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Enrolment
Selected AbstractsA BRIEF NOTE ON AUSTRALIAN ECONOMICS DEGREE ENROLMENTS IN THE 21st CENTURYECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 3 2004Alex Millmow No abstract is available for this article. [source] Enrolment and response rates in a longitudinal birth cohortPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2009Jean Golding For the scientific credibility of study results, longitudinal cohort studies need to invest time, money and creative thought in establishing and maintaining the maximum number of study participants. Although success depends to a large extent on the resources available, much can be achieved by establishing a culture of integrity and enthusiasm among study staff that is conveyed to participants at all times. In this paper we outline various strategies that can be included in order to maximise the response rates. [source] Higher Education and the Largest Impoverished and Marginalized Group of the Indian Population: Reviewing Enrolment and Access to Higher Education among Tribals in IndiaASIAN SOCIAL WORK AND POLICY REVIEW, Issue 2 2010Kishor Joshi Higher education has been found to have a significant relationship with the Human Development Index and also the Gender Development Index. Its significance is especially apparent in the largest impoverished and marginalized group of the Indian population, Tribals. Tribals constitute the second largest social group in India and account for approximately 8% (equivalent to 85 million people) of the total population. Access to higher education in the Tribal population as reflected by the Gross Enrolment Ratio (GER) is an issue of concern as it falls behind the rest of the population even when compared with other deprived groups. Additionally, the GER of female Tribals falls behind that of their male counterparts. These factors reflect the inequality persisting among Tribals within Indian society. The present paper provides and analyses the current GER of Tribals in India and across states as well as taking a more detailed look at the enrolment of Tribals across various faculties in higher education. [source] How Much of the Gender Difference in Child School Enrolment Can Be Explained?BULLETIN OF ECONOMIC RESEARCH, Issue 2 2004Evidence from Rural India I21; O15 Abstract There are significant gender differences in child schooling in the Indian states though very few studies explain this gender difference. Unlike most existing studies we take account of the implicit and explicit opportunity costs of schooling and use a bivariate probit model to jointly determine a child's participation in school and market jobs. Results obtained from the World Institute of Development Economics Research (WIDER) villages in West Bengal suggest that indicators of household resources, parental preferences, returns to and opportunity costs of domestic work significantly affect child school enrolment. While household resources have similar effects on enrolment of boys and girls, other arguments tend to explain a part of the observed gender difference. Even after taking account of all possible arguments, there remains a large variation in gender differences in child schooling that cannot be explained by differences in male and female characteristics in our sample. [source] Enrolment in Higher Education and Changes in Income InequalityBULLETIN OF ECONOMIC RESEARCH, Issue 3 2003Kevin Sylwester O15; I21 Using a cross-section of countries, this paper empirically examines whether greater enrolment rates in higher education are associated with increases or decreases in subsequent income inequality as measured by the Gini coefficient. It finds a negative association between the two, suggesting that countries with larger enrolment rates saw their income inequality decrease relative to other countries. These findings are robust to the inclusion of several control variables and to limiting the sample to non-OECD countries. [source] Immunogenicity and reactogenicity of DTPa-HBV-IPV/Hib vaccine as primary and booster vaccination in low-birth-weight premature infantsACTA PAEDIATRICA, Issue 9 2008Liliana Vázquez Abstract Aim: To assess suitability of a combined DTPa-HBV-IPV/Hib vaccine (Infanrix hexaÔ) for immunization of low-birth-weight (<2.0 kg) preterm infants, with particular focus on the hepatitis B response. Methods: Open-label study in 170 preterm infants receiving primary vaccination at 2, 4 and 6 months of age and booster vaccination at 18,24 months. Enrolment and analysis were stratified in two groups: infants with birth weight between 1.5 kg and 2.0 kg (low birth weight: LBW), infants with BW <1.5 kg (very low birth weight: VLBW). Results: One month after the three dose primary vaccination, 93.7% and 94.9% of infants in VLBW and LBW groups, respectively, had anti-HBs antibody concentrations , 10 mIU/mL. High seroprotection and response rates (92.4,100%) to all vaccine antigens were observed. Those were reinforced (>98%) by booster vaccination for all antigens except for HBs in VLBW children: only 88.7% of those had anti-HBs antibody concentrations , 10 mIU/mL, compared with 96.5% of LBW children (difference statistically not significant). The vaccine was well tolerated in both groups of infants. Conclusion: Preterm infants will benefit by the administration of a primary and booster vaccination with DTPa-HBV-IPV/Hib vaccine. [source] Reducing Child Labour Through Conditional Cash Transfers: Evidence from Nicaragua's Red de Protección SocialDEVELOPMENT POLICY REVIEW, Issue 6 2010Kevin A. Gee Conditional Cash Transfer (CCT) programmes, providing eligible households with periodic cash payments, contingent on their children's adherence to school enrolment and attendance requirements, hold considerable promise for reducing levels of child labour across the developing world. This article presents the results of an analysis of a CCT programme in Nicaragua, Red de Protección Social, and compares them with those of other CCT programmes, discussing how the structure of each programme's incentives, including differences in targeting, subsidy amounts and educational requirements, contributes to the variation in their effectiveness at reducing child labour. [source] PROCEED: Prospective Obesity Cohort of Economic Evaluation and Determinants: baseline health and healthcare utilization of the US sample,DIABETES OBESITY & METABOLISM, Issue 12 2008A. M. Wolf Aim:, To summarize baseline characteristics, health conditions, resource utilization and resource cost for the US population for the 90-day period preceding enrolment, stratified by body mass index (BMI) and the presence of abdominal obesity (AO). Methods:, PROCEED (Prospective Obesity Cohort of Economic Evaluation and Determinants) is a multinational, prospective cohort of control (BMI 20,24.0 kg/m2), overweight (BMI 25,29.9 kg/m2) and obese (BMI , 30 kg/m2) subjects with AO and without AO [non-abdominal obesity (NAO)], defined by waist circumference (WC) >102 and 88 cm for males and females, respectively. Subjects were recruited from an Internet consumer panel. Outcomes were self-reported online. Self-reported anthropometric data were validated. Prevalence of conditions and utilization is presented by BMI class and AO within BMI class. Differences in prevalence and means were evaluated. Results:, A total of 1067 overweight [n = 474 (NAO: n = 254 and AO: n = 220)] and obese [n = 493 (NAO: n = 39 and AO: n = 454)] subjects and 100 controls were recruited. Self-reported weight (r = 0.92) and WC (r = 0.87) were correlated with measured assessments. Prevalence of symptoms was significantly higher in groups with higher BMI, as were hypertension (p < 0.0001), diabetes (p < 0.0001) and sleep apnoea (p < 0.0001). Metabolic risk factors increased with the BMI class. Among the overweight class, subjects with AO had significantly more reported respiratory, heart, nervous, skin and reproductive system symptoms. Overweight subjects with AO reported a significantly higher prevalence of diabetes (13%) compared with overweight subjects with NAO (7%, p = 0.04). Mean healthcare cost was significantly higher in the higher BMI classes [control ($456 ± 937) vs. overweight ($1084 ± 3531) and obese ($1186 ± 2808) (p < 0.0001)]. Conclusion:, An increasing gradient of symptoms, medical conditions, metabolic risk factors and healthcare utilization among those with a greater degree of obesity was observed. The independent effect of AO on health and healthcare utilization deserves further study with a larger sample size. [source] Flexible, intensive insulin therapy and dietary freedom in adolescents and young adults with Type 1 diabetes: a prospective implementation studyDIABETIC MEDICINE, Issue 5 2008A. Sämann Abstract Aims To assess the outcome of a Diabetes Treatment and Teaching Programme (DTTP) on glycated haemoglobin (HbA1c), severe hypoglycaemia (SH) and severe ketoacidosis (SKA) in adolescents and young adults with Type 1 diabetes. Methods Quality-assurance project with assessment of participants 1 year after participation in a DTTP (5-day inpatient course, groups , 10 patients, fixed curriculum of education/training, introduction of dietary freedom). Before,after analyses of participants aged 12,15, 15,18, 18,21 and 21,24 years. Main outcome measures were HbA1c, SH and SKA. Results For the 1592 participants, aged 12 to 24 years, mean age at enrolment was 19 ± 3 years, mean duration of diabetes was 7.3 ± 5.4 (range 0.3,24) years, mean baseline HbA1c declined from 8.8 ± 2.3% to 8.1 ± 2.0%. The incidence of SH was 0.31 vs. 0.11 events/patient/year; the incidence of SKA 0.17 vs. 0.07 events/patient/year. In mixed effects models taking into account effects of centres, age and diabetes duration, the mean difference was ,0.64%[P < 0.001, 95% confidence interval (CI) ,0.79 to ,0.5] for HbA1c, ,0.2 events/patient/year (P < 0.0001, 95% CI ,0.28 to ,0.12) for SH and ,0.1 events/patient/year (P < 0.0001, 95% CI ,0.14 to ,0.06) for SKA. Conclusions Adolescents and young adults with Type 1 diabetes benefit from participation in a standard DTTP for flexible, intensive insulin therapy and dietary freedom. [source] Rate of detoxification service use and its impact among a cohort of supervised injecting facility usersADDICTION, Issue 6 2007Evan Wood ABSTRACT Background Vancouver, Canada recently opened a medically supervised injecting facility (SIF) where injection drug users (IDU) can inject pre-obtained illicit drugs. Critics suggest that the facility does not help IDU to reduce their drug use. Methods We conducted retrospective and prospective database linkages with residential detoxification facilities and used generalized estimating equation (GEE) methods to examine the rate of detoxification service use among SIF participants in the year before versus the year after the SIF opened. In secondary analyses, we used Cox regression to examine if having been enrolled in detoxification was associated with enrolling in methadone or other forms of addiction treatment. We also evaluated the impact of detoxification use on the frequency of SIF use. Results Among 1031 IDU, there was a statistically significant increase in the uptake of detoxification services the year after the SIF opened. [odds ratio: 1.32 (95% CI, 1.11,1.58); P = 0.002]. In turn, detoxification was associated independently with elevated rates of methadone initiation [relative hazard = 1.56 (95% CI, 1.04,2.34); P = 0.031] and elevated initiation of other addiction treatment [relative hazard = 3.73 (95% CI, 2.57,5.39); P < 0.001]. Use of the SIF declined when the rate of SIF use in the month before enrolment into detoxification was compared to the rate of SIF use in the month after discharge (24 visits versus 19 visits; P = 0.002). Conclusions The SIF's opening was associated independently with a 30% increase in detoxification service use, and this behaviour was associated with increased rates of long-term addiction treatment initiation and reduced injecting at the SIF. [source] Brain natriuretic peptide in the prediction of recurrence of angina pectorisEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2004H. Takase Abstract Background, Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure, but little is known about its prognostic usefulness in patients with stable angina pectoris. We investigated whether BNP could be used as a marker for the prediction of anginal recurrence after successful treatment. Design, Brain natriuretic peptide levels of 77 patients with stable angina pectoris were measured at enrolment and after confirmation of successful treatment (i.e. no anginal attack for at least 6 months: chronic phase) with percutaneous transluminal coronary angioplasty and/or conventional medication. Then, we prospectively followed them up for 25·9 ± 1·4 months, with the endpoint being a recurrence of anginal attacks. Results, An anginal attack recurred in seven patients. In patients without recurrence, BNP levels in the chronic phase (21 ± 12 [median ± median absolute deviation] pg mL,1) were lower than those measured at enrolment (46 ± 25 pg mL,1, P < 0·0001), whereas the levels in patients with recurrence increased during the same period (from 36 ± 16 to 72 ± 42 pg mL,1, P < 0·05). A univariate analysis revealed that the BNP level measured in the chronic phase was the significant predictor of future anginal recurrence. Analysis of the receiver operating characteristic curve indicated that the cutoff level of BNP in the chronic phase was 68 pg mL,1. The Kaplan-Meier method revealed that the incidence of anginal recurrence was higher in patients with higher (71·4%) than lower levels of BNP (2·9%; P < 0·0001). Conclusions, Measurement of BNP levels after successful therapy is clinically useful for the prediction of recurrence of anginal attacks in patients with angina pectoris. [source] Defining Expertise in Software Development While Doing GenderGENDER, WORK & ORGANISATION, Issue 4 2007Esther Ruiz Ben The optimism regarding opportunities for women to enter the professionalization process in software development during the past years has not been fully realized and the gender gap in Germany's information technology (IT) sector still persists. Women are almost completely unrepresented in the technical fields of the German software industry, particularly in small enterprises. In this article, I firstly offer an overview of the German IT sector's development and current status. Secondly, I discuss the construction of expertise and gendered meanings in the practice of software development and related implications for the enrolment of women in this field. Gender stereotypical assumptions about expertise in the practice of software development and structural factors related to the lack of life,work balance programmes, as well as the lack of internal training in most IT companies, contribute to organizational segregation [source] Does free complementary health insurance help the poor to access health care?HEALTH ECONOMICS, Issue 2 2008Evidence from France Abstract The French government introduced a ,free complementary health insurance plan' in 2000, which covers most of the out-of-pocket payments faced by the poorest 10% of French residents. This plan was designed to help the non-elderly poor to access health care. To assess the impact of the introduction of the plan on its beneficiaries, we use a longitudinal data set to compare, for the same individual, the evolution of his/her expenditures before-and-after enrolment in the plan. This before-and-after analysis allows us to remove most of the spuriousness due to individual heterogeneity. We also use information on past coverage in a difference-in-difference analysis to evaluate the impact of specific benefits associated with the plan. We attempt at controlling for changes other than enrolment through a difference-in-difference analysis within the eligible (rather than enrolled) population. Our main result is the plan's lack of an overall effect on utilization. This result is likely attributable to the fact that those who were enrolled automatically in the free plan (the majority of enrollees), already benefited from a relatively generous plan. The significant effect among those who enrolled voluntarily in the free plan was likely driven by those with no previous complementary coverage. Copyright © 2007 John Wiley & Sons, Ltd. [source] The intention to switch health insurer and actual switching behaviour: are there differences between groups of people?HEALTH EXPECTATIONS, Issue 2 2010Michelle Hendriks PhD Abstract Background, Several western countries have introduced managed competition in their health care system. In the Netherlands, a new health insurance law was introduced in January 2006 making it easier to switch health insurer each year. Objective, The objective was to measure people's intention to switch health insurer and actual switching behaviour. We also examined whether some groups were less inclined to switch health insurer and/or had more difficulty to exert their intention to switch. Design, In October 2006, members of three Dutch panels indicated whether they intended to switch health insurer during that year's open enrolment period. In the beginning of 2007, the same people were asked whether they indeed switched health insurer. Results, Only 1% intended to switch health insurer. Women, older people, lower educated people, people who were insured for a longer period and people who reported a bad or moderate health were less inclined to switch health insurer. The amount of switching was higher among individuals who intended to switch (31%) than among individuals who did not know whether they would switch (7%) and individuals with no intention to switch (2%). Among those who intended to switch health insurer, women and people who reported a good health switched health insurer more often. The years of enrolment were also associated with actual switching behaviour. Discussion and Conclusions, We might have to temper the optimistic expectations on enhanced choice. Future research should determine why people do not switch health insurer when they intend to and which barriers they experience. [source] Serological Responses of FldA and Small-Molecular-Weight Proteins of Helicobacter pylori: Correlation with the Presence of the Gastric MALT TissueHELICOBACTER, Issue 1 2004Hsiao-Bai Yang ABSTRACT Purpose., We tested whether the serological response to Flavodoxin-A (FldA) protein and anti- Helicobacter pylori immunoblots correlated to the degree of mucosa-associated lymphoid tissue (MALT) in the stomach. Methods., Eighty H. pylori -infected patients with different degrees of MALT in the stomach were investigated with serum sampling and endoscopy on enrolment, the 2nd and the 12th months after anti- H. pylori therapy. All sera were tested for the anti-FldA protein and anti- H. pylori immunoblots, including 19.5, 26.5, 30, 35, 89, and 116 KDa (CagA). Regression of follicular gastritis was assessed by histology. Results., Patients with dense lymphoid follicles had higher prevalence rates of anti-FldA protein, 19.5, 26.5, and 30 KDa antibodies of H. pylori (p < .05). Histologic downgrade of MALT was observed in 25% (10/40) of patients in the 2nd month and in 60% (23/38) in the 12th month after H. pylori therapy. After H. pylori eradication, the patients with MALT and dense lymphoid follicles had significantly negative seroconversions of 19.5, 26.5, 30, and 35 KDa antibodies (p < .05), but not of CagA and FldA. Conclusion., Patients with gastric MALT and dense lymphoid follicles had different anti- H. pylori serological responses to those with scanty or an absence of lymphoid follicles. The negative seroconversion of the smaller-molecular-weight proteins, but not CagA and FldA, may correlate with the regression of MALT by H. pylori eradication. [source] Horizontal and Vertical Differentiation within Higher Education , Gender and Class PerspectivesHIGHER EDUCATION QUARTERLY, Issue 1-2 2008Caroline Berggren The study outline differences among classes and genders within higher education. Because of the expansion of places of study, higher education has lost some of its former selectivity. The matriculation of one full birth cohort into Swedish higher education was studied. The results showed that the enrolment of working- and intermediate-class women had increased, while women from the upper-middle class, also previously enrolled in higher education, had expanded their educational options becoming involved in prestigious and previously male-dominated programmes. [source] Assessment of a HER2 scoring system for gastric cancer: results from a validation studyHISTOPATHOLOGY, Issue 7 2008M Hofmann Aims:, Human epidermal growth factor receptor 2 (HER2) overexpression/amplification is implicated in the development of various solid tumour types. Validated methods and scoring systems for evaluating HER2 status exist in breast cancer, but not in gastric cancer. The aim was to establish a HER2 scoring system for gastric cancer to identify suitable patients for enrolment in a trial of trastuzumab (Herceptin®) in advanced metastatic gastric cancer. Methods and results:, Formalin-fixed paraffin-embedded gastric cancer samples were tested for HER2 status using the fluorescence in situ hybridization (FISH) pharmDxÔ kit (Dako Denmark A/S). Immunohistochemistry (IHC) was performed using the HercepTestÔ (Dako). Concordance between FISH and IHC was 93.5% in 168 evaluable samples. Eleven samples were scored as FISH+ but IHC, or equivocal. Conclusions:, IHC/FISH discrepancies were attributed to basolateral membranous immunoreactivity of glandular cells resulting in incomplete membranous reactivity and/or a higher rate of tumour heterogeneity in gastric cancer compared with breast cancer. With modifications to the IHC scoring system, the HercepTestÔ is considered valid for the identification of HER2+ gastric tumours for this clinical trial. Correlation of HER2 scores with clinical outcomes will be needed to determine which patients might benefit from trastuzumab therapy. [source] Risk factors and occurrence of rash in HIV-positive patients not receiving nonnucleoside reverse transcriptase inhibitor: data from a randomized study evaluating use of protease inhibitors in nucleoside-experienced patients with very low CD4 levels (<50 cells/m,L)HIV MEDICINE, Issue 1 2004M Floridia Background Most of the studies evaluating rash in HIV-positive patients have focused on nonnucleoside reverse transcriptase inhibitors (NNRTI), particularly nevirapine, and little is known about the occurrence of rash and the risk factors for its development in patients receiving regimens not based on NNRTI. Methods We evaluated all cases of rash observed during a 48-week randomized multicentre trial in 1251 nucleoside-experienced patients who started treatment with protease inhibitors (ritonavir or indinavir) at CD4 counts below 50 cells/,L. Incidence rates for rash were calculated according to gender, clinical status, age, use of highly active antiretroviral therapy (HAART), Pneumocystis carinii pneumonia (PCP) prophylaxis and use of individual antiretroviral drugs at enrolment. Differences between groups defined according to the above characteristics were tested for statistical significance using the log-rank test in a Kaplan-Meier survival analysis. All factors that gave results in the univariate analyses below the significance level of 0.05 were included in a multivariate analysis using a Cox regression model. Results During a follow-up period of 9690 person-months, 66 patients (5.3%) developed rash (0.68 events/100 person-months). In the univariate analyses, risk of rash did not differ with trial treatment (indinavir or ritonavir), clinical status, PCP prophylaxis, or age. During follow-up, rash was observed in 7.5% of enrolled women and in 4.5% of enrolled men (P=0.03). Serious rash occurred in 4.5% of enrolled women and in 1.6% of enrolled men (P=0.003). Use of HAART (P<0.001) and inclusion of zidovudine and of zalcitabine in the prescribed regimen (P=0.02) appeared to be associated with a lower risk of rash. In the multivariate analysis, the variables that remained significantly predictive of rash were gender (risk for women compared to men: 1.65, 95% confidence interval (CI): 1.00,2.72, P=0.048) and use of a non-HAART regimen (risk for non-HAART patients compared to HAART: 2.73, 95% CI: 1.49,5.02, P=0.001). Conclusions In our study, about 5% of HIV-positive patients who started treatment with protease inhibitors at very low CD4 counts developed rash, generally in the first few weeks after treatment. Risk was significantly higher in women and in patients who did not receive a HAART regimen. Our data indicate that women have a higher risk of rash than men, also with regimens that do not include NNRTI. [source] Solifenacin treatment for overactive bladder in Hispanic patients: patient-reported symptom bother and quality of life outcomes from the VESIcare® Open-Label TrialINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2008J. P. Capo' Jr Summary Objective:, The primary goal of overactive bladder (OAB) treatment is to reduce symptoms and improve health-related quality of life (HRQoL). Although trials open enrolment to everyone, most OAB studies feature Caucasians. Here we present Hispanic data. Methods:, VESIcare® Open-Label Trial was a 12-week, open-label, flexible-dosing study in patients with OAB symptoms for , 3 months. All patients started on solifenacin 5 mg/day, with a dosing option of 5 or 10 mg/day at weeks 4 and 8. Three patient-reported outcome (PRO) measures assessed symptom improvement and treatment satisfaction: the Patient Perception of Bladder Condition (PPBC) scale, a Visual Analogue Scale (VAS), the Overactive Bladder Questionnaire (OAB-q). Results:, 94/2205 patients in the full population were Hispanic. Urgency was most frequently reported at baseline (93.6%), followed by frequency (91.5%), nocturia (84.0%) and urge incontinence (UI) (67.0%). Frequency was reported as the most bothersome symptom (MBS) by a higher proportion of Hispanics than the full population (40.4% vs. 28.1%). UI was reported as the MBS by a smaller proportion of Hispanics (18.1% vs. 27.3%). Patients reporting moderate-to-severe problems related to bladder condition at baseline reported improvement to ,some minor problems' at week 12. Over 72.0% of patients experienced PPBC score improvement. Both groups reported significant improvements in urgency, UI, frequency and nocturia on the VAS (all p < 0.001) and all OAB-q domains (all p < 0.001) at week 12. Conclusion:, Although numbers were small, Hispanics receiving solifenacin for OAB reported improvement from baseline in symptom bother and HRQoL, as assessed by three independent PRO measures. [source] The effect of tadalafil on psychosocial outcomes in Swedish men with erectile distress: a multicentre, non-randomised, open-label clinical studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2006K. S. FUGL-MEYER Summary A multicentre, non-randomised, open-label study assessed whether personal distress caused by erectile dysfunction (ED) affected psychosocial outcomes of tadalafil treatment. Eligible Swedish men at least 18 years old reporting ,3-month history of ED were stratified into two groups (manifest or mild/no distress) based upon a distress question administered at enrolment. Tadalafil 20 mg was taken as needed for 8 weeks. The primary outcome was the difference between the two distress groups in change from baseline in the Psychological and Interpersonal Relationship Scales (PAIRS) spontaneity domain. Secondary outcome measures were PAIRS sexual self-confidence and time concerns domains, Life Satisfaction (LiSat-11) checklist and a Global Assessment of Treatment Response. The study also assessed tolerability. Of 662 men enrolled, 88% had manifest distress and 12% had mild/no distress. Baseline-to-endpoint changes for PAIRS domains were not significantly different between groups. Baseline-to-endpoint changes in LiSat-11 items were not significantly different between groups except for satisfaction with sexual life. Compared with men without ED, below normal baseline satisfaction with partner relationship and family life were normalised at endpoint. Over 90% of men reported improved erection and ability to engage in sexual activity. The most common treatment-emergent adverse events were headache, myalgia, dyspepsia, flushing and back pain. One man discontinued because of myalgia; 630 (95%) completed the study. In conclusion, erectile distress levels vary among patients with ED and distress can affect intra-familiar aspects of life, which may have implications for clinical practise. However, distress does not appear to hinder improvement in both mechanical and psychosocial outcomes of tadalafil treatment. [source] The collaborative atorvastatin diabetes study: preliminary results,INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2005Olwen Glynn Owen Summary The Collaborative AtoRvastatin Diabetes Study (CARDS) is the first large primary prevention study to focus specifically on the role of a statin in patients aged 40,75 years with type 2 diabetes, but no signs or symptoms of pre-existing vascular disease and who had only average or below average cholesterol levels. The trial was a prospective double-blind randomised trial with 2383 type 2 diabetic subjects randomised to either 10-mg atorvastatin daily or placebo. Originally designed to run for 5 years, the trial was terminated over a year early in June 2003 on account of a clear benefit demonstrated for the intervention group. Over half of patients had a low-density lipoprotein cholesterol (LDL-C) below 3.3 mmol/l at entry and a quarter had an LDL-C <2.6 mmol/l. Atorvastatin 10 mg reduced LDL-C by 40% (1.2 mmol/l) on average. Results at 4 years showed a 37% relative risk reduction (p < 0.001) for atorvastatin 10 mg in the primary endpoint (acute coronary heart disease death, fatal or non-fatal myocardial infarction, unstable angina requiring hospital admission, resuscitated cardiac arrest, coronary revascularisation procedures and stroke). Among the secondary endpoints, total mortality was reduced by 27% (p = 0.05), acute coronary events by 36%, coronary revascularisation by 31% and stroke by 48%. The same magnitude of benefit was observed among patients with LDL-C above or below 3 mmol/l. Results observed were against a background where 9% of placebo patients had been permitted to start statin therapy after enrolment and 15% of patients on active treatment had discontinued atorvastatin. The true benefit of the intervention is therefore probably around 25% greater than the intention to treat analysis reports. [source] Improving Australian pharmacists' attitudes to internet use in community pharmacy practiceINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2005Margaret Bearman Lecturer Objective The internet now provides a significant part of consumers' healthcare information. While little is known about how community pharmacists regard the internet, there is some suggestion that issues of confidence and motivation may provide significant barriers to appropriate use. The objectives of this study were to measure any changes in pharmacists' attitudes towards the internet after completing a four-module educational course, ,Advanced web skills for pharmacists: finding quality on the internet'. Method We developed a 30-item instrument measuring pharmacists' attitudes toward the internet. Pharmacists completed the survey upon enrolment, then again on completion of the CD ROM course and for a third time three months after completing the course. Key findings The instrument was completed prior to the course by 147 participating pharmacists. The numbers of responses at the end of the course and 3,4 months post-course were 104 and 88 respectively. We established a reliable measure of pharmacists' attitudes to the internet with an appropriate degree of face validity. There was a significant improvement in attitude after course completion (P <0.005) and a further significant improvement in attitude three months after course completion (P <0.01). Conclusions A short distance education programme in internet skills can markedly improve community pharmacists' attitudes to the internet. [source] Strategies for teaching nursing research onlineINTERNATIONAL NURSING REVIEW, Issue 2 2004P. Moore RN Abstract Background:, Nursing, like many disciplines in university settings, is experiencing increasing demand for online courses. Development and implementation of online courses with the quality of education nursing students experience in traditional classroom settings, is essential to maintaining integrity of the educational process. Nursing research has been offered in the online format in the RN-BSN programme for 2 years. This course has an average enrolment of 80 to 90 students each semester. Purpose:, This article presents strategies used in teaching an RN-BSN nursing research course online. Conclusions:, Feedback from faculty and students indicates that these strategies have been successful in facilitating this writing intensive course through distance learning. [source] A high HIV DNA level in PBMCs at antiretroviral treatment interruption predicts a shorter time to treatment resumption, independently of the CD4 nadirJOURNAL OF MEDICAL VIROLOGY, Issue 11 2010Christophe Piketty Abstract This study aimed to evaluate the safety of antiretroviral treatment interruption (TI) in HIV-infected patients who started treatment based on earlier guidelines, and to identify baseline factors predictive of the time to reach fixed criteria for treatment resumption. Prospective, open-label, multicenter trial. Patients were eligible if they had a CD4 cell count >350/mm3 and plasma HIV RNA <50,000,copies/ml when they first started antiretroviral therapy (ART); and if they had a CD4 count >450/mm3 and stable plasma HIV RNA <5,000,copies/ml for at least 6 months prior to enrolment. The criteria for ART resumption were a CD4 cell count <300/mm3 and/or a CDC stage B or C event. 116 patients had received ART for a median of 5.3 years. The median CD4 cell count and plasma HIV RNA values at inclusion were 809/mm3 and 2.6,log copies/ml, respectively. Median HIV DNA load at inclusion was 2.3,log copies/106 peripheral blood mononuclear cells (PBMCs). Thirty-six months after TI, 63.9% of the patients had not yet reached the criteria for ART resumption, and 55.9% of patients had not resumed ART. In Cox multivariable analysis, a high HIV DNA level at TI, a low CD4 nadir, and pre-existing AIDS status were the only significant risk factors for reaching the criteria for ART resumption (hazards ratio: 2.15 (1.02,4.53), 4.59 (1.22,17.24), and 5.74 (1.60,20.56), respectively). Patients who started ART with a CD4 cell count above 350/mm3 were able to interrupt treatment for long periods without a high absolute risk of either AIDS or severe non-AIDS morbidity/mortality. A high PBMC HIV DNA level at TI was a strong predictor for more rapid treatment resumption. J. Med. Virol. 82:1819,1828, 2010. © 2010 Wiley-Liss, Inc. [source] Hepatitis B, C seroprevalence and delta viruses in HIV-1 Senegalese patients at HAART initiation (retrospective study)JOURNAL OF MEDICAL VIROLOGY, Issue 8 2008H. Diop-Ndiaye Abstract The aim of this study was to determine hepatitis co-infection in a cohort of HIV infected patients at their inclusion in the Senegalese Initiative of ART Access. B, C, and D Hepatitis viruses serological markers were checked retrospectively on 363 stored plasma. For HBV, the Abbott laboratories equipment IMx was used to detect HBs Ag and anti Core Ab on negative HBs Ag samples. For HDV, anti Delta Ab was performed using the Abbott Murex Kit on all HBs Ag positive samples. For HCV, anti HCV Ab was detected by IMx as double screening test and confirmed by INNO-LIATM HCV Core of Innogenetics laboratories. The statistical analysis was done with STATA V8. The study population was composed of 164 men and 199 women aged between 16 and 66 years. The immune and virological markers averages at their enrolment were 154 cell/mm3 for TLCD4+ (n,=,355 patients) and 4.9 log for viral load (n,=,277 patients). HBs Ag was found in 61 patients or 16.8% and the prevalence of anti-HBc Ab was 83.2% (252/295). 2 patients or 3% on HBs Ag positive sample presents HBV/HDV co-infection Ab anti HCV was detects in 6 patients or 1.6% after confirmation and 2 patients had triple infection with HBV. These results showed that the prevalence of HBV and HCV in the population of persons living with HIV/AIDS in Senegal is similar to that found in the general population. Our data indicated that hepatitis pathology in the PLwHIV was essentially due to HBV. Further studies are needed to diagnose occult hepatitis in order to set up therapeutic strategies taking into account co-infections by hepatitis viruses in the ART programmes. J. Med. Virol. 80:1332,1336, 2008. © 2008 Wiley-Liss, Inc. [source] Cellular HIV-1 DNA quantitation in patients during simplification therapy with protease inhibitor-sparing regimensJOURNAL OF MEDICAL VIROLOGY, Issue 7 2007Loredana Sarmati Abstract Simplified regimens containing protease-inhibitors (PI)-sparing combinations were used in patients with virological suppression after prolonged highly active antiretroviral therapy. This study evaluated the total HIV-1 DNA quantitation as a predictor of long-term success for PI-sparing simplified therapy. Sixty-two patients were enrolled in a prospective non-randomized cohort. All patients have been receiving a triple-therapy regimen, two nucleoside reverse transcriptase inhibitors (NRTIs) plus one PI, for at least 9 months and were characterized by undetectable plasma HIV-1 RNA levels (<50 cp/ml) for at least 6 months. Patients were changed to a simplified PI-sparing regimen to overcome PI-associated adverse effects. HIV-DNA levels in peripheral blood mononuclear cells (PBMCs) were evaluated at baseline and at the end of follow-up. Patients with proviral DNA levels below the median value (226 copies/106 PBMCs) had a significant higher CD4 cell count at nadir (P,=,0.003) and at enrolment (P,=,0.001) with respect to patients with HIV-DNA levels above the median value. At month 18, 53 out of 62 (85%) patients on simplified regimen showed virological success, 4 (6.4%) patients experienced virological failure and 5 (8%) patients showed viral blip. At logistic regression analysis, HIV-DNA levels below 226 copies/106 PBMCs at baseline were associated independently to a reduced risk of virological failure or viral blip during simplified therapy (OR 0.002, 95% CI 0.001,0.46, P,=,0.025). The substitution of PI with NRTI or non-NRTIs may represent an effective treatment option. Indeed, treatment failure or viral blip were experienced by 6% and 8% of the patients on simplified therapy, respectively. In addition, sustained suppression of the plasma viral load was significantly correlated with low levels of proviral DNA before treatment simplification. J. Med. Virol. 79:880,886, 2007. © 2007 Wiley-Liss, Inc. [source] Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of deliveryJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2006Kyo Hoon Park Abstract Aim:, To evaluate the effect of premature rupture of membranes (PROM) at term on the duration of labor and mode of delivery in comparison with intact membranes in nulliparous women with an unfavorable cervix whose labor was induced. Methods:, This retrospective cohort study included all term nulliparous women with an unfavorable cervix requiring labor induction over a 2-year period. Prostaglandin E2 (dinoprostone) and oxytocin were used for labor induction. Criteria for enrolment included (i) singleton pregnancy; (ii) term nulliparous women; or (iii) Bishop score below 6. Statistics were analyzed with Student's t -test, ,2 -test, Fisher's exact test, and multiple logistic regression. Results:, Our study subjects were 82 women whose labor was induced for PROM and 219 women with intact membranes whose labor was induced for social or fetal reasons. The mean durations of active phase of labor were not significantly different between women with PROM and those with intact membranes. However, the women with PROM had a significantly longer mean duration of second stage and a higher rate of cesarean delivery for failure to progress than those with intact membranes. Multiple logistic regression demonstrated that only PROM and fetal macrosomia were significantly associated with an increased risk of cesarean delivery for failure to progress after other confounding variables were adjusted. Conclusions:, Labor induction for PROM at term in nulliparous women with an unfavorable cervix is associated with longer duration of the second stage and a higher risk of cesarean delivery for failure to progress in comparison to those with intact membranes. [source] Appropriateness of therapy for fistulizing Crohn's disease: findings from a national inflammatory bowel disease cohortALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2010V. Pittet Aliment Pharmacol Ther 2010; 32: 1007,1016 Summary Background, About 30,50% of patients with Crohn's disease (CD) develop fistulae, implying significant disease burden and complicated clinical management. Aim, To assess appropriate use of therapy for fistulizing CD patients enrolled in the Swiss Inflammatory Bowel Disease Cohort using criteria developed by the European Panel on the Appropriateness of Crohn's disease Therapy. Methods, Specific questionnaires were used to gather information on disease and its management. We assessed appropriateness of therapy at enrolment for adult CD patients with one or several fistulae. Results, Two hundred and eighty-eight CD patients had fistulizing disease, of which 80% had complex fistulae and 32% currently had active draining fistulae. Mean age (s.d.) at diagnosis was 27 years (11), 51% males. Of the patients, 78% were judged as having globally an appropriate therapy, which was more often given for complex fistulae (87%) than for simple fistulae (67%). Antibiotics, azathioprine/MP, methotrexate and conservative surgery were almost always appropriate. Anti-tumor necrosis factor , was considered globally appropriate (91%), although most often with an uncertain indication. The 5ASA compounds, steroids and aggressive surgery were most often inappropriate (84%, 58% and 86% respectively). Conclusions, Formal appropriateness criteria for CD therapy were applied to a national cohort of IBD patients. For more than three-quarters of the patients with fistulizing CD, therapy was globally appropriate. [source] Discrepancy between recalled and recorded bowel habits in irritable bowel syndromeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010M. Coletta Aliment Pharmacol Ther 2010; 32: 282ash;288 Summary Background, A discrepancy between recalled and recorded bowel habit subtypes has been reported in irritable bowel syndrome (IBS), but the reasons for it remain unclear. Aim, To assess the agreement between recalled and recorded bowel habit subtypes; to determine whether any discrepancy is related to stool form variability or psychological factors; and to test the correlations of recalled and recorded stool form with colonic transit time. Methods, Bowel habit subtype was established in 54 IBS patients at the enrolment visit (recalled) and with the aid of diary cards (recorded). Colonic transit time, the variability of stool form and the patients' psychological profiles were also recorded. Results, Recalled and recorded bowel habit subtypes agreed in only 54% of the patients (kappa = 0.28). Stool form variability was greater among the patients whose recalled and recorded bowel habit subtypes were discordant (P = 0.03), whereas the psychological profiles were not different. Colonic transit time significantly correlated with stool form only when it was recorded on diary cards. Conclusion, The discrepancy between recalled and recorded bowel habits in IBS patients is related more to stool form variability than an altered psychological profile. Diary cards should be used to ensure that stool form reflects colonic transit time. [source] Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2010M. RUGGE Aliment Pharmacol Ther,31, 1104,1111 Summary Background, Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk. Aim, To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression. Methods, Ninety-three Italian patients were followed up for more than 12 years (range: 144,204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2). Results, All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P < 0.001). OLGA-staging at T1 predicted both the OLGA stage (Kaplan,Maier log-rank test, P = 0.001) and the neoplasia at T2 (Kaplan,Maier log-rank test, P = 0.001). Conclusions, This long-term follow-up study provides the first evidence that gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori- status, gastritis patients could be confidently stratified and managed according to their different cancer risks. [source] | ||||||||||||||||||||||||||||||||||||||||||||||