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Francois Pradeau Greater Denver Area. Maptek Years August - June Conclusions: This is one of the largest cohort of patients with IGE. This study reiterates the importance of segregating IGE syndrome and such analysis will aid to the current understanding and management. Assessing the accuracy of algorithm-derived cardiorespiratory fitness in surgical patients: a prospective cohort study.
Following research ethics board approval, an observational cohort study was conducted in selected, consenting patients undergoing elective surgery. Participants completed questionnaires assessing their self-reported exercise capacity. Their height, weight, waist circumference, and vital signs were measured. A six-minute walk test was performed twice with a min rest interval between tests.
Two hundred forty-two participants were included. A non-exercise algorithm can estimate cardiorespiratory fitness in patients presenting for elective surgery. The variables required to compute CRF A can be obtained in a clinic setting without the need to engage in formal exercise testing. Further evaluation of CRF A as a predictor of long-term outcome in patients is warranted.
Suspected placenta accreta and cesarean hysterectomy: observational cohort utilizing an intraoperative decision strategy. Planned cesarean hysterectomy CH is recommended to minimize morbidity for suspected placenta accreta PA , yet this ends fertility. We examined CH frequency and post-operative morbidities for suspected PA cases when an intra-operative decision strategy to perform CH was used.
Suspected PA cases were pre-operatively identified in one tertiary care center. Women were assessed intra-operatively, prior to uterine incision, for immediate CH or for attempted placental separation. Our cohort , from to , comprised 99 women with suspected PA; 54 Surgery duration, packed cell transfusion requirement and postoperative outcomes were similar among women with PA regardless of immediate CH versus attempted placental separation, except for a higher cystotomy rates following attempted placental separation.
Emergency deliveries were performed at significantly earlier gestational ages. Consideration of attempted placental separation did not increase blood transfusion or post-operative complications, but was associated with a higher rate of cystotomy. Maternal obesity and its effect on labour duration in nulliparous women: a retrospective observational cohort study.
Obesity is increasing among primipara women. We aimed to describe the association between body mass index BMI during early-pregnancy and duration of labour in nulliparous women. Total duration of labour and the first and second stages of labour were compared between early-pregnancy normal-weight BMI women. Proportional hazards and multiple logistic regression models were applied.
Early pregnancy BMI classified Median active labour duration was 5. The risk of caesarean delivery increased significantly for overweight and obese compared to normal weight women odds ratios OR 1. BMI had no significant effect on total duration of active labour. Risk of caesarean delivery increased with increasing BMI. Caesarean deliveries are undertaken earlier in obese women compared to normal weight women following the onset of active labour, shortening the total duration of active labour.
Depression and anxiety in women with early breast cancer: five year observational cohort study. Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London.
Main outcome measures Prevalence of clinically important depression and anxiety structured psychiatric interview with standardised diagnostic criteria and clinical and patient risk factors, including stressful life experiences Bedford College life events and difficulties schedule. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis one month before diagnosis to four months after diagnosis. Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences.
Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time.
Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study. The effectiveness of prenatal treatment to prevent serious neurological sequelae SNSD of congenital toxoplasmosis is not known.
Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.
This effect was robust to most sensitivity analyses. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone adjusted odds ratio 0. The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion.
As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary. Full Text Available The effectiveness of prenatal treatment to prevent serious neurological sequelae SNSD of congenital toxoplasmosis is not known.
Observation for Biodiversity Assessment EO-BA programme is designed to enhance biodiversity assessment and conservation through the application of earth observation data, with particular focus on the African continent. Problem behavior of individuals with down syndrome in a nationwide cohort assessed in late adolescence. Gameren-Oosterom, H. Full Text Available Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity.
We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Myelodysplastic syndromes MDS and acute myeloid leukemia AML are myeloid neoplasms in which outgrowth of neoplastic clones disrupts normal hematopoiesis.
Some patients with unexplained persistent cytopenias may not meet minimal diagnostic criteria for MDS but an alternate diagnosis is not apparent; the term idiopathic cytopenia of undetermined significance ICUS has been used to describe this state.
MDS and AML occur primarily in older patients who are often treated outside the clinical trial setting. Consequently, our understanding of the patterns of diagnostic evaluation, management, and outcomes of these patients is limited. Furthermore, there are few natural history studies of ICUS. Diagnosis will be confirmed by central review.
A tissue substudy to explore the relationship between karyotypes, molecular markers, and clinical outcomes will be conducted, and is optional for patients. Full Text Available Abstract Environmental exposures during pregnancy and early life may have adverse health effects. To improve the use of existing data and to facilitate collaboration among these studies, an inventory of the environmental exposure and health data in these studies was made as part of the ENRIECO Environmental Health Risks in European Birth Cohorts project.
The focus with regard to exposure was on outdoor air pollution, water contamination, allergens and biological organisms, metals, pesticides, smoking and second hand tobacco smoke SHS, persistent organic pollutants POPs, noise, radiation, and occupational exposures. Exposure modeling is increasingly used for long-term air pollution exposure assessment ; biomonitoring is used for assessment of exposure to metals, POPs and other chemicals; and environmental monitoring for house dust mite exposure assessment.
Collaborative analyses with data from several birth cohorts have already been performed successfully for outdoor air pollution, water contamination, allergens, biological contaminants, molds, POPs and SHS.
Key success factors for collaborative analyses are common definitions of main exposure and health variables. Our review emphasizes that such common definitions need ideally be arrived at in the study design phase. However, careful comparison of methods used in existing studies also offers excellent opportunities for collaborative analyses.
Investigators can use this review to evaluate the potential for future collaborative analyses with respect to data availability and methods used in the different cohorts and to identify potential partners. Use of atomoxetine and suicidal ideation in children and adolescents: Results of an observational cohort study within general practice in England. To investigate the association between atomoxetine, a drug used in the treatment of Attention Deficit Hyperactivity Disorder ADHD , and suicidal ideation, within a cohort of year-old patients in England.
The study was conducted using the observational cohort technique of Modified prescription event monitoring M-PEM. Patients prescribed atomoxetine were identified from dispensed prescriptions issued by primary care physicians.
A customised postal GP questionnaire was used to capture outcome data for suicidal ideation. A matched pair cohort analysis was performed within patients to compare the risk of suicidal ideation in the period after starting atomoxetine with the risk prior to starting atomoxetine; this was stratified by age and concomitant use of methylphenidate. Additional information on patient characteristics, and events of interest was also collected; individual cases of suicidal ideation were qualitatively assessed for drug relatedness.
Almost a quarter of the cohort had been co-prescribed methylphenidate. Results of the matched pair cohort analysis indicated that the period after starting atomoxetine was not associated with an increase in the incidence of suicidal ideation compared to the period prior to starting treatment RR: 0. Individual case assessment of suicidal ideation suggested a causal association within a number of cases.
This study found no evidence of an increased risk of suicidal ideation during treatment with atomoxetine, compared to the period prior to starting treatment. Amongst age specific subgroups, this risk may change. Nonetheless, individual case assessment suggested a causal relationship in some patients, hence physicians need to be aware of the possibility of developing this event, and furthermore consider how best to detect it in.
Assessment of participation bias in cohort studies: systematic review and meta-regression analysis. Full Text Available Abstract The proportion of non-participation in cohort studies, if associated with both the exposure and the probability of occurrence of the event, can introduce bias in the estimates of interest. The aim of this study is to evaluate the impact of participation and its characteristics in longitudinal studies.
Among the 2, initially identified, 50 were selected. The average proportion of participation was Using a meta-regression model with mixed effects, only age, year of baseline contact and study region borderline were associated with participation. Considering the decrease in participation in recent years, and the cost of cohort studies, it is essential to gather information to assess the potential for non-participation, before committing resources.
Finally, journals should require the presentation of this information in the papers. Maternal, fetal and perinatal alterations associated with obesity, overweight and gestational diabetes: an observational cohort study PREOBE. Full Text Available Abstract Background Maternal overweight, obesity, and gestational diabetes GD have been negatively associated with offspring development.
Further knowledge regarding metabolic and nutritional alterations in these mother and their offspring are warranted. Methods In an observational cohort study we included pregnant women from Granada, Spain. The mothers were categorized into four groups according to BMI and their GD status; overweight n, obese n, GD n, and healthy normal weight controls n Results Obese and GD mothers had significantly lower weight gain during pregnancy and infant birth weight, waist circumference, and placental weight were higher in the obese group, including a significantly increased prevalence of macrosomia.
GD mothers had similar differences in hemoglobin and C-reactive protein but higher levels of folate. The latter was seen also in cord blood. Conclusions We identified several metabolic alterations in overweight, obese and GD mothers compared to controls. Together with the observed differences in infant anthropometrics, these may be important biomarkers in future research regarding the programming of health and disease in children.
Trial registration The trial was registered at clinicaltrials. Safety assessment of an anti-obesity drug sibutramine : a retrospective cohort study. Regardless of whether or not the model controlled for prior CV disease CVD , the direction and statistical significance of the differences did not change.
In the sensitivity analyses including only those without a history of CVD in the days prior to the index date there was no increased risk of CV events in either Germany or the UK. This study offers a framework for the safety assessment of anti-obesity drugs using an observational epidemiological study design.
Large electronic health databases were used to construct retrospective cohorts to examine the risk in a population using one specific anti-obesity drug. Use of sibutramine in general practice settings was not found to increase the risk of acute CV events. Outpatient treatment of acute poisoning by substances of abuse: a prospective observational cohort study.
Procedures for the clinical assessment of acute poisoning by substances of abuse should identify patients in need of hospital admission and avoid hazardous discharges, while keeping the observation time short. Data were collected on pre-set registration forms. Information on re-presentations to health services nation-wide during the first week following discharge was retrieved from the Norwegian Patient Register and from local electronic medical records.
Information on fatalities was obtained from the Norwegian Cause of Death Registry. There were cases of acute poisoning by substances of abuse. Median observation time was four hours. Two patients died during the first week following discharge, both from a new opioid poisoning.
Among the patients with missed diagnoses, five needed further treatment for the same poisoning episode, two were admitted with psychosis, one had hemorrhagic gastritis, another had fractures in need of surgery and four had minor injuries.
The high re-presentation rate calls for better follow-up. A total of patients were enrolled. The purpose of this study was to investigate the assessment of geological observation through the development and field testing of performance tasks.
The study addressed a central challenge in geoscience education: for students to observe the world around them and make real-world connections. Yet, there existed no cohesive research approach for the study of observation in geoscience education. The research goal was to understand the assessment of geological observation. The design research of geological observation encountered the situation where few performance assessments existed and few domain-specific learning theories were available.
Design research is suited to inquiries in which a domain of learning is unexplored and the phenomena needs to be supported in the classroom in order to study it. This dissertation addressed one general research question and four subquestions: RQ How should geological observation be assessed?
S1 What role did perception play in assessing students' geological observations? S2 What role did explanation play in assessing students' geological observations? S3 What role did gestures play in assessing students' geological observations? S4 Were there performance differences between the first and second trial of the GO Inquire prototype with fourth graders? Students were supported in making geological observations with three performance tasks: GO Inquire stamp task, Cutting task, and Fieldguide task.
The data set for this study consisted of student response data, videorecordings, and participant observations from seven field tests across one fourth and one fifth grade class. Three data-analytic methods, qualitative coding, item-difficulty analysis, and non-parametric comparisons, were utilized based on four mixed-method data analysis strategies: typology development, data transformation, extreme case analysis, and data consolidation. Analysis revealed that assessment should take into account the separation of visual from verbal.
Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA. Childcare has been associated with obesity in children in cross-sectional and longitudinal studies, although some observed no association. Few studies have focused on care during infancy, a period when children may be especially vulnerable.
The Nurture Study is an observational birth cohort designed to assess longitudinal associations of childcare and the presence of multiple caregivers on infant adiposity and weight trajectories throughout the first year of life. We examine as potential mediators feeding, physical activity, sleep and stress. We completed recruitment in Of the women who enrolled during pregnancy, delivered a single live infant who met our inclusion criteria. Of those, mothers Findings will also inform intervention and policy efforts to improve childcare environments and help prevent obesity in settings where many infants spend time.
The Swiss Transplant Cohort Study's framework for assessing lifelong psychosocial factors in solid-organ transplants. Understanding outcomes after transplant requires a biopsychosocial model that includes biomedical and psychosocial factors. The latter, to date, are assessed only in a limited way as part of transplant registries or cohort studies. This article describes the framework underpinning STCS's psychosocial assessment. The STCS framework was adapted from the multidimensional conceptual perspective of Dew et al to describe transplant psychosocial domains and specific outcomes by adding a time perspective, a system perspective, and interaction among domains.
We propose a multidimensional, multilevel biopsychosocial framework representing mutually influencing domains from before to after transplant, and exemplify each domain by factors included in STCS and their measurement. The transplant patient, centrally positioned, is described by clinical and sociodemographic characteristics eg, socioeconomic status, educational, professional, and relationship status.
Factors associated with health care system level eg, trust in transplant team are also included in the model. The STCS's psychosocial framework provides a basis for studying the interplay of biomedical, sociodemographic, psychosocial, behavioral, and health care system factors in view of transplant outcomes and therefore has the potential to guide biopsychosocial transplant research.
Candida infective endocarditis: an observational cohort study with a focus on therapy. Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts.
The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality.
Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy.
Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis. All Rights Reserved. Johnson, Melissa; Bayer, Arnold S.
Full Text Available Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. The 9 published scoring systems performed poorly. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM. Direct Observation vs. Video-Based Assessment in Flexible Cystoscopy. Interrater reliability was 0. A hawk-dove effect was seen between the 2 raters.
Direct observer bias was detected when comparing direct observer scores to the assessment by an independent video-rater p. Systematic evaluation of observational methods assessing biomechanical exposures at work. Generally, the observations showed moderate to good agreement with the corresponding assessments made from video recordings; agreement was the best for large-scale body postures and work actions. Postures of wrist and hand as well as trunk rotation seemed to be more Intra- and inter- observer repeatability were reported for 7 and 17 methods, respectively, and were judged mostly to be good or moderate.
Many observational The objectives of this communication are to describe methods of cohort ascertainment and data collection and to characterise the study population. A stepwise methodology involving computerised searches of electronic medical records and free-text validation of eligibility and gender identity was used to identify a cohort of members with first evidence of transgender status index date between and Cohort follow-up extends through the end of Results indicate that there are sufficient numbers of events in the TF and TM cohorts to further examine mental health status, cardiovascular events, diabetes, HIV and most common cancers.
STRONG is well positioned to fill existing knowledge gaps through comparisons of transgender and reference populations and through analyses of health status before and after gender affirmation treatment. Analyses will include incidence of cardiovascular disease, mental health, HIV and diabetes, as well as changes in laboratory-based endpoints eg, polycythemia and bone density , overall and in relation to.
Symptomatic dengue infection during pregnancy and livebirth outcomes in Brazil, a retrospective observational cohort study. Dengue is a major public health challenge in Brazil. We assessed the relationship between symptomatic dengue infection during pregnancy and adverse birth outcomes in the country between and We probabilistically linked confirmed dengue-positive and dengue-negative pregnancies with live childbirths using Fine-Grained Record Integration and Linkage FRIL software.
We also included an external reference population of randomly selected newborn babies. Pregnancy was adopted as the unit of analysis. We assessed the relationship between symptomatic dengue infection during pregnancy and adverse birth outcomes, using multivariable logistic regression adjusted for relevant covariates.
In the adjusted analysis, the risk of preterm birth. Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study. Design Population based cohort study. Settings Outpatient interventional setting in New York State. Participants Women undergoing interval sterilization procedure, including hysteroscopic sterilization with Essure device and laparoscopic surgery, between and Main outcomes measures Safety events within 30 days of procedures; unintended pregnancies and reoperations within one year of procedures.
Mixed model accounting for hospital clustering was used to compare 30 day and 1 year outcomes, adjusting for patient characteristics and other confounders. Time to reoperation was evaluated using frailty model for time to event analysis. There was a significant increase in the use of hysteroscopic procedures during this period, while use of laparoscopic sterilization decreased. Patients undergoing hysteroscopic sterilization were older than those undergoing laparoscopic sterilization and were more likely to have a history of pelvic inflammatory disease Economic losses due to cattle mortality and culling have a substantial impact on the feedlot industry.
Since criteria for culling may vary and may affect measures of cumulative mortality within cattle cohorts , it is important to assess both mortality and culling when evaluating cattle losses over time and among feedlots. To date, there are no published multivariable assessments of factors associated with combined mortality and culling risk. Our objective was to evaluate combined mortality and culling losses in feedlot cattle cohorts and quantify effects of commonly measured cohort -level risk factors weight at feedlot arrival, gender, and month of feedlot arrival using data routinely collected by commercial feedlots.
We used retrospective data representing 8,, animals in 54, cohorts from 16 U. The sum of mortality and culling counts for each cohort given the number of cattle at risk was used to generate the outcome of interest, the cumulative incidence of combined mortality and culling. Associations between this outcome variable and cohort -level risk factors were evaluated using a mixed effects multivariable negative binomial regression model with random effects for feedlot, year, month and week of arrival.
Mean arrival weight of the cohort , gender, and arrival month and a three-way interaction and corresponding two-way interactions among arrival weight, gender and month were significantly Prisk decreased, but effects of arrival weight were modified both by the gender of the cohort and the month of feedlot arrival. There was a seasonal pattern in combined mortality and culling risk for light and middle-weight male and female cohorts , with a significantly Prisk for cattle arriving at the feedlot in spring and summer March-September than in cattle arriving during fall, and winter months November-February.
Our results quantified effects of covariate patterns that have been heretofore difficult to fully evaluate in. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study. Age in antiretroviral therapy programmes in South Africa: a retrospective, multicentre, observational cohort study. As access to antiretroviral therapy ART expands, increasing numbers of older patients will start treatment and need specialised long-term care.
However, the effect of age in ART programmes in resource-constrained settings is poorly understood. We explored the effect of age on mortality of patients on ART in South Africa and whether this effect is mediated by baseline immunological status. The primary outcome was mortality. We ascertained patients' vital status through linkage to the National Population Register.
We used inverse probability weighting to correct mortality for loss to follow-up. We estimated mortality using Cox's proportional hazards and competing risks regression. We tested the interaction between baseline CD4 cell count and age. Of these, we followed up 83, patients for , patient-years.
Langland and Baker introduced an approach to assess the impact of observations on the forecasts. In that, a state-space aspect of the forecast is defined and a procedure is derived that relates changes in the aspect with changes in the initial conditions associated with the assimilation of observations ultimately providing information about the impact of individual observations on the forecast.
Some features of the approach are to be noted. The typical choice of forecast aspect employed in related works is rather arbitrary and leads to an incomplete assessment of the observing system. Furthermore, the state-space forecast aspect requires availability of a verification state that should ideally be uncorrelated with the forecast but in practice is not.
Lastly, the approach involves the adjoint operator of the entire data assimilation system and as such it is constrained by the validity of this operator. In this presentation, an observation -space metric is used that, for a relatively time-homogeneous observing system, allows inferring observation impact on the forecast without some of the limitations above.
Specifically, using observation -minus-forecast residuals leads to an approach with the following features: i it suggests a rather natural choice of forecast aspect, directly linked to the analysis system and providing full assessment of the observations ; ii it naturally avoids introducing undesirable correlations in the forecast aspect by verifying against the observations ; and iii it does not involve linearization and use of adjoints; therefore being applicable to any length of forecast.
The state and observation -space approaches might be complementary to some degree, and involve different limitations and complexities. However, access to HCV treatment is limited and success rates are generally poor. The pooled proportion of patients who discontinued treatment due to drug toxicities reported by 33 studies was low, at 4. Defaulting from treatment, reported by 33 studies, was also low 5. Assessing the observed impact of anthropogenic climate change.
Impacts of recent regional changes in climate on natural and human systems are documented across the globe, yet studies explicitly linking these observations to anthropogenic forcing of the climate are scarce. Here we provide a systematic assessment of the role of anthropogenic climate change for the range of impacts of regional climate trends reported in the IPCC's Fifth Assessment Report.
We find that almost two-thirds of the impacts Maternal caffeine intake during pregnancy and childhood growth and overweight: results from a large Norwegian prospective observational cohort study. Design Prospective nationwide pregnancy cohort. We used a growth model to assess individual growth trajectories. Very high caffeine exposures were associated with higher weight gain velocity from infancy to age 8 years.
Conclusion Any caffeine consumption during pregnancy is associated with a higher risk of excess infant growth and of childhood overweight, mainly at preschool ages. Maternal caffeine intake may modify the overall weight growth trajectory of the child from birth to 8 years. This study adds supporting evidence for the current advice to reduce caffeine intake during pregnancy.
Delays in diagnosis occur with complex regional pain syndrome CRPS. We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS postfracture. The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility sensitivity, specificity, positive predictive value, negative predictive value for identifying CRPS within a Fracture cohort.
This was a single UK teaching hospital prospective cohort study with recruits from pain-free volunteers and patients with chronic pain conditions. FP and BS were the best performing tests. Novel signs are reliable, easy to perform, and present in chronic pain patients.
FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention. To study the association between maternal caffeine intake during pregnancy and the child's weight gain and overweight risk up to 8 years.
Prospective nationwide pregnancy cohort. Child's body size information at 11 age points from 6 weeks to 8 years. Any caffeine consumption during pregnancy is associated with a higher risk of excess infant growth and of childhood overweight, mainly at preschool ages. No commercial use is permitted unless otherwise expressly granted. High inter- observer agreement of observer -perceived pain assessment in the emergency department.
The aim of the present study was to assess the inter- observer agreement of perceived pain among emergency department nurses and to evaluate if it was influenced by predetermined factors like age and gender. Method: A project assistant randomly recruited two nurses, who Patient age, gender, localization of pain, examination room or presence of a significant other did not affect the inter- observer agreement.
Background: Triage is used to prioritize the patients in the emergency department. The majority of the triage systems include the patients' pain score to assess their level of acuity by using a combination of patient reported pain and observer -perceived pain; the latter therefore requires a certain Quality of life and psychosocial outcomes after fixed orthodontic treatment: a year observational cohort study.
However, little is known of the long-term outcomes of orthodontic treatment. Respondents completed a questionnaire, which collected information on quality of life, receipt of orthodontic treatment and psychosocial factors, and were invited for a clinical examination.
Oral health conditions including occlusal status using the Dental Aesthetic Index were recorded. Analysis of variance and multiple linear regression were used to examine the relationship between the measured factors.
There was no statistically significant association between occlusal status at adolescence and quality of life at adulthood. Those individuals who had orthodontic treatment but did not need orthodontic treatment had higher self-esteem Receipt of fixed orthodontic treatment does not appear to be associated with oral health-related quality of life but appears to be negatively associated with self-esteem and satisfaction with life.
Large observer variation of clinical assessment of dyspnoeic wheezing children. In children with acute dyspnoea, the assessment of severity of dyspnoea and response to treatment is often performed by different professionals, implying that knowledge of the interobserver variation of this clinical assessment is important. To determine intraobserver and interobserver variation in clinical assessment of children with dyspnoea.
From September to September , we recorded a convenience sample of 27 acutely wheezing children aged 3 months-7 years in the emergency department of a general teaching hospital in the Netherlands, on video before and after treatment with inhaled bronchodilators.
These video recordings were independently assessed by nine observers scoring wheeze, prolonged expiratory phase, retractions, nasal flaring and a general assessment of dyspnoea on a Likert scale Assessment was repeated after 2 weeks to evaluate intraobserver variation. We analysed observations. Intraobserver variation is modest, and interobserver variation is large for most clinical findings in children with dyspnoea.
The measurement error induced by this variation is too large to distinguish potentially clinically relevant changes in dyspnoea after treatment in two-thirds of observations. The poor interobserver reliability of clinical dyspnoea assessment in children limits its usefulness in clinical practice and research, and highlights the need to use more objective measurements in these patients.
Ubiquitous computing and mobile technologies provide a new perspective for designing innovative outdoor learning experiences. The purpose of this study is to propose a formative assessment design for integrating PDAs into ecology observations. Three learning activities were conducted in this study. An action research approach was applied to….
Global climate change is unequivocal, and greenhouse gas emissions continue rising despite international mitigation efforts. Hence whether and to what extent the impacts of human induced. A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology. We investigated the relationship between high-quality HQ defined using NOS and the results of subgroup analysis according to study design.
HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence.
Prehospital interventions: Time wasted or time saved? An observational cohort study management in initial trauma care. Ringburg Akkie ; E. Bergs Engelbert ; E. Steyerberg Ewout ; P. Patka Peter ; I. Schipper Inger. The aim of this study was to examine the duration of performed interventions and to study the effect of on-scene time OST and interventions performed. Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.
Benchmarking Controlled Trial BCT is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized.
The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.
However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial BCT is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals.
Espeland, Mark A. Background Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials, however its performance in these settings has not been systematically evaluated. We describe relationships that test scores have with those from interviewer-administered cognitive function tests and risk factors for cognitive deficits and describe performance measures completeness, intra-class correlations.
Results Computer-based assessments of cognitive function had consistent relationships across the pilot and full scale trial cohorts with interviewer-administered assessments of cognitive function, age, and a measure of physical function. In the LIFE cohort , their external validity was further demonstrated by associations with other risk factors for cognitive dysfunction: education, hypertension, diabetes, and physical function.
The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis. The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.
Prospective analysis of data from the International Surgical Outcomes Study ISOS , an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications.
In the ISOS cohort , a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. We included 44 patients from hospitals in 27 countries in the ISOS analysis. There were 40 Checklist exposure was associated with reduced mortality [odds ratio OR 0. Checklist exposure was associated with both reduced postoperative mortality [OR 0.
Objectives To evaluate risk factors associated with exacerbation frequency in primary care. Information on exacerbations of chronic obstructive pulmonary disease COPD has mainly been generated by secondary care-based clinical cohorts. Design Retrospective observational cohort study. Setting Electronic medical records database England and Wales. Independent predictors of increased odds of having exacerbations during the follow-up, either frequent episodes or one episode, included prior exacerbations, increasing dyspnoea score, increasing grade of airflow limitation, females and prior or current history of several comorbidities eg, asthma, depression, anxiety, heart failure and cancer.
Conclusions Primary care-managed patients with COPD at the highest risk of exacerbations can be identified by exploring medical history for the presence of prior exacerbations, greater COPD disease severity and co-occurrence of other medical conditions. Evaluation of a questionnaire to assess sedentary and active behaviors in the Southern Community Cohort Study.
The PAQ test-retest reliability ranged from 0. The SCCS-PAQ has fair to moderate test-retest reliability and demonstrated some evidence of criterion validity for ranking participants by their level of sedentary and active behaviors. Our aim was to investigate the evolution of the CAT in a telehealthcare THC cohort and to evaluate its potential to predict exacerbations.
The evolution of the CAT was analyzed using linear regression. The association between this evolution and the occurrence of exacerbations was evaluated using the Andersen-Gill formulation of the Cox proportional hazards model for the analysis of recurrent time-to-event data with time-varying predictors. The median CAT at inclusion was 17 interquartile range points.
In about one-fifth of patients, there was a significant learning effect in filling out the CAT, before reliable results could be obtained. The evolution of the CAT could help to assess the risk for future exacerbations. Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic—An observational cohort study. AIM: To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period. The patients were treated according to the International Consensus During the period the chiropodist staffing in the foot clinic was doubled; new offloading material and orthopedic foot corrections for recalcitrant ulcers were introduced.
Healing was investigated in toe ulcers in Cox regression models. Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic-An observational cohort study. To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period.
The study was retrospective, consecutive and observational during through The patients were treated according to the International Consensus on the Diabetic Foot. The results show that the healing of toe ulcers improved. This outcome could not be explained by changes in the patient characteristics, but coincided with a number of improvements in organization and therapy.
Assessment of inappropriate antibiotic prescribing among a large cohort of general dentists in the United States. The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States.
We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, , and December 31, , with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription.
Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists.
In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Also, personal histories of medical and psychiatric illnesses and the range of socio-epidemiologic and clinical data were collected from each participant. Results One thousand one hundred eighty three participants were recruited from 18 hospitals.
The mean age of the participants was The majority The average HDRS was Significant gender differences at baseline were shown in age, education, marriage, employment, religion, and first depressive episode. Conclusion The baseline findings in the CRESCEND study showed some different characteristics of depression in Korea, suggesting a possibility of ethnic and cultural factors in depression.
Numerous methods have been developed to assess physical workload biomechanical exposures in order to identify hazards leading to musculoskeletal disorders, to monitor the effects of ergonomic changes, and for research. No indvidual method The inter- observer repeatability of MAC and the Washington state model has been found to be moderate.
Asian countries have seen the expansion of combination antiretroviral therapy cART over the past decade. We examined trends in treatment outcomes in patients who initiated cART between and Time of cART initiation was grouped into three periods: , , and We analyzed trends in undetectable viral load VL; defined as VL treatment outcomes, with older age and higher CD4 counts being associated with undetectable VL.
Greater effort should be made to facilitate earlier HIV diagnosis and linkage to care and treatment, to achieve greater improvements in treatment outcomes. Virtual reality paced serial assessment test for neuropsychological assessment of a military cohort. The assessment and treatment of traumatic brain injury TBI has become a difficult challenge for the DoD medical health system. Clinical neuropsychologists are being asked to make statements regarding a soldier's functional skills, ability to return to active duty, and competence in tasks of community living.
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