954 resultados para Following up


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Purpose – Interviewing victims of child sex abuse requires considerable care in order to minimise error. Due to children’s heightened suggestibility any question asked of a child could potentially incite error that could undermine the witness’s credibility. A focus group was conducted in order to facilitate the development of guidance for interviewers around the circumstances in which it is necessary to ask children follow-up questions in an interview. The paper aims to discuss these issues.

Design/methodology/approach – Seven Crown prosecutors representing every Australian state and territory (with the exception of one small state) were issued with 25 hypothetical narrative accounts of child abuse and asked to indicate what information, if any, required follow-up in the child’s narrative. Their responses and rationale for requiring following up in some cases and not others were discussed.

Findings – Thematic analysis revealed three recommendations to guide questioning: whether the case involved identification or recognition evidence; the presence of contextual features that may influence the witness’s memory, or that should trigger a particular line of questioning; and whether the information can or should be sought at a later stage by the trial prosecutor, rather than by the interviewer. Practical implications – The recommendations are discussed within the context of their implications for interviewing, that is, how each recommendation could be implemented in practice.

Originality/value – The present study extends prior literature by elucidating principles to guide decision making across interview topic areas. The need for such guidance is highlighted by research suggesting that topics such as offender identity, offence time and place, and witnesses are a source of overzealous questioning in interviews.

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Introducción: La evaluación de programas sociales, ha sido, desde sus inicios, de gran importancia para fortalecer los procesos de toma de decisiones de los hacedores de los programas, ya que retroalimenta lo ejecutado y ayuda a aplicar correctivos necesarios para lograr el impacto deseado en la población objetivo, que generalmente son comunidades vulnerables como las personas con discapacidad. En los últimos años, esta población ha sido foco de múltiples programas y proyectos en diferentes temáticas como la actividad física, la recreación, el deporte y la educación física. Por esto, en el año 2013, Coldeportes en aras de poder parametrizar y permitir un impacto adecuado en esta población, diseñó un grupo de lineamientos los cuales son los encargados de generar las directrices de los programas que se diseñen y ejecuten en los entes territoriales. Para poder realizar el seguimiento y resultado de su aplicación, es necesario hacerlo por intermedio de una herramienta de evaluación. De acuerdo con las últimas tendencias en la evaluación de programas sociales, debe hacerse por intermedio de indicadores, los cuales permiten realizarla de una manera más eficiente. Por tal motivo, la herramienta de evaluación para los lineamientos será a través de indicadores. Objetivo: Generar una herramienta de evaluación para los programas y actividades en actividad física, recreación y deporte para la población con discapacidad en Colombia, a partir de los lineamientos de inclusión definidos por Coldeportes. Metodología: Se realizó una revisión bibliográfica acerca de la evaluación de programas sociales, indicadores de evaluación y población con discapacidad, seguido a esto se diseñaron los indicadores de evaluación con base en las variables de los lineamientos propuestos por Coldeportes, posteriormente, los indicadores fueron sometidos a una validación en un grupo nominal, conformado por expertos en programas sociales y trabajo en población con discapacidad, por último, se sistematizaron y analizaron los resultados. iii Resultados: La herramienta de evaluación fue validada por parte de los expertos, hubo ajustes en los indicadores de evaluación de los lineamientos de accesibilidad a la comunicación e información, accesibilidad a la formación académica y accesibilidad al entorno físico. Conclusiones: La herramienta de evaluación diseñada, es un primer paso para mejorar los métodos actuales de evaluación, encaminada a fortalecer los datos existentes de la población con discapacidad y tener una visión del impacto de los planes, programas y proyectos en actividad física, recreación y deporte ejecutados en la actualidad, por lo cual queda continuar con la investigación en nuevas alternativas de evaluación que permitan mejorar los procesos de toma de decisiones y así garantizar planes, programas y proyectos sociales adecuados para la población, sin distinguir características particulares.

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Following up on earlier work on the $q\bar{q}$-bound-state problem using a covariant, chiral-symmetric formalism based upon the Covariant Spectator Theory, we study the heavy–light case for both pseudoscalar and vector mesons. Derived directly in Minkowski space, our approach approximates the full Bethe–Salpeter-equation, taking into account, effectively, the contributions of both ladder and crossed ladder diagrams in the kernel. Results for several mass spectra using a relativistic covariant generalization of a Cornell plus a constant potential to model the interquark interaction are given and discussed.

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Men aged 50 years or older are at high risk of melanoma, and both incidence and mortality are increasing in this group1. Skin self-examination (SSE) could be one avenue to improve outcomes from melanoma. Several recent intervention trials successfully increased SSE, but resistance to such interventions is less well studied. This posthoc secondary analysis of interventional study data aimed to identify characteristics of older men who did not take up SSE for the early signs of skin cancer, despite exposure to educational materials during a randomized intervention trial

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Objectives: To determine the incidence and clinical relevance of newly diagnosed cases of prostate cancer in a group of men who had an elevated PSA and benign prostate biopsy 7 years previously. Patients and Method: Patients under the age of 80 years with an elevated PSA who had had a benign prostate biopsy in the 12 months between March 1, 1994 and February 28, 1995 were studied. One hundred and sixty four patients with a mean age of 66.8 years (range 47-79 years) were identified. The mean PSA for this group was 10.3 ng/ml (range 4.1-81 ng/ml). One hundred and fifty nine of the 164 (97%) hospital records were available for review and all but 21 (12.8%) of the General Practitioners were contacted. Results: Eighteen (11%) of the original 164 patients were subsequently diagnosed with prostate cancer, 2 died from their disease. Conclusions: In a population where the follow-up of patients with a benign biopsy was arranged on clinical grounds alone, 11% of the study group were diagnosed with prostate cancer during a seven-year follow-up. Although some of these cancers appear to be slow growing, most of those diagnosed in the initial follow-up period were deemed to be clinically significant and a small proportion progressed rapidly to metastases. All patients who have an elevated PSA, but benign biopsy, should undergo a period of PSA monitoring until it is clear that their PSA is not rising. We propose an initial intensive monitoring period to avoid missing those with clinically aggressive disease. (C) 2003 Elsevier Science B.V. All rights reserved.

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Evidence suggests that static stretching inhibits muscular power. However, research does not reflect practice whereby individuals follow up stretching with secondary activity. This study investigated muscular power following stretching, and after a second bout of activity. Participants (n = 13) completed 3 randomized testing sessions which included a 5 min warm-up, followed by a vertical jump (VJ) on a force platform; an intervention (static stretching, dynamic, or control), followed by a second VJ. Participants then completed a series of movements, followed by a VJ, up to 60 min post activity. Immediately following the intervention, there was a 10.7% difference in VJ between static and dynamic stretching. The second warm up bout increased VJ height following the dynamic intervention, whereas the static stretching condition did not show any  differences. The novel finding from this study demonstrates a second exercise bout does not reverse the effects of static stretching and is still detrimental to VJ.

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OBJECTIVES: Cognitive deficits are apparent in the early stages of bipolar disorder; however, the timing and trajectory of cognitive functioning following a first episode of mania remains unclear. The aim of this study was to assess the trajectory of cognitive functioning in people following a first episode of mania over a 12-month period, relative to healthy controls. METHOD: The cohort included 61 participants who had recently stabilised from a first treated manic episode, and 21 demographically similar healthy controls. These groups were compared on changes observed over time using an extensive cognitive battery, over a 12-month follow-up period. RESULTS: A significant group by time interaction was observed in one measure of processing speed (Trail Making Test - part A,) and immediate verbal memory (Rey Auditory Verbal Learning Test - trial 1), with an improved performance in people following a first episode of mania relative to healthy controls. On the contrary, there was a significant group by time interaction observed on another processing speed task pertaining to focussed reaction time (Go/No-Go, missed go responses), with first episode of mania participants performing significantly slower in comparison with healthy controls. Furthermore, a significant group by time interaction was observed in inhibitory effortful control (Stroop effect), in which healthy controls showed an improvement over time relative to first episode of mania participants. There were no other significant interactions of group by time related to other measures of cognition over the 12-month period. CONCLUSION: Our findings revealed cognitive change in processing speed, immediate memory and one measure of executive functioning over a 12-month period in first episode of mania participants relative to healthy controls. There was no evidence of change over time for all other cognitive domains. Further studies focussed on the at-risk period, subgroup analysis, and the effects of medication on the cognitive trajectory following first episode of mania are needed.

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This study evaluated the enamel loss and composite remnants after debonding and clean-up. The tested null hypothesis is that there are no differences between different polishing systems regarding removing composite remnants without damaging the tooth surface. Brackets were bonded to 75 extracted human molars and removed after a storage period of 100 hours. The adhesive remnant index (ARI) was evaluated. The clean-up was carried out with five different procedures: 1. carbide bur; 2. carbide bur and Brownie and Greenie silicone polishers; 3. carbide bur and Astropol polishers; 4. carbide bur and Renew polishers; and 5. carbide bur, Brownie, Greenie and PoGo polishers. Silicone impressions were made at baseline (T0) and after debonding (T1) and polishing (T2) to produce plaster replicas. The replicas were analysed with a three-dimensional laser scanner and measured with analytical software. Statistical analysis was performed with the Kruskal-Wallis test and pairwise Wilcoxon tests with Bonferroni-Holm adjustment (α = 0.05). Enamel breakouts after debonding were detectable in 27 per cent of all cases, with a mean volume loss of 0.02 mm(3) (±0.03 mm(3)) and depth of 44.9 μm (±48.3 μm). The overall ARI scores was 3 with a few scores of 1 and 2. The composite remnants after debonding had a mean volume of 2.48 mm(3) (±0.92 mm(3)). Mean volume loss due to polishing was 0.05 mm(3) (±0.26 mm(3)) and the composite remnants had a mean volume of 0.22 mm(3) (±0.32 mm(3)). There were no statistically significant differences in volumetric changes after polishing (P = 0.054) between the different clean-up methods. However, sufficient clean-up without enamel loss was difficult to achieve.

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BACKGROUND: The concept of early implant placement is a treatment option in postextraction sites of single teeth in the anterior maxilla. Implant placement is performed after a soft tissue healing period of 4 to 8 weeks. Implant placement in a correct three-dimensional position is combined with a simultaneous guided bone regeneration procedure to rebuild esthetic facial hard and soft tissue contours. METHODS: In this retrospective, cross-sectional study, 45 patients with an implant-borne single crown in function for 2 to 4 years were recalled for examination. Clinical and radiologic parameters, routinely used in implant studies, were assessed. RESULTS: All 45 implants were clinically successful according to strict success criteria. The implants demonstrated ankylotic stability without signs of a peri-implant infection. The peri-implant soft tissues were clinically healthy as indicated by low mean plaque (0.42) and sulcus bleeding index (0.51) values. None of the implants revealed a mucosal recession on the facial aspect as confirmed by a clearly submucosal position of all implant shoulders. The mean distance from the mucosal margin to the implant shoulder was -1.93 mm on the facial aspect. The periapical radiographs showed stable peri-implant bone levels, with a mean distance between the implant shoulder and the first bone-implant contact of 2.18 mm. CONCLUSIONS: This retrospective study demonstrated successful treatment outcomes for all 45 implants examined. The mid-term follow-up of 2 to 4 years also showed that the risk for mucosal recession was low with this treatment concept. Prospective clinical studies are required to confirm these encouraging results.

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BACKGROUND Early implant placement with simultaneous contour augmentation is documented with short- and medium-term studies. The long-term stability of contour augmentation is uncertain. METHODS In this prospective, cross-sectional study, 41 patients with an implant-borne single crown were examined twice, in 2006 and 2010. Clinical, radiologic, and esthetic parameters were assessed at both examinations. In addition, a cone beam computed tomographic (CBCT) image was obtained during the second examination to assess the dimensions of the facial bone wall. RESULTS All 41 implants demonstrated ankylotic stability without signs of peri-implant infection at both examinations. The clinical parameters remained stable over time. Satisfactory esthetic outcomes were noted, as assessed by the pink and white esthetic score (PES/WES) indices. Overall, the PES scores were slightly higher than the WES scores. None of the implants developed mucosal recession over time, as confirmed by values of the distance between implant shoulder and mucosal margin and cast measurements. The periapical radiographs yielded stable peri-implant bone levels, with a mean distance between implant shoulder and first visible bone-implant contact value of 2.18 mm. The CBCT analysis demonstrated a mean thickness of the facial bone wall ≈2.2 mm. In two implants (4.9%) no facial bone wall was detectable radiographically. CONCLUSIONS This prospective cross-sectional study demonstrates stable peri-implant hard and soft tissues for all 41 implants examined and satisfactory esthetic outcomes overall. The follow-up of 5 to 9 years confirmed again that the risk for mucosal recession is low with early implant placement. In addition, contour augmentation with guided bone regeneration was able to establish and maintain a facial bone wall in 95% of patients.

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AIMS To assess serially the edge vascular response (EVR) of a bioresorbable vascular scaffold (BVS) compared to a metallic everolimus-eluting stent (EES). METHODS AND RESULTS Non-serial evaluations of the Absorb BVS at one year have previously demonstrated proximal edge constrictive remodelling and distal edge changes in plaque composition with increase of the percent fibro-fatty (FF) tissue component. The 5 mm proximal and distal segments adjacent to the implanted devices were investigated serially with intravascular ultrasound (IVUS), post procedure, at six months and at two years, from the ABSORB Cohort B1 (n=45) and the SPIRIT II (n=113) trials. Twenty-two proximal and twenty-four distal edge segments were available for analysis in the ABSORB Cohort B1 trial. In the SPIRIT II trial, thirty-three proximal and forty-six distal edge segments were analysed. At the 5-mm proximal edge, the vessels treated with an Absorb BVS from post procedure to two years demonstrated a lumen loss (LL) of 6.68% (-17.33; 2.08) (p=0.027) with a trend toward plaque area increase of 7.55% (-4.68; 27.11) (p=0.06). At the 5-mm distal edge no major changes were evident at either time point. At the 5-mm proximal edge the vessels treated with a XIENCE V EES from post procedure to two years did not show any signs of LL, only plaque area decrease of 6.90% (-17.86; 4.23) (p=0.035). At the distal edge no major changes were evident with regard to either lumen area or vessel remodelling at the same time point. CONCLUSIONS The IVUS-based serial evaluation of the EVR up to two years following implantation of a bioresorbable everolimus-eluting scaffold shows a statistically significant proximal edge LL; however, this finding did not seem to have any clinical implications in the serial assessment. The upcoming imaging follow-up of the Absorb BVS at three years is anticipated to provide further information regarding the vessel wall behaviour at the edges.