3,041 research outputs found

    Sex, age and normal post-anticoagulation D-dimer as risk factors for recurrence after idiopathic venous thromboembolism in the Prolong study extension

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    BACKGROUND: The PROLONG randomized study showed that patients with an abnormal D-dimer after anticoagulation suspension for a first unprovoked episode of venous thromboembolism (VTE) benefited from anticoagulation resumption. Patients with normal D-dimer after anticoagulation suspension had a low recurrence rate (4.4% patient-years) but their anticoagulation optimal duration remained uncertain. OBJECTIVES: To assess whether sex and age, in combination with normal D-dimer, are risk factors for VTE recurrence in patients enrolled in the PROLONG study extended follow-up. METHODS: D-dimer was measured at 1 month after anticoagulation suspension. Patients with a normal D-dimer did not resume anticoagulants, whereas patients with an abnormal D-dimer were randomized either to resume or not anticoagulants. Primary outcome was recurrent VTE. RESULTS: After excluding patients resuming anticoagulants for abnormal D-dimer, recurrences were higher in males than females [7.4% patient-years - 47/639 vs. 4.3% patient-years - 27/626; hazard ratio (HR) = 1.7; P = 0.027] and in patients aged 65 or older than in younger patients (8.4% patient-years - 50/598 vs. 3.6% patient-years - 24/667; HR = 2.1; P = 0.003). In patients with normal D-dimer and younger than 65, recurrences were higher in males than in females (5.1% vs. 0.4% patient-years; adjusted HR = 10.6; P = 0.023) and both females and males aged 65 years or older had more recurrences (6.6% and 8.1% patient-years, respectively, adjusted HR: 16.0; P = .008 and 16.0; P = 0.008, respectively) than females younger than 65. CONCLUSIONS: In patients with idiopathic VTE and a normal D-dimer at 1 month after anticoagulation suspension, females younger than 65 had a very low risk of recurrence

    WISDOM: history and early demise - was it inevitable?

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    In 1989, the UK Medical Research Council (MRC) agreed that, if feasible, a randomized controlled trial to assess the long-term risks and benefits of hormone replacement therapy (HRT) was a priority. Feasibility work began in 1990 and demonstrated that a large-scale multicenter trial was possible. An application for funding for a main trial was submitted to MRC in 1993 and, after extensive review, funding was released in late 1996. Set-up work for the trial - the Women's International Study of long Duration Oestrogen after Menopause (WISDOM) - began in 1997 with recruitment in 1999. In October 2002, following the early discontinuation of one arm of the US Women's Health Initiative HRT trial, the MRC decided to stop the WISDOM trial. This article, by the principal UK investigators of WISDOM, sets out the background and history of the trial

    Discourse on formation of investigators’ competencies

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    One of the most important aims of law enforcement agencies is crime investigation and prevention. Consequently, one of the main activities of the law enforcement agencies, especially in the pre-trial investigation sphere, is to optimise the organisation of the pre-trial investigation in order to save the experienced skilled and competent specialists. The author of this research offers a new approach and analyses the qualification and competence of the pre-trial investigation subjects not only in terms of personnel management, but all elements of the model of pre-trial investigation to make pre-trial investigation organisation more effective. It should be noted that the content of an investigators‘ qualification or levels of competence are still not determined or strictly regulated and this is the reason for many discussions in this area. These discussions surround what qualification and level of competence the investigators should have in pre-trial investigation, what general and special competencies they should acquire and how the content of the competencies should be determined. In the present article the author analyses the investigators‘ qualification and competence as a presumption that it is an essential aspect of an effective pre-trial investigation. Analysing this question the author compares other subjects such as the regulation of qualifications and levels of competence of the prosecutors and pre-trial investigation judges. The author also identifies the problem of how to define an investigators qualification and level of competence making recommendations to create a Description of Investigators Competencies. Qualification requirements should be determined in this legal act and general, occupational and special competencies should be identified with the content also being determined within this framework. Formation of the Description of Investigators‘ Competencies should determine not only the content of the investigators‘ required level of competence but also this process should be consistent with the assessment and career development of investigators‘ including the process of gaining the investigators‘ qualification. The aim of this research is to identify the problems associated with defining an investigators‘ qualification and levels of competence and to propose recommendations on how this could be achieved. The subject of this research is limited to only looking at investigators‘ qualification and level of competence. The author is using a qualitative method for this research based upon the contents of documents. The author will analysis eight legal acts related to the qualification and competence of pre-trial investigation and fifty different investigators‘ job descriptions.Straipsnyje nagrinėjama ikiteisminio tyrimo pareigūnų (tyrėjų) kvalifikacija ir kompetencija kaip viena iš veiksmingo ikiteisminio tyrimo organizavimo prielaidų. Analizuojant tyrėjų kvalifikacijos ir kompetencijos turinį ir jo reglamentavimą, lyginama kitų ikiteisminio tyrimo subjektų – prokurorų ir ikiteisminio tyrimo teisėjų – kvalifikacijos ir kompetencijos turinio reglamentavimo ypatumai, identifikuojamos tyrėjų kvalifikacijos ir kompetencijos apibrėžties problemos ir pateikiami sprendimo būdai – siūlomas ikiteisminio tyrimo pareigūnų (tyrėjų) kompetencijų aprašas, kuriame būtų tiksliai nustatyti tyrėjų kvalifikaciniai reikalavimai, identifikuotos bendrosios, profesinės ir specialiosios kompetencijos ir apibrėžtas šių kompetencijų turinys. Ikiteisminio tyrimo pareigūnų kompetencijų aprašo suformavimas sudarytų galimybę ne tik aiškiai apibrėžti tyrėjo kompetencijos turinį, bet ir šį procesą nuosekliai susieti su tyrėjo veiklos vertinimu, karjera ir kvalifikacijos tobulinimu. Straipsnį sudaro įvadas ir dvi dalys. Pirmoje dalyje nagrinėjama tyrėjo kvalifikacijos apibrėžties problematika, gretinama ikiteisminio tyrimo pareigūno, prokuroro ir teisėjo kvalifikacijos apibrėžtys. Šioje dalyje siūloma tiksliai nustatyti ir apibrėžti tyrėjo kvalifikacinius reikalavimus. Antrojoje dalyje analizuojama tyrėjo kompetencijos turinys. Nagrinėjant prokurorų, teisėjų kompetencijos turinį ir jo reglamentavimo ypatumus, siūloma sudaryti tyrėjo kompetencijų aprašą, kuriame būtų tiksliai apibrėžtas tyrėjo kompetencijos turinys

    Internet technologies relevant to private investigators’ working practices

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    Much has been written and discussed especially in the various US media and in legislative organs, about how the Internet is used illegally (hacking, stalking for instance), but hardly if any research has been done as to how the investigative industry employs the new medium to its benefit. The author described in this thesis how private investigators (PIs) execute their profession these days using the facilities the Internet avail them in contrast to the time before the dawn of the Internet. This contrast is also investigated in an international context, an important part of the thesis, drawn from the author's 32 years of international business experience and that of PIs worldwide. The availability of the various online facilities in different countries are compared. To better understand the new medium, and its facilities a short outline of the Internet’s history, it’s set up in general and for the use of PIs in particular is supplied. PIs also face limitations in their daily work, limitations originating from online, legal, educational, financial and international causes. The new medium not only helps PIs in their investigative, but also in their office work. Finally PIs' wishes for new tools to facilitate their daily investigative work and their outlook as to where the new medium will head are also discussed
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