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Piras-Straub K, Bachmann H, Bedreli S, Khairzada K, Müller J, Paul A, Gerken G, Herzer K. Der SNP3099 im mTOR Gen ist prädiktiv für die Verträglichkeit und Wirkung von Everolimus nach Lebertransplantation. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2016. [DOI: 10.1055/s-0036-1597468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pless-Petig G, Bröring R, Canbay A, Sauer IM, Paul A, Rauen U. Kaltlagerung und Kryokonservierung primärer humaner Hepatozyten in modifizierter TiProtec®-Lösung. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2016. [DOI: 10.1055/s-0036-1597479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bedreli S, Rashidi J, Willuweit K, Piras-Straub K, Khairzada K, Gerken G, Paul A, Herzer K. 3 Jahre Real-Life Essener Erfahrungen einer Everolimus-basierten Immunsuppression nach Lebertransplantation. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2016. [DOI: 10.1055/s-0036-1597382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lindemann M, Lenz V, Nyadu B, Heinemann FM, Heinold A, Guberina H, Eisenberger U, Lachmann N, Schönemann C, Kribben A, Paul A, Horn PA, Witzke O. Effect of ABO incompatibility on T-cell flow cytometry cross-match results prior to living donor kidney transplantation. CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 94:623-630. [PMID: 27860206 DOI: 10.1002/cyto.b.21496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Due to its high sensitivity, the flow cytometry cross-match (FCXM) has been described as valuable tool for identifying an optimal donor. We here focused on the impact of ABO incompatibility on FCXM results. METHODS We analyzed 29 ABO incompatible and 89 ABO compatible donor-recipient pairs (73 and 175 datasets, respectively) prior to living donor kidney transplantation. In all patients, lymphocytotoxic cross-matches for B and T cells were negative. RESULTS Recipients with blood group O (A to O and B to O) displayed significantly (P < 0.05) higher T-FCXM results than those with blood group A and B (A to B, B to A and AB to A), respectively. Donor-specific T-FCXM responses (ΔMFI values) were significantly higher (P < 0.05) in ABO incompatible vs. compatible pairs (ABO incompatible recipients with blood group O: 32 ± 6; with blood group A: 19 ± 7; with blood group B: 7 ± 4; recipients with ABO compatibility: 3 ± 2, respectively, data represent mean ± SEM). Consistent with the T-FCXM results donor-specific isohemagglutinins (IgG titers) were significantly higher in recipients with blood group O vs. A, both prior to rituximab treatment and plasmapheresis/immune adsorption (P = 0.004) and immediately prior to transplantation, i.e., after rituximab and antibody-depleting therapies (P = 0.04). CONCLUSIONS ABO incompatibility was associated with higher T-FCXM responses, especially in recipients with blood group O. This finding has major impact on the interpretation of flow cross-match results. Current cut-off values need to be reassessed in the ABO incompatible setting. © 2016 International Clinical Cytometry Society.
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Paul A, Mazighi M, Lenck S, Bresson D, Herman P, Hautefort C. Isolated intermittent bilateral hearing loss revealing a brain hemorrhage. J Neurol Sci 2016; 370:18-20. [DOI: 10.1016/j.jns.2016.08.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/01/2016] [Accepted: 08/27/2016] [Indexed: 11/15/2022]
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Paul A, Clark JN, Salama IE, Jenkins BJ, Goodwin N, Wilkes AR, Mahoney PF, Hall JE. Laboratory evaluation of a novel anaesthesia delivery device. Anaesthesia 2016; 72:63-72. [PMID: 27785790 DOI: 10.1111/anae.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2016] [Indexed: 11/30/2022]
Abstract
Here, we describe proof of concept of a novel method for delivering volatile anaesthetics, where the liquid anaesthetic (sevoflurane or isoflurane) is formulated into an emulsion that is contained in a compact, lightweight device through which carrier gas flows. Release of anaesthetic is achieved by stirring of the formulation, allowing controlled and responsive release of anaesthetic at a variety of fixed flow rates between 0.5 l.min-1 and 5 l.min-1 , with ventilated, non-ventilated and draw-over breathing systems. Anaesthetic release was evaluated using target anaesthetic concentrations ranging from 0.5% v/v to 8% v/v to mimic those typically required for induction and maintenance of anaesthesia, and lower concentrations suitable for sedation. Under all conditions, output could be maintained within 0.1% v/v of the intended setting, and the device could deliver a controlled level of anaesthetic for at least 60 min, with compensation for different ambient temperatures (10-30 °C) and carrier gas flow rates. This device offers a simple, inexpensive method of delivering safe concentrations of volatile anaesthetics for a wide range of applications.
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Hoyer DP, Klein C, Kathemann S, Paul A, Mathé Z. [Left-Lateral Living Related Liver Donation - The Essen Experience]. Zentralbl Chir 2016; 141:570-576. [PMID: 23696207 DOI: 10.1055/s-0032-1328346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The international organ shortage for liver transplantation exists particularly in paediatric transplantation. Therefore left-lateral living related liver donation (LLRLD) plays a major role in this field. The aim of the present study was to analyse all procedures of LLRLD in terms of donor safety from December 2008 to October 2012 at the University Hospital of Essen, Germany. Methods: All procedures of LLRLD from December 2008 to October 2012 at the University Hospital of Essen were included in the present study. All operations were carried out via an open narrowed median longitudinal laparotomy. General donor data were analysed. Complications were recorded and classified in accordance to their relevance. Results: 35 LLRLD were performed between December 2008 and October 2012 at the University Hospital of Essen, Germany. Mean age of the donors was 31.9 (23.4-61.7) years and 60 % were female. Past medical histories of the donors showed no relevant diagnoses. Mean length of the surgical procedure was 180 (± 89) minutes. Survival rate was 100 %. Minor complications were seen in 1 of 35 patients. Laboratory data showed a peak of the transaminases on the first postoperative day which resolved during the further course. Median postoperative hospital stay was 7 (5-11) days. Conclusion: LLRLD can be performed safely for the donors after adequate donor selection. The organ pool for paediatric recipients can be expanded by this procedure at suitable transplant centres.
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Donovan JL, Hamdy FC, Lane JA, Mason M, Metcalfe C, Walsh E, Blazeby JM, Peters TJ, Holding P, Bonnington S, Lennon T, Bradshaw L, Cooper D, Herbert P, Howson J, Jones A, Lyons N, Salter E, Thompson P, Tidball S, Blaikie J, Gray C, Bollina P, Catto J, Doble A, Doherty A, Gillatt D, Kockelbergh R, Kynaston H, Paul A, Powell P, Prescott S, Rosario DJ, Rowe E, Davis M, Turner EL, Martin RM, Neal DE. Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med 2016; 375:1425-1437. [PMID: 27626365 PMCID: PMC5134995 DOI: 10.1056/nejmoa1606221] [Citation(s) in RCA: 837] [Impact Index Per Article: 104.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Robust data on patient-reported outcome measures comparing treatments for clinically localized prostate cancer are lacking. We investigated the effects of active monitoring, radical prostatectomy, and radical radiotherapy with hormones on patient-reported outcomes. METHODS We compared patient-reported outcomes among 1643 men in the Prostate Testing for Cancer and Treatment (ProtecT) trial who completed questionnaires before diagnosis, at 6 and 12 months after randomization, and annually thereafter. Patients completed validated measures that assessed urinary, bowel, and sexual function and specific effects on quality of life, anxiety and depression, and general health. Cancer-related quality of life was assessed at 5 years. Complete 6-year data were analyzed according to the intention-to-treat principle. RESULTS The rate of questionnaire completion during follow-up was higher than 85% for most measures. Of the three treatments, prostatectomy had the greatest negative effect on sexual function and urinary continence, and although there was some recovery, these outcomes remained worse in the prostatectomy group than in the other groups throughout the trial. The negative effect of radiotherapy on sexual function was greatest at 6 months, but sexual function then recovered somewhat and was stable thereafter; radiotherapy had little effect on urinary continence. Sexual and urinary function declined gradually in the active-monitoring group. Bowel function was worse in the radiotherapy group at 6 months than in the other groups but then recovered somewhat, except for the increasing frequency of bloody stools; bowel function was unchanged in the other groups. Urinary voiding and nocturia were worse in the radiotherapy group at 6 months but then mostly recovered and were similar to the other groups after 12 months. Effects on quality of life mirrored the reported changes in function. No significant differences were observed among the groups in measures of anxiety, depression, or general health-related or cancer-related quality of life. CONCLUSIONS In this analysis of patient-reported outcomes after treatment for localized prostate cancer, patterns of severity, recovery, and decline in urinary, bowel, and sexual function and associated quality of life differed among the three groups. (Funded by the U.K. National Institute for Health Research Health Technology Assessment Program; ProtecT Current Controlled Trials number, ISRCTN20141297 ; ClinicalTrials.gov number, NCT02044172 .).
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Mishra S, Thakur N, Somal A, Parmar M, Yadav V, Bharati J, Bharti M, Paul A, Verma M, Chouhan V, Sharma GT, Singh G, González L, D'Occhio M, Sarkar M. Expression and localization of angiopoietin family in buffalo ovarian follicles during different stages of development and modulatory role of angiopoietins on steroidogenesis and survival of cultured buffalo granulosa cells. Theriogenology 2016; 86:1818-33. [DOI: 10.1016/j.theriogenology.2016.05.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 11/16/2022]
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Mishra S, Thakur N, Somal A, Parmar M, Reshma R, Rajesh G, Yadav V, Bharti M, Bharati J, Paul A, Chouhan V, Sharma G, Singh G, Sarkar M. Expression and localization of fibroblast growth factor (FGF) family in buffalo ovarian follicle during different stages of development and modulatory role of FGF2 on steroidogenesis and survival of cultured buffalo granulosa cells. Res Vet Sci 2016; 108:98-111. [DOI: 10.1016/j.rvsc.2016.08.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 07/09/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
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Kasper S, Meiler J, Knipp H, Höhler T, Reimer P, Steinmetz H, Berger W, Linden G, Ting S, Markus P, Paul A, Dechêne A, Schumacher B, Kostbade K, Worm K, Schmid K, Herold T, Schuler M, Trarbach T. Cetuximab biweekly (q2w) plus mFOLFOX6 as 1st line therapy in patients (pts) with KRAS wild-type (wt) (exon 2) metastatic colorectal cancer (mCRC) – Primary endpoint and subgroup analysis of the CEBIFOX trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kern S, Meyer K, Paul A, Maiwald M. Ugly Spectra and Lousy interfaces - Challenges for Compact NMR Spectroscopy in Process Control. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Meyer K, Ruiken JP, Illner M, Paul A, Müller D, Esche E, Repke JU, Maiwald M. Prozessanalytik für die moderne Verfahrenstechnik - Online-NMR- und -Raman-Spektroskopie im mizellaren Stoffsystem. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mishra SR, Parmar MS, Yadav VP, Reshma R, Bharati J, Bharti MK, Paul A, Chouhan VS, Taru Sharma G, Singh G, Sarkar M. Expression and localization of angiopoietin family in corpus luteum during different stages of oestrous cycle and modulatory role of angiopoietins on steroidogenesis, angiogenesis and survivability of cultured buffalo luteal cells. Reprod Domest Anim 2016; 51:855-869. [DOI: 10.1111/rda.12739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
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Davidson J, Paul A, Patel S, Davenport M, Ade-Ajayi N. Central Vein Preservation in Critical Venous Access. Eur J Pediatr Surg 2016; 26:357-62. [PMID: 26262564 DOI: 10.1055/s-0035-1556567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction The lack of suitable veins in children with critical central venous access requirements is a major obstacle to optimal care and is potentially life-threatening. We present outcomes following the use of vein-preserving (VP) surgical techniques, notably the sheath exchange for tunneled lines (SETL). Materials and Methods A retrospective, single observer analysis of a prospectively maintained departmental logbook as well as the medical records of patients. Two broad groups of central line replacements were identified; those inserted following removal of a previous line and a traditional "plastic-free" (PF) period and those exchanged without such an interval. Results Overall, 19 lines were directly exchanged during the study period and compared with 34 inserted after a PF period. Similar catheter life spans and infection rates were demonstrated in each group; 125 (range, 78-173) days in VP exchanges versus 122 (range, 70-175) days in PF replacements (p = 0.41). Line Sepsis resulting in removal or change of line occurred at 103 (range, 60-147) days in VP group versus 104 (range, 45-164) days in PF (p = 0.73). Conclusion For children with critical venous access requirements, direct line exchange procedures are a robust and reproducible means of vein preservation. The outcomes compare favorably with those following the more traditional removal, a PF period and reinsertion.
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Mishra S, Parmar M, Chouhan V, Rajesh G, Yadav V, Bharti M, Bharati J, Mondal T, Reshma R, Paul A, Dangi S, Das B, González L, Sharma G, Singh G, Sarkar M. Expression and localization of fibroblast growth factor (FGF) family in corpus luteum during different stages of estrous cycle and synergistic role of FGF2 and vascular endothelial growth factor (VEGF) on steroidogenesis, angiogenesis and survivability of cultured buffalo luteal cells. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.aggene.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Dalfino J, Paul A, Hnath J. P-013 Use of the Solitaire Device for Emergency Revascularization of the Superior Mesenteric Artery. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rashidi-Alavijeh J, Heinold A, Willuweit K, Baba HA, Horn PA, Paul A, Witzke O, Gerken G, Herzer K. Diagnostics and treatment of a severe humoral rejection after liver transplantation: donor-specific antibodies as a still underestimated cause of graft failure. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2016; 54:647-52. [PMID: 27429102 DOI: 10.1055/s-0042-108212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Donor-specific antibodies (DSAs) are increasingly being considered a cause of complications after liver transplant (LT). However, neither monitoring of DSAs nor the appropriate therapeutic procedures for humoral graft damage are yet standardized. Here we report a case of DSA-positive humoral rejection after LT that was successfully treated with plasmapheresis and immunoglobulins. METHODS Human leukocyte antigen (HLA)-specific DSAs were detected by Luminex bead assay. Patient characteristics, laboratory values, and data about the patient's general condition were documented from April 2013 to June 2015. CASE REPORT Eighteen months after LT, a 54-year-old man experienced severe hepatopathy with rapidly increasing transaminase activity and total bilirubin levels. Histologic findings were inconclusive, demonstrating chronic cholestasis and minimal positive staining for C4 d. However, an analysis for anti-HLA antibodies detected DSAs against HLA class II molecules with high mean fluorescence intensity. The patient underwent 8 courses of plasmapheresis, resulting in sustained amelioration of his condition and decreases in bilirubin levels and transaminase activity. CONCLUSION De novo DSAs can be responsible for graft failure after LT. Thus, procedures aimed at detecting DSAs are recommended, and regular monitoring of DSAs after LT is important for individualized risk management. Plasmapheresis is an efficient therapeutic procedure for DSA-associated graft failure.
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Paul A, Anwer S, Rau S, Alghadir A. Comparison of the Combined Effects of Hip and Knee Muscle Strengthening vs. Knee Muscle Strengthening Alone on Pain, Function and Gait Parameters in Knee Osteoarthritis. PHYSIKALISCHE MEDIZIN REHABILITATIONSMEDIZIN KURORTMEDIZIN 2016. [DOI: 10.1055/s-0042-106302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Paul A, Dalfino J, Yamamoto J, Boulos A. P-019 The Plavix Conundrum: Determining Who Will Respond to Plavix. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Paul A, Dalfino J, Yamamoto J, Boulos A. O-018 Single Institution Experience with Two Flow Diverters: A Head to Head Comparison. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meerschaert R, Nalichowski A, Burmeister J, Paul A, Miller A, Zhuang L. SU-C-202-02: A Comprehensive Evaluation of Adaptive Daily Planning for Cervical Cancer HDR Brachytherapy. Med Phys 2016. [DOI: 10.1118/1.4955570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Meerschaert R, Paul A, Chen W, Miller S, Zhuang L. WE-AB-207B-04: A Preliminary Investigation of Indicators for Treatment Outcomes of CT Guided Cervical Cancer Brachytherapy. Med Phys 2016. [DOI: 10.1118/1.4957785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mia MT, Sultana N, Paul A. Studies on the Causes, Impacts and Mitigation Strategies of Landslide in Chittagong city, Bangladesh. ACTA ACUST UNITED AC 2016. [DOI: 10.3329/jesnr.v8i2.26854] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Landslide is becoming a regular hazard in the urbanized hilly areas in Chittagong, Bangladesh. Generally, the hills consist of unconsolidated sedimentary rocks such as sandstone, siltstone, shale and conglomerate. Applying questionnaire survey with 120 respondents, and collection of secondary information, the study was carried out in two landslide prone sites located in Batali hill and Motijhrna area of Chittagong city for assessing the socio-economic condition of the people, causes of landslide, impacts of landslide on local people and mitigation strategies of landslide. People living in the study area were characterized by dominance of middle age group of population (52%), illiterate (49%), day laborer (27%), migrated from the other places (93%), low income (57%) and having poor housing infrastructure. The present study indicates that landslide affect the poor people living on the slope of hilly areas. The main reasons identified for landslide were hill cutting (36%), weak soil structure (23%) and devegetation (16%). The major impacts of landslide on the local communities, as reported by the respondents were loss of natural scenic beauty (77%), economic loss (77%), destruction of lives (57%) and environmental problems (47%). According to the respondents, the main mitigation strategies were stopping of hill cutting (75%), resettlement of the affected people in other places (57%), planting the affected area (55%) and development of robust policy (42%).J. Environ. Sci. & Natural Resources, 8(2): 1-5 2015
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Martin TPC, Moualed D, Paul A, Ronan N, Tysome JR, Donnelly NP, Cook R, Axon PR. The Cambridge Otology Quality of Life Questionnaire: an otology-specific patient-recorded outcome measure. A paper describing the instrument design and a report of preliminary reliability and validity. Clin Otolaryngol 2016; 40:130-9. [PMID: 25927083 DOI: 10.1111/coa.12338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The Cambridge Otology Quality of Life Questionnaire (COQOL) is a patient-recorded outcome measurement (PROM) designed to quantify the quality of life of patients attending otology clinics. DESIGN Item-reduction model. A systematically designed long-form version (74 items) was tested with patient focus groups before being presented to adult otology patients (n. 137). Preliminary item analysis tested reliability, reducing the COQOL to 24 questions. This was then presented in conjunction with the SF-36 (V1) questionnaire to a total of 203 patients. Subsequently, these were re-presented at T + 3 months, and patients recorded whether they felt their condition had improved, deteriorated or remained the same. Non-responders were contacted by post. A correlation between COQOL scores and patient perception of change was examined to analyse content validity. SETTING Teaching hospital and university psychology department. PARTICIPANTS Adult patients attending otology clinics with a wide range of otological conditions. MAIN OUTCOME MEASUREMENTS Item reliability measured by item–total correlation, internal consistency and test– retest reliability. Validity measured by correlation between COQOL scores and patient-reported symptom change. RESULTS Reliability: the COQOL showed excellent internal consistency at both initial presentation (a = 0.90) and 3 months later (a = 0.93). Validity: One-way analysis of variance showed a significant difference between groups reporting change and those reporting no change in quality of life (F(2, 80) = 5.866, P < 0.01). CONCLUSIONS The COQOL is the first otology-specific PROM. Initial studies demonstrate excellent reliability and encouraging preliminary criterion validity: further studies will allow a deeper validation of the instrument.
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