Describe studies patient dropouts. Medical search. Frequent questions

Methods A systematic search of records up to March 2020 was performed on PubMed, CINAHL, Medline (Ovid), Cochrane and Embase to retrieve clinical trials that evaluated the efficacy of OPEP devices in patients with COPD. (bmj.com)
Methods The INTENSE study is a multicentre, open-label, randomised, pragmatic, phase-IV clinical trial to demonstrate the non-inferiority of a 7-day vs 14-day course for the treatment of uncomplicated enterococcal bacteraemia and incorporating the early switching to oral antibiotics when feasible. (bmj.com)
Methods This was a single-blind, single-arm study over 3-4 weeks from September 2005 to November 2006. (bmj.com)
Methods: We enrolled and randomized 61 patients (mean age = 63(49–71) years, Female/Male = 35/26) who were planned for an uncemented Vanguard TKA (Biomet, Warsaw, Indiana, USA) to receive either a VR or a VP coated tibial component (31/29). (lu.se)
Kaspar's research interests are methods to optimize study designs, advanced survival analysis, probability of success, estimands and causal inference, estimation of treatment effects in subgroups, and general nonparametric statistics. (psiweb.org)
Methods: The study was approved by the local ethics committee, including data from 60 patients scheduled for ambulatory surgery undergoing general anaesthesia with propofol and remifentanil, using TCI. (researchgate.net)

The Role of Patient-reported Outcomes and Medication Adheren. (lww.com)
Drug development of immunosuppressive therapies (ISTs) for use in transplantation has historically focused on morbidity and mortality as the primary clinical outcomes of interest, with patient experiences often being an afterthought. (lww.com)
Childhood-onset schizophrenia is a severe form of psychotic disorder that occurs at age 12 years or younger and is often chronic and persistently debilitating, with worse outcomes than patients who have later onset of symptoms. (medscape.com)
For the current pilot study, the researchers developed an integrated platform to collect patient-centered data from wearables and mobile devices using digital patient-reported outcomes (ePROs), with the aim of testing the resulting tool kit's feasibility and usability in people with multiple sclerosis. (medscape.com)
Pedullà told Medscape Medical News that they wanted to have "passive monitoring" of patients over the course of their daily lives and therefore searched for the best devices and the most relevant patient reported outcomes as well as used "innovative algorithms" to analyze the data to try to predict the disease course. (medscape.com)
The research group (Lutz) participated in the SMART Tournament (Stratified Medicine Approaches foR Treatment Selection (SMART) - Mental Health Prediction Tournament), a scientific competition to determine the best method for predicting treatment outcomes and the optimal allocation of patients to different treatment conditions (funded by UK Wellcome Trust). (uni-trier.de)
In many longitudinal studies, the outcomes recorded on each subject include both a sequence of repeated measurements at pre-specified times and the time at which an event of particular interest occurs: for example, death, recurrence of symptoms or drop out from the study. (lancs.ac.uk)
The present study will evaluate implementation and effectiveness outcomes of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) implemented in community mental health centers (CMHCs). (biomedcentral.com)
We will investigate whether adapting TranS-C to fit CMHC contexts improves providers' perceptions of fit and patient outcomes. (biomedcentral.com)
Aim 3 will evaluate whether the relation between TranS-C treatment condition (Adapted versus Standard) and patient outcomes is mediated by better provider perceptions of fit in the Adapted condition. (biomedcentral.com)
Exploratory analyses will (1) compare Adapted versus Standard TranS-C on patient perceptions of credibility/improvement and select PhenX Toolkit outcomes and (2) evaluate possible moderators. (biomedcentral.com)
identified program characteristics (eg, leadership support, well-defined staff roles, use of support and maintenance sessions) associated with successful program implementation (9,11,12) and better patient weight-loss outcomes (13). (cdc.gov)
A recent breast cancer cohort study in Africa - the African Breast Cancer - Disparities in Outcomes (ABC-DO) Study - found that across five sub-Saharan African countries the number of children left motherless due to breast cancer deaths exceeded the number of breast cancer deaths. (who.int)
Other studies of adults reported on the following additional outcomes. (bvsalud.org)

Unfortunately, key aspects of the addiction treatment Lute described were outdated and have been shown to backfire in studies. (time.com)
Not one study has ever found that disrespecting or humiliating people with addiction is effective treatment. (time.com)
Barriers surrounding the healthcare system seem to hinder patients to seek help through conventional healthcare, even after entering opioid substitution treatment (OST), resulting in a high level of unmet healthcare needs. (hindawi.com)
Patients in opioid substitution treatment (OST) are suspected to suffer from poor health due to prior, or ongoing, substance use [ 1 ]. (hindawi.com)
Four patients receiving exercise and three receiving flexibility treatment dropped out before completion. (bmj.com)
16 of 29 patients rated themselves as better after completing exercise treatment compared with eight of 30 patients who completed flexibility treatment. (bmj.com)
12 of 22 patients who crossed over to exercise after flexibility treatment rated themselves as better after completing exercise treatment. (bmj.com)
32 of 47 patients rated themselves as better three months after completing supervised exercise treatment. (bmj.com)
35 of 47 patients rated themselves as better one year after completing supervised exercise treatment. (bmj.com)
In this paper, we describe a portable, passive simulated jogging device that is low-cost and targeted to home use for future long-term evaluation as primary treatment or ancillary to drug therapies for fibromyalgia. (omicsonline.org)
In 2004, we published a small study dealing with symptomatic treatment of fibromyalgia using a non-invasive, passive exercise technology called whole body periodic acceleration (WBPA) which increases release of nitric oxide into the circulation through increased shear stress (friction) to endothelial cells [ 4 ]. (omicsonline.org)
Regarding the clinical management of enterococcal bacteraemia, the evidence on the duration of antibiotic treatment is scarce and the studies do not discriminate between complicated and uncomplicated bacteraemia. (bmj.com)
On September 27-28, 2018, the US Food and Drug Administration (FDA) and the Critical Path Institute's Transplant Therapeutics Consortium convened a public workshop to address drug development in the field of transplantation, titled "Evidence-based Treatment Decisions in Transplantation: The Right Dose & Regimen for the Right Patient/Individualized Treatment. (lww.com)
When conducting meta-analyses, some variation in treatment effect between trials is expected due to differences in study quality (e.g. potential bias in design, acquisition and adjudication of specific data elements) which may become evident when performing bias assessment with validated instruments such as the Cochrane Bias Assessment tool. (jafib.com)
The authors note that the primary aim of the pan-European ALAMEDA project is to leverage "big data" through artificial intelligence and machine learning to provide "clinically actionable information" on patients with brain disorders that "complements medical recommendations" and thus improves treatment. (medscape.com)
However, this personalization is unsystematic and raises the question of whether this personalization could be supported by an evidence-based approach and result in improved treatment, especially for high-risk patients. (uni-trier.de)
Many studies have shown that online therapy can be effective as a treatment option for various disorders. (uni-trier.de)
The problems of long-term levodopa treatment are well established, and a number of studies describe the use of bromocriptine as a first-line agent in patients under 65 years. (curehunter.com)
Therefore, we decided to design a proof-of-concept study to assess the synthetic cannabinoid nabilone for the treatment of NMS. (springer.com)
A total of 38 patients will have 80% power to detect a probability of 0.231 that an observation in the treatment group is less than an observation in the placebo group using a Wilcoxon rank-sum test with a 0.050 two-sided significance level assuming a true difference of 2.5 points between nabilone and placebo in the primary outcome measure and a standard deviation of the change of 2.4 points. (springer.com)
study reveal that hydrocortisone augmentation during prolonged exposure therapy may result in a greater retention in the treatment group, thereby improving PTSD symptom response ( 7 ). (frontiersin.org)
MDD, 296.22 [ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR )] was diagnosed, and the patient received escitalopram 20 mg/d, with no improvement after 5 weeks' treatment. (frontiersin.org)
Individual patient data was hidden or distorted, statistical tests were massaged, and a company ghostwriter spun a narrative that turned an ineffective, risky drug into a safe and effective treatment. (davidhealy.org)
Vitamins are essential micronutrients with antioxidant potential that may provide a complementary treatment for patients with chronic diseases. (biomedcentral.com)
Palliative patients, in particular, sometimes had unrealistic beliefs about the effectiveness of the trial treatment. (biomedcentral.com)
Unfortunately, many patients with SMI do not receive evidence-based psychological treatment (EBPTs) in routine practice settings. (biomedcentral.com)
CMHC sites are cluster-randomized by county to Adapted TranS-C or Standard TranS-C. Within each county, patients are randomized to immediate TranS-C or usual care followed by delayed treatment with TranS-C (UC-DT). (biomedcentral.com)
EMDR therapy has been listed as an effective treatment by the American Psychiatric Association, Departments of Defense and Veterans Affairs, International Society for Traumatic Stress Studies, the World Health Organization, the Substance Abuse and Mental Health Services and numerous other international agencies. (emdrhap.org)
More than a dozen studies support the use of EMDR therapy for trauma resulting from natural disaster and treatment of war- and terrorism-related trauma. (emdrhap.org)
Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder. (emdrhap.org)
The minimum duration of therapy considered was one week, and studies had to report either a global assessment of cure or improvement in symptoms, or cure of or improvement in abdominal pain, after treatment. (bmj.com)
Results 12 studies compared fibre with placebo or no treatment in 591 patients (relative risk of persistent symptoms 0.87, 95% confidence interval 0.76 to 1.00). (bmj.com)
The primary objective of this study is to compare changes in the levels of blood markers of inflammation and oxidative stress after treatment with EGb 761 in a cohort of 100 patients with MCI. (bvsalud.org)
In addition, we aim to assess changes in these blood markers during an additional 12-month extension phase in which patients in the control group will also receive EGb 761 and patients in the active group will extend their treatment duration. (bvsalud.org)
After the first 12 months of the study, patients in the EGb 761-treated group will continue treatment, and patients in the control group will be offered one EGb 761 240 mg tablet per day orally. (bvsalud.org)
The study is still ongoing, and results for the first year of treatment (v0, v1, v2) are expected by 2023. (bvsalud.org)
Clinical Pharmacology in Athletic Training empowers athletic trainers with a functional understanding of pharmacology that enables them to formulate a treatment plan intended to mitigate disease and improve the overall health of their patients. (humankinetics.com)
The study was undertaken to evaluate patient characteristics, (Age and sex distribution) long term sequelae of CNS prophylaxis (growth retardation) and the treatment outcome in these 66 paediatric patients who were treated and followed up at Cancer Institute, Maharagama, Sri Lanka during the period between 1st May 1982 and 27th September 1993. (who.int)
To date, no study has evaluated the benefits of physical activity on the side effects of treatment in patients with HER2 positive breast cancer. (biomedcentral.com)
If these benefits are confirmed, this exercise intervention could be systematically proposed to patients during the course of treatment by trastuzumab in addition to standard oncological care. (biomedcentral.com)
The analysis of the obstacles related to treatment entry, attendance, and drop-out among alcoholic patients shows that systemic, social, cultural, and individual factors are all involved, including the structural ones. (rivistadipsichiatria.it)
We conclude that several factors at different levels exist that prevent the patient from overcoming these treatment obstacles. (rivistadipsichiatria.it)
There are few studies addressing the patient's access to treatment and as a result the evidence on treatment obstacles is rather inconclusive, although the reasons and barriers contributing to this are known to differ between women and men, particularly, between the patients. (rivistadipsichiatria.it)
It is clear that any treatment program can only be effective if the patient attends the sessions for a given period of time necessary to promote positive changes (1). (rivistadipsichiatria.it)
Studies have reported that the majority of patients reach significant improvement at the third month of treatment (6), whereas others report that outpatient treatment should be last between 3-6 months, including continuous evaluation of the individual needs of each patient (7). (rivistadipsichiatria.it)
Research studies point that the rates of treatment retention are, in general, higher among patients with acute diseases compared to those with chronic illnesses (8), and the latter's adherence tends to decrease after six months of treatment (9). (rivistadipsichiatria.it)
Baseline data (patient characteristics, clinical status, generalized self-efficacy, expectations of future work ability) and treatment variables were used as independent variables in logistic regressions. (biomedcentral.com)
Assessing work ability and expectations of RTW at the beginning of treatment is recommended to identify patients at risk of long-term sick leave. (biomedcentral.com)
There is a lack of interventional studies that combine baseline data with treatment variables in analyses of predictors for RTW. (biomedcentral.com)
As one of the TB Epidemiologic Studies Consortium (TBESC) research studies, this project aims to understand the scope of treatment of latent tuberculosis infection (LTBI) in the United States and Canada and to elucidate factors associated with acceptance and completion of treatment. (cdc.gov)
Phase 3 of the study is a prospective cohort study of approximately 2,400 adult patients 18 years and older who have been offered treatment for LTBI in the United States and Canada. (cdc.gov)
The primary objectives of the study are to identify potentially modifiable factors associated with acceptance or nonacceptance of LTBI treatment, and to identify potentially modifiable factors related to completion or noncompletion of treatment. (cdc.gov)
and 5) a clinic survey to describe the local context and LTBI treatment protocols. (cdc.gov)
This study was performed on 56 patients with leprosy: 28 under treatment and 28 treated for the disease. (bvsalud.org)
The treatment group had more women (Pearson ÷2=12.47, p=0.0004) and younger patients (Pearson ÷2=9.688, p=0.0079) than the healed group. (bvsalud.org)
The sample consisted of 56 patients of both genders with a history of leprosy: 28 under treatment and 28 were already treated for the disease. (bvsalud.org)
At the conclusion of the session, the participant will be able to describe Diagnostic and Statistical Manual of Mental Disorders 5th edition , DSM-5 assessment criteria for opioid use disorder, discuss the evidence for opioid use disorder medication assisted treatment with types of medications and settings used in medication assisted therapy. (cdc.gov)

Because more than 80% of PDAC is locally advanced unresectable or metastatic at the time of diagnosis [ 2 ], the prognosis of PDAC patients is dismal with a 5-year relative survival rate of 11.4% [ 3 ]. (jcancer.org)
These obstacles contribute negatively to both clinical evolution and prognosis of the patients, affecting their quality of life and raising the social costs. (rivistadipsichiatria.it)

Later we discovered that the patient took part in two interventional studies. (prothor.info)

The first step, in order to provide suitable and accessible primary healthcare, is to assess the extent of physical symptoms and unmet healthcare needs within the OST population, which, to this point, has been sparsely studied. (hindawi.com)
To assess OST patients' self-rated physical health and healthcare seeking behaviour. (hindawi.com)
The aim of this study is to assess OST patients' self-rated physical health and healthcare seeking behaviour. (hindawi.com)
The second phase, funded under the R33, will provide support to assess the abilities of the quantitative measures developed in the R61 phase to measure tissue changes in response to therapies or manipulations that may relieve pain using rigorous, longitudinal clinical study design. (nih.gov)
Case series of patients have been intensively described and investigated by evaluations of cerebrospinal fluid (CSF), brain imaging, and video electroencephalography (EEG), and 4 case-control studies have been conducted to assess risk factors for the disease and test for infectious pathogens, toxin exposures, and nutritional deficiencies ( 2 , 6 - 10 ). (cdc.gov)
Our aim was to assess the effect of vitamin supplementation on the antioxidant status and glycemic index of type 2 diabetes mellitus patients. (biomedcentral.com)
Although physical exercise is recommended to reduce the side effects of adjuvant treatments in breast cancer patients, no randomized study has been conducted to assess the benefits of a physical training program in patients with HER2 overexpressing breast cancer. (biomedcentral.com)

To reduce dropouts and increase adherence to the tool kit, they described the project to patients with multiple sclerosis and asked for their feedback to determine whether what they had designed was feasible from the patient perspective, Pedullà said. (medscape.com)
Pedullà said that the researchers now want to evaluate the feasibility of the tool kit further by analyzing the adherence and usability data and target it to the patients who are most likely to use it. (medscape.com)

The objective of this study was to evaluate, at 4 and 5 years posttreatment, the long-term safety and efficacy of unilateral MRI-guided focused ultrasound (MRgFUS) thalamotomy for medication-refractory essential tremor in a cohort of patients from a prospective, controlled, multicenter clinical trial. (thejns.org)
As a result, this study has been proposed to evaluate the antioxidant and anti-inflammatory effects on plasma markers and their potential clinical correlation with the progression of cognitive decline in patients with MCI.Trial registration: Registro Español de estudios clínicos (REec) number 2020-003776-41, ClinicalTrials.gov Identifier: NCT05594355. (bvsalud.org)
The aim of this study is to evaluate the impact of 3 months' exercise intervention on myocardial function and in particular on the rate of cardiotoxicity. (biomedcentral.com)
The aim of this study was to evaluate the association between ideal cardiovascular health (Life's simple 7) and the odds of having short telomeres in a subsample of participants older than 55 years from the Seguimiento Universidad de Navarra (SUN) study. (unav.edu)
Emergency medical study has signification (FISH), is littermal predical evaluate response and latency of ACHBLF. (simplecommunion.com)
Thus, the present study aimed to evaluate the oral health status of patients with leprosy in relation to the presence of associated lesions, prevalence of caries and plaque accumulation. (bvsalud.org)

Conclusion The use of OPEP devices can have a positive impact in COPD, but confidence in effect sizes is low and there is a need for further, higher quality studies to examine their long-term efficacy in COPD as well as to identify specific patient phenotypes that are more likely to respond. (bmj.com)
This multicentre double-blind study compared the efficacy of low and very low dose bromocriptine in 64 elderly subjects with newly diagnosed Parkinson's disease . (curehunter.com)
This study should be the basis for further evaluations of long-term efficacy and safety of the use of cannabinoids in PD patients. (springer.com)
Thus, shared decision making and patient preferences are central to care models that can improve efficacy, patient and clinician satisfaction, and help reduce health disparities. (ahrq.gov)
Various antispasmodics were studied, but otilonium (four trials, 435 patients, relative risk of persistent symptoms 0.55, 0.31 to 0.97) and hyoscine (three trials, 426 patients, 0.63, 0.51 to 0.78) showed consistent evidence of efficacy. (bmj.com)

Analysis by intention to treat gave similar results (17/33 v 9/33 patients better). (bmj.com)
Results Following full-text review of 77 articles, eight (six randomised control trials and 2 cross-over studies) were eligible for inclusion. (bmj.com)
will allow obtaining results with 194 patients recruited. (bmj.com)
Results GORD was present in 203/308 (66%) patients. (bmj.com)
Accordingly, the results of the study should provide new insights in the field of patient-centered care research and promote further development of the profession as well as the discipline. (uni-trier.de)
This is quite a simple study but it does reveal a range of interesting results which add to the field. (meassociation.org.uk)
Overall, this study provides some useful results allowing separation of groups and also implications for managing PCS conditions. (meassociation.org.uk)
You will be introduced to the background and disease context of the case study, the concept of an estimand, and important clinical events (increased dropout rate and crossover therapy) that occurred in the trial and affected interpretation of the results. (psiweb.org)
They wouldn't have to worry if the study design was seen as biased, or the results too good to be true. (davidhealy.org)
This could affect their personal welfare, and the reliability of the study results as well. (davidhealy.org)
Inability to generalise the results of this study to the overall estate population of Sri Lanka is a limitation of this study. (who.int)
We undertook this study inclusion-free microenvironment (ED) determination results were revised as a results. (simplecommunion.com)

Thirty-seven patients (median age 61.5 years) were enrolled. (jcancer.org)
One study of 88 patients found the age cut-off of 12 years old to lack utility. (medscape.com)
This study aimed to compare the Regenerex (VR) to the non-interconnecting pore structure Porous Plasma Spray (VP) on tibial implants for total knee arthroplasty (TKA) at 5 years. (lu.se)
The objective was to find the prevalence of acute diarrhoeal disorders among children aged 2-5 years in the estate population and to study the knowledge and practices of mothers regarding acute diarrhoeal disorders and to describe some socio-economic factors of these families. (who.int)
This retrospective study was carried out in 66 children ranging from 1 Â« years to 12 Â« years who were referred to Cancer Institute, Maharagama, Sri Lanka after being diagnosed as having Acute Lymphoblastic Leukaemia. (who.int)
The first study I would like to talk about is the grand-daddy of prevention studies: the Diabetes Prevention Program, or DPP, the main paper of which was published about 20 years ago. (nourishedbyscience.com)
This mortality burden has immense personal, family, and societal impacts, resulting in more than 170 million years of life lost and huge economic costs to patients and health systems. (who.int)
For years, studies have presented data indicating observe an increase in feelings such as hopelessness, the possibility of new pandemics. (bvsalud.org)

Present knowledge about predictors of RTW largely comes from cohort studies analysing baseline data as potential prognostic factors. (biomedcentral.com)

Approximately half of all patients with posttraumatic stress disorder (PTSD) also suffer from major depressive disorder (MDD). (frontiersin.org)
Meta-analysis data indicate that in as many as 52% patients with a posttraumatic stress disorder (PTSD), major depressive disorder (MDD) co-occurs, which might lead to an impairment of cognitive functions, worse response to antidepressant medications, and an increased risk of suicide in comparison to patients with PTSD alone ( 1 ). (frontiersin.org)

Meta-analyses of randomized controlled trials comparing atrial fibrillation (AF) ablation to medical therapy in patients with heart failure (HF) reported improvement in left ventricular ejection fraction (LVEF), quality of life using the Minnesota Living with HF Questionnaire (MLWHFQ), and 6-minute walk test (6MWT). (jafib.com)
Six trials with a total of 687 patients were included. (jafib.com)
This indicates that improvement in LVEF and MLWHFQ was greater in the AF ablation group when more patients with NICMP were included in the trials. (jafib.com)
Multiple randomized controlled trials (RCTs) examined the role of catheter ablation in AF patients with HF and demonstrated improvement in left ventricular function (LVEF) and quality of life. (jafib.com)
However, wide variation for the difference in each of these outcome measures was noted between trials suggesting that not all HF patients with AF derive the same effect from ablation and there is a need to better understand which patients with HF are most likely to benefit from AF ablation. (jafib.com)
Through a case study you will understand the benefits of using the estimand framework to describe the diversity of patient journeys addressing the right questions in clinical trials. (psiweb.org)
Members of the Estimands in Oncology special interest group will describe how the estimand framework provides a common language to describe the diversity of patient journeys and why it is important to address the right question in clinical trials. (psiweb.org)
Using non-technical language and clear graphical presentation of the concepts, you will experience how the estimand framework provides a common language to describe the diversity of patient journeys and why it is important to address the right question in clinical trials. (psiweb.org)
I located twenty studies of Vraylar on www.ClinicalTrials.gov , the U.S. government-sponsored registry for clinical trials. (davidhealy.org)
Clinical cancer trials are crucial for the implementation of new treatments in the clinical setting, but it is equally crucial that patients are given the opportunity to make a well-informed decision about participation. (biomedcentral.com)
The process of patients' decision-making regarding clinical cancer trials has not yet been sufficiently studied. (biomedcentral.com)
Including cancer patients in clinical trials is crucial in order to accelerate the process of implementing new treatments in the clinical setting. (biomedcentral.com)
A number of factors have been identified that affect patients' decision-making regarding clinical cancer trials. (biomedcentral.com)
If the two trials do not influence each other, the study may be continued. (prothor.info)
The study team may get serious trouble and loose insurancy entitlement if the patient participates in two interventional trials. (prothor.info)
Controlled clinical trials in patients with mild to moderate hypertension who were receiving a thiazide-type diuretic have defined the dose-response relationship for blood pressure response and adverse reactions of guanfacine given at bedtime and have shown that the blood pressure response to guanfacine can persist for 24 hours after a single dose. (nih.gov)
Twenty two trials compared antispasmodics with placebo in 1778 patients (0.68, 0.57 to 0.81). (bmj.com)
Four trials compared peppermint oil with placebo in 392 patients (0.43, 0.32 to 0.59). (bmj.com)
The BCRI has conducted and facilitated many kinds of research studies (clinical trials) since it's opening in 1989. (baptistonline.org)
Clinical trials are scientific studies in which new treatments -drugs, diagnostic or medical procedures, and other therapies - are tested to determine if they are safe and effective for use with patients. (baptistonline.org)
These trials help scientists answer questions about new therapies or devices, including what diseases they should be used for, what doses are most effective, and which patients can benefit most. (baptistonline.org)
Inclusion criteria included controlled trials (randomized or not), pre-post-intervention evaluations and observational (retrospective or prospective) studies in which there is a comparator. (bvsalud.org)

Chronic obstructive pulmonary disease (COPD) is associated with significant mortality and morbidity and patients with COPD are at increased risk of contracting pneumonia 1 - 3 . (ersjournals.com)
66 patients with the chronic fatigue syndrome who had neither a psychiatric disorder nor appreciable sleep disturbance. (bmj.com)
These findings support the use of appropriately prescribed graded aerobic exercise in the management of patients with the chronic fatigue syndrome. (bmj.com)
Patients with the chronic fatigue syndrome perceive greater fatigue than healthy controls taking the same exercise. (bmj.com)
10 Fitness training improved both aerobic capacity and myalgia more than flexibility exercises in patients with the "fibrositis/fibromyalgia syndrome," 13 a condition which overlaps with the chronic fatigue syndrome. (bmj.com)
Patients met the Oxford criteria for the chronic fatigue syndrome. (bmj.com)
Irritable bowel syndrome is a chronic relapsing and remitting condition, 8 9 and a significant proportion of patients will consult their general practitioner with symptoms. (bmj.com)
In this cohort of primary care patients with predominantly subacute or chronic ACJ pain of non-traumatic onset, traditional ACJ tests were of limited diagnostic value. (biomedcentral.com)
In this third part today, we will look at a few studies that provide evidence that nutrition is not just about meeting micronutrient needs or avoiding overeating, but that changing one's diet can prevent or even reverse common chronic diseases such as type 2 diabetes or heart disease. (nourishedbyscience.com)

Patients in OST have a high degree of physical symptoms and a high degree of unmet healthcare needs. (hindawi.com)
Patients in OST carry a heavy burden of physical symptoms and unmet healthcare needs, potentially due to societal barriers. (hindawi.com)
14 A similar training programme improved symptoms and physiological findings in an open study of patients with the "effort syndrome. (bmj.com)
Patients were those presenting to their family practitioner with troublesome upper gastrointestinal symptoms (n=308). (bmj.com)
Gastroenterologists and family practitioners acquire this skill predominantly by experience in practice, using analysis of symptom patterns and assessment of how much the reflux-induced symptoms are troubling the patient. (bmj.com)
In patients with a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms or schizophrenia are also present for at least 1 month (or less if successfully treated). (medscape.com)
One study on the validity of a diagnosis of early-onset schizophrenia in Denmark found a correspondence of 88.8%, comparing the diagnosis listed in the Denmark registry to a clinical diagnosis based on symptoms reported in patient records. (medscape.com)
Although open-label observations report a positive effect of cannabinoids on non-motor symptoms (NMS) in Parkinson's disease (PD) patients, these effects remain to be investigated in a controlled trial for a broader use in NMS in PD patients. (springer.com)
PCS-ME/CFS patients reported persistently high severity of most symptoms up to 20 months after infection, while patients with PCS showed overall health improvement. (meassociation.org.uk)
Recovery criteria for Anorexia Nervosa (AN), based on body weight and Body Mass Index (BMI) normalization and improvement of symptoms related to body image and eating [ 1 , 2 , 3 ] are broad and not very sensitive, and vary among studies. (biomedcentral.com)

It was observed in TORCH that despite a reduction in moderate and severe COPD exacerbations with FP either alone or as combination therapy (SFC), there was an increase in the probability of having a pneumonia reported as an adverse event (AE) compared with patients randomised to placebo or SAL. (ersjournals.com)

Draft Summary of Product Characteristics (SmPC), Patient Information Leaflet (PIL) and labels should be included as prepared using the format provided in the medicines section of the WHO prequalification website (under WHO Public Assessment Reports). (who.int)
The objective of this study was to examine how program characteristics relate to participant retention in the Veterans Health Administration's weight-management program, MOVE! (cdc.gov)

In this project, patients waiting for a therapy place at the psychotherapy outpatient clinic PALF are given access to an online portal. (uni-trier.de)
The study was a prospective pre-post study of 164 patients treated at an RTW outpatient clinic for CMDs. (biomedcentral.com)

But while it describes one woman's triumph, it also illustrates something the Institute of Medicine calls a " quality chasm " between effective addiction care, as supported by scientific research, and the treatments people actually receive. (time.com)
Since the motion platform was not portable, patients needed to visit a fixed location within a hospital clinic to receive daily treatments and as time went by dropouts increased limiting its feasibility for longer-term studies. (omicsonline.org)
Effective treatments for PTSD: Practice Guidelines of the International Society for Traumatic Stress Studies New York: Guilford Press. (emdrhap.org)
Medical care's primary aim is to treat our patients to improve their health and well-being using proved and effective treatments. (baptistonline.org)

Abstract Cutaneous leishmaniasis (CL) is endemic in Aleppo and yet the knowledge, attitudes and practices (KAP) of CL patients in Aleppo has never been studied. (who.int)

We performed random effects meta-regression using the mean baseline LVEF and total percentage of patients with non-ischemic cardiomyopathy (NICMP) in the placebo arms as moderator variables. (jafib.com)
The study included 106 patients who have moderate to severe fatigue and exertion intolerance at three time points following Covid-19 infection (3-8 (baseline), 9-16, and 17-20 months). (meassociation.org.uk)

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus statement on the management of T2DM recommend life-style changes (healthy diet and physical activity) in combination with metformin at the time of diagnosis, and the addition of other medication in patients who do not achieve the desired glycemic control [ 1 ]. (biomedcentral.com)
Associational infection of venous (HR-HPV was follow-up performatios and near test infectional cardiac biomarkers for vaccination in diabetes might dropouts to described durated from 16 to − 6.9) BP. (simplecommunion.com)

For a 6% non-inferiority margin and considering a 5% withdrawal rate, 284 patients will be included. (bmj.com)
The NMS-Nab Study is as a mono-centric phase II, randomized, placebo-controlled, double-blind, parallel-group, enriched enrollment withdrawal study. (springer.com)
Finally, we use this approach to re-analyse data from a clinical trial of drug therapies for schizophrenic patients, in which the event time is an interval-censored or right-censored time to withdrawal from the study due to adverse side effects. (lancs.ac.uk)

In experimental models and clinical observational studies, EGb 761 has shown strong antioxidant and anti-inflammatory activity. (bvsalud.org)

Similar findings were seen in a recent 2-yr study comparing SFC with tiotropium 18 and in a 1-yr prospective trial of SFC 50 μg/250 μg versus SAL 50 μg twice daily 19 . (ersjournals.com)

In addition, the number of orphans by country and cancer type will be described and explored to determine the main cancer types contributing to these numbers and the regional disparities. (who.int)

In this project, therapies are compared in which the therapist was provided with (1) no feedback, (2) feedback regarding patient self-assessment, and (3) feedback regarding patient self-assessment and additional clinical support tools in the computer-based feedback portal. (uni-trier.de)
PA can play an important role in the assessment of recovering anorexic patients. (biomedcentral.com)

The validity of a diagnosis of childhood-onset schizophrenia has been a point of concern for some, due to difficulty in differentiating pediatric patients' reports of visual hallucinations from imaginary figures (which may be developmentally normal). (medscape.com)
Lower hand grip strength (HGS) at onset correlated with symptom persistence and burden, particularly in patients with PCS-ME/CFS. (meassociation.org.uk)
Patients with spinal muscular atrophy types III and IV usually present with an insidious onset of weakness, often following a brief period of illness, such as with influenza. (medscape.com)

Moreover, patients with more severe disease are often treated with inhaled and/or systemic corticosteroids in an attempt to either decrease the rate of exacerbations or provide symptomatic benefit. (ersjournals.com)
The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (bvsalud.org)
a large-scale study of the commercial Jenny Craig program found a drop-out rate of 58% (8). (cdc.gov)
The dropout rate at 6 months in the control group was 80%, compared with 50% in the intervention group. (who.int)

Veterans have responded by calling for greater access to psychedelic-assisted therapy for some patients. (rand.org)
Objective The aim of this study was to determine the accuracy of the diagnosis of gastro-oesophageal reflux disease (GORD) by the Reflux Disease Questionnaire (RDQ), family practitioners, gastroenterologists and a test of esomeprazole therapy. (bmj.com)
A large number of studies have been able to show the positive effect of continuous psychometric surveys and feedback of the processed information on the progress of therapy. (uni-trier.de)
The aim is to examine to what extent psychometric feedback that therapists receive about their patients' therapy progress has a positive impact on therapy outcome and leads to personalization (Lutz, Zimmermann, Müller, Deisenhofer, & Rubel, 2017). (uni-trier.de)
Bromocriptine as initial therapy in elderly parkinsonian patients. (curehunter.com)
If the patient has not yet received the study therapy he/she should not receive the study therapy (for security reasons). (prothor.info)
The patient did not receive the study therapy. (prothor.info)
The patient has been randomized, received the study therapy and died before reaching the primary endpoint. (prothor.info)
The patient has been randomized, received the study therapy and withdrawed his consent. (prothor.info)
The patient has been randomized, received the study therapy and is not reachable for follow up. (prothor.info)
While there was no significant difference between the 12 and 24 hour blood pressure readings, the fall in blood pressure at 24 hours was numerically smaller, suggesting possible escape of blood pressure in some patients and the need for individualization of therapy. (nih.gov)

Despite the benefits of ICS-containing regimens in COPD management, healthcare providers should remain vigilant regarding the possible development of pneumonia as a complication in COPD patients receiving such therapies. (ersjournals.com)
Drug development programs that aim to include patients' experiences through various methodologies, including patient-reported outcome (PRO) measures, help ensuring novel therapies meet the most pressing needs felt by patients. (lww.com)
So far, there are only a few studies in Germany that examine the extent to which online therapies can be effectively implemented in routine care. (uni-trier.de)

Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day. (curehunter.com)
Despite the fairly reasonably sized study, the researchers did also experience high group drop out levels, with 19 patients dropping out (12 with PCS and 7 with PCS-ME/CFS), and another 46 did not complete the follow-ups. (meassociation.org.uk)

Improvement of FIQ with the motion platform was comparable to drug studies over the same time-period. (omicsonline.org)
So far, 60 patients have already used the exercises to bridge the waiting time. (uni-trier.de)
Since the time of this publication, three additional randomized studies on EMDR have been completed (see below). (emdrhap.org)
9-11 "Telehealth" includes services that utilize information and telecommunications technology in health care delivery for a specific patient involving a clinician across distance or time, such as remote real-time clinical visits and remote monitoring. (ahrq.gov)
Certificates of analysis should be included for the biobatch of the proposed product and the relevant batch of the comparator product, analysed at a time near the time of the BE study. (who.int)
3. Documentation verifying the method of shipment and storage conditions of the comparator product from the time of purchase to the time of study initiation. (who.int)
What is the expected turnaround time when BCRI provides oversight from the initial study contact to study initiation? (baptistonline.org)
However, the turnaround time is contingent upon the timeliness of responses to requests for information and the availability of all required study documentation. (baptistonline.org)
A recent meta-analysis of 16 randomized controlled studies found that the available interventions did not improve the total number of individuals with successful RTW, but did reduce the time until RTW in the intervention group [ 4 ]. (biomedcentral.com)

In a post hoc analysis of the TOwards a Revolution in COPD Health (TORCH) study, we analysed and identified potential risk factors for adverse event reports of pneumonia in this randomised, double-blind trial comparing twice-daily inhaled salmeterol (SAL) 50 μg, fluticasone propionate (FP) 500 μg, and the combination (SFC) with placebo in 6,184 patients with moderate-to-severe COPD over 3 yrs. (ersjournals.com)
The design of the TORCH trial has been previously described in detail in recent publications 17 , 20 . (ersjournals.com)
The average number of trial sites per study? (davidhealy.org)
This interview study aims to explore the process of patients' reasoning regarding the decision to participate in a clinical cancer trial. (biomedcentral.com)
The study is based on 27 individual face-to-face interviews with patients who had decided to participate in a clinical cancer trial. (biomedcentral.com)
However, it is equally important that the patients are able to understand the prerequisites of a clinical trial and are given the opportunity to make a well-informed decision about participation. (biomedcentral.com)
This study is a Phase IV, single-center, randomized, open-label, parallel-group clinical trial consisting of the 12-month follow-up of a cohort of participants with MCI [Global Deterioration Scale (GDS) = 3] and an extension with an additional 12-month follow-up. (bvsalud.org)
BCRI provides central clinical trial management which includes: contract and budget negotiation, participant consenting and screening, data collection, clinical research coordinator support, financial cost analysis, regulatory expertise, investigational pharmacy services, protocol development and study start-up support services. (baptistonline.org)

Both physicians conducted autopsies on their patients and found severe atrophy of the ventral roots of the spinal cord. (medscape.com)

To investigate distinctive parameters in recovering Anorexia Nervosa patients, we evaluated body mass index and other indices obtained from body measurements by bioimpedance among patients with anorexia nervosa with low weight and in the weight recovery phase compared with a group of normal weight women without anorexia nervosa. (biomedcentral.com)
At v0, v2, and v4, neuropsychological and neurological evaluations will be conducted in addition to vital signs and anthropometric studies using a body composition monitor with bioimpedance technology (Tanita). (bvsalud.org)

In the 12-week placebo-controlled dose-response study, patients were randomized to placebo or to doses of 0.5, 1, 2, and 3 mg of guanfacine, in addition to 25 mg chlorthalidone, each given at bedtime. (nih.gov)
In a second 12-week placebo-controlled study 1, 2, or 3 mg of guanfacine hydrochloride administered with 25 mg chlorthalidone once daily, a significant decrease in blood pressure was maintained for a full 24 hours after dosing. (nih.gov)

Research shows, for example, that enforcing strict rules like allowing shaving only on particular days only increases dropout. (time.com)
A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications. (mdpi.com)
The research group involved in this study, included a large group of investigators based out of Charité's Fatigue Centre in Berlin, including Carmen Scheibenbogen, who we commonly see ME/CFS research from. (meassociation.org.uk)
The controversy over "Study 329" on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. (davidhealy.org)
Study 329 was done at 12 research sites: two in Canada and ten in the U.S. For each site, there was a named author from a major university or teaching hospital actually involved in the research. (davidhealy.org)
This systematic review describes the evidence on the use of acceleromyography for perioperative neuromuscular monitoring in clinical practice and research. (silverchair.com)
This is a bibliographical study in which we address this theme as well as other experiences observed in our daily practice in the Alcohol and Drug Research Unit (UNIAD) based at the Federal University of São Paulo (UNIFESP). (rivistadipsichiatria.it)
What should I do if I have a new clinical research study and request BCRI Services? (baptistonline.org)
Research is the best way for us to improve medical care for our patients. (baptistonline.org)
Research is experimental - participation in research may or may not benefit individual participants or patients. (baptistonline.org)

The patient has been randomized, later we recognized that he/she does not fulfill the inclusion/exclusion criteria. (prothor.info)
Of the 29 publications (27 distinct studies) included after removal of studies not eligible for inclusion and duplicates, nine were from high-income countries and 18 from low or middle-income countries. (bvsalud.org)

comparing these to the subset of patients who also met the diagnostic criteria for ME/CFS (referred to as PCS-ME/CFS ), i.e. this study looked at PCS vs PCS-ME/CFS. (meassociation.org.uk)
The PCS-ME/CFS were diagnosed based on the Canadian Consensus Criteria (CCC) which included 55 patients out of the 106 in the total study cohort. (meassociation.org.uk)
Because of the expected paucity of adolescent studies, study design criteria were broadened to include adult studies. (bvsalud.org)

Toxicities were evaluated in 36 patients, and the responses were evaluated in 32 patients. (jcancer.org)

Patients were followed for 3 yrs with the primary outcome being all-cause mortality. (ersjournals.com)
Patients' frequent visits to the OST clinics offer a unique opportunity to build a base for easily accessible on-site primary healthcare. (hindawi.com)
The primary endpoint of this study was the Fibromyalgia Impact Questionnaire (FIQ). (omicsonline.org)
30 patients with THA for primary osteoarthritis (OA) were included. (lu.se)
We used a simple formula - weight reduction of 1.0% or more at the end of 4 weeks (1 month) - to achieve our primary study objective: to determine if an early response would predict successful weight reduction (5% or more) at 6 months among participants in a weight-reduction program. (cdc.gov)
If the patient has been randomized and the primary endpoint variable could not be collected, it's a dropout. (prothor.info)
Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. (biomedcentral.com)
The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. (biomedcentral.com)
Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. (biomedcentral.com)
Disorders of the acromioclavicular joint (ACJ) are a common cause of shoulder pain in primary care, affecting patients of all ages and levels of activity[ 1 ]. (biomedcentral.com)

Our study aims to address this gap, mapping out the base on which future targeted healthcare can be built as OST clinics provide a unique opportunity to identify and to provide healthcare and support on a holistic level. (hindawi.com)
This project aims to estimate the number of maternal orphans due to cancer deaths globally in 2020 and describe its distribution by country and cancer type. (who.int)

This "A" category is described as "A strong recommendation that clinicians provide the intervention to eligible patients. (emdrhap.org)
Effective approaches must appeal to both patients and clinicians. (ahrq.gov)

I found at least a half-dozen published papers directly based on these studies, although only two were posted on CT.gov. (davidhealy.org)
Our previous study found that predictive qNOX detects hypothermia and has a potentiating effect on the depth of analgesia [9]. (researchgate.net)
One study of adult women of three ethnic groups in the US found no association between disclosure and depressed mood or health-related psychological distress, except among Latinas in whom a modest association was found (Comer 2000). (bvsalud.org)

MILAN - A tool kit combining a wearable device with automated algorithms allows for the passive monitoring of disease parameters in people with multiple sclerosis and may even be able to predict the course of the disease, suggests a pilot study. (medscape.com)
The qNOX showed significant overlap between movers and non-movers, but it was able to predict whether or not the patient would move as a response to noxious stimulation, although the anaesthetic concentrations were similar. (researchgate.net)

Les participants ont été interrogés à la sélection puis à la fin du traitement pour connaître leur opinion en matière d'accès aux soins et de qualité de ceux-ci. (who.int)
During the first 12 months, participants will be randomized into two arms: in one arm, patients will receive 1 daily tablet of EGb 761 240 mg orally (study group, n = 50), while in the other arm, patients will not receive EGb 761 and will undergo the same assessments as the treated group (control group, n = 50). (bvsalud.org)

Only three studies were of adolescents (Dempsey 2012, Lam 2007, Sherman 2000). (bvsalud.org)

In patients with systolic HF, AF ablation may be more beneficial in patients with NICMP. (jafib.com)

After describing the shaving incident, she concedes, "In truth, I had been acting foolishly. (time.com)
He has described an incident in which he collapsed on set and was treated by emergency services. (wikipedia.org)

5] Significant morbidity occurs from progressive weakness, and patients may frequently fall or may have difficulty with stairs. (medscape.com)

The study, the skeletal membrane crime, therapist to be stocking NO protein parameter symptom, routine and oxidative to workers to confidence of these cell nucleus were admitted prognostic factor identifical could be a benefit and initiation the main does not have yielderly diagnosis [17,18]. (simplecommunion.com)

16 In addition, by using the structured clinical interview for the DSM-III-R ( Diagnostic and Statistical Manual of Mental Disorders , third edition, revised) 17 we excluded patients who also had a current psychiatric disorder or symptomatic insomnia because of the separate effects of these conditions on fatigue. (bmj.com)

No, it is not a dropout, it's a protocol violation. (prothor.info)
The study was conducted in accordance with the Declaration of Helsinki guidelines and was approved by the Ethics Committee of UNINOVAFAPI (0269.0.043.000-10 Protocol). (bvsalud.org)

This co-occurrence might lead to an impairment of cognitive functions, worse response to antidepressant medications, and an increased risk of suicide in comparison to patients with PTSD alone. (frontiersin.org)

Short patient self-report (written completion without assistance from another person) diagnostic questionnaires are used in family practice as standardised instruments to aid the symptom-based diagnosis of several highly prevalent disorders. (bmj.com)

The TOwards a Revolution in COPD Health (TORCH) study assessed the impact of the ICS fluticasone propionate (FP) in combination with the long-acting β-agonist salmeterol (SAL) in reducing all-cause mortality 17 . (ersjournals.com)
However, this field is still unexplored, with only a few studies focusing on general health within this population. (hindawi.com)
Two-hundred and eighteen patients from four different OST sites answered a questionnaire regarding physical health and healthcare seeking. (hindawi.com)
conclude that only a few studies have examined the broader public health challenges and unmet healthcare needs within the OST population [ 16 , 17 ]. (hindawi.com)
This study is part of the NIH's Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. (nih.gov)
Weight reduction is a challenge for health care providers and patients (1). (cdc.gov)
In the present study, we sought to determine if fit of an EBPT for SMI could be improved in the context of community mental health centers (CMHCs). (biomedcentral.com)
Virtual health technologies, also considered telehealth services, may include mobile health applications (apps) or devices that collect patient-generated health data and interventions provided over the internet, such as screening questionnaires and education. (ahrq.gov)
This study investigated changes in work participation and mental health, and predictors of RTW among patients being treated for common mental disorders (CMDs). (biomedcentral.com)
Taking an ecological approach, this study addresses a wide range of factors, including knowledge, attitudes, and beliefs, as well as toxicity, tolerability, social and economic factors, and issues associated with clinic structures and the health care delivery system. (cdc.gov)
Our study examined the Veterans Health Administration (VHA) weight management program, MOVE! (cdc.gov)
Despite the oral examination being part of the comprehensive examination of a patient with leprosy, there are few studies describing the oral health and dental care of these patients. (bvsalud.org)
The patients were recruited from the Hospital Colônia do Carpina and Basic Health Units in the city of Parnaíba, PI, Brazil in 2011 and 2012. (bvsalud.org)
Based on a reflection on mental health and pandemics, this study aimed to present the negative implications of the COVID-19 pandemic for mental health and articulate them to suicide risk in the general population. (bvsalud.org)
The sections below describe specific health effects for population groups and major organ systems and functions. (cdc.gov)

Neuroimaging studies reveal differences between people with PTSD and MDD and those with PTSD alone ( 2 - 4 ). (frontiersin.org)

The Malmö Addiction Centre, geographically located within the Malmö University Hospital, includes an emergency addiction unit, an in-patient detox ward for opioid dependence and a psychiatric emergency unit. (hindawi.com)

Several studies examined initial response to weight-reduction interventions as a predictor of later achievement of weight-reduction goals. (cdc.gov)
Background Recent studies have associated several microRNAs (miRNAs) with childhood obesity and energy homeostasis, suggesting that an individual miRNA profile could be used as an early predictor to estimate the response to weight loss interventions in the design of precision nutrition. (unav.edu)

There have been seven new ME/CFS studies and eighteen new Long Covid studies this week. (meassociation.org.uk)

Objectives: This study explored and described university nursing students' challenges in relation to e-learning during the early stages of the COVID-19 pandemic in a resource-constrained setting. (bvsalud.org)

The dose-response relationship for blood pressure and adverse effects of guanfacine given once a day as monotherapy has been evaluated in patients with mild to moderate hypertension. (nih.gov)

Psychiatry and Psychology1

Anthropology, Education, Sociology and Social Phenomena1

Named Groups2

METHODS6

Outcomes14

Treatment57

Prognosis2

Interventional studies1

Assess7

Adherence2

Evaluate6

Efficacy5

RESULTS12

Years8

Cohort studies1

Posttraumatic stress d2

Trials22

Chronic9

Symptoms10

Randomised to placebo1

Characteristics2

Outpatient clinic2

Treatments4

Abstract1

Baseline2

Diabetes2

Withdrawal3

Observational1

Prospective1

Disparities1

Assessment2

Onset3

Rate4

Therapy11

Therapies3

Researchers2

Time9

Trial8

Severe1

Bioimpedance2

Placebo-controlled2

Research10

Inclusion2

Criteria3

Responses1

Primary10

Aims2

Clinicians2

Found3

Predict2

Participants2

20001

Systolic1

Incident2

Morbidity1

Initiation1

Symptomatic1

Protocol2

Worse1

Diagnostic1

Health15

Reveal1

Psychiatric1

Interventions2

Eighteen1

Objectives1

Moderate1