Completion Time Length Research Articles

Smartphone-controlled patch electro-acupuncture versus conventional pain relief during colonoscopy: a randomized controlled trial.

Smartphone-controlled patch electro-acupuncture (SCEA) is a novel device which gives the same analgesic effect as with conventional acupuncture. There are no published articles in the English literature on the use of this device as a primary mode of pain relief during colonoscopy. Primary aims of this study were to investigate the efficacy of SCEA as a substitute for pain relief during colonoscopy. Thirty-seven patients were randomized to receive SCEA (n=19) or placebo (n=18) during colonoscopy. Additional rescue sedation was administered to patients if they had pain or discomfort during the procedure. Visual analogue scale was used to quantify the intensity of pain from the beginning to end of the procedure. Other variables analysed were the amount of sedation used, duration from start to caecal intubation, length of time for completion of colonoscopy and recovery time to home discharge. Patients who received SCEA had a lower median pain score of 4.6 (interquartile range 5.7) compared to the placebo group of 6.0 (interquartile range 3.2). Statistical analysis comparing the groups revealed a non-significant P-value of 0.12, although more than 90% of the patients indicated willingness for SCEA as the primary analgesia if they were to repeat the procedure. Throughout the study, there were no adverse complications that occurred during the use of SCEA. Even though this study did not demonstrate, a significance in pain reduction, SCEA remains a safe modality which, more than 90% of patients favoured as a substitute for pain relief during colonoscopy.

Testing the reliability of the Health Literacy Questionnaire with carers of older adults receiving hospital care.

To determine the re-test reliability of the Health Literacy Questionnaire (HLQ) with carers of older adults discharged from hospital or attending the outpatient clinic. Carers completed the HLQ twice by telephone and rated the acceptability of completing the tool. Tool completion time was recorded. Correlations were calculated between the test occasions using intraclass correlation coefficients (ICC) and 95% confidence intervals. Fifty-one carers of older patients participated. The HLQ showed good reliability (ICC=0.75-0.90) for seven of the nine scales and moderate reliability (0.50-0.74) for the other two scales. Median completion time was 16.5minutes (range 9-50), and acceptability was rated as 9.5/10. The HLQ is a reliable tool for use with carers of older adults attending hospital. However, the length of time for completion of the HLQ may limit its feasibility for use by hospital staff and carers, given the high stress and time pressures of acute care.

Delivering Post Hematopoietic Stem Cell Transplant (HSCT) Vaccines in a Pediatrician's Office Versus Specialty Care Setting

Topic Significance & Study Purpose/Background/Rationale Children undergoing hematopoietic stem cell transplant (HSCT) lose their prior immunity post-allogeneic transplant and need reimmunization post-transplant. Traditionally, immunizations post-HSCT were administered at a pediatrician's office (PO), but studies in adult patients have shown compliance with re-vaccination to be low and no data exists on adherence in pediatrics. An internal audit of HSCT patients who received vaccinations at a PO revealed delays in starting vaccines when eligible, non-completion of the schedule in its entirety happened often, and there was an extended length of time for completion of the schedule. Methods, Intervention, & Analysis Through the establishment of an outpatient re-vaccination clinic (RC) within our transplant center, we aimed to: 1. Increase the percentage of patients starting re-vaccination within one month, after deemed eligible for vaccination by standard immune parameters 2. Decrease the duration of time from start to completion of immunizations as compared with retrospective data 3. Increase the proportion of patients who complete the entire re-vaccination schedule to greater than 90% A post-transplant re-immunization clinic was started at our center and prospective data was been collected for the first year of the clinic's operation (2018) and was compared to a retrospective cohort of patients who were transplanted between 2015-2017. Data collected in both periods included time from vaccine eligibility to start of re-vaccination, proportion completing the entire series, and time from start to completion of series. Findings & Interpretation 55% of post-HSCT patients who received immunizations at a PO from 2015-2017 started within one month of being immune-eligible for vaccines. This increased to 80% when patients were revaccinated through our RC (p = 0.0128).Historically, only 9% of patients re-vaccinated in a PO completed the entire series as compared with 69% completing the schedule in our RC (p Discussion & Implications Establishing a post-HSCT re-vaccination clinic in a transplant center should be considered when delivering immunizations. Time to initiation of vaccines, the proportion of patients completing vaccines, and length of time for completion of series substantially improved all three metrics when delivering vaccines in a specialty RC as compared to in a PO.

Influências da iniciação científica na pós-graduação

Este artigo avalia a influência da iniciação científica nos cursos de mestrado de uma instituição federal de ensino superior. Foram utilizados quatro indicadores para comparar os dados de concluintes de cursos de mestrado egressos e não egressos da iniciação científica. A população estudada foi constituída de 895 concluintes de mestrado, dos quais 242 eram egressos de programas de iniciação científica, e 653 eram não egressos. Os resultados revelam um efeito positivo na antecipação da realização da formação pós-graduada, na vinculação com a pesquisa e na produção científica dos egressos. A iniciação científica não teve influência sobre o tempo de conclusão do mestrado, comparado com o tempo de conclusão dos não egressos.

Regulatory Review of Novel Therapeutics — Comparison of Three Regulatory Agencies

BackgroundThe upcoming reauthorization of the Prescription Drug User Fee Act focuses on improving the review process for new drug applications at the Food and Drug Administration (FDA).MethodsUsing publicly available information from the FDA, the European Medicines Agency (EMA), and Health Canada, we compared the time for completion of the first review and the total review time for all applications involving novel therapeutic agents approved by the three regulatory agencies from 2001 through 2010 and determined the geographic area in which each novel therapeutic agent was first approved for use.ResultsThere were 510 applications for novel therapeutic agents approved from 2001 through 2010 — 225 by the FDA, 186 by the EMA, and 99 by Health Canada; among the applications, there were 289 unique agents. The median length of time for completion of the first review was 303 days (interquartile range, 185 to 372) for applications approved by the FDA, 366 days (interquartile range, 310 to 445) for those approved by the EMA, and 352 days (interquartile range, 255 to 420) for those approved by Health Canada (P<0.001 for the comparison across the three agencies). The median total review time was also shorter at the FDA than at the EMA or Health Canada (P=0.002). Among the 289 unique novel therapeutic agents, 190 were approved in both the United States and Europe (either by the EMA or through the mutual recognition process), of which 121 (63.7%) were first approved in the United States; similarly, 154 were approved in both the United States and Canada, of which 132 (85.7%) were first approved in the United States.ConclusionsFor novel therapeutic agents approved between 2001 and 2010, the FDA reviewed applications involving novel therapeutics more quickly, on average, than did the EMA or Health Canada, and the vast majority of these new therapeutic agents were first approved for use in the United States. (Funded by the Pew Charitable Trusts.)

Hand-Sewn Proximal Anastomoses in Off-Pump Coronary Artery Bypass without the Need for Partial Occlusion Clamping: Experience with the Heartstring II Proximal Seal System

: To evaluate the use of the Heartstring II Proximal Seal System (HPSS) in saphenous vein to aorta anastomoses in off-pump coronary artery bypass (OPCAB). : The HPSS consists of an aortic cutter and a proximal seal system. A prospective study was done using the HPSS to facilitate proximal hand-sewn anastomoses in OPCAB without partial occlusion clamping. Intraoperative observations, including technical success and post operative clinical data, were recorded. : Using the HPSS, 84 hand-sewn proximal saphenous vein-to-aorta anastomoses were done in 50 patients. In no case was conversion to partial occlusion clamping required. After deployment of the HPSS, operator evaluation showed acceptable hemostasis in 83 of the grafts. One graft required redeployment of a second HPSS. Each bypass graft was evaluated using the Medtronic Medistem Flow Probe. Acceptable flow probe values were present in all grafts, and no revisions were required. The mean length of time for completion of the proximal anastomosis was 5 minutes (range, 4 to 14 minutes). Postoperative clinical evaluation showed no adverse events attributed to the use of the HPSS. : The use of HPSS is a safe and effective method to avoid partial occlusion clamping in hand-sewn proximal anastomoses with OPCAB.

Preceptors' perceptions of a competency-based orientation.

The purpose of this study was to describe preceptors' perceptions of a competency-based orientation. Results of a 26-item questionnaire that was distributed to all preceptors indicated the majority of preceptors agreed that 1. the identified core competencies were role- and unit-specific, and 2. competency-based orientation is an effective method of orientation. However, the majority of preceptors indicated that the length of time for completion of core competencies was insufficient; this may reflect in the new employee's ability to function as a competent practitioner. Learner-focused orientation programs that provide sufficient time for validation of competencies must be developed.

The Double-Contrast Study of the Colon

Since the description of the technic for double-contrast examination of the colon by Fischer (1) in 1923, barium sulfate, with or without the addition of various other agents, has been the chief medium used in such studies. Other substances, such as “Umbrathor,” a colloidal suspension of thorium dioxide, have appeared from time to time but have not gained wide acceptance. It is our feeling that the unsatisfactory results of the double-contrast procedure which can be traced to the medium are in many instances attributable to a poor selection of the material to be used or to its inconstant composition due to (a) difficulties in mixing the ingredients and (b) the necessity of preparing it in amounts sufficient only for immediate use. Because of our own experience and that of other radiologists in various parts of the country, we have conducted the study to be reported here, chiefly with the idea of determining the possibilities of the ready-prepared media now on the open market. As a working basis we have set up the following criteria for comparison of the available media: 1. Radiopacity: The medium must have sufficient opacity to roentgen rays to give a low-grade contrast to soft tissues when it is spread in a thin layer over the mucosa of the colon. It must not be opaque enough, in a thin layer, to obscure mucosal detail and intraluminal lesions. 2. Adherence: The medium must adhere to the intestinal mucosa as a thin layer and not form lumps in the intestinal canal. 3. Suspension: The medium must stay in suspension for a sufficient length of time for completion of the study, without “drying out.” 4. Preparation: A minimum of time and effort should be required to make a uniform preparation for immediate and subsequent examinations. The possibility of using “left-over” solutions by addition of freshly made solutions would be desirable to avoid waste. Absence of staining qualities and of other objectionable characteristics is necessary. 5. Toxicity: The medium must, of course, be non-toxic and free of adverse reactions for the patient. 6. Cost: The cost should be within a reasonable range to make use of the medium feasible. 7. End-Results: The final approval of any medium used for double-contrast studies must rest upon consistently good diagnostic roentgenograms, all other factors being equal. We know of only two commercial ready-prepared special barium sulfate mixtures for colon study on the open market at the present time. This study is a comparison of these two products and two barium sulfate U.S.P. products which are distributed by different companies. Characteristics Preparation I: Barium Sulfate U.S.P. (3): This preparation is a white, finely granular, uniform powder with no tendency to cohesion of particles. It forms practically no clumps on the stirring apparatus and requires very little stirring to complete its suspension.