Likelihood Of Successful Completion Research Articles

Advanced magnetic resonance imaging of chronic whiplash patients: a clinical practice-based feasibility study

BackgroundWhiplash injury is common following road traffic crashes affecting millions worldwide, with up to 50% of the injured developing chronic symptoms and 15% having a reduced working capability due to ongoing disability. Many of these patients receive treatment in primary care settings based upon clinical and diagnostic imaging findings. Despite the identification of different types of injuries in the whiplash patients, clinically significant relationships between injuries and chronic symptoms remains to be fully established. This study investigated the feasibility of magnetic resonance imaging (MRI) techniques including quantitative diffusion weighted imaging and measurements of cerebrospinal fluid (CSF) flow as novel non-invasive biomarkers in a population of healthy volunteers and chronic whiplash patients recruited from a chiropractic clinic for the purpose of improving our understanding of whiplash injury.MethodsTwenty chronic whiplash patients and 18 healthy age- and gender matched control subjects were included [mean age ± SD (sex ratio; females/males), case group: 37.8 years ± 9.1 (1.22), control group: 35.1 years ± 9.2 (1.25)]. Data was collected from May 2019 to July 2020. Data from questionnaires pertaining to the car crash, acute and current symptoms were retrieved and findings from clinical examination and MRI including morphologic, diffusion weighted and phase-contrast images were recorded. The apparent diffusion coefficient and fractional anisotropy were calculated, and measurement and analysis of CSF flow was conducted. Statistical analyses included Fisher’s exact test, Mann Whitney U test and analysis of variance between groups.ResultsThe studied population was described in detail using readily available clinical tools. No statistically significant differences were found between the groups on MRI.ConclusionsThis study did not show that MRI‐based measures of morphology, spinal cord and nerve root diffusion or cerebrospinal fluid flow are sensitive biomarkers to distinguish between chronic whiplash patients and healthy controls. The detailed description of the chronic whiplash patients using readily available clinical tools may be of great relevance to the clinician. In the context of feasibility, clinical practice-based advanced imaging studies with a technical setup similar to the presented can be expected to have a high likelihood of successful completion.

Active surveillance for adverse events in patients on longer treatment regimens for multidrug-resistant tuberculosis in Viet Nam.

ObjectiveManagement of multidrug-resistant tuberculosis (MDR-TB) is a significant challenge to the global healthcare system due to the complexity and long duration of the MDR-TB treatment. This study analyzed the safety of patients on longer injectable-based MDR-TB treatment regimens using active pharmacovigilance data.MethodWe conducted an observational, prospective study based on active pharmacovigilance within the national TB program. A total of 659 MDR-TB patients were enrolled and followed up at 9 TB- hospitals in 9 provinces of all 3 regions in Vietnam between 2014 and 2016. Patients received a treatment regimen (standardized or individualized) based on their drug susceptibility test result and their treatment history. Baseline and follow-up information was collected at the start and during treatment. Adverse events (AE) were defined and classified as serious adverse events (SAEs) or otherwise. Multivariate Cox regression following the Iterative Bayesian Model Averaging algorithm was performed to identify factors associated with AE occurrence.ResultsOut of 659 patients assessed, 71.3% experienced at least one AE, and 17.5% suffered at least one SAE. The most common AEs were gastrointestinal disorders (38.5%), arthralgia (34.7%), and psychiatric disorders (30.0%). The proportion of patients with nephrotoxicity and hearing loss or vestibular disorders were 7.4% and 15.2%, respectively. 13.1% of patients required modifications or interruption of one or more drugs. In 77.7% of patients, treatment was completed successfully, while 9.3% lost to follow-up, in 3.0% treatment failed, and 7.4% died. Some significant risk factors for nephrotoxicity included diabetes mellitus (HR = 8.46 [1.91–37.42]), renal dysfunction (HR = 8.46 [1.91–37.42]), alcoholism (HR = 13.28 [5.04–34.99]), and a higher average daily dose of injectable drugs (HR = 1.28 [1.14–1.43]).ConclusionWhile a majority of patients on the longer injectable-based regimens experienced non-serious AEs during MDR-TB treatment, one in six patients experienced at least an SAE. Active TB drug-safety monitoring is useful to understand the safety of MDR-TB treatment and explore the risk factors for toxicity. All-oral, shorter MDR-TB regimens might be able to reduce the inconvenience, discomfort, and toxicity of such regimens and increase adherence and likelihood of successful completion.

Systémový a procesní přístup v metodě RIPRAN

Příspěvek popisuje motivaci, principy návrhu, strukturu a používání metody RIPRAN (Risk Project Analysis) pro analýzu rizik projektu. Metoda RIPRAN slouží k identifikaci, kvantifikaci rizik a ke zpracování návrhů, které vedou ke snížení rizik v projektu, aby byla zvýšena pravděpodobnost úspěšného ukončení projektu. Metoda využívá systémového a procesního přístupu k analýze rizik a respektuje mezinárodní normy ISO, které doporučují, jak provádět kvalitní analýzu rizik projektu. Metoda byla začleněna v národním standardu ČR mezi doporučené znalosti, které mají zvládnout a používat certifikovaní projektoví manažeři. V současnosti je k dispozici její třetí verze. Metoda je zařazena do výuky na mnoha vysokých školách v ČR, školí ji řada vzdělávacích firem a je používána firmami při analýze rizik firemních projektů nebo různými institucemi pro analýzu rizik projektů, které jsou financovány strukturálními fondy EU. Cílem článku je informovat o metodě RIPRAN. Zároveň příspěvek upozorňuje, že metoda popisuje postup pro analýzu rizik projektu a uvádí přínosy aplikace metody RIPRAN. Popis aplikace systémového přístupu při návrhu metody RIPRAN slouží jako příklad aplikace systémového přístup v rizikovém inženýrství.

Behind the textual: considerations of knowledge challenges in postgraduate students’ planning, researching and writing of theses

Research into academic literacy demands on postgraduate students, particularly at the doctoral level, has increased significantly in the last decade or so. Academic literacy is often configured in relation to students needing to understand the conventions of the discourse community and being able to respond to the challenges associated with the practices, skills, and particularly the text forms associated with it. While this is of value in guiding pedagogical support and interventions, it must be complemented with an understanding of the students themselves: what they bring to the community and learning context in terms of prior knowledge and expertise, what they personally find challenging in knowledge terms, and how they respond to the challenges. This requires us to ‘go behind the textual’. A productive framework for this analysis is the work of Eraut (2000, 2003, 2004, 2008), which encompasses a view of discourse community or group membership, considers challenges arising from transitions to different communities or situations, and focuses on how knowledge demands shift and change. This paper presents data from international students representing knowledge transitions and challenges in masters research study, as the students plan their research, write about (or ‘codify’) their planning, and write about it in the form of a thesis. As the data shows, challenges and successes in these transitions impact on a student’s developing identity as a researcher, and also on the likelihood of successful completion and aspirations to engage in further research.