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Assessment of treatment interruption among pulmonary tuberculosis patients: Directory of Open Access Journals Sweden. Full Text Available Background: Multi-drug resistant tuberculosis TB is a rising peril of the TB control in India caused mostly by incomplete treatment. A cross-sectional study was carried out for a period of 9 months among PTB patients. The data were collected from the patients or their caretakers to obtain the source of treatment given previously before default, number of treatment interruptions , phase and reasons for treatment interruption treatment.
A total of defaulters were identified during the study period. In the present study, The most common reason for the treatment interruptions were felt well with TB treatment The study revealed that most of the defaulters were in the age group between 35 and 60 years, male gender, illiterates, daily wage labor, and married.
The treatment interruptions were minimized by putting the efforts to improve direct supervision ; pretreatment counseling and retrieve treatment interrupters were recommended. HIV models for treatment interruption: In recent years, Antiretroviral Therapy ART has become commonplace for treating HIV infections, although a cure remains elusive, given reservoirs of replicating latently-infected cells, which are resistant to normal treatment regimes.
Treatment interruptions , whether ad hoc or structured, are known to cause a rapid increase in viral production to detectable levels, but numerous clinical trials remain inconclusive on the dangers inherent in this resurgence. In consequence, interest in examining interruption strategies has recently been rekindled. This overview considers modelling approaches, which have been used to explore the issue of treatment interruption.
We highlight their purpose and the formalisms employed and examine ways in which clinical data have been used. Implementation of selected models is demonstrated, illustrative examples provided and model performance compared for these cases. Possible extensions to bottom-up modelling techniques for treatment interruptions are briefly discussed. Optimal treatment interruptions control of TB transmission model.
A tuberculosis model which incorporates treatment interruptions of infectives is established. Optimal control of individuals infected with active TB is given in the model.
It is obtained that the control reproduction numbers is smaller than the reproduction number, this means treatment controls could optimize the decrease in the spread of active TB. For this model, controls on treatment of infection individuals to reduce the actively infected individual populations, by application the Pontryagins Maximum Principle for optimal control.
The result further emphasized the importance of controlling disease relapse in reducing the number of actively infected and treatment interruptions individuals with tuberculosis. Neurocognition and quality of life after reinitiating antiretroviral therapy in children randomized to planned treatment interruption. Understanding the effects of antiretroviral treatment ART interruption on neurocognition and quality of life QoL are important for managing unplanned interruptions and planned interruptions in HIV cure research.
Compensability index for compensation radiotherapy after treatment interruptions. The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index.
The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. The compensability index calculation may serve as a decision support system based on existing and established recommendations.
Full Text Available Abstract Background The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect.
Methods We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. Results The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. Conclusions The compensability index calculation may serve as a decision support system based on existing and established recommendations.
Statistics, causes and management in service radiotherapy. Despite the clinical maximum administer the prescribed dose at a given time, treatment interruptions are unavoidable in practice. In tumors quickly reproduce no evidence that the prolongation thereof entails loss of tumor control.
It has tracked two of these conditions: Platelet count kinetics following interruption of antiretroviral treatment. To investigate the mechanisms of platelet kinetics in the Strategies for Management of Antiretroviral Therapy SMART study that demonstrated excess mortality with CD4 guided episodic antiretroviral therapy ART drug conservation compared with continuous treatment viral suppression.
Follow-up analyses of stored plasma samples demonstrated increased activation of both inflammatory and coagulation pathways after stopping ART.
SMART patients from sites that determined platelets routinely. Platelet counts were retrospectively collected from patients from visits at study entry, and during follow-up. D-dimer levels were measured at study entry, month 1, and 2.
Platelet levels decreased in the drug conservation group following randomization, but remained stable in the viral suppression group [median IQR decline from study entry to month 4: Factors contributing to declines in platelets after interrupting ART may include activation of coagulation pathways or HIV-1 replication itself.
The contribution of platelets in HIV-related procoagulant activity requires further study. The effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinoma. The effect of interruptions and prolonged overall treatment time in radiotherapy for nasopharyngeal carcinoma and the significance of timing of interruption was investigated. Treatment records of patients treated with continuous course CC and patients treated with split course SC radiotherapy for nonmetastatic NPC were reviewed.
Overall treatment time without inclusion of time for boost was calculated. Treatment that extended 1 week beyond scheduled time was considered prolonged. Outcome in patients who completed treatment 'per schedule' were compared with those who had 'prolonged' treatment. Because of known patient selection bias between CC and SC, patients on the two schedules were analyzed separately. Multivariate analysis was performed for patients on SC. Total number of days of interruption , age, sex, T and N stage, and the use of boost were tested for the whole SC group.
Analysis on the effect of timing of interruption was performed in a subgroup of patients on SC who had a single unplanned interruption. Timing of interruption , either before or after the fourth week for the unplanned interruption , was tested in addition to the other variables in multivariate analysis for this subgroup of SC.
For CC, the effect of prolonged treatment on outcome was not significant. The small number of events for patients on CC probably account for the insignificant finding. The number of days of interruption was confirmed as prognostic factor, independent of T and N stages, for loco-regional control and disease-free survival in multivariate analysis for SC. The hazard rate for loco. Chemoradiotherapy in patients with anal cancer: Impact of length of unplanned treatment interruption on outcome.
The aim of this retrospective analysis was to evaluate feasibility and effectiveness of definitive chemoradiotherapy without split-course technique in anal cancer patients. From to , 81 patients were treated; 13 were excluded due to various chemotherapeutic regimes, thus 68 patients were analysed. In case of acute grade 3 toxicities, treatment was halted until improvement or resolution independent of dose.
Short interruption was defined as completing treatment without exceeding eight cumulative treatment days beyond scheduled plan, other patients were considered to have had prolonged interruption. Median follow-up was 46 months.
Median overall treatment time was 53 days corresponding to an interruption of eight cumulative treatment days. Comparing patients with short vs. Chemoradiotherapy with short individualised treatment interruptions seems to be feasible with acceptable acute or late toxicities.
Treatment is highly effective in terms of local control and colostomy-free survival. Cerebrospinal fluid signs of neuronal damage after antiretroviral treatment interruption in HIV-1 infection. Full Text Available Abstract Background The neurofilament is a major structural component of myelinated axons. Increased cerebrospinal fluid CSF concentrations of the light chain of the neurofilament protein NFL can serve as a sensitive indicator of central nervous system CNS injury.
Results A total of 8 subjects were studied. HIV reservoirs and immune surveillance evasion cause the failure of structured treatment interruptions: Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance.
Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions.
We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings.
We anticipate that it is feasible to steer new clinical trials using computational models. An android radiobiological tool for compensation of radiotherapy treatment interruption.
Treatment interruption is not uncommon in radiotherapy. Common reasons for treatment interruption include machine breakdown, holidays and patient severe radiation reactions. Here RTtxGap, an Android application to assist calculations of compensation for treatment gap, is reported. It uses linear quadratic LQ model to calculate the biological effective dose BED that is used to solve for treatment gap compensations.
Solutions are calculated using BED equation, with consideration for tissue proliferation. Five treatment interruption examples were used to illustrate the capability of the software to calculate the treatment compensation schedules.
Solving these examples also illustrates the general consensus regarding compensating for unscheduled treatment interruptions , which ultimately involves balancing the BEDs of tumour and organ at risk. In addition to compensation for treatment gap, RTtxGap can also be used to calculate equivalent total dose in 2-Gy fraction EQD2 , to modify treatment schedule and to calculate alternative dose prescriptions having the same isoeffect.
Full Text Available Abstract Objective The objective of this work was to study the virological outcomes associated with two different types of treatment interruption strategies in patients with allergic reactions to nevirapine NVP. We compared the virological outcomes of 1 HIVinfected patients who discontinued an initial NVP-based regimen because of cutaneous allergic reactions to NVP; different types of interruption strategies were used, and second-line regimen was based on efavirenz EFV; and 2 HIVinfected patients who began an EFV-based regimen as a first-line therapy controls.
Methods This retrospective cohort included patients who began an EFV-based regimen, between January and December , as either an initial regimen or as a subsequent regimen after resolving a cutaneous allergic reaction against an initial NVP-based regimen.
The study ended in March Results A total of patients were stratified into three groups: The overall median follow-up time was 43 months. Incidence of virological failure in Simultaneous Interruption was However, differences were not statistically significant. Conclusions Among the patients who had an acute allergic reaction to first.
We conducted a retrospective review of patients treated at our institution with SRS without prior whole-brain radiation therapy WBRT for brain metastases between and Outcome metrics included administration of concurrent systemic therapy, myelosuppression, neurotoxicity, and survival.
Median overall survival was similar after SRS alone In patients with a new diagnosis of primary cancer with brain metastasis, early treatment with concurrent systemic therapy and SRS correlated with improved survival versus SRS alone Rethinking delayed and interrupted HIV treatment among married Swazi women. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining.
Community mapping of sex work criminalization and violence: Despite the high HIV burden faced by sex workers, data on access and retention in antiretroviral therapy ART are limited. Using an innovative spatial epidemiological approach, we explored how the social geography of sex work criminalization and violence impacts HIV treatment interruptions among sex workers living with HIV in Vancouver over a 3.
Drawing upon data from a community-based cohort AESHA, and linked external administrative data on ART dispensation, GIS mapping and multivariable logistic regression with generalized estimating equations to prospectively examine the effects of spatial criminalization and violence near women's places of residence on 2-day ART interruptions. In adjusted multivariable models, heightened density of displacement due to policing independently correlated with HIV treatment interruptions AOR: The social geography of sex work criminalization may undermine access to essential medicines, including HIV treatment.
Interventions to promote 'enabling environments' e. Deiss, Robert; Garfein, Richard S. We sought to identify correlates of reported lifetime diagnoses of TB among injection drug users in the border city of Tijuana, Mexico. Injection drug users in Tijuana were recruited into a prospective cohort study during and We used weighted multivariate logistic regression to identify correlates of TB diagnoses.
Of the participants, 9. Mobility and migration are important factors in identifying and treating TB patients diagnosed in the US—Mexico border region.
Strengthening capacity on both sides of the border to identify, monitor, and treat TB is a priority. Understanding reasons for treatment interruption amongst patients on antiretroviral therapy — A qualitative study at the Lighthouse Clinic, Lilongwe, Malawi.
In recent years, scaling up of antiretroviral therapy ART in resource-limited settings moved impressively towards universal access. Understanding reasons for treatment interruption TI can inform strategies for improving drug adherence and retention in care. We analysed an assessment form for patients with TI using pre-defined categories and a comments field to identify frequently stated reasons for TI. Additionally, we conducted 26 in-depth interviews to deepen our understanding of common reasons for TI.
Qualitative data analysis was based on a thematic framework approach. A total of patients Despite the presence of social support and sufficient knowledge of possible consequences of TI, all patients experienced situations that resulted in TI.
Analysis of in-depth interviews led to new and distinct categories for TI. The most common reason for TI was travel Medically supervised water-only fasting in the treatment of borderline hypertension.
Hypertension-related diseases are the leading causes of morbidity and mortality in industrially developed societies. Dietary and lifestyle modifications are effective in the treatment of borderline hypertension. One such lifestyle intervention is the use of medically supervised water-only fasting as a safe and effective means of normalizing BP and initiating health-promoting behavioral changes.
Sixty-eight 68 consecutive patients with borderline hypertension with systolic BP in excess of mm Hg and diastolic BP less than 91 mm Hg were treated in an inpatient setting under medical supervision.
The treatment program consisted of a short prefasting period approximately days on average during which food consumption was limited to fruits and vegetables followed by medically supervised water-only fasting approximately Fasting was followed by a refeeding period approximately 6.
The refeeding program consisted of a low-fat, low-sodium, plant-based, vegan diet. A linear regression of BP decrease against baseline BP showed that the estimated BP below which no further decrease would be expected was These levels are in agreement with other estimates of the BP below which stroke events are eliminated, thus suggesting that these levels could be regarded as the "ideal" BP values. Medically supervised water-only fasting appears to be a safe and effective means of normalizing BP and may assist in motivating health-promoting diet and lifestyle changes.
Muscle-invasive bladder cancer treated with external beam radiation: To evaluate and eventually quantify a possible influence of tumor proliferation during the external radiation course on local control in muscle invasive bladder cancer.
The influence of total dose, overall treatment time, and treatment interruption has retrospectively been analyzed in a series of patients with nonmetastasized, muscle-invasive transitional cell carcinoma of the urinary bladder. All patients received external beam radiotherapy at the Netherlands Cancer Institute between and Total dose varied between 50 and 75 Gy with a mean of Overall treatment time varied between 20 and days with a mean of 49 days and a median of 41 days. Number of fractions varied between 17 and 36 with a mean of 27 and a median of Two hundred and forty-four patients had a continuous radiation course, whereas had an intended split course or an unintended treatment interruption.
Median follow-up was 22 months for all patients and 82 months for the 30 patients still alive at last follow-up. A stepwise procedure using proportional hazard regression has been used to identify prognostic treatment factors with respect to local recurrence as sole first recurrence. One hundred and thirty-six patients experienced a local recurrence and of these occurred before regional or distant metastases. The actuarial local control rate was In a multivariate analysis total dose showed a significant association with local control p 0.
In fact only those patients treated with a dose below This remained the case even after adjustment for overall treatment time and all significant tumor and patient characteristics. Treatment interruptions and non-adherence with imatinib and associated healthcare costs: Identify treatment interruptions and non-adherence with imatinib; examine the clinical and patient characteristics related to treatment interruptions and non-adherence; and estimate the association between treatment interruptions and non-adherence with imatinib and healthcare costs for US managed care patients with chronic myeloid leukaemia CML.
This retrospective analysis utilised electronic healthcare claims data from a US managed care provider. Medication possession ratio MPR , calculated as total days' supply of imatinib divided by , was also examined.
All costs were converted to US dollars values using the medical component of the Consumer Price Index. MPR was modelled using ordinary least squares regression. Presence of treatment interruptions was modelled using logistic regression. The association between MPR and healthcare costs was estimated using a generalised linear model specified with a gamma error distribution and a log link.
All models included adjustment for age, gender, number of concomitant medications, starting dose of imatinib and cancer complexity. A total of patients were identified.
Mean MPR was However, all of these. Statistics, causes and management in service radiotherapy; Interrupciones de tratamiento: Tuberculosis treatment delivery in high burden settings: To determine the effect of patient choice of treatment delivery option on the treatment outcomes of tuberculosis TB patients in a high burden setting under actual programme conditions. Cohort study involving new and retreatment TB patients recruited from 45 randomly selected clinics. Patients were interviewed and subsequent follow-up was done through regular visits to the clinics to check progress through formal health records.
This is of particular relevance in high burden, resource-limited settings where universal DOT for all TB patients is generally unfeasible. Supervised and non- supervised Nordic walking in the treatment of chronic low back pain: Full Text Available Abstract Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit.
Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Patients continuing to have pain greater than three on the point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and patients were randomized to receive A Nordic walking supervised by a specially trained instructor twice a week for eight weeks B One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter.
Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers.
Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in. Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Results No mean differences were found between the three groups in relation to any of the outcomes.
To set up a useful supervising method around PTCA treatment. All of the indexes obtained from steps combination imaging before and after PTCA were contrasted with each other in pairs.
Individuals involved in the criminal justice system have disproportionately high rates of psychiatric disorders when compared to the general U. If left untreated, the likelihood of subsequent arrest increases and risk for adverse health consequences is great, particularly among opioid users.
To explore the prevalence, characteristics, and treatment of mood disorders among justice involved opioid-dependent populations. The current study enrolled treatment -seeking opioid-dependent individuals under community-based criminal justice supervision e.
Participants self-reported mood disorders at higher rates than they screened positive for these conditions. Participants screening positive for these conditions experienced significantly greater family, legal, and medical problems on the Addiction Severity Index-Lite ASI-Lite than those who did not screen positive.
Incidence of a lifetime suicide attempt was found to be associated with a positive screen for both mood disorders. Findings suggest universal mood disorder screening to improve comprehensive psychiatric care and treatment of opioid-dependent justice-involved individuals. Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution Current interruption transients calculation.
This book provides an original, detailed and practical description of current interruption transients, origins,. Efficacy of a hyperglycemia treatment program in a Vascular Surgery Department supervised by Endocrinology.
The aim of this study was to evaluate the strategy and efficacy of a hyperglycemia treatment program supervised by Endocrinology. All patients with type 2 diabetes hospitalized at the vascular surgery department over a 12 month period were retrospectively reviewed.
Clinical characteristics and hyperglycemia treatment during hospitalization, at discharge and month after discharge were collected. Glycemic control was assessed using capillary blood glucose profiles and HbA1c at admission and months post-discharge.
A total of hospitalizations of patients were included. The protocol to choose the insulin regimen was applied in The hyperglycemia treatment protocol applied by an endocrinologist in the hospital, allows the identification of the appropriate therapy and the improvement of the glycemic control during hospitalization and discharge, supporting its efficacy in clinical practice.
Data were obtained in person via paper-and-pencil surveys from matched SUD counselor-clinical supervisor dyads working in 27 SUD treatment organizations across the United States. ECS was rated by counselors and measured with five multi-item scales i. Clinical supervisors rated counselors' job performance, which was measured with two multi-item scales i.
Thus, ECS may indeed enhance counselors' task performance and performance within the supervisory relationship, and, as a consequence, offset limited formal SUD training. Interrupt Handlers in Java. An important part of implementing device drivers is to control the interrupt facilities of the hardware platform and to program interrupt handlers. Current methods for handling interrupts in Java use a server thread waiting for the VM to signal an interrupt occurrence.
It means that the interrupt We present constructs that allow interrupts to be handled directly and not at a later point decided by a scheduler.
A desirable feature of our approach is that we do not require a native middleware layer but can handle interrupts entirely with Java We have implemented our approach using an interpreter and a Java processor, and give an example demonstrating its use Not all are lost: Most studies have not distinguished between those who briefly interrupt , but return to care, and those more chronically lost to follow-up.
We distinguished among patients with early death, within the first 7 months on ART; patients with interruptions in laboratory monitoring ILM, defined as missing visits in the first 7 months on ART, but returning to care by 12 months; and those LTFU, defined as missing all follow-up visits in the first 12 months on ART.
We used multilevel logistic regression models to determine patient and clinic-level characteristics associated with these outcomes. Risk of LTFU decreased with increasing enrollment year, and was lowest for patients who enrolled in compared to [OR 0.
The risk of chronic LTFU decreased with enrollment year. A comparison of conventional LEDs with the one fabricated with our method shows that the latter has better optical properties. Photoluminescence PL full-width at half maximum FWHM is reduced, light output power is much higher and the blue shift of electroluminescence EL dominant wavelength becomes smaller with current increasing.
These improvements should be attributed to the reduced interface roughness of MQW and more uniformity of indium distribution in MQWs by the interruptions with TMIn- treatment.
Antiretroviral treatment interruption and loss to follow-up in two HIV cohorts in Australia and Asia: Both antiretroviral treatment interruption TI and cessation have been strongly discouraged since Survival analysis and Poisson regression methods were used. With median follow-up of 4. In conclusion, since , 7. Acute toxicity and treatment interruption related to electron and photon craniospinal irradiation in pediatric patients treated at the University of Texas M.
To determine the incidence of acute toxicity and treatment interruption associated with electron and photon craniospinal irradiation CSI in children treated with or without chemotherapy. A retrospective study involving a computerized search of the radiotherapy database at the University of Texas M.
Chemotherapy sequencing was categorized as before or after CSI or no chemotherapy. The incidences of weight loss and skin toxicity were recorded and differences in treatment interruption and hematologic values with respect to modality used electron vs. The median age of the electron group was lower than that of the photon group 6. The two groups were otherwise well matched in terms of median spinal dose The mean number of days interrupted was 0.
Chemotherapy given before radiotherapy vs. However, such strategies will require analytical treatment interruptions ATIs to determine their efficacy. We investigated how U. We conducted 36 in-depth interviews with three groups of stakeholders: Qualitative data revealed several themes.
First, there was little consensus on when ATIs would be ethically warranted. Second, the most frequent perceived hypothetical motivators for participating in research on ATIs were advancing science and contributing to society. Third, risks related to viral rebound were the most prevalent concerns related to ATIs. Increased cooperation between scientists and local communities may be useful for minimizing risk.
Further ethics research is necessary. Causes of unplanned interruption of radiotherapy. To evaluate the occurrence and causes of unplanned interruption of radiotherapy.
Retrospective study developed in the Division of Radiotherapy of Hospital Alemao Oswaldo Cruz in Sao Paulo, SP, Brazil, with data collected from dossiers of patients submitted to radiotherapy in the period between January 1, and December 31, Chi-squared and Student t tests were utilized in the data analysis, and p Interruption of treatment was identified in cases, corresponding to The reasons for treatment interruption were the following: The interruption time interval ranged between 1 and 24 days mean 1.
One-day interruption was mostly due to preventive device maintenance The most frequent cause of interruption was preventive device maintenance, with maximum two-day time interval. ResultsEarly treatment arrested the decline in CD4 count but did not fully restore it to the levels observed in HIV-uninfected children.
A strong correlation was observed between thymic output and the stable CD4 count both before and after treatment interruption. ConclusionEarly identification and treatment of HIV-infected infants is important to stabilize CD4 counts at the highest levels possible. Given the difficulty of eradicating HIV-1, a functional cure for HIV-infected patients appears to be a more reachable short-term goal. We identified 14 HIV patients post- treatment controllers [PTCs] whose viremia remained controlled for several years after the interruption of prolonged cART initiated during the primary infection.
Moreover, the incidence of viral control after the interruption of early antiretroviral therapy was higher among the PTCs than has been reported for spontaneous control. Off therapy, the PTCs were able to maintain and, in some cases, further reduce an extremely low viral reservoir. Our results show that early and prolonged cART may allow some individuals with a rather unfavorable background to achieve long-term infection control and may have important implications in the search for a functional HIV cure.
Impact of imatinib interruption and duration of prior hydroxyurea on the treatment outcome in patients with chronic myeloid leukemia: Duration of prior hydroxyurea had no impact on response or progression free survival, while patients regular on imatinib had statistically significant difference with respect to major molecular response, complete molecular response and progression free survival compared to those who had periods of drug interruption , thus we need more governmental support to supply the drug without interruption to improve the outcome of therapy.
Interrupting transmission of soil-transmitted helminths: In recent years, an unprecedented emphasis has been given to the control of neglected tropical diseases, including soil-transmitted helminths STHs. The mainstay of STH control is school-based deworming SBD , but mathematical modelling has shown that in all but very low transmission settings, SBD is unlikely to interrupt transmission, and that new treatment strategies are required.
This study seeks to answer the question: Two cluster randomised trials are being implemented in contrasting settings in Kenya. The interventions are annual mass anthelmintic treatment delivered to preschool- and school-aged children, as part of a national SBD programme, or to entire communities, delivered by community health workers.
Allocation to study group is by cluster, using predefined units used in public health provision-termed community units CUs. CUs are randomised to one of three groups: The primary outcome measure is the prevalence of hookworm infection, assessed by four cross-sectional surveys. Secondary outcomes are prevalence of Ascaris lumbricoides and Trichuris trichiura, intensity of species infections and treatment coverage.
Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, worm burden and proportion of unfertilised eggs will be assessed longitudinally. A nested process evaluation, using semistructured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system.
The study has a. This chapter summarizes the fundamental aspects of supervised methods. The chapter provides an overview of concepts from various interrelated fields used in subsequent chapters. It presents basic definitions and arguments from the supervised machine learning literature and considers various issues, such as performance evaluation techniques and challenges for data mining tasks. Group supervision for general practitioners. Group supervision is a sparsely researched method for professional development in general practice.
The aim of this study was to explore general practitioners' GPs' experiences of the benefits of group supervision for improving the treatment of mental disorders. The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems.
However, more studies are needed to assess the impact of supervision groups A hepatitis E outbreak caused by a temporary interruption in a municipal water treatment system, Baripada, Orissa, India, In January , we investigated a cluster of acute hepatitis in Baripada, Orissa, India. Between January and March , cases definition: Forty-seven of 48 sera were positive for IgM antibodies to hepatitis E virus. Cases peaked in February and decreased rapidly, suggesting a common source outbreak.
Five neighbourhoods supplied by a common water supply were most affected. The neighbourhood's water was pumped directly from a river and had not been treated during a day period in early January 1 month before the peak of the outbreak because of a strike at the treatment plant. This large hepatitis E outbreak was associated with drinking untreated raw river water. Measures must be in place to check the quality of municipal water and to ensure essential services in case of strikes.
On randomly interrupted diffusion. Processes driven by randomly interrupted Gaussian white noise are considered. An evolution equation for single-event probability distributions in presented. Stationary states are considered as a solution of a second-order ordinary differential equation with two imposed conditions. A linear model is analyzed and its stationary distributions are explicitly given.
This paper inquires if the school supervision is in decadence. Waite responds that the answer will depend on which perspective you look at it. Waite suggests taking in consideration three elements that are related: When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision , but there are coincidences related Sound, memory and interruption.
This chapter considers how art can interrupt the times and spaces of urban development so they might be imagined, experienced and understood differently. It focuses on the construction of the M11 Link Road through north-east London during the s that demolished hundreds of homes and displaced The first is in relation to the pace of the work and its deployment of slowness and arrest in a context Interruption Practice Reduces Errors.
There are cases where the user medical staff, MD, Nurse , etc. The effects of interruptions in work activ- ity: Field and laboratory results. Applied Ergonomics , 31 5 , — A staged approach evaluation of remotely supervised myofeedback treatment RSMT in women with neck-shoulder pain due to computer work.
Huis in 't Veld, M. Remotely supervised myofeedback treatment RSMT is a relatively new intervention aimed at reducing neck-shoulder pain and disabilities. Subjects are equipped with a garment that can be worn under the clothes during daily work. Dry surface electrodes incorporated in this garment measure muscle. Full Text Available This paper inquires if the school supervision is in decadence. When these three elements are revised, it emphasizes that there is not a consensus about the field of supervision , but there are coincidences related to its importance and that it is related to the improvement of the practice of the students in the school for their benefit.
Waite suggests that the practice on this field is not always in harmony with what the theorists affirm. When referring to the supervisor or the skilled person, the author indicates that his or her perspective depends on his or her epistemological believes or in the way he or she conceives the learning; that is why supervision can be understood in different ways. About the context, Waite suggests that there have to be taken in consideration the social or external forces that influent the people and the society, because through them the education is affected.
He responds to the initial question saying that the supervision authorities, the knowledge on this field, the performers, and its practice, are maybe spread but not extinct because the supervision will always be part of the great enterprise that we called education. Optimal response requires that patients should be maintained on the drug continuously. To evaluate the influence of imatinib interruption and prior hydroxyurea use on the outcome of patients with chronic myeloid leukemia.
Between January and November , patients with chronic phase who received imatinib at the Kasr Al-ainy Center of Clinical Oncology were included. In terms of response, only major molecular response and complete molecular response were statistically significant in favor of patients who were receiving imatinib regularly compared to those who had interruption phydroxyurea. The median progression free survival was Production and hosting by Elsevier B.
This study describes a field study in which nurses at a surgical ward desired to gain insights to what they experienced as interruptions from phone calls of the coordinating nurse. Employing an effects-driven approach data about The data as well as the data became a way for the nurses to learn about the problem and use it as a stepping stone for discussing possible solutions Full Text Available Interruptions are causal factors in medication errors.
Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to 1 document the nature, frequency, and timing of interruptions during medication ordering, and 2 quantify the use of coping mechanisms by oncologists.
While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.
Comparison of effects of Cyriax physiotherapy, a supervised exercise programme and polarized polychromatic non-coherent light Bioptron light for the treatment of lateral epicondylitis.
To compare the effectiveness of Cyriax physiotherapy, a supervised exercise programme, and polarized polychromatic non-coherent light Bioptron light in the treatment of lateral epicondylitis. Rheumatology and rehabilitation centre.
This study was carried out with 75 patients who had lateral epicondylitis. They were allocated to three groups by sequential allocation. All patients received three treatments per week for four weeks. Pain was evaluated using a visual analogue scale and function using a visual analogue scale and pain-free grip strength at the end of the four-week course of treatment week 4 , one month week 8 , three months week 16 and six months week 28 after the end of treatment.
The supervised exercise programme produced the largest effect in the reduction of pain and in the improvement of function at the end of the treatment PBioptron light may be suitable. The relationship between social support, treatment interruption and treatment outcome in patients with multidrug-resistant tuberculosis in China: We examined the relationship between social support and treatment outcomes in MDR-TB patients and evaluated barriers to social support.
In-depth interviews were conducted with 10 community health workers and 10 patients. Pathway analysis was employed to examine the association between social support and treatment outcomes, and the mediating effect of medication adherence on their relationship.
There is an urgent need for consistent and specific psychological support for MDR-TB patients in their communities. This article is protected by copyright. Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence: Statistical analysis plan for a randomised controlled trial.
The condition is surrounded by taboo; it can have a devastating impact on quality of life and lead to major limitations in daily life. Pelvic floor muscle training in combination with information and fibre supplements is recommended as first-line treatment for faecal incontinence. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment and compared this to an attention-control massage treatment including conservative treatment.
The aim of this trial is to investigate if 16 weeks of supervised pelvic floor muscle training in combination with conservative treatment is superior to attention-control massage treatment and conservative treatment in patients with faecal incontinence. Randomised, controlled, superiority trial with two parallel arms. Follow-up assessment at 36 months will be conducted. This paper describes and discusses the rationale, the methods and in particular the statistical analysis plan of this trial.
Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system. Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders CODs. This population is at high risk for recidivism and presents numerous challenges to those working in the justice system.
To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings.
Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams CIT , day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment -based courts e.
Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities MTCs. Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs. Full Text Available If nation is increasingly perceived as a less than honourable institution formed through war, invasion and geo-political territorialisation, and government is widely denounced as the site of political intrigue and the means of subjectification of citizen—voters, community appears to escape this critique and to be viewed as an idyllic formation based on bonds of affinity.
However, this romancing of community is disrupted by trans-cultural and sub-cultural formations that expose the fantasy of a harmonious, homogenous community. While community is often conceived as arising organically from familial, tribal or cultural similarity, or as constituted through a common history and shared cultural institutions, this totalising conception of community is interrupted by the demands of difference and heterogeneity and by a questioning of the idyll of community authenticated in myths of archaic origin.
Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age. Interrupted aortic arch IAA is a rare congenital anomaly affecting 1. Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.
From January to December , 19 patients with IAA have undergone complete single-stage repair. The patients' mean age was 4. Preoperative cardiac catheterization data were available from all patients. The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case. All patients underwent echocardiographic examinations before discharged from the hospital. In addition, cardiac catheterization and echocardiographic examinations were performed during follow-up.
Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients. Mean follow-up was 1. One patient died of pulmonary hypertension crisis, and another died of postoperative low cardiac output. Five cases had other main postoperative complications but no postoperative neurologic complications. Seventeen survivors were followed up, and there were no late deaths or reoperation.
Two patients required delayed sternal closure at two days postoperatively. The purpose of this work is to test the response of this dosimeter for radiation processes having undergone one or more interruptions. This experimental study based on the development of a factorial experimental design on two levels showed that the response of this dosimeter increases for the interrupted treatments. The value of the estimated amount of response increase is all the more significant as the temperature during the interruption is high.
Also it made possible to determine a mathematical model binding the value of the amount posted to the factors of influence: Temperature, target amount, a number of interruptions and duration of each interruption. Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles Fifteen patients were unable to complete Vacuum interrupters used for the interruption of high dc currents.
Conventional ac vacuum interrupters are being used to interrupt currents in pulsed energy storage systems. They have been tested with dc currents of up to 37 kA. The limit to the current which can be successfully interrupted has been measured as a function of various parameters. Among these are 1 the size of the interrupter , 2 the magnitude of the counterpulse current, 3 the nature and flux rating of the saturable reactor used, and 4 the kind of ''snubber'' circuit used. Fragmentary data have also been collected on electrode erosion rates and on mechanical failure of the bellows.
A description is given of the circuits used in these tests and of the results found for a representative selection of the commercially available domestic interrupters.
More recently efforts have been made to increase the values found for the maximum interruptible current.
The techniques used have included connecting interrupters in parallel and operating them in an impressed axial magnetic field. The results of this work are discussed.
Interruption and defaulting of multidrug therapy against leprosy: Low adherence to multidrug therapy against leprosy MDT is still an important obstacle of disease control, and may lead to remaining sources of infection, incomplete cure, irreversible complications, and multidrug resistance.
We performed a population-based study in 78 municipalities in Tocantins State, central Brazil, and applied structured questionnaires on leprosy-affected individuals. We used two outcomes for assessment of risk factors: Defaulting was significantly associated with: Interruption of treatment was associated with: Defaulting and interruption of MDT are associated with some poverty-related variables such as family income, household size, and migration. Intermittent problems of drug supply need to be resolved, mainly on the municipality level.
MDT producers should consider oral drug formulations that may. Security system signal supervision. This purpose of this NUREG is to present technical information that should be useful to NRC licensees for understanding and applying line supervision techniques to security communication links.
Material is also presented on security for atmospheric transmission and video line supervision. A glossary of security communication line supervision terms is appended.
Customer interruption cost and results. Results of a comprehensive study on short-term direct impacts and consumer interruption costs, incurred as a result of power supply interruption , were discussed.
The emphasis was on questionnaire development, general responses and the average customer damage function of some selected sectors.
The customer damage function was established for each category of customers agriculture, industry, mining, wholesale, retail merchandising, residential, etc as well as for different locations. Results showed that the average customer damage function depended mostly on customer category.
Size and location were not significant factors. Mentoring, coaching and supervision. This chapter considers the purpose of coaching, mentoring and supervision in early childhood eduaction and care. It examines a number of different approaches and considers the key skills required for effective coaching, mentoring and supervision. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission--a randomized trial.
Recent studies have suggested that procalcitonin PCT is a safe marker for the discrimination between bacterial and viral infection, and that PCT-guided treatment may lead to substantial reductions in antibiotic use. The present objective was to evaluate the effect of a single PCT measurement Physicians could overrule treatment guidelines.
The mean duration of antibiotic treatment during hospitalization in the PCT group was 5. In a subgroup analysis of chronic obstructive pulmonary In the case of any project involving Step 3, Optimal preventive bank supervision. Early regulator interventions into problem banks is one of the key suggestions of Basel Committee on Banking Supervision.
However, no guidance is given on their design. To fill this gap, we outline an incentive-based preventive supervision strategy that eliminates bad asset management in banks. Two supervision techniques are combined: Our design ensures good management without excessive supervision costs, through a gradual adjustment of A Supervision of Solidarity. This article illustrates an approach to therapeutic supervision informed by a philosophy of solidarity and social justice activism.
Called a " Supervision of Solidarity", this approach addresses the particular challenges in the supervision of therapists who work alongside clients who are subjected to social injustice and extreme marginalization. In this part next aspects are described: Protocol for the specialist supervised individualised multifactorial treatment of new clinically diagnosed type 2 diabetes in general practice IDA. We present the protocol for a multifactorial intervention study designed to test whether individualised treatment , based on pathophysiological phenotyping and individualised treatment goals, improves type 2 diabetes T2D outcomes.
We will conduct a prospective Current interruption by density depression. Using a one-dimensional electrostatic particle code, we examine processes associated with current interruption in a collisionless plasma when a density depression is present along the current channel. Current interruption due to double layers was suggested by Alfven and Carlqvist as a cause of solar flares.
At a local density depression, plasma instabilities caused by an electron current flow are accentuated, leading to current disruption. Our simulation study encompasses a wide range of the parameters in such a way that under appropriate conditions, both the Alfven and Carlqvist regime and the Smith and Priest regime take place.
In the latter regime the density depression decays into a stationary structure ''ion-acoustic layer'' which spawns a series of ion-acoustic ''solitons'' and ion phase space holes travelling upstream. A large inductance of the current circuit tends to enhance the plasma instabilities. Procedural Error and Task Interruption. A cognitive model we discuss below explains this effect in terms of increases in performance speed having the effect of compressing memory for Early counterpulse technique applied to vacuum interrupters.
Interruption of dc currents using counterpulse techniques is investigated with vacuum interrupters and a novel approach in which the counterpulse is applied before contact separation. Important increases have been achieved in this way in the maximum interruptible current and large reductions in contact erosion.
The factors establishing these new limits are presented and ways are discussed to make further improvements to the maximum interruptible current. Effects of Interruptibility -Aware Robot Behavior. As robots become increasingly prevalent in human environments, there will inevitably be times when a robot needs to interrupt a human to initiate an interaction.
Our work introduces the first interruptibility -aware mobile robot system, and evaluates the effects of interruptibility -awareness on human task performance, robot task performance, and on human interpretation of the robot's social aptitude.
Our results show that our robot is effective at predicting interruptibility at high accuracy, Good supervision and PBL. This field study was conducted at the Faculty of Social Sciences at Aalborg University with the intention to investigate how students reflect on their experiences with supervision in a PBL environment. The overall aim of this study was to inform about the continued work in strengthening supervision This particular study invited Master level students to discuss: Similar decreases in local tumor control are calculated for treatment protraction and for interruptions in the radiotherapy of carcinoma of the larynx in four centers.
Robertson, Chris; Robertson, A. Gerald; Hendry, Jolyon H. Hugh; Kerr, Gillian R. Data on patients with cancer of the larynx are analyzed using statistical models to estimate the effect of gaps in the treatment time on the local control of the tumor. Patients from four centers, Edinburgh, Glasgow, Manchester, and Toronto, with carcinoma of the larynx and treated by radiotherapy were followed up and the disease-free period recorded.
In all centers the end point was control of the primary tumor after irradiation alone. T stage, nodal involvement, and site of the tumor were important determinants of the disease-free interval, as was the radiation schedule used. Elongation of the treatment time by 1 day, or a gap of 1 day, was associated with a decrease in P c of 0.
An increase of 5 days was associated with a 3. Any gaps public holidays are the majority in the treatment schedule have the same deleterious effect on the disease free period as an increase in the prescribed treatment time. For a schedule, where dose and fraction number are specified, any gap in treatment is potentially damaging.
Important increases have been achieved in this way in the maximum interruptible current as well as large reductions in contact erosion.
The factors establishing these new limits are presented and ways are discussed to make further improvements. Several countries in Asia have demonstrated that reducing transmission in sex work can reverse established epidemics among sex workers, their clients and the general population. Experience and emerging research from Africa reaffirms unprotected sex work to be a key driver of sexual transmission in different contexts and regardless of stage or classification of HIV epidemic.
This validation of the epidemiology behind sexual transmission carries an urgent imperative to realign prevention resources and scale up effective targeted interventions in sex work settings, and, given declining HIV resources, to do so efficiently.
Eighteen articles in this issue highlight the importance and feasibility of such interventions under four themes: In addition, the disproportionate burden of HIV borne by sex workers calls for facilitated access to ART, care and support. Busco mujere De 30 a Wm seeking hispanic female. Must be willing to relocate, must have a income, in ok shape and love to try new things such as food, places, etc.
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