824 research outputs found
Patterns and frequency of recurrences of squamous cell carcinoma of the vulva
No full textJorien M. Woolderink, Geertruida H. de Bock, Joanne A. de Hullu, Margaret J. Davy, Ate G.J. van der Zee, Marian J.E. Mourit
Additional file 3: of Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts â a systematic review and meta-analysis
No full textSubgroup analysis - Recall rate of DBT and DM in screening studies using two study groups by outcome definition. (DOCX 30 kb
"Timed Up & Go": a screening tool for predicting 30-day morbidity in onco-geriatric surgical patients? A multicenter cohort study.
No full textTo determine the predictive value of the "Timed Up & Go" (TUG), a validated assessment tool, on a prospective cohort study and to compare these findings to the ASA classification, an instrument commonly used for quantifying patients' physical status and anesthetic risk.In the onco-geriatric surgical population it is important to identify patients at increased risk of adverse post-operative outcome to minimize the risk of over- and under-treatment and improve outcome in this population.280 patients ≥70 years undergoing elective surgery for solid tumors were prospectively recruited. Primary endpoint was 30-day morbidity. Pre-operatively TUG was administered and ASA-classification was registered. Data were analyzed using multivariable logistic regression analyses to estimate odds ratios (OR) and 95% confidence intervals (95%-CI). Absolute risks and area under the receiver operating characteristic curves (AUC's) were calculated.180 (64.3%) patients (median age: 76) underwent major surgery. 55 (20.1%) patients experienced major complications. 50.0% of patients with high TUG and 25.6% of patients with ASA≥3 experienced major complications (absolute risks). TUG and ASA were independent predictors of the occurrence of major complications (TUG:OR 3.43; 95%-CI = 1.14-10.35. ASA1 vs. 2:OR 5.91; 95%-CI = 0.93-37.77. ASA1 vs. 3&4:OR 12.77; 95%-CI = 1.84-88.74). AUCTUG was 0.64 (95%-CI = 0.55-0.73, p = 0.001) and AUCASA was 0.59 (95%-CI = 0.51-0.67, p = 0.04).Twice as many onco-geriatric patients at risk of post-operative complications, who might benefit from pre-operative interventions, are identified using TUG than when using ASA
Violência contra mulheres paroaras: contribuições para a enfermagem
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem, Florianópolis, 2009.Neste estudo sao analisadas as violencias contra mulheres Paroaras residentes em Belem e as implicacoes para o cuidado de enfermagem. O estudo foi fundamentado no Metodo Epidemiologico e na Analise de Conteudo, com a abordagem quantitativa e qualitativa. Foi desenvolvido a partir das materias publicadas em um jornal regional - O Liberal, do Sistema de Informacao de Mortalidade do Ministerio da Saude do Brasil (SIM/MS) e de referencias bibliograficas. Elegeu-se a forma de artigos para apresentacao dos resultados do estudo. No primeiro artigo, Violencias contra mulheres amazonicas, sao apresentadas as barbaridades como o esquartejamento, cortes profundos na regiao do pescoco, abertura de abdomen com exposicao de visceras e retirada de feto, alem da introducao de madeira em orgaos genitais. E, tambem, que as mulheres foram submetidas a violencia sexual desde a infancia ate a idade adulta. No segundo, Mortes violentas em mulheres paroaras. residentes em Belem: Estudo exploratorio, foi encontrado que das 15.523 mortes de mulheres, as Agressoes ocuparam a vigesima nona posicao no conjunto das causas letais. Calculado e aplicado o indicador Anos Potenciais de Vida Perdidos (APVP), a ordenacao das causas letais foi modificada e as agressoes passaram a ocupar a decima terceira posicao, subindo dezesseis posicoes na ordenacao das causas letais. No terceiro, Homicidios contra mulheres paroaras. residentes em Belem: Estudo exploratorio, dentre os 581 obitos por causas externas, 19,4% foi homicidio. Das mulheres vitimas de homicidio, 31,9% encontravam-se com idade compreendidas entre 20 a 29 anos, 76,1% eram solteiras, 40,7% tinham de 4 a 7 anos de estudos e 55,8% dos homicidios foram perpetrados com disparo de arma de fogo. No quarto artigo, Mulheres paroaras. e violencia: Anos potenciais de vida perdidos em homicidios, no conjunto das causas externa com 19.727 Anos Potencias de Vida Perdidos (APVP), os homicidios ocuparam a segunda posicao na ordenacao das causas externas de morte com 5.459 APVP. O homicidio por arma de fogo resultou em 3.059 anos de vida potencialmente perdidos. O quinto, Violencia contra a mulher: implicacoes para o cuidado de enfermagem, Estudo de revisao integrativa, cuja exploracao tematica foi realizada com suporte da analise de conteudo e da Teoria de Horta, resultou na identificacao de que a violencia contra a mulher afeta todas as necessidades humanas basicas e que o cuidado de enfermagem pode ser aplicado a partir dessa teoria. Apesar da violencia fisica nao estar entre as cinco principais causas de morte em mulheres acarreta um impacto no conjunto das causas letais. A morte de mulheres produtivas e a sua importância como problema social, político e de saúde publica, requer planejamento de ações de controle, prevenção e redução da mortalidade por homicídio. O cuidado de enfermagem é uma das estratégias para a mulher superar a dor, o medo, a vergonha, as doenças associadas à violência e encontrar caminhos para satisfazer as suas necessidades humanas básicas que foram comprometidas pela violência e, com isso, também prevenir e/ou reduzir os homicídios.En este estudio son analizadas las violencias contra mujeres paroaras. residentes en Belem y las implicaciones para el cuidado de enfermeria. El estudio fue fundamentado en el Metodo Epidemiologico y en el Analisis de Contenido, con el abordaje cuantitativo y cualitativo. Fue desarrollado a partir de las materias publicadas en un periodico regional . O Liberal, del Sistema de Informacion de Mortalidad del Ministerio de Salud de Brasil (SIM/MS) y de referencias bibliograficas. Se escogio la forma de articulos para presentacion de los resultados del estudio. En el primer articulo, Violencias contra mujeres amazonicas, son presentadas las barbaridades como el descuartizamiento, cortes profundos en la region del cuello, abertura de abdomen con exposicion de visceras y retirada de feto, ademas de la introduccion de madera en organos genitales. Y, tambien, que las mujeres fueron sometidas a violencia sexual desde la infancia hasta la edad adulta. En el segundo articulo, Muertes violentas en mujeres paroaras. residentes en Belem: Estudio exploratorio, fue encontrado que de las 15.523 muertes de mujeres, las Agresiones son las que ocuparon la vigesima nona posicion en el conjunto de las causas letales. Calculado y aplicado el indicador Anos Potenciales de Vida Perdidos (APVP), la ordinacion de las causas letales fue modificada y las agresiones pasaron a ocupar la decima tercera posicion, subiendo dieciseis posiciones en la ordinacion de las causas letales. En el tercer articulo, Homicidios contra mujeres paroaras.residentes en Belem: Estudio exploratorio, de entre los 581 obitos por causas externas, 19,4% fueron homicidios. De las mujeres victimas de homicidio, 31,9% se encontraban con edad comprendidas entre 20 a 29 anos, 76,1% eran solteras, 40,7% tenian de 4 a 7 anos de estudios y 55,8% de los homicidios fueron perpetrados con disparo de arma de fuego. En el cuarto articulo, Mujeres paroaras. y violencia: Anos potenciales de vida perdidos en homicidios, en conjunto de las causas externas con 19.727 Anos Potenciales de Vida Perdidos (APVP), los homicidios ocuparon la segunda posicion en la ordinacion de las causas externas de muerte con 5.459 APVP. El homicidio por arma de fuego tuvo un resultado de 3.059 anos de vida potencialmente perdidos. El quinto articulo, Violencia contra la mujer: Reflexion sobre las implicaciones para el cuidado de enfermeria, presenta reflexion sobre el contenido de las bibliografias, a la luz de la Teoria de Horta, resulto en la identificacion de que la violencia contra la mujer afecta a todas las necesidades humanas basicas y que el cuidado de enfermería para ellas puede ser aplicado a partir de esa teoría. A pesar de la violencia física, no estar entre las cinco principales causas de muerte en mujeres, acarrea un impacto conjunto de las causas letales. La muerte de mujeres productivas y su importancia como problema social, político y de salud pública, requiere planeamiento de acciones de control, prevención y reducción de la mortalidad por homicidio. El cuidado de enfermería es una de las estrategias para que la mujer supere el dolor, el miedo, la verguenza, las enfermedades asociadas a la violencia y encontrar caminos para satisfacer sus necesidades humanas básicas que fueron comprometidas por la violencia
Comparison of analysis methods and design choices for treatment-by-period interaction in unidirectional switch designs:a simulation study
No full textBackground: Due to identifiability problems, statistical inference about treatment-by-period interactions has not been discussed for stepped wedge designs in the literature thus far. Unidirectional switch designs (USDs) generalize the stepped wedge designs and allow for estimation and testing of treatment-by-period interaction in its many flexible design forms. Methods: Under different forms of the USDs, we simulated binary data at both aggregated and individual levels and studied the performances of the generalized linear mixed model (GLMM) and the marginal model with generalized estimation equations (GEE) for estimating and testing treatment-by-period interactions. Results: The parallel group design had the highest power for detecting the treatment-by-period interactions. While there was no substantial difference between aggregated-level and individual-level analysis, the GLMM had better point estimates than the marginal model with GEE. Furthermore, the optimal USD for estimating the average treatment effect was not efficient for treatment-by-period interaction and the marginal model with GEE required a substantial number of clusters to yield unbiased estimates of the interaction parameters when the correlation structure is autoregressive of order 1 (AR1). On the other hand, marginal model with GEE had better coverages than GLMM under the AR1 correlation structure. Conclusion: From the designs and methods evaluated, in general, parallel group design with a GLMM is, preferred for estimation and testing of treatment-by-period interaction in a clustered randomized controlled trial for a binary outcome.</p
Outstanding negative prediction performance of solid pulmonary nodule volume AI for ultra-LDCT baseline lung cancer screening risk stratification
No full textOBJECTIVE: To evaluate performance of AI as a standalone reader in ultra-low-dose CT lung cancer baseline screening, and compare it to that of experienced radiologists.METHODS: 283 participants who underwent a baseline ultra-LDCT scan in Moscow Lung Cancer Screening, between February 2017-2018, and had at least one solid lung nodule, were included. Volumetric nodule measurements were performed by five experienced blinded radiologists, and independently assessed using an AI lung cancer screening prototype (AVIEW LCS, v1.0.34, Coreline Soft, Co. ltd, Seoul, Korea) to automatically detect, measure, and classify solid nodules. Discrepancies were stratified into two groups: positive-misclassification (PM); nodule classified by the reader as a NELSON-plus /EUPS-indeterminate/positive nodule, which at the reference consensus read was < 100 mm3, and negative-misclassification (NM); nodule classified as a NELSON-plus /EUPS-negative nodule, which at consensus read was ≥ 100 mm3.RESULTS: 1149 nodules with a solid-component were detected, of which 878 were classified as solid nodules. For the largest solid nodule per participant (n = 283); 61 [21.6 %; 53 PM, 8 NM] discrepancies were reported for AI as a standalone reader, compared to 43 [15.1 %; 22 PM, 21 NM], 36 [12.7 %; 25 PM, 11 NM], 29 [10.2 %; 25 PM, 4 NM], 28 [9.9 %; 6 PM, 22 NM], and 50 [17.7 %; 15 PM, 35 NM] discrepancies for readers 1, 2, 3, 4, and 5 respectively.CONCLUSION: Our results suggest that through the use of AI as an impartial reader in baseline lung cancer screening, negative-misclassification results could exceed that of four out of five experienced radiologists, and radiologists' workload could be drastically diminished by up to 86.7%.</p
Are language production problems apparent in adults who no longer meet diagnostic criteria for attention-deficit/hyperactivity disorder?
No full textIn this study, we examined sentence production in a sample of adults (N = 21) who had had attention-deficit/hyperactivity disorder (ADHD) as children, but as adults no longer met DSM-IV diagnostic criteria (APA, 2000). This “remitted” group was assessed on a sentence production task. On each trial, participants saw two objects and a verb. Their task was to construct a sentence using the objects as arguments of the verb. Results showed more ungrammatical and disfluent utterances with one particular type of verb (i.e., participle). In a second set of analyses, we compared the remitted group to both control participants and a “persistent” group, who had ADHD as children and as adults. Results showed that remitters were more likely to produce ungrammatical utterances and to make repair disfluencies compared to controls, and they patterned more similarly to ADHD participants. Conclusions focus on language output in remitted ADHD, and the role of executive functions in language production
Optimal unidirectional switch designs
No full textStepped wedge designs and delayed start designs can all be considered as special cases of the so-called unidirectional switch design. This paper provides optimal proportions of clusters that are allocated to switch patterns in a unidirectional switch design to minimize the asymptotic variance of the treatment effect estimator. This unique optimal design applies to certain cross-sectional and longitudinal variance component models. When the intraclass correlation coefficient is zero, the optimal unidirectional switch design coincides with the classic (cluster) parallel group design. The optimal unidirectional switch design is more efficient than the optimal stepped wedge design and delayed start designs. Compared with the uniform unidirectional switch design, the efficiency gain of the optimal unidirectional switch design can be substantial, but it depends on the intraclass correlation and the cluster size. We also showed that augmenting the optimal stepped wedge design with pure control pattern is more efficient than the optimal stepped wedge design. In addition, robust minimax design for unidirectional switch design, delayed start design, and stepped wedge design are provided
Severity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence: a population-based study as part of a randomized controlled trial in primary care
No full textSeverity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence Barentsen, J.A.; Visser, Els; Hofstetter, H.; Maris, A.M.; Dekker, J.H.; de Bock, G.H. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Abstract Background: Urinary incontinence negatively influences the lives of 25-50% of elderly women, mostly due to feelings of shame and being limited in activities and social interactions. This study explores whether differences exist between types of urinary incontinence (stress, urgency or mixed) and severity of the symptoms, with regard to their effects on generic and condition-specific quality of life. Methods: This is a cross-sectional study among participants of a randomized controlled trial in primary care. A total of 225 women (aged ≥ 55 years) completed a questionnaire (on physical/emotional impact and limitations) and were interviewed for demographic characteristics and co-morbidity. Least squares regression analyses were conducted to estimate differences between types and severity of urinary incontinence with regard to their effect on quality of life. Results: Most patients reported mixed urinary incontinence (50.7%) and a moderate severity of symptoms (48.9%). Stress urinary incontinence had a lower impact on the emotional domain of condition-specific quality of life compared with mixed urinary incontinence (r = −7.81). There were no significant associations between the types of urinary incontinence and generic quality of life. Severe symptoms affected both the generic (r = −0.10) and condition-specific (r = 17.17) quality of life. Conclusions: The effects on condition-specific quality of life domains differ slightly between the types of incontinence. The level of severity affects both generic and condition-specific quality of life, indicating that it is not the type but rather the severity of urinary incontinence that is the main predictor of decreased quality of life
- …
