate supplier performance and negotiate contracts by quantifying the effect of delivery lead times on costs and customer service. © 2001 John Wiley & Sons, Inc. Naval Research Logistics 48:409,429, 2001 [source] Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida,PRENATAL DIAGNOSIS, Issue 9 2010Lily J. Tsai Abstract Objective To determine the completion rate of ultrasound surveys for aneuploidy markers by maternal body mass index (BMI). Methods A retrospective review of ultrasounds on midtrimester singleton pregnancies was performed. Subjects were grouped as normal, overweight (BMI 25,29.9 kg/m2), and obese: class I (30,34.9 kg/m2), class II (35,39.9 kg/m2), and class III (, 40 kg/m2). Examinations with visualization of at least seven of eight markers were considered complete. Results Of 14 353 ultrasounds reviewed, 5690 patients were eligible: 43% normal, 29% overweight, 27% obese. Completion rates differed significantly between groups (64% normal, 64% overweight, 61% class I, 55% class II, 47% class III, p < 0.001). The screen positive rates (,1 marker) differed significantly overall (16% normal, 13% overweight, 15% class I, 12% class II, 10% class III, p < 0.02), but not for complete examinations (p = 0.42). Conclusions Since completion rates for ultrasound aneuploidy screening are inversely related to maternal obesity, obese women are underscreened. Copyright © 2010 John Wiley & Sons, Ltd. [source] Inpatient Initiation of Buprenorphine Maintenance vs.THE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2006Detoxification: Can Retention of Opioid-Dependent Patients in Outpatient Counseling Be Improved? Buprenorphine-naloxone is an office-based opioid agonist released in 2003 in the United States for the maintenance of heroin- and other opioid-dependent patients. Concern has been raised that the medication will distract or otherwise inhibit patients from participating in a holistic recovery program or abstinence-based counseling. Using a retrospective chart review, the first thirty opioid-dependent patients induced on buprenorphine maintenance therapy in an inpatient detoxification unit were compared to thirty age- and gender-matched patients who underwent detoxification (with a tramadol taper) and referral to intensive outpatient treatment. The clinical outcomes were a comparison of completion rates for an intensive outpatient program (IOP) and retention in treatment after twelve weeks of aftercare therapy. Patients induced on buprenorphine maintenance over three days had similar relief of withdrawal symptoms to patients detoxified from opioids over five days with tramadol. Patients maintained on buprenorphine had a markedly increased initiation of IOP and remained in outpatient treatment longer than patients who were detoxified (8.5 wks vs. 0.4 wks, p<0.001). This study indicates that induction and maintenance on buprenorphine may be more effective than detoxification for engaging and retaining patients in abstinence-based comprehensive outpatient addiction treatment. [source] | |||||||||||||||||||