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Measurable Changes (measurable + change)
Selected AbstractsSmoking cessation advice provided in 53 Norwegian pharmaciesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2004Dr. Anne G. Granas Director of research Objective To investigate the quality of the smoking cessation advice on over-the-counter (OTC) nicotine replacement treatment (NRT) provided by community and hospital pharmacies in Norway and to assess any change in customer services and pharmaceutical smoking cessation advice after a change in legislation deregulating NRT from pharmacy-only to general sale. Method A mystery shopper made 106 visits to 53 pharmacies in Oslo, Norway. The first visit was when NRT was a pharmacy-only medicine and the second when it had become available from any outlet as a general sales product. The pharmacies were scored on 12 observation parameters regarding customer service and pharmaceutical advice (score 0,4, total possible score was 48). Key findings There was considerable inter- and intra-pharmacy variation in scores. The pharmacies' total score ranged from 3 to 45. On only 14.2% of the visits was the service categorised as ,Good'. There was no statistically significant difference in total score between the two test periods (P = 0.56), and hence no measurable difference in customer services and pharmaceutical advice as a result of increased competition after the switch to general sale. A scatter plot showed no relationship between the individual pharmacies' total score at the two visits. Conclusions Pharmacies' scores for the quality of their smoking cessation advice were generally low. There was no measurable change in pharmacies' customer service and pharmaceutical advice following the deregulation of NRT. There was little consistency in the total score between the first and the second visit to the same pharmacy. Improvement is needed in the smoking cessation advice provided by Norwegian pharmacies. [source] Influence of chronic alcohol abuse and ensuing forced abstinence on static subjective accommodation function in humansOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2001Hugh Campbell Summary Purpose. Acute alcohol ingestion can change accommodation, but the long term effects of sustained alcohol consumption on accommodative function have not been studied in detail. This study was thus undertaken on individuals with a history of alcohol abuse. Methods. Thirty-seven male individuals aged 25,56 years (average 40 years) from an alcohol rehabilitation centre in Inverness, Scotland, were assessed on admission and after a week of forced abstinence. The results were compared to a paired age-matched set of control male subjects. The static amplitude of accommodation was measured by an RAF rule, and the pupil size measured with a pupil gauge. Results. On admission, the group mean measured amplitude of accommodation was 4.7±2.2 D (mean±SD). These values for the alcoholics were lower than age-matched controls (of5.9±2.9 D). The slope of the age-dependent decline in RAF rule accommodation measures was significantly smaller for the alcoholics compared to controls (at 0.215±0.027 D/year versus0.332±0.015 D/year, respectively; p <0.001), with the younger alcoholics showing a greater impairment. Following abstinence, there was no measurable change in accommodation measured, indicating the lower amplitude in the alcoholics was not attributable to circulatory alcohol levels. The resting pupil diameter in the alcoholics was4.37±0.63 mm compared to the controls of3.97±0.75 mm, with a higher incidence of small pupils (,3 mm) in the controls. Conclusions. The results indicate that chronic alcohol use can adversely affect subjective static accommodation, especially in younger alcoholics, as well as cause slight mydriasis. [source] Acceleration of lung disease in children with cystic fibrosis after Pseudomonas aeruginosa acquisitionPEDIATRIC PULMONOLOGY, Issue 4 2001Michael R. Kosorok PhD Abstract As part of the ongoing Wisconsin Cystic Fibrosis (CF) Neonatal Screening Project, we had the unique opportunity to study the longitudinal relationship between Pseudomonas aeruginosa (Pa) acquisition and infection and developing lung disease in children with CF. The primary objective was to determine whether acquisition of Pa was associated with a measurable change in the progression of lung disease. Two outcome measures were used to study 56 patients who were diagnosed through newborn screening: 1) Wisconsin additive chest radiograph score (WCXR), based on the average of scores from a pulmonologist and a radiologist, and 2) the highest forced expired volume in 1 sec (FEV1)/forced vital capacity (FVC) ratio. We used two measures of Pa acquisition: 1) time of first positive protocol-determined oropharyngeal (with cough) culture, and 2) the magnitude of antibody titer detected by ELISA assays, using as antigen a crude cell lysate, purified exotoxin A, or an elastase toxoid prepared from three Pa strains. Other predictor variables included age, pancreatic status, height-for age, and weight-for-age-percentiles. The best regression model for predicting changes in the WCXR included time to first positive culture and antibody titer for Pa elastase. Prior to Pa acquisition, WCXR worsened by 0.45 points/year (P,>,0.25); after Pa acquisition, the rate of worsening increased significantly (P,<,0.001) to 1.40 points/year. Each antibody titer level (log base 2) increased the score by 0.48 points (P,<,0.001). The best regression model for predicting change in the FEV1/FVC included only time to first positive culture. Prior to Pa acquisition, the FEV1/FVC ratio declined by 1.29%/year; after Pa infection, the rate of decrease significantly accelerated to 1.81%/year (P,=,0.001). Our data show that Pa acquisition is associated with declining pulmonary status in children with CF, and that this effect is probably gradual rather than precipitous. Because these patients were diagnosed and treated aggressively, our estimates of the effects of Pa acquisition may be conservative. We also conclude that the WCXR appears to be more sensitive than FEV1/FVC in detecting early changes in lung disease associated with CF. Pediatr Pulmonol. 2001; 32:277,287. © 2001 Wiley-Liss, Inc. [source] Teledermatology: Influence of zoning and education on a clinician's ability to observe peripheral lesionsAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2002Keng Chen SUMMARY Teledermatology can benefit rural and remote communities, where specialist dermatological services may not be readily available. Regarding store-and- forward teledermatology, we hypothesized that the site of a lesion in an image (zoning) may influence a clinician's ability to observe target lesions, and that education on image viewing may improve use of this technology. We examined this by conducting both pre- and post-education studies. The education on image viewing consisted of a presentation on the outcome of the first study-survey on image viewing. The first study demonstrated that zoning influences a clinician's visual attention and that significant, concurrent lesions in the periphery may be missed. The second study demonstrated that brief education could produce a measurable change in observing peripheral lesions. These findings have medico-legal implications and suggest that further education in the use of such technology is necessary in order to optimize patient care and prevent potential errors. [source] Acute effects of caffeine and tobacco on arterial function and wave travelEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2006J. Swampillai Abstract Background, Caffeine and tobacco consumption are risk factors for heart failure, but their effects remain controversial. It has been hypothesized that they cause alterations in arterial stiffness and arterial wave travel which may increase ventricular loading. In this study the authors examined the influence of these widely used stimulants on wave intensity and arterial stiffness parameters using carotid wave intensity analysis. Materials and methods, A new Doppler-based ultrasound method was used to measure the acute effects of caffeine and tobacco on wave intensity in the right common carotid artery. The measurements enabled changes in arterial stiffness parameters to be recorded. Results, In 17 subjects compared with 10 controls, caffeine increased blood pressure, early systolic wave intensity and wave speed, but late-systolic wave intensity and mid-systolic reflections were unchanged. In 11 smokers studied before and after smoking one cigarette, blood pressure and arterial stiffness increased but wave intensity was unchanged. No changes were observed in the controls. Conclusions, Increased wave intensity during ejection after caffeine suggested sympathomimetic effects on the left ventricular function. Increased wave speed in the common carotid artery implied augmented central loading after caffeine, but the absence of measurable changes in local arterial stiffness in the carotid artery suggested more complex and regional effects. Cigarette smoking acutely increased local arterial stiffness in the common carotid artery. These changes can be detected using wave intensity analysis. [source] Organic carbon additions: effects on soil bio-physical and physico-chemical propertiesEUROPEAN JOURNAL OF SOIL SCIENCE, Issue 2 2009A. Bhogal Summary The effects of organic carbon (OC) additions from farm manures and crop residues on selected soil bio-physical and physico-chemical properties were measured at seven experimental sites, on contrasting soil types, with a history of repeated applications of farm manure or differential rates of inorganic fertilizer nitrogen (N). Repeated (> 7 years annual additions) and relatively large OC inputs (up to 65 t OC ha,1) were needed to produce measurable changes in soil properties, particularly physical properties. However, over all the study sites, there was a positive relationship between OC inputs and changes in total soil OC and ,light' fraction OC (LFOC), with LFOC providing a more sensitive indicator of changes in soil organic matter status. Total soil OC increased by an average of 3% for every 10 t ha,1 manure OC applied, whereas LFOC increased by c. 14%. The measured soil OC increases were equivalent to c. 23% of the manure OC applied (up to 65 t OC ha,1 applied over 9 years) and c. 22% of the crop residue OC applied (up to 32 t OC ha,1 over 23 years). The manure OC inputs (but not crop residue OC inputs) increased topsoil porosity and plant available water capacity, and decreased bulk density by 0.6%, 2.5% and 0.5% with every 10 t ha,1 manure OC applied, respectively. Both OC sources increased the size of the microbial biomass (11% increase in biomass C with 10 t OC ha,1 input), but only manure OC increased its activity (16% increase in the soil respiration rate with 10 t OC ha,1 input). Likewise, the potentially mineralizable N pool only increased with manure N inputs (14% increase with 1 t manure total N ha,1). However, these soil quality benefits need to be balanced with any potential environmental impacts, such as excessive nutrient accumulation, increased nitrate leaching and phosphorus losses and gaseous emissions to the atmosphere. [source] Response of secondary production by macroinvertebrates to large wood addition in three Michigan streamsFRESHWATER BIOLOGY, Issue 8 2009SALLY A. ENTREKIN Summary 1.,We measured responses in macroinvertebrate secondary production after large wood additions to three forested headwater streams in the Upper Peninsula of Michigan. These streams had fine-grained sediments and low retention capacity due to low amounts of in-channel wood from a legacy of past logging. We predicted that wood addition would increase macroinvertebrate secondary production by increasing exposed coarse substrate and retention of organic matter. 2.,Large wood (25 logs) was added haphazardly to a 100-m reach in each stream, and a 100-m upstream reach served as control; each reach was sampled monthly, 1 year before and 2 years after wood addition (i.e. BACI design). Macroinvertebrate secondary production was measured 1 year after wood addition in two habitat types: inorganic sediments of the main channel and debris accumulations of leaf litter and small wood. 3.,Overall macroinvertebrate production did not change significantly because each stream responded differently to wood addition. Production increased by 22% in the main-channel of one stream, and showed insignificant changes in the other two streams compared to values before wood addition. Changes in main-channel macroinvertebrate production were related to small changes in substrate composition, which probably affected habitat and periphyton abundance. Macroinvertebrate production was much greater in debris accumulations than in the main-channel, indicating the potential for increased retention of leaf litter to increase overall macroinvertebrate production, especially in autumn. 4.,Surrounding land use, substrate composition, temperature and method of log placement are variables that interact to influence the response of stream biota to wood additions. In most studies, wood additions occur in altered catchments, are rarely monitored, and secondary production is not a common metric. Our results suggest that the time required for measurable changes in geomorphology, organic matter retention, or invertebrate production is likely to take years to achieve, so monitoring should span more than 5 years, and ecosystem metrics, such as macroinvertebrate secondary production, should be incorporated into restoration monitoring programs. [source] Changes in grassland ecosystem function due to extreme rainfall events: implications for responses to climate changeGLOBAL CHANGE BIOLOGY, Issue 7 2008PHILIP A. FAY Abstract Climate change is causing measurable changes in rainfall patterns, and will likely cause increases in extreme rainfall events, with uncertain implications for key processes in ecosystem function and carbon cycling. We examined how variation in rainfall total quantity (Q), the interval between rainfall events (I), and individual event size (SE) affected soil water content (SWC) and three aspects of ecosystem function: leaf photosynthetic carbon gain (), aboveground net primary productivity (ANPP), and soil respiration (). We utilized rainout shelter-covered mesocosms (2.6 m3) containing assemblages of tallgrass prairie grasses and forbs. These were hand watered with 16 I×Q treatment combinations, using event sizes from 4 to 53 mm. Increasing Q by 250% (400,1000 mm yr,1) increased mean soil moisture and all three processes as expected, but only by 20,55% (P,0.004), suggesting diminishing returns in ecosystem function as Q increased. Increasing I (from 3 to 15 days between rainfall inputs) caused both positive () and negative () changes in ecosystem processes (20,70%, P,0.01), within and across levels of Q, indicating that I strongly influenced the effects of Q, and shifted the system towards increased net carbon uptake. Variation in SE at shorter I produced greater response in soil moisture and ecosystem processes than did variation in SE at longer I, suggesting greater stability in ecosystem function at longer I and a priming effect at shorter I. Significant differences in ANPP and between treatments differing in I and Q but sharing the same SE showed that the prevailing pattern of rainfall influenced the responses to a given event size. Grassland ecosystem responses to extreme rainfall patterns expected with climate change are, therefore, likely to be variable, depending on how I, Q, and SE combine, but will likely result in changes in ecosystem carbon cycling. [source] Changes in blood flow velocity in the middle and anterior cerebral arteries evoked by walkingJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2002Krassen Nedeltchev MD Abstract Purpose Transcranial Doppler sonography (TCD) is an established method for assessing changes in blood flow velocity (BFV) coupled to brain activity. Our objective was to investigate whether walking induces measurable changes in BFV in healthy subjects. Methods Changes in BFV in both middle cerebral arteries (MCAs) of 40 healthy adult subjects during walking on a treadmill were measured using bilateral TCD. In 8 of the 40 subjects, 1 anterior cerebral artery (ACA) was monitored simultaneously with the contralateral MCA. The percentage increase in BFV (BFVI%) compared with the baseline velocity (V0), the percentage decrease in BFV (BFVD%) compared with the V0, and the normalized ACA-MCA ratio were analyzed. Results The overall mean (± standard deviation [SD]) V0 was 59.9 ± 11.6 cm/second in the left MCA and 60.1 ± 12.9 cm/second in the right MCA. Women had higher V0 values than men had. Walking evoked an initial mean overall BFVI% in both left (8.4 ± 5.1%) and right MCAs (9.1 ± 5.1%), followed by a decrease to below baseline values in 38 of 40 subjects. A statistically significant increase of the normalized ACA-MCA ratio was measured, indicating that changes in BFV in the ACA territory were coupled to brain activation during walking. Conclusions The use of functional TCD showed different changes in BFV in the ACAs and MCAs during walking. This method may be an interesting tool for monitoring progress in patients with motor deficits of the legs, such as paresis. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:132,138, 2002; DOI 10.1002/jcu.10047 [source] Exact Tests using Two Correlated Binomial Variables in Contemporary Cancer Clinical TrialsBIOMETRICAL JOURNAL, Issue 6 2009Jihnhee Yu Abstract New therapy strategies for the treatment of cancer are rapidly emerging because of recent technology advances in genetics and molecular biology. Although newer targeted therapies can improve survival without measurable changes in tumor size, clinical trial conduct has remained nearly unchanged. When potentially efficacious therapies are tested, current clinical trial design and analysis methods may not be suitable for detecting therapeutic effects. We propose an exact method with respect to testing cytostatic cancer treatment using correlated bivariate binomial random variables to simultaneously assess two primary outcomes. The method is easy to implement. It does not increase the sample size over that of the univariate exact test and in most cases reduces the sample size required. Sample size calculations are provided for selected designs. [source] | |||||||||||||