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Search Results: 1 - 10 of 1049 matches for " Pilot Projects "
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Transpedicular Screw Insertion Guidance Device (TSIGD), A New Device for Spinal Transpedicular Screw Placement (A Pilot Study)
Mostafa Torkashvand,Mehran Moradi,Saeid Abrishamkar,Majid Rezvani
Archives of Neuroscience , 2013, DOI: 10.5812/archneurosci.11057
Abstract: Background: Trans-pedicular screw placements have been an increasingly popular procedure in many neurosurgery and orthopedic departments. Any mistake at performing the technique could be followed by irreversible neurological deficit and damage of Para spinal vital structures as well as less stability for future fusion.Objectives: In this study we tried to show the benefits and capabilities of a new device, Transpedicular Screw Insertion Guidance Device (TSIGD) for best possible correct transpedicular screw placement.Patients and Methods: This study is a quasi-experimental study performed in 2010 in Isfahan at Al-Zahra General hospital. The study was based on the application of a new device, which is named Transpedicular Screw Insertion Guidance Device (TSIGD) that leads the neurosurgeon to find the Proper Pedicular Angle (PPA).Results: 10 patients were enrolled in this study, all of them with the waiver of consent. A total of 54 screws were assigned to evaluate the capability of the TSIGD for correct screw placement by PPA (Proper Pedicular angle) and SA (Screw Angle). Only 2 screws (5.5%) were identified as medial pedicular breach on postoperative CT scans without any neurological deficit. The mean Proper Pedicular Angle (PPA) was 26.15 (± 0.4) that was calculated based on axial CT scan performed before the operation and mean screw angel (SA) that was calculated based on axial CT scan after the operation was 25.79 (± 0.8), (P ≥ 0.05).Conclusions: Not only this method is less expensive for the patients but it also saves time during surgery in contrast to CT based surgery. Also, this device is useful for neurosurgical assistants and young surgeons to reduce misplacement of pedicular screw.
Mixed methods evaluation of a randomized control pilot trial targeting sugar-sweetened beverage behaviors  [PDF]
Jamie Zoellner, Emily Cook, Yvonnes Chen, Wen You, Brenda Davy, Paul Estabrooks
Open Journal of Preventive Medicine (OJPM) , 2013, DOI: 10.4236/ojpm.2013.31007
Abstract: This Excessive sugar-sweetened beverage (SSB) consumption and low health literacy skills have emerged as two public health concerns in the United States (US); however, there is limited research on how to effectively address these issues among adults. As guided by health literacy concepts and the Theory of Planned Behavior (TPB), this randomized controlled pilot trial applied the RE-AIM framework and a mixed methods approach to examine a sugar-sweetened beverage (SSB) intervention (SipSmartER), as compared to a matched-contact control intervention targeting physical activity (Move-More). Both 5-week interventions included two interactive group sessions and three support telephone calls. Executing a patient-centered developmental process, the primary aim of this paper was to evaluate patient feedback on intervention content and structure. The secondary aim was to understand the potential reach (i.e., proportion enrolled, representativeness) and effectiveness (i.e. health behaviors, theorized mediating variables, quality of life) of SipS- martER. Twenty-five participants were randomized to SipSmartER (n = 14) or MoveMore (n = 11). Participants’ intervention feedback was positive, ranging from 4.2 - 5.0 on a 5-point scale. Qualitative assessments reavealed several opportuneties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipS-martER participants (?256.9 ± 622.6 kcals), there were no significant group differences when compared to control participants (?199.7 ± 404.6 kcals). Across both groups, there were significant improvements for SSB attitudes, SSB behavioral intentions, and two media literacy constructs. The value of using a patient-centered approach in the developmental phases of this intervention was apparent, and pilot findings suggest decreased SSB may be achieved through targeted
Acceptability of an acupuncture intervention for geriatric chronic pain: an open pilot study
Marie-France Couilliot,Eric Vicaut
Journal of Integrative Medicine (JIM) , 2013,
Abstract: OBJECTIVE: This study investigated the acceptability and effectiveness of acupuncture for persistent musculoskeletal pain in the elderly and assessed the conditions for a future controlled trial.METHODS: A total of 60 patients, hospitalized in a geriatric hospital were enrolled. The intervention consisted of eight acupuncture sessions. The main outcome was the patient’s participation rate. Regarding pain, the evaluation was based on pre- and post-treatment variations. As a high proportion of the patients had cognitive impairment, the behavioral pain scale DOLOPLUS-2 was chosen although self evaluation was used wherever possible.RESULTS: The mean age of the patients was 83 years. The acceptance rate was very high (89.6%) and 90% of the patients completed the entire course of treatment. After five weeks, the mean DOLOPLUS score had decreased significantly (P<0.01). The patients reported improved sleep quality and a reduction in their anxiety symptoms. Furthermore, caregivers noticed a decrease in patient aggressiveness making care easier.CONCLUSION: Our results suggest that acupuncture is highly acceptable and could be very useful in the management of chronic pain when performed in very old frail people with chronic physical and mental disability.TRIAL REGISTRATION IDENTIFIER: NCT01043692 ClinicalTrials.gov.
Pilot Projects in Water Management
Heleen Vreugdenhil,Jill Slinger,Wil Thissen,Philippe Ker Rault
Ecology and Society , 2010,
Abstract: Pilot projects appear in many forms in policy making and management. In an effort to understand the nature and use of pilot projects and improve their effectiveness, we undertake a practice-based and theoretical study of the pilot project phenomenon. First, we examine the roles assigned to pilot projects in the policy development literature and explore their use in a Dutch water innovation platform. Second, we determine characteristics of pilot projects to deepen insights into the nature of the pilot project phenomenon and the dimensions useful in the design of pilot projects. Third, we identify three pilot types and nine ways to use a pilot project and we develop a Pilot Project Nonagon that can be used to assess pilot projects' uses and to compare stakeholders' perspectives on these uses. Fourth, we identify hurdles to diffusion of the knowledge developed from pilot projects and suggest strategies to overcome these. Lastly, we formulate a research agenda aimed at addressing the identified knowledge gaps.
DESARROLLO DE UN PROGRAMA PILOTO DE FARMACOVIGILANCIA EN EL HOSPITAL SAN JUAN DE DIOS DE ZIPAQUIRá
Tribi?o E.,Gabriel;
Revista U.D.C.A Actualidad & Divulgación Científica , 2008,
Abstract: pharmacovigilance hospital programs play a key role in the consolidation of a national program and the continuous improvement of health care. the goal of this study was to develop a pharmacovigilance pilot program in a level two hospital and identify the salient clinical features of the adverse reactions detected. the program was presented before the hospital's epidemiologic surveillance committee and the professionals of the wards included (internal medicine, surgery, obstetrics and gynecology and emergency). information was collected by spontaneous reporting by the medical staff and intensive follow-up, carried out by the researcher during a six month period (march-september 2006). a format based on the invima reporting sheet was used. reports presented periodically to the committee were produced. sixty adverse drug reactions were detected, of which 48 occurred in hospitalized patients (incidence 19x1000); eight led to hospitalization and four were detected in the emergency ward. adverse reactions affecting gastrointestinal system were the most frequent ones reported in hospitalized patients (27%). hypoglycemia was the adverse reaction that more often led to hospitalization (62.5%). 82% of the adverse reactions were reported by the author and 18% by the medical staff. some of the clinical features of the adverse reactions detected are similar to those found in studies performed at level three hospitals. the rate of spontaneous notification was low. the features of the program match those of a second level hospital and allow its continuity.
Estudo da morfologia macular após a remo??o da membrana epirretiniana idiopática utilizando a tomografia de coerência óptica (OCT): um estudo piloto
Saraceno, Janaína Jamile Ferreira;Mateus, Ismênia Machado;Machado, Tamara Lopes;Gon?alves, Fernando Pistarini;Negretto, Alan Diego;Nakashima, Yoshitaka;Gomes, André Marcelo Vieira;Abujamra, Suel;
Arquivos Brasileiros de Oftalmologia , 2007, DOI: 10.1590/S0004-27492007000600009
Abstract: purpose: to describe the relation between visual results and macular morphology through optical coherence tomography (oct) in patients submitted to removal of the idiopathic epiretinal membranes. methods: ten eyes of ten patients with diagnosis of idiopathic epiretinal membranes underwent standard 20-g pars plana vitrectomy. posterior hyaloid attachments were identified and dealt with. idiopathic epiretinal membranes were removed in all cases. corrected visual acuity, retinography, fluorescein angiography, fundus biomicroscopy and the optical coherence tomography in the pre- and postoperative periods were performed in all patients. in oct, three characteristics were considered in each image: presence of foveal depression, presence of cystoid macular edema and mean central macular thickness. results: pre-operative visual acuity varied from 20/80 to counting fingers. the mean age was 63 years, ranging from 57 to 78 years. five patients were male and five female. preoperative visual acuity (va) varied from 20/80 to cd to 1 meter. an improvement in va of at least two lines was noted in all cases and metamorphopsia in eight eyes (80%). four patients did not present metamorphopsia according to amsler grid test, and the remaining presented partial improvement. on optical coherence tomography all eyes maintained increased central thickness, ranging from 232 to 605 μ (mean of 351.9 μ). three eyes maintained cystoid macular edema. four eyes presented final va better or equal to 20/30. in this group the mean central thickness was of 277 μ. foveal contour was recovered in two of these eyes. four patients had no residual cystoid macular edema. conclusions: optical coherence tomography is a tool that evaluates the structural changes before and after surgery to remove idiopathic epiretinal membranes. although the foveal area architecture stays irregular six months after surgery, the visual outcomes are very promising. other prognostics factors may be involved in the final visual r
Information and communication technologies and health in low income countries: the potential and the constraints
Chandrasekhar,C.P.; Ghosh,J.;
Bulletin of the World Health Organization , 2001, DOI: 10.1590/S0042-96862001000900010
Abstract: this paper outlines the potential offered by technological progress in the information and communication technologies (icts) industries for the health sector in developing countries, presents some examples of positive experiences in india, and considers the difficulties in achieving this potential. the development of icts can bring about improvements in health in developing countries in at least three ways: as an instrument for continuing education they enable health workers to be informed of and trained in advances in knowledge; they can improve the delivery of health and disaster management services to poor and remote locations; and they can increase the transparency and efficiency of governance, which should, in turn, improve the availability and delivery of publicly provided health services. these potential benefits of icts do not necessarily require all the final beneficiaries to be reached directly, thus the cost of a given quantum of effect is reduced. some current experiments in india, such as the use of personal digital assistants by rural health workers in rajasthan, the disaster management project in maharashtra and the computerized village offices in andhra pradesh and pondicherry, suggest creative ways of using icts to improve the health conditions of local people. however, the basic difficulties encountered in using icts for such purposes are: an inadequate physical infrastructure; insufficient access by the majority of the population to the hardware; and a lack of the requisite skills for using them. we highlight the substantial cost involved in providing wider access, and the problem of resource allocation in poor countries where basic infrastructure for health and education is still lacking. educating health professionals in the possible uses of icts, and providing them with access and "connectivity", would in turn spread the benefits to a much wider set of final beneficiaries and might help reduce the digital divide.
Coverage of pilot parenteral vaccination campaign against canine rabies in N'Djaména, Chad
Kayali,U.; Mindekem,R.; Yémadji,N.; Vounatsou,P.; Kaninga,Y.; Ndoutamia,A.G.; Zinsstag,J.;
Bulletin of the World Health Organization , 2003, DOI: 10.1590/S0042-96862003001000009
Abstract: canine rabies, and thus human exposure to rabies, can be controlled through mass vaccination of the animal reservoir if dog owners are willing to cooperate. inaccessible, ownerless dogs, however, reduce the vaccination coverage achieved in parenteral campaigns. this study aimed to estimate the vaccination coverage in dogs in three study zones of n'djaména, chad, after a pilot free parenteral mass vaccination campaign against rabies. we used a capture-mark-recapture approach for population estimates, with a bayesian, markov chain, monte carlo method to estimate the total number of owned dogs, and the ratio of ownerless to owned dogs to calculate vaccination coverage.when we took into account ownerless dogs, the vaccination coverage in the dog populations was 87% (95% confidence interval (ci), 84-89%) in study zone i, 71% (95% ci, 64-76%) in zone ii, and 64% (95% ci, 58-71%) in zone iii. the proportions of ownerless dogs to owned dogs were 1.1% (95% ci, 0-3.1%), 7.6% (95% ci, 0.7-16.5%), and 10.6%(95% ci, 1.6-19.1%) in the three study zones, respectively. vaccination coverage in the three populations of owned dogs was 88% (95% ci, 840-92%) in zone i, 76% (95% ci, 71-81%) in zone ii, and 70% (95% ci, 66-76%) in zone iii. participation of dog owners in the free campaign was high, and the number of inaccessible ownerless dogs was low. high levels of vaccination coverage could be achieved with parenteral mass vaccination. regular parenteral vaccination campaigns to cover all of n'djaména should be considered as an ethical way of preventing human rabies when post-exposure treatment is of limited availability and high in cost.
Surveillance of patients with acute flaccid paralysis in Finland: report of a pilot study
Hovi,T.; Stenvik,M.;
Bulletin of the World Health Organization , 2000, DOI: 10.1590/S0042-96862000000300004
Abstract: who recommends that surveillance of patients with acute flaccid paralysis (afp) be used to demonstrate the eradication of wild poliovirus. in this article we report the results of a study to assess the frequency of afp patients referred to finnish hospitals and whether virological diagnostic coverage could be improved by repeated reminders and active feedback. for this purpose, we sent monthly questionnaires to all neurological and paediatric neurological units in finland, requesting retrospective reporting on investigated paralytic patients with defined clinically relevant diagnoses, rather than afp. reminder letters included a pre-paid return envelope. virological investigations were offered cost free. of the 492 reporting forms sent, 415 (84%) were returned, evenly covering both the population and the study period (july 1997 to june 1998). of the 90 patients reported, 83 were evaluable. the apparent incidences of the diagnoses covered were 1.6 per 100 000 at any age, and 1.0 per 100 000 for under-15-year-olds. guillain-barré syndrome was the most common diagnosis (0.80 per 100 000). the two faecal specimens required were virologically investigated in nine out of the 10 patients under 15 years of age, but in only 46% of all patients. four adenovirus strains, but no polioviruses or other enteroviruses, were isolated. we conclude that a satisfactory monthly reporting system was readily established and that a sufficient number of patients with diagnoses resembling afp are being referred to finnish hospitals. active feedback did not increase the proportion of virologically investigated patients to an acceptable level in all age groups. it is clear that other approaches must be used to quantify the circulation of poliovirus in finland.
Health system reform and the role of field sites based upon demographic and health surveillance
Tollman,S.M; Zwi,A.B;
Bulletin of the World Health Organization , 2000, DOI: 10.1590/S0042-96862000000100019
Abstract: field sites for demographic and health surveillance have made well-recognized contributions to the evaluation of new or untested interventions, largely through efficacy trials involving new technologies or the delivery of selected services, e.g. vaccines, oral rehydration therapy and alternative contraceptive methods. their role in health system reform, whether national or international, has, however, proved considerably more limited. the present article explores the characteristics and defining features of such field sites in low-income and middle-income countries and argues that many currently active sites have a largely untapped potential for contributing substantially to national and subnational health development. since the populations covered by these sites often correspond with the boundaries of districts or subdistricts, the strategic use of information generated by demographic surveillance can inform the decentralization efforts of national and provincial health authorities. among the areas of particular importance are the following: making population-based information available and providing an information resource; evaluating programmes and interventions; and developing applications to policy and practice. the question is posed as to whether their potential contribution to health system reform justifies arguing for adaptations to these field sites and expanded investment in them.
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