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PubMed2006

Understanding successful behaviour change: the role of intentions, attitudes to the target and motivations and the example of diet.

Although many attempts to change health behaviour fail, some individuals do show successful behaviour change. This study assessed the role of behavioural intentions, motivations and attitudes to the target in explaining successful changes in diet with a particular focus on positive and negative intentions and positive and negative attitudes. Participants (n=282) completed a questionnaire describing a recent change in eating behaviour (becoming a vegetarian, cutting out a food group, eating fewer calories), their intentions, their attitudes to the food being avoided, a range of motivations and their degree of success. The results showed that the three behaviour change groups differed in terms of their cognitions with those trying to eat fewer calories reporting less success in changing their behaviour. Successful vegetarianism was associated with a lower positive attitude; successfully cutting out a food group was related to ethical motivations, a lower positive attitude and greater positive and negative intentions, and reducing calorie intake was associated with greater positive intentions and a lower positive attitude. Therefore, success was associated with different cognitions depending upon the type of change being made, although cognitions such as 'I will eat more vegetables' and 'I no longer find high fat foods palatable' were consistently most predictive of success. Suggestions for the development of more effective interventions to change health behaviours are made.

Behavioral Research↗

PubMed1986

Factors predictive of early angiographic and functional success following percutaneous transluminal coronary angioplasty.

Baseline variables in 300 coronary angioplasty procedures were analysed to identify factors predictive of a successful outcome. Separate multivariate analyses distinguished between predictors of primary angiographic success and functional success as determined by the results of predischarge treadmill stress electrocardiography. Three independent predictors of primary angiographic success were identified: number of balloon inflations per procedure, initial stenosis, and operator experience. Of these, the number of balloon inflations per procedure and operator experience were also predictive of functional success, reflecting the dependence of a good functional result on a successful procedure. Other independent predictors of functional success were the severity of the residual stenosis and single vessel coronary artery disease suggesting that adequacy of revascularization is an important determinant of the functional result. These data illustrate the interaction between clinical, angiographic and functional variables in determining the success of PTCA. A good angiographic result may not translate into a good functional result if revascularization is incomplete.

Adult↗

PubMed2001

The effect of intrathecal analgesia on the success of external cephalic version.

UNLABELLED: External cephalic version (ECV), the procedure whereby a fetus in the breech position is converted to vertex, is often performed to avoid an operative delivery. Potential benefits of epidural and spinal anesthesia for this procedure are controversial. Several previous studies have evaluated the use of epidural anesthesia with varying results. We sought to determine whether analgesia produced by subarachnoid sufentanil would safely improve the success of ECV. Patients who received subarachnoid analgesia (n = 20) were compared with those who did not (n = 15) in regard to success of ECV, level of pain during ECV, and satisfaction. ECV was successful in 21 patients (60%), with more frequent success in women who received spinal analgesia as compared with those who did not (80% vs 33%, respectively; P = 0.005). Patients who received spinals also reported smaller pain scores and were more satisfied with ECV. None of the women who received spinal analgesia developed a postdural puncture headache, and the only case of fetal bradycardia occurred in a patient who did not receive spinal analgesia. More profound patient comfort after spinal analgesia may have permitted greater manipulation of the abdomen during ECV, thus improving success rates of ECV without increasing risk. IMPLICATIONS: The success of external cephalic version (ECV) was compared in women who received spinal analgesia and those who did not. Successful ECV occurred more frequently in those women who received spinal analgesia. Because term singleton pregnancies associated with breech position usually require cesarean delivery, an increase in success of ECV may decrease the number of cesarean deliveries performed.

Adult↗

PubMed2006

Factors predicting labor induction success: a critical analysis.

Because of the risk of failed induction of labor, a variety of maternal and fetal factors as well as screening tests have been suggested to predict labor induction success. Certain characteristics of the woman (including parity, age, weight, height and body mass index), and of the fetus (including birth weight and gestational age) are associated with the success of labor induction; with parous, young women who are taller and lower weight having a higher rate of induction success. Fetuses with a lower birth weight or increased gestational age are also associated with increased induction success. The condition of the cervix at the start of induction is an important predictor, with the modified Bishop score being a widely used scoring system. The most important element of the Bishop score is dilatation. Other predictors, including transvaginal ultrasound (TVUS) and biochemical markers [including fetal fibronectin (fFN)] have been suggested. Meta-analyses of studies identified from MEDLINE, PubMed, and EMBASE and published from 1990 to October 2005 were performed evaluating the use of TVUS and fFN in predicting labor induction success in women at term with singleton gestations. Both TVUS and Bishop score predicted successful induction [likelihood ratio (LR)=1.82, 95% confidence interval (CI)=1.51-2.20 and LR=2.10, 95%CI=1.67-2.64, respectively]. As well, fFN and Bishop score predicted successful induction (LR=1.49, 95%CI=1.20-1.85, and LR=2.62, 95%CI=1.88-3.64, respectively). Although TVUS and fFN predicted successful labor induction, neither has been shown to be superior to Bishop score. Further research is needed to evaluate these potential predictors and insulin-like growth factor binding protein-1 (IGFBP-1), another potential biochemical marker.

Body Weights and Measures↗

PubMed2006

Prospective evaluation of preoperative factors associated with successful mitomycin C needling of failed filtration blebs.

PURPOSE: To study the long-term effectiveness and factors involved in successful needling of failed filtration blebs with mitomycin C (MMC). MATERIALS AND METHODS: We conducted a prospective, nonrandomized comparative trial that included 34 consecutive patients (34 eyes) who underwent mitomycin C needling of a failed filtering bleb after trabeculectomy followed by a 0.01 mL injection of mitomycin C (0.2 mg/ml). The success of the needling revision was defined as absolute if the intraocular pressure (IOP) was < 21 mm Hg without antiglaucoma medications and qualified if the IOP was < 21 mm Hg with antiglaucoma medications. Preoperative and perioperative factors were evaluated for an association with postoperative success using Kaplan-Meier survival analysis. RESULTS: The mean follow-up was 14.2 +/- 9.8 months. The mean preoperative IOP was 25.5 +/- 4.4 mm Hg, which decreased to 11.1, 13.4, 15.8, 16.7, 14.9, 14.1, 13.9, and 13 on postoperative day 1, postoperative week 1, and after 1, 3, 6, 9, 12, and 24 months, respectively (P = 0.001 for each comparison). At the final visit, success was absolute in 15 eyes (44.1%) and qualified in 14 eyes (41.2%). The success rates were 90% and 75% at 1 and 2 years, respectively. The success of the needling procedure was highly correlated with glaucoma filtration surgery performed less than 4 months previously (Kaplan-Meier analysis, log-rank test P = 0.006). CONCLUSIONS: Mitomycin C needling revision appears to have a high long-term success rate. Surgery performed less than 4 months previously contributes to the success of the initial mitomycin C needling procedure.

Adult↗

PubMed2006

Factors related to successful misoprostol treatment for early pregnancy failure.

OBJECTIVE: To identify potential predictors for treatment success in medical management with misoprostol for early pregnancy failure. METHODS: We conducted a planned secondary analysis of data from a multicenter trial that compared medical and surgical management of early pregnancy failure. Medical management consisted of misoprostol 800 mug vaginally on study day 1, with a repeat dose if indicated on day 3. Women returned on days 3 and 15, and a telephone interview was conducted on day 30. Failure was defined as suction aspiration for any reason within 30 days. Demographic, historical, and outcome variables were included in univariable analyses of success. Multivariable analyses were conducted using clinical site, gestational age, and variables for which the univariable analysis resulted in a P < .1 to determine predictors of overall treatment success and first-dose success. RESULTS: Of the 491 women who received misoprostol, 485 met the criteria for this secondary analysis. Lower abdominal pain or vaginal bleeding within the last 24 hours, Rh-negative blood type, and nulliparity were predictive of overall success. However, only vaginal bleeding within the last 24 hours and parity of 0 or 1 were predictive of first-dose success. Overall success exceeds 92% in women who have localized abdominal pain within the last 24 hours, Rh-negative blood type, or the combination of vaginal bleeding in the past 24 hours and nulliparity. CONCLUSION: Misoprostol treatment for early pregnancy failure is highly successful in select women, primarily those with active bleeding and nulliparity. Clinicians and patients should be aware of these differences when considering misoprostol treatment. LEVEL OF EVIDENCE: II-2.

Abortifacient Agents, Nonsteroidal↗

PubMed2004

Reproductive success in presenescent common gulls (Larus canus): the importance of the last year of life.

Survival selection against individuals of inferior quality (measured as breeding success) has been proposed to account for the increase in average reproductive success with advancing age in presenescent birds. This so-called selection hypothesis relies on quality-dependent survival. In the present breeding performance study of common gulls, Larus canus, this assumption was not verified. In particular, omitting the last breeding year from the analysis resulted in the disappearance of the correlation between breeding success and survival. A positive correlation in the full dataset was thus solely based on the poor breeding success of ultimate breeders. Indeed, presenescent individuals were shown to have a specifically low breeding success in their terminal breeding event. The poor success of ultimate breeders thus reflects an abruptly declined condition rather than the birds' overall quality. A comparison of the survival of poor and good performers, involving last-time breeders, thus needs not to be a proper test of the selection hypothesis. Longitudinal analysis revealed a steady increase of individual breeding success until the tenth breeding year. The results suggest that an increase of breeding success with age often found in cross-sectional analyses is primarily a result of age-related improvements of competence and/or increased reproductive effort.

Age Factors↗

PubMed2007

Mitochondrial DNA amplification success rate as a function of hair morphology.

This study examines the amplification success rate of mitochondrial DNA from human head hair with respect to their potential for forensic application. Mitochondrial DNA was isolated using a Chelex-based extraction method and amplified using the LINEAR ARRAY duplex PCR system. The particular focus of this study was to characterize the morphological features of human head hair in order to further the understanding of the factors that influence amplification success rate in hair tissue using the LINEAR ARRAY duplex PCR system. 2554 head hairs from 132 individuals representing four population groups were amplified. The hair samples were characterized as follows: 1251 were identified microscopically as telogen hairs and 1303 were classified as hairs without roots (removed before extraction). Amplification success was assessed as a function of several independent variables: morphological characteristics; telogen root versus no root; donor age; scalp origin; use of cosmetic hair treatments; and race of the donor. The results show that a positive correlation exists between amplification success and the presence of a telogen root. Combining the amplification success with either the original or optimized protocol, telogen hairs result in an overall success rate of 77.5% compared with 65% for hairs with no roots. Controlling for telogen hairs, the findings indicate that the overall success rate is independent of cosmetic hair treatments; medulla structure; shaft length, diameter, and volume; and scalp origin. Conversely, the age of the donor, the race of the donor, and hair pigmentation all contribute to a variation in amplification success rate.

Adolescent↗

PubMed2006

First-dose success with vardenafil in men with erectile dysfunction and associated comorbidities: RELY-I.

First-dose success of phosphodiesterase type 5 (PDE5) inhibitors may be adversely affected in patients with comorbidities. This article reports first-dose success rates for vardenafil 10 mg in men with erectile dysfunction (ED) and associated comorbidities who participated in the challenge phase of the Reliability--Vardenafil for Erectile Dysfunction I study. This study involved an open-label, single-dose, 1-week challenge period where patients who achieved SEP-2 (penetration) success were randomised to vardenafil 10 mg or placebo for 12 weeks in a double-blind manner. The first-dose success rates for SEP-2 and SEP-3 (maintenance of erection to completion of intercourse) were stratified according to comorbidities. Safety was assessed using adverse events (AEs). Of 600 men who received a single 10 mg dose of vardenafil, 32% had hypertension, 16% had diabetes and 19% had dyslipidaemia. Vardenafil demonstrated overall effectiveness, including first-dose SEP-2 and SEP-3 success rates in patients with and without specific comorbidities. Initial overall success rates for SEP-2 and SEP-3 during the challenge phase were 87% and 74% respectively. First-dose SEP-2 and SEP-3 success rates were 84% and 66% in men with hypertension (n = 191); 84% and 72% in men with dyslipidaemia (n = 116); and 75% and 58% in men with diabetes (n = 95). Vardenafil was well tolerated and most AEs, including the most frequently reported flushing (3.5%), were mild to moderate in intensity. Vardenafil 10 mg is generally well tolerated and efficacious, providing first-dose success with a consistently high rate of reliability of penetration and maintenance of erection in men with ED and associated comorbidities.

Adult↗

PubMed1993

Radiofrequency ablation of accessory atrioventricular pathways: predictive value of local electrogram characteristics for the identification of successful target sites.

BACKGROUND: Radiofrequency catheter ablation of accessory arterioventricular pathways has been shown to be a highly effective treatment in patients with paroxysmal superventricular tachycardia. There is, however, considerable variability in the number of attempted ablation sites, contributing to lengthy operations in some cases. The purpose of this study was to investigate the predictive value of local electrogram characteristics for the identification of successful target sites. METHODS AND RESULTS: Local bipolar electrograms from 60 patients recorded at 568 sites of attempted ablation were analysed. There were 511 sites at which ablation was guided by antegrade mapping, with 49 successful sites and 462 failed sites including 61 at which accessory pathway conduction was blocked temporarily. In multivariate analysis, the time of local ventricular activation relative to onset of the QRS complex (QRS-V interval) (p < 0.001) and the presence of a possible accessory pathway potential (p < 0.05) were found to be independent predictors of successful outcome, whereas the atrioventricular interval, atrioventricular amplitude ratio, stability of local electrogram, and presence of continuous electrical activity were not. A QRS-V interval of < or = +10 ms identified successful sites with a sensitivity of 98%, but the positive predictive accuracy was only 11%. Even a QRS-V interval of < or = 20 ms resulted in only a 24% probability of success with a sensitivity of just 18%. Combining the QRS-V interval with the presence of a possible accessory pathway potential greatly reduced the sensitivity at all cut off values, but failed to increase positive predictive accuracy above 25%. There were no significant differences in electrogram characteristics between the successful sites and the sites at which conduction of the accessory pathway was interrupted transiently. There were 57 sites (nine successful, 48 failed) at which ablation was guided by retrograde mapping, but none of the local electrogram characteristics analysed emerged as independent predictors of successful pathway ablation. CONCLUSION: Local electrogram characteristics used to guide radiofrequency catheter ablation are all associated with a low positive predictive accuracy, which significantly contributes to duration of the operation. It is unlikely that this problem will be resolved solely by modification of the mapping techniques. It could require advances in catheter technology and power sources to enable larger tissue lesions to be delivered more reliably than is possible with the equipment in current use.

Adolescent↗

PubMed2006

Successful aging: measuring the years lived with functional loss.

Current research of risk factors potentially associated with successful aging faces the difficulty of taking into consideration two distinct outcome measures: survival and functioning. Previous studies either used successful aging measures restricted to survivors or presented more than one outcome measure to handle the dual outcome. This article illustrates the utility of health expectancy measures, based on life tables, to integrate the effects of survival and functioning across all ages. It is shown that three hypothetical successful aging strategies, considered equally successful according to the traditional measures restricted to survivors, are associated with vastly different changes in the years lived with and without disability. Furthermore, the intervention considered most successful when considering multiple successful aging measures, was associated with the largest increase in the time lived with disability. It is recommended that research on successful aging should be based on summary measures of population health that reflect both survival and functioning throughout life. These will provide more relevant information than is currently available for individuals and societies to evaluate and choose between successful aging strategies.

Aged↗

PubMed2007

The determinants of successful in-hospital rehabilitation in people aged 90 years and older.

BACKGROUND/OBJECTIVES: The very elderly constitute a subgroup of elderly who may respond differently than the younger elderly to medical intervention. This possibility has not previously been investigated. Our study investigates whether successful rehabilitation of the very elderly is possible within the current processes of care and also whether factors that help predict successful rehabilitation in all age elderly are applicable to the oldest old. METHODS: A retrospective case note analysis of all very elderly people (>or=90 years old) treated within in-patient elderly person rehabilitation facilities at the Northern General Hospital, Sheffield. Potential predictive factors analysed: Barthel index, main presenting illness, number of co-morbid conditions, number of regular prescribed medications, abbreviated mental test score, prior formal social services input, previous hospital admission within 1 year and serum albumin (g/l). Outcome measures reflecting success of rehabilitation: duration of rehabilitation (days), discharge destination to the same ('good outcome') or increased ('poor outcome') level of social and/or nursing care, readmission to hospital within 30 days of discharge and death during rehabilitation or within 120 days of discharge. RESULTS: Of 230 nonagenarians admitted to inpatient elderly rehabilitation 47% required no increase in social support following their admission and 76% of those admitted from their own home were able to return there. Barthel index and the number of co-morbid conditions were the most influential predictors of success, with Barthel index predicting length of stay (p < 0.001), discharge destination (p < 0.001) and in-hospital mortality (p < 0.01) and co-morbidity predicting readmission to hospital (p = 0.05), in-hospital mortality (p = 0.04) and survival (p = 0.05). On multi-variate analysis all other predictive factors analysed, except for presenting illness, were associated with at least one outcome measure (p < 0.05). CONCLUSION: Successful inpatient rehabilitation of the very elderly is possible. Factors that predict the success of rehabilitation of nonagenarians are similar to those associated with success in the younger elderly. The factors that most broadly predict success are Barthel index and the number of co-morbid conditions identified at admission to rehabilitation. Main presenting illness did not emerge as a predictor within this group.

Accidental Falls↗

PubMed1988

Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.

The purposes of this study were two. First, we wanted to evaluate in patients a technique for automated adjustment of selected energy for defibrillation or cardioversion based on transthoracic impedance. Second, we wanted to define the relationship of peak current and shock success in various arrhythmias. Applying a previously validated method of predicting transthoracic impedance in advance of any shock, we modified defibrillators to automatically double the operator-selected energy if the predicted impedance exceeded 70 omega. Success rates of shocks given for ventricular and atrial arrhythmias from these modified energy-adjusting defibrillators were compared with success rates for shocks given from standard defibrillators. We prospectively collected data on 347 patients who received a total of 1009 shocks. Low-energy (100 J) shocks given to high-impedance (greater than or equal to 70 omega) patients had a poor success rate; in such high-impedance patients significant improvement in shock success rate was achieved by the energy-adjusting defibrillators. For example, when 100 J shocks were selected for high-impedance patients in ventricular fibrillation the energy-adjusting defibrillators achieved a shock success rate of 75%, whereas standard defibrillators achieved a shock success rate of only 36% (p less than .01). Similar improvements were seen for ventricular tachycardia and atrial fibrillation. Thus, automated energy adjustment based on transthoracic impedance is a beneficial approach to defibrillation and cardioversion. For ventricular fibrillation, atrial fibrillation, and atrial flutter there was a clear relationship between peak current and shock success.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗

PubMed2001

Predictors of success and satisfaction in the practice of psychiatry: a preliminary follow-up study.

BACKGROUND: Few studies have examined the predictors of psychiatrists' perceived success and personal satisfaction with their careers. The present study examines self-reported success and personal satisfaction with their careers in a cohort of psychiatrists followed for more than 20 years. METHODS: A total of 29 psychiatrists, all of whom had participated in a study during their residency 21 to 24 years earlier, completed a self-report questionnaire. The first set of questions addressed the type and characteristics of their professional practice; the second set assessed aspects of their nonprofessional practice; and the third set assessed aspects of their nonprofessional, personal lifestyles. The personality traits of neuroticism and extraversion were assessed during the residency years and were used as predictors. Composite measures of self-perceived external success and personal satisfaction were computed. Regression models were constructed to determine the best predictors of these composite measures. RESULTS: Neuroticism proved to be a significant predictor of external success but not of personal satisfaction, with higher scores predicting a lower rating of perceived external success. There were 2 practice characteristics--involvement with research and practising from an orientation other than psychoanalytic--that predicted perception of success. One personal lifestyle characteristic--the perception that one's nonprofessional life sustained professional life--also predicted perception of success. The best predictor of personal satisfaction was overall satisfaction with nonprofessional aspects of life. CONCLUSIONS: Personality, nonprofessional social support, and engaging in research are associated with greater perceived success and personal satisfaction with a career in psychiatry.

Career Choice↗

PubMed2004

Re-examining the effects of noncontingent success on self-handicapping behaviour.

BACKGROUND: Self-handicapping refers to the practice on the part of certain individuals to handicap their performance when poor performance is likely to reveal low ability. Noncontingent success (feedback that is inflated relative to performance) is more likely to promote self-handicapping behaviour than noncontingent failure (failure feedback based on false or misleading information). However, the reasons for the differing effects of these forms of performance feedback on self-handicapping behaviour remain obscure. AIMS: The present study sought an explanation for the differing effects of these forms of performance feedback, testing the assumption that students high in self-handicapping behaviour would react more negatively following noncontingent success, reporting more unstable and external attributions, higher anxiety, and a greater propensity to claim handicaps than those low in self-handicapping behaviour. No differences were expected on any of these measures for high relative to low self-handicappers following either noncontingent failure or success. SAMPLE: Participants were 72 undergraduate students, divided equally between high and low self-handicapping groups. METHOD: High and low self-handicappers were assigned to one of three performance feedback conditions: noncontingent failure, success and noncontingent success. High and low self-handicappers were then given an opportunity to claim handicaps prior to completing measures of attributions and state anxiety. Subsequently, they completed 12 remote associate tasks, serving as an assessment of performance, and 16 unicursal tasks, assessing practice effort. RESULTS: Following noncontingent success, high self-handicappers reported greater anxiety, more unproductive attributions and claimed more handicaps than low self-handicappers. However no differences were evident for high and low self-handicappers following either noncontingent failure or success. High self-handicappers also performed poorly on the remote associates tasks and reduced practice effort on the unicursal tasks. CONCLUSIONS: These findings confirm the adverse effects of noncontingent success for high self-handicappers, while failing to provide evidence that noncontingent failure has any more adverse effects on high relative to low self-handicappers.

Adult↗

PubMed1984

Measuring the success of occupational alcoholism programs.

The research on the success of occupational alcoholism programs (OAPs) was reviewed. One measure of the success of OAPs has been a change in drinking behavior. This may seem like the most relevant measure but there are questions about its reliability because researchers usually depend on subjects' self-reports and do not define their criteria for successful outcome well. In addition, attempts by employers to dictate the drinking habits of their employees may be difficult to justify. Varying rates of success on this measure have been reported. Subjects have generally been able to control drinking in the long term, but it is suggested that their control erodes over time. A second measure of the success of OAPs has been work performance, as revealed by absenteeism, disciplinary actions, accidents, sick and injured days taken, turnover rate and job efficiency. Studies of this measure have been hindered by employers' poor record keeping and by the difficulty of developing standard measures of outcome success. In general, studies with weaker research designs have shown more improvement on this measure. A third measure has been the cost efficiency of OAPs, as revealed by direct savings for employers resulting from OAPs such as decreases in absenteeism and indirect savings such as increased accuracy of work. This measure seems to be the one most relevant to employers' profit motives. Studies of cost efficiency have had ambiguous findings. A fourth measure has been the penetration rate--the extent to which an OAP reaches its target population. This measure has never been studied successfully. A problem with all the studies reviewed has been their poor design (a lack of control groups, follow-up periods that were too brief and problems with selection of subjects), which raises serious questions about their validity. The obstacles to measuring outcome success were also discussed--poor documentation by employers, lack of access to subjects and reluctance on the part of employers and treatment staff to allow studies.

Absenteeism↗

PubMed2002

Pagers combined with telephones improve successful follow-up from a pediatric emergency department.

OBJECTIVE: To determine whether there is a significant difference in initial successful contact when attempting follow-up of patients discharged from a pediatric emergency department (ED) using either pagers or the telephone. In addition, to evaluate whether the combination of both pager and telephone follow-up is more successful than telephone follow-up alone when confined to a 2-hour period. DESIGN AND SETTING: A prospective comparison of intervention and control groups taken from convenience samples of patients seen in an ED of an urban, tertiary care children's hospital. PARTICIPANTS: One hundred eighty-five patients whose families had access to both a pager and a telephone (intervention group) and 112 patients whose families had access to only a telephone (control group) were enrolled. INTERVENTION: Before discharging the patient from the ED, the investigators verified a pager number and/or a best contact telephone number for a follow-up telephone call. Participants were divided into 2 groups. The intervention group consisted of caretakers with both pagers and telephones. The control group consisted of caretakers with only telephones. On even calendar days after ED visits, intervention group caretakers were paged initially from 11:00 AM to 11:59 AM. On odd calendar days, intervention group caretakers were telephoned initially from 11:00 AM to 11:59 AM. Successful contact was defined as communication with a family member or guardian over the age of 18. If the caretaker spoke only Spanish, a translator was used. In a crossover design with the intervention group, if contact was unsuccessful after 1 hour, the alternative mode of communication was used at noon. Control group caretakers were telephoned from 11:00 AM to 11:59 AM. If telephone contact was unsuccessful, they were called again 1 hour later. RESULTS: Two hundred forty-six (36%) of 685 of the convenience sample of caretakers had access to both a pager and a telephone. Fifty-two (55%) of 94 intervention caretakers were contacted initially using pagers versus 47 (52%) of 91 intervention caretakers contacted initially by telephones. Overall successful contact of intervention caretakers (telephones and pagers) was 145 (78%) of 185 when confined to a 2-hour time period. In contrast, overall successful contact of control caretakers was 68 (61%) of 112 when confined to a 2-hour time period. Successful contact was greater with the intervention caretakers than with control caretakers (78% vs 61%). CONCLUSIONS: No significant difference in successful contact was seen whether paged or telephoned initially. The combination of both pagers and telephone follow-up was more successful than telephone follow-up alone when confined between 11:00 AM to 1:00 PM.

Aftercare↗

PubMed2001

A comparison of the success of root resected molars and molar position implants in function in a private practice: results of up to 15-plus years.

BACKGROUND: When faced with a furcated molar, today's clinician must decide between a number of treatment options, including root resection, tooth removal, and implant placement. This paper assesses the results in one private clinical practice of root resection and subsequent restoration or molar implant placement and subsequent restoration. Clinical considerations in treatment selection are discussed. METHODS: A retrospective analysis of treated patients was carried out by examining active and inactive patient charts. When patients had discontinued therapy, every effort was made to determine the reason for leaving the private practice, so as to assess the impact of previously undocumented treatment failure on the statistics in question. RESULTS: A total 701 root resected molars and 1,472 molar implants were evaluated after > or = 15 and 13 years in function, respectively. Resection of the distal root of a mandibular molar demonstrated the lowest success rate (75%). All other success rates for various root resected molars in function ranged from 95.2% to 100%. Lone standing implants in second molar positions demonstrated the lowest success rate (85%). All other implant use in molar positions demonstrated a success rate ranging from 97.0% to 98.6%. Root resected molars and molar implants demonstrated the highest degree of failure when they were lone standing terminal abutments. Seven out of 23 (30.4%) root resected molar failures, and 17 of 45 (37.8%) of the molar implant failures were associated with untreated parafunction. Cumulative success rates were 96.8% for root resected molars and 97.0% for molar implants. Success and failure are discussed by tooth and/or implant position, and resected root, where applicable. Possible ramifications of these findings upon treatment planning are also reviewed. CONCLUSIONS: Both molar root resection and appropriate restoration and molar implant placement and restoration demonstrated a high degree of success in function. However, this success rate is markedly affected when either the root resected molar or molar implant is a lone standing terminal abutment. Care must be taken to choose the appropriate treatment modality for a given patient scenario.

Adult↗