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Journal articles on the topic 'Incompetence'

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Author: Grafiati

Published: 4 June 2021

Last updated: 20 February 2023

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1

Nusrat Mahjabeen and Shaikh Zinnat Ara Nasreen. "McDonald’s suture: A successful case." Z H Sikder Women’s Medical College Journal 3, Number 1 (January 1, 2021): 38–40. http://dx.doi.org/10.47648/zhswmcj.2021.v0301.09.

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Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester. Cervical cerclage (CC) has been utilized for the cure of loss in second trimester pregnancy. The detection of cervical incompetency is difficult. Usually patients have history of repeated second trimester demise or early preterm delivery after cervical dilatation without pain having no bleeding, contractions, or other reasons. We report a 28years old patient, 3rd gravida, para 0+2, at 11 weeks’ gestation with the diagnosis of cervical incompetence, in whom cervical cerclage (McDonald’s suture) was performed successfully. There were no operative or immediate postoperative complications. A healthy infant was delivered at 37 weeks by caesarean section. After delivery the suture was removed. Cervical cerclage during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence.

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2

Valentín, L. I., W. H. Valentín, S. Mercado, and C. J. Rosado. "Venous Reflux Localization: Comparative Study of Venography and Duplex Scanning." Phlebology: The Journal of Venous Disease 8, no. 3 (September 1993): 124–27. http://dx.doi.org/10.1177/026835559300800309.

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Objective: To compare the results obtained by duplex ultrasound imaging and ascending and descending phlebography in patients with chronic venous insufficiency. Design: Prospective comparison between venography and duplex ultrasound imaging in a single patient group with chronic venous insufficiency. Setting: Private vascular clinic in Puerto Rico. Patients: Twenty-one patients presenting with clinical evidence of venous disease of the lower limb. Main outcome measures: Presence of valvular incompetence in deep and superficial veins as indicated by duplex ultrasound imaging and ascending and descending phlebography. Results: Duplex ultrasound imaging showed twice as many patients with popliteal vein incompetence (eight veins compared with four veins) and twice as many incompetent long saphenous veins (14 detected by duplex, eight detected by venography). In the proximal venous system, 13 common femoral veins were thought incompetent on venography, but only seven on duplex scanning; in the superficial femoral vein, 11 were incompetent on venography and three on duplex scanning. Conclusion: Duplex ultrasound scanning provides greater sensitivity for detection of valvular incompetence in distal veins compared with venography. Descending phlebography is poor in demonstrating distal venous valvular incompetence.

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3

Bozeman, Barry, and Jiwon Jung. "The Corruption-Incompetence Nexus: Analysis of Corrupt US Mayors." Journal of Policy Studies 37, no. 2 (June 30, 2022): 1–12. http://dx.doi.org/10.52372/jps37201.

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The paper seeks to develop some preliminary ideas about the relation of corruption and incompetence, two different but perhaps related instances of political and administrative failure. We pose a corruption-competence nexus and suggest that corruption and incompetence are related in predictable ways. Indeed, in extreme cases of incompetence, incompetence often enables corruption due to a variety of factors including the inability to monitor corruption or to select quality advisors. We further suggest that a variety of factors mitigate the relation of incompetence and corruption, including level of political authority and impact, size of political and business networks, and availability of professionalized and empowered public service. To further examine the corruption-incompetence nexus, we use simple typology (e.g., corrupt-competent or corrupt-incompetent) to help organize and, to some extent, explain the forms of relationship between incompetence and corruption in the organizational setting. Four cases of U.S. mayors’ performance are evaluated to better understand the propositions.

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4

Stücker, M., R. Moritz, P. Altmeyer, and S. Reich-Schupke. "New Concept: Different Types of Insufficiency of the Saphenofemoral Junction Identified by Duplex as a Chance for a More Differentiated Therapy of the Great Saphenous Vein." Phlebology: The Journal of Venous Disease 28, no. 5 (May 6, 2013): 268–74. http://dx.doi.org/10.1177/0268355513476215.

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Even though the item ‘saphenofemoral junction’ (SFJ) is anatomically well defined, the incontinence of the SFJ is often incompetently described in clinical practice and studies. Especially with regard to the optimal therapy of the great saphenous vein, it might be of importance to have a more distinct regard to the SFJ as it is known that about 10–30% of the saphenous refluxes have no femoral origin. Considering the terminal and preterminal valve three types of incompetence of the SFJ may be differentiated: Type 1: Incompetent terminal, but competent preterminal valve; Type 2: Competent terminal, but incompetent preterminal valve; Type 3: Incompetent terminal and preterminal valve (complete incompetence). A review on prior studies and reports leads to the assumption that the differentiation of the distinct types of SFJ-incompetence allows a more individual and – perhaps – more effective therapy. Finally, studies are necessary to evaluate the here given new concept.

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5

Sakaguchi, Takuki, Takaaki Sugihara, Ken Ohnita, Daisuke Fukuda, Tetsuro Honda, Ryohei Ogihara, Hiroki Kurumi, Kazuo Yashima, and Hajime Isomoto. "Pyloric Incompetence Associated with Helicobactor pylori Infection and Correlated to the Severity of Atrophic Gastritis." Diagnostics 12, no. 3 (February 23, 2022): 572. http://dx.doi.org/10.3390/diagnostics12030572.

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Duodenogastric reflux (DGR) causes bile reflux gastritis (BRG) and may develop into gastric cancer. DGR is classified as primary in non-operated stomachs or secondary to surgical intervention. Primary DGR and Helicobacter pylori (H. pylori) infection are reportedly related. However, the mechanism is not fully understood. This study aimed to elucidate the relationship between H. pylori infection and pyloric incompetence in a non-operated stomach. A total of 502 non-operated participants who underwent an upper intestinal endoscopy were prospectively enrolled. Endoscopic findings (EAC, endoscopic atrophy classification; nodular gastritis; xanthoma; fundic gland polyp; and incompetence of pylorus), sex, age, gastrin, pepsinogen (PG) I and PG II levels were evaluated. PG I/PG II ratio, anti-H. pylori-Ab positivity, and atrophic gastritis status were significantly different between the normal and incompetent pylori (p = 0.043, <0.001, and 0.001, respectively). Open-type atrophic gastritis was significantly higher in the incompetent pylori. Incompetence of the pylorus and EAC were moderately correlated (Cramer’s V = 0.25). Multivariate analysis revealed that the presence of anti-H. pylori-Ab was the only independent factor associated with the incompetence of the pylorus, with an adjusted odds ratio of 2.70 (95% CI: 1.47–4.94, p = 0.001). In conclusion, pyloric incompetence was associated with H. pylori infection and moderately correlated to the severity of atrophic gastritis in non-operated stomachs.

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6

Riding, David M., Emma J. Pond, Charles McCollum, and Ann L. Caress. "Seeking consensus amongst UK-based interventional radiologists on the imaging diagnosis of pelvic vein incompetence in women with chronic pelvic pain: A modified Delphi study." Phlebology: The Journal of Venous Disease 34, no. 7 (January 8, 2019): 486–95. http://dx.doi.org/10.1177/0268355518821554.

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Objectives This modified Delphi study of vascular interventional radiologists sought to achieve consensus statements on the optimal imaging strategy and definitions of important imaging diagnostic features in women with pelvic vein incompetence. Method The UK-based interventional radiologists with the experience of investigating and treating pelvic vein incompetence responded to up to three rounds of online questionnaires. Results Three consensus statements emerged from 27 responders: (1) catheter venography is the ‘gold standard’ investigation for the diagnosis of pelvic vein incompetence; (2) pelvic vein incompetence should be defined as ‘retrograde flow along the ovarian or internal iliac veins’; (3) pelvic varices should be defined as ‘tortuous, often dilated, vulval, adnexal, para-uterine veins arising from incompetent internal iliac or ovarian veins.’ Conclusion This study achieved consensus statements on imaging diagnosis in women with suspected pelvic vein incompetence. These can be used to minimise heterogeneity of research protocols, and represent baseline positions which can, themselves, be tested.

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7

Netterville, James L., and Brian B. Burkey. "Medialization Laryngoplasty and Arytenoid Adduction." Otolaryngology–Head and Neck Surgery 112, no. 5 (May 1995): P86. http://dx.doi.org/10.1016/s0194-5998(05)80199-8.

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Educational objectives: To analyze the causes of glottal incompetence, including vocal cord paralysis, paresis, and senile bowing, and to perform surgery to correct the incompetency, including Silastic medialization, arytenoid adduction, and reinnervation.

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Arias, Jalayne J. "A Time to Step In: Legal Mechanisms for Protecting Those with Declining Capacity." American Journal of Law & Medicine 39, no. 1 (March 2013): 134–59. http://dx.doi.org/10.1177/009885881303900103.

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Current estimates approximate that the population over sixty-five years of age will increase from 40 million in 2010 to 72.1 million by 2030. As society ages, the number of elderly with cognitive deficits that impair decision-making abilities will also increase. This will place additional burdens on families and probate courts seeking to balance individual autonomy with necessary protections. A legal determination of incompetency is a prerequisite to a judicial order appointing a guardianship or other protective mechanism. The current legal-medical model for competency determinations fails to reflect the complexities of declining capacity in an aging population. A global structure for competency determinations leaves a critical gap between competent and incompetent. The gap between competence and incompetence not only raises concerns about how to classify those that fall between the two, but also highlights the lack of legal protections for those within the gap. A revised model is needed to provide protections to individuals who do not yet meet the threshold for incompetence but require additional protections for their personal or financial welfare. This Article provides an unprecedented examination of the legal model for determining competence through a comparison of the medical model for evaluating capacity. While a number of legal scholars have examined the appointment and oversight of guardians, fewer articles have critically examined the process by which individuals are declared incompetent. This Article presents a comprehensive overview of competency and clinical capacity determination procedures, legal mechanisms available to protect individuals with declining capacity, and policy recommendations for improving legal protections in light of inefficiencies related to legal competency determinations.

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9

Greiner, Milka, and Geoffrey L. Gilling-Smith. "Leg Varices Originating from the Pelvis: Diagnosis and Treatment." Vascular 15, no. 2 (April 2007): 70–78. http://dx.doi.org/10.2310/6670.2006.00030.

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This article reports the investigation and treatment of 24 women presenting with recurrent lower limb varicosities secondary to reflux within the pelvic venous circulation. Diagnosis based on selective retrograde pelvic phlebography enabled precise identification and classification of sites of incompetence. A total of 74 veins were treated by embolization with platinum coils and glue prior to repeat surgery to the lower limb veins. At 4-year follow-up, signs of stasis had disappeared in all patients. Repeat phlebography revealed no evidence of recurrent reflux at the sites of treatment. One patient developed recurrent varices due to incomplete embolization of incompetent pelvic veins. Endovascular occlusion of incompetent pelvic veins is an effective treatment for varicose veins secondary to pelvic venous incompetence.

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10

Prabhu, M. Ajoo Anto, and Alok Mohanty. "Accuracy of clinical methods and doppler ultrasound in detection of incompetency of sapheno-femoral junction and perforators compared with operative results." International Surgery Journal 4, no. 10 (September 27, 2017): 3300. http://dx.doi.org/10.18203/2349-2902.isj20174165.

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Background: Varicose veins, though a common condition, many time remains asymptomatic. The accurate diagnosis of varicose veins is of great importance in planning effective treatment. It is essential to bring out the accuracy of various diagnostic methods of varicose veins, so that early intervention can be achieved and recurrence can be prevented. The objective of this study was to our study was done with the intention of assessing the accuracy of Clinical evaluation of incompetence of Sapheno-Femoral Junction (SFJ) and perforators over doppler ultrasound evaluation and its Intra-operative confirmation, and also to assess the sensitivity, specificity, positive and negative predictive values and significance of both clinical as well as doppler ultrasound evaluation of varicose veins.Methods: The study was conducted in the in-patients of General Surgery Department from September 2011 to August 2013. Patients presented with dilated tortuous veins in lower limb(s) and operated were included in the study. Patients who had recurrent varicose veins and who were unfit for surgery were excluded from the study. The patients were first evaluated clinically using Brodie - Trendelenburg Test I and II, Tourniquet Test, Schwartz Test, Pratt’s Test, Morrissey’s Cough Impulse Test and Fegan’s Method. Following this, patients were evaluated by Ultrasound Doppler study of Venous system of the Lower limb(s) and sites of perforator incompetence were marked. Intra-operative confirmation of incompetence was done by Turner Warwick’s Bleed back sign. The accuracy of clinical methods and doppler ultrasound evaluation compared with operative findings were assessed.Results: Accuracy of clinical methods in detecting SFJ incompetence was checked with intra-operative findings. The sensitivity was 100%, specificity 100%, PPV 100% and NPV 100%. Similar results were obtained when checking the accuracy of doppler with intra-operative findings. Accuracy of clinical methods in detecting perforator incompetence was checked with intra-operative findings. The sensitivity was 82.93%, specificity 22.22%, PPV 90.67% and NPV 12.5%. Accuracy of doppler evaluation in detecting perforator incompetence was checked with Intra-operative findings. The sensitivity was 97.56%, specificity 12.5%, PPV 91.95% and NPV 33.33%.Conclusions: Diagnosis of varicose veins is essential for planning of treatment if needed. Clinical methods predict the diagnosis of incompetent SFJ and perforators for which patient need not spend money, and are easy to perform. But doppler ultrasound evaluation has been proved to be more reliable, non-invasive and compatible in detecting venous incompetence. Hence, we conclude that doppler ultrasound evaluation is more accurate than clinical methods in detecting incompetent veins.

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11

Abdul Razak, Razileyana, Norhalizawaty Abdul Razak, and Yusrita Zolkefli. "Community Nurse Managers’ Views of Incompetent Nursing Practice: An Interview Study." INTERNATIONAL JOURNAL OF CARE SCHOLARS 4, Supp1 (December 9, 2021): 86–92. http://dx.doi.org/10.31436/ijcs.v4isupp1.204.

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Introduction: Nurses' professional competence is a key factor for the quality of nursing practice, as the competence level directly influences the patient’s safety. A lack of competence among nurses raises several concerns and thus contributes to adverse effects of patient outcomes. These concerns, particularly how nurse managers understand and address incompetent practices, have not been thoroughly explored in the local context. Objective: The purpose of the study was to explore nurse managers' views of incompetent nursing practice in a community healthcare setting. Methods: A descriptive qualitative research was conducted in one single district in Brunei Darussalam with a purposive sample of nine community nurse managers from six healthcare centres. Data collection was by audio recorded of in-depth interviews. These interviews were coded and thematically analysed. Findings: The study participants discussed their perspectives on incompetent practice, the reasons for incompetence, and nurse managers' reactions to incompetence. Conclusion: The findings show that the standard views of 'incompetent' meant were elusive and inconsistent among nurse managers. Such inconsistency resulted in poor identification and management of ethical issues. Therefore, to ensure consistency, a clear view and understanding of what constitutes incompetent nursing practice must be established.

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12

Belcaro, G., and B. M. Errichi. "Selective Saphenous Vein Repair: A 5-Year Follow-up Study." Phlebology: The Journal of Venous Disease 7, no. 3 (September 1992): 121–24. http://dx.doi.org/10.1177/026835559200700310.

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objective: To evaluate the effect of selective saphenous vein repair (SSVR) in a 5-year follow-up study. Design: Prospective, randomized study of 44 subjects randomized to an SSVR group and a control group. Setting: University Clinic, Chieti, and Angiology and vascular Surgery Clinic, Pescara, Italy. Patients: Twenty-two patients in the SSVR group and 22 in the control group. Inclusion criteria were incompetence of the saphenofemoral junction (SFJ) with presence of valve cusps and two to five venous sites in the long saphenous vein. interventions: SFJ plication and selective interruption of the incompetent sites under general anaesthetic. Main outcome measures: Ambulatory venous pressure measurements (refilling time) and colour duplex scanning to detect the number of incompetent sites. Result: After 5 years, 18 patients in the SSVR group and 19 in the control group completed the study. SSVR increased refilling time ( p<0.02) and the number of incompetent sites was decreased ( p<0.02); in the control group, refilling time remained short and the number of incompetent sites increased ( p<0.05). Conclusion: SSVR is an effective treatment with good 5-year results on incompetence and the development of new incompetent venous sites.

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13

Barron, Chris. "Do we need a second opinion here?" Journal of Practice Teaching and Learning 5, no. 2 (December 26, 2012): 22–38. http://dx.doi.org/10.1921/jpts.v5i2.307.

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In contrast to research undertaken in other aspects of practice teaching, relatively little attention has been paid to measuring the effectiveness of practice teachers. This paper begins with an attempt to establish why it is important that we take the issue of practice teaching standards very seriously, focusing in particular on the ever increasing prospect of legal action against practice teachers alleged to be incompetent and the possibility of a connection between a practice teacher’s incompetence and his or her incompetence as a social work practitioner.Ways of supporting and monitoring the performance of practice teachers are explored with these considerations in mind before moving on to consider how practice teachers who cannot or will not change practice which is deemed to be incompetent should be managed. The paper concludes with some final reflections with tentative suggestions as to how to monitor the practice of other social work educators.

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14

Sottiurai, V. S. "Incompetent Transplanted Arm Vein Valves: Surgical Correction and Result." Phlebology: The Journal of Venous Disease 6, no. 1 (March 1991): 41–46. http://dx.doi.org/10.1177/026835559100600108.

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Nine arm vein valve transplantations were performed when the valves of femoral or popliteal veins were damaged beyond valvuloplasty in deep-valve correction. In four of the nine arm vein valves (44%) incompetence was recognized immediately following transplantation. Valvuloplasty successfully restored valvular competence of the four transplanted arm veins. Intraoperative direct venous pressure of the dorsalis pedis in the supine position improved by 5–30 mmHg (mean 8 mmHg) in six of seven limbs following vein-valve transplantation. Competence of the arm vein valve should be tested before and after transplantation. Valvuloplasty of the incompetent transplanted valves is feasible and has produced no added susceptibility to thrombosis and recurrent incompetence.

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15

Wilkinson, Ray. "Dana Kovarsky, Judith Duchan, & Madeline Maxwell (eds.), Constructing (in)competence: Disabling evaluations in clinical and social interaction. Mahwah, NJ: Lawrence Erlbaum Associates, 1999. Pp. vi, 381. Hb $89.95." Language in Society 30, no. 4 (October 2001): 643–46. http://dx.doi.org/10.1017/s0047404501224051.

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The 15 articles in this book focus on the evaluation of competence in clinical, educational, and other contexts in which people are regularly judged as incompetent. Several focus on interactions involving adults and children with communication disorders; others present issues of competence and incompetence in foreign-language learning, educational assessment, the discussion of medical diagnoses between medical staff and clients, and psychotherapy sessions. Although there is no single prevailing research methodology used throughout, a consistent theme is that competence and incompetence are socially constructed within interaction, and that the evaluation of (in)competence is central to the creation and negotiation of social identity in everyday life.

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Belcaro, G., A. Ricci, G. Laurora, M. R. Cesarone, M. T. De Sanctis, and L. Incandela. "Superficial Femoral Vein Valve Repair with Limited Anterior Plication." Phlebology: The Journal of Venous Disease 9, no. 4 (December 1994): 146–49. http://dx.doi.org/10.1177/026835559400900403.

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Objective: To evaluate the effects after 3 years of a new surgical technique, limited anterior plication (LAP) of the superficial femoral vein. Design: Patients with venous hypertension resulting from deep and superficial venous incompetence were randomized into two treatment groups. Setting: Angiology and Vascular Surgery, Pierangeli Clinic, Pescara, and Cardiovascular Institute, Chieti University, Italy. Patients: Both groups were treated with superficial vein surgery. Group 2 was also treated with LAP. Interventions: Valvuloplasty of the superficial femoral vein was performed with plication of the anterior vein wall after limited dissection of the vein. Main outcome measures: During a 3-year follow-up results were evaluated with colour duplex and ambulatory venous pressure (AVP) measurements. Endpoints were AVP, refilling time (RT), number of incompetent venous sites, presence/absence of the reflux at the superficial femoral vein and the diameter of the vein. Results: No complications were observed. All femoral veins treated with LAP were competent at 36 months. Significantly lower AVP and longer RT were observed in the LAP group. The number of incompetent venous sites was lower in both groups. The average diameter of the vein was higher in Group 1. Conclusions: In selected subjects – moderate deep venous incompetence, functional cusps, incompetence mainly due to relative enlargement of the vein – LAP may be an alternative to external valvuloplasty.

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Johns, Donnell F., Rod J. Rohrich, and Mariam Awada. "Velopharyngeal Incompetence:." Plastic and Reconstructive Surgery 112, no. 7 (December 2003): 1890–98. http://dx.doi.org/10.1097/01.prs.0000091245.32905.d5.

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18

Marzlin, Karen M., and Cynthia Webner. "Chronotropic Incompetence." AACN Advanced Critical Care 30, no. 3 (September 15, 2019): 294–300. http://dx.doi.org/10.4037/aacnacc2019182.

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19

Jo, Jinhee, and Lawrence S. Rothenberg. "Rational incompetence." Journal of Theoretical Politics 24, no. 1 (November 14, 2011): 3–18. http://dx.doi.org/10.1177/0951629811423232.

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20

Launer, J. "Unconscious incompetence." Postgraduate Medical Journal 86, no. 1020 (October 1, 2010): 628. http://dx.doi.org/10.1136/pgmj.2010.108423.

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&NA;. "Velopharyngeal Incompetence:." Plastic and Reconstructive Surgery 112, no. 7 (December 2003): 1982. http://dx.doi.org/10.1097/00006534-200312000-00070.

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SCHREIBER, MELVYN H. "Institutionalized Incompetence." INVESTIGATIVE RADIOLOGY 28, no. 6 (June 1993): 560. http://dx.doi.org/10.1097/00004424-199306000-00019.

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23

Pannbacker, Mary. "Velopharyngeal Incompetence." American Journal of Speech-Language Pathology 13, no. 3 (August 2004): 195–201. http://dx.doi.org/10.1044/1058-0360(2004/020).

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Speech-language pathologists are often involved in the diagnosis and treatment of velopharyngeal incompetence (VPI). Some speech-language pathologists have extensive educational and clinical experience with VPI; others have limited training and experience. Thus, the quality of speech-language services for people with VPI is heterogenous, and it ranges from poor to excellent. There are, as yet, no specific guidelines for speech-language pathologists providing services to people with VPI. Optimal services require specific guidelines for training and experience. The purpose of this article was to (a) review speech-language pathology standards and qualifications, (b) provide reasons for identifying qualified speech-language pathologists, and (c) identify strategies for reduction of risks involved in the delivery of speech-language services for people with VPI.

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Caulford, P. G., S. B. Lamb, T. B. Kaigas, E. Hanna, G. R. Norman, and D. A. Davis. "Physician incompetence." Academic Medicine 69, no. 10 (October 1994): S16–8. http://dx.doi.org/10.1097/00001888-199410000-00028.

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Ellestad, Myrvin H. "Chronotropic Incompetence." Circulation 93, no. 8 (April 15, 1996): 1485–87. http://dx.doi.org/10.1161/01.cir.93.8.1485.

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Wallach, Edward E., Barbara Shortle, and Raphael Jewelewicz. "Cervical incompetence." Fertility and Sterility 52, no. 2 (August 1989): 181–88. http://dx.doi.org/10.1016/s0015-0282(16)60839-7.

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27

Heaven, Douglas. "Artificial incompetence." New Scientist 236, no. 3157-3158 (December 2017): 49–51. http://dx.doi.org/10.1016/s0262-4079(17)32515-0.

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Inch, Sally. "PROFESSIONAL INCOMPETENCE." Lancet 327, no. 8485 (April 1986): 864–65. http://dx.doi.org/10.1016/s0140-6736(86)90980-3.

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Lauer, Michael S. "Chronotropic incompetence." Journal of the American College of Cardiology 44, no. 2 (July 2004): 431–32. http://dx.doi.org/10.1016/j.jacc.2004.05.001.

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Swibel Rosenthal, Laura H., Kathleen Walsh, and Dana M. Thompson. "Velopharyngeal incompetence." Current Opinion in Otolaryngology & Head and Neck Surgery 26, no. 6 (December 2018): 356–66. http://dx.doi.org/10.1097/moo.0000000000000494.

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Brubaker, Peter H., and Dalane W. Kitzman. "Chronotropic Incompetence." Circulation 123, no. 9 (March 8, 2011): 1010–20. http://dx.doi.org/10.1161/circulationaha.110.940577.

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32

Cook, T. "Managerial incompetence." Physics Bulletin 37, no. 9 (September 1986): 366. http://dx.doi.org/10.1088/0031-9112/37/9/008.

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McGillis, Rod. "Literary Incompetence." Children's Literature Association Quarterly 10, no. 3 (1985): 144–45. http://dx.doi.org/10.1353/chq.0.0417.

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Gianesini, Sergio, Savino Occhionorelli, Erica Menegatti, Anna Maria Malagoni, Mirko Tessari, and Paolo Zamboni. "Femoral vein valve incompetence as a risk factor for junctional recurrence." Phlebology: The Journal of Venous Disease 33, no. 3 (January 29, 2017): 206–12. http://dx.doi.org/10.1177/0268355517690056.

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Background Recurrent varicose veins occur up to 80% of procedures. The sapheno-femoral junction can be involved in more than 50% of cases. A detailed pathophysiological explanation of the phenomenon is still missing. The aim of the present work is to evaluate the role of femoral vein incompetence as risk factor for sapheno-femoral junction recurrence. Methods Three-hundred-eighty-one patients presenting an incompetent great saphenous vein system and eventually also an incompetent femoral tract (C2-6EpAsdPr) underwent a great saphenous vein high ligation with flush ligation also of the incompetent tributaries along the leg, sparing the saphenous trunk. Pre-operatively, all patients underwent a sonographic evaluation assessing the superficial and deep venous systems, including a detailed analysis of the iliac-femoral vein tract above the sapheno-femoral junction. A retrospective statistical analysis assessed the recurrence risk associated with iliac-femoral vein tract incompetence. Results In a 5.5 ± 1.9 years follow-up, great saphenous vein trunk reflux recurrence was detected in 45/381 (11.8%) cases. The reflux source was found in a reconnected sapheno-femoral stump in 11/45 cases (24.5%), in the pelvic network in 8/45 cases (17.8%), in a neovascularization process in 7/45 (15.5%) and in a newly incompetent great saphenous vein tributary in 19/45 (42.2%). At the pre-operative assessment, iliac-femoral vein tract reflux was present in 7 (26.9%) of the 26 cases who developed a sapheno-femoral junction recurrence and in 25 (7%) of the 355 patients who did not demonstrate sapheno-femoral junction recurrence (odds ratio: 4.8; confidence interval 95%: 1.8–12.6; p < .003). Discussion Despite many technical diagnostic and therapeutic refinements, varicose veins recurrence remains a frequent event. The present investigation points out the association among iliac-femoral vein tract incompetence and sapheno-femoral junction recurrences after high ligation.

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Al Jubair, Khalid A., Abdullah Jaralla, Mohsen Fadala, Emad Bukhari, Yahya Al Faraidi, Huwaida Al Qethami, and Mohamed R. Al Fagih. "Repair of the mitral valve because of pure rheumatic mitral valvar incompetence in the young." Cardiology in the Young 8, no. 1 (January 1998): 90–93. http://dx.doi.org/10.1017/s1047951100004698.

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AbstractBetween January 1985 and April 1994, 42 children aged between 7 and 14 years (mean 11.3 years) underwent repair of severely incompetent rheumatic mitral valves with no accompanying mitral stenosis. In 19 patients the tricuspid valve was severely incompetent, while 8 patients had severe aortic incompetence. Overall, the repair incorporated shortening of elongated tendinous cords and insertion of a Duran or Carpentier prosthetic ring. The repair was the sole procedure in 15 patients, whilst 19 patients also had a De Vega tricuspid valvar annuloplasty and 8 had repair or replacement of the aortic valve. There were no hospital deaths. Postoperative transthoracic echocardiographic studies revealed trivial residual mitral valvar regurgitation in 6 patients, mild regurgitation in 18, moderate in 15, and regurgitation severe enough to warrant replacement of the mitral valve in 3 patients. The mean follow-up period was 37 months (maximum 120 months, minimum 1 month). 0139 patients followed-up, 28 attended for more than 5 years. Of these, 7 underwent replacement of the mitral valve for severe regurgitation within 4 years of the repair. Severe mitral regurgitation in 3 patients was controlled by medical therapy. One was eventu ally lost to follow-up, and one patient died of causes unrelated to surgery. The remaining 16 patients had absent to moderate mitral valvar regurgitation. These results contrast with 10 repairs of congenital mitral incompetence, where no patients required re-operation in the immediate 5 years period of follow-up. Every effort should be made in children with rheumatic mitral incompetence to preserve the natural valve by con servative repair, despite the fact that repair of the incompetent rheumatic mitral valve is not so durable as repair of congenitally incompetent valves.

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Berridge, D. C., K. G. Mercer, C. Thornton, M. J. Weston, and D. J. A. Scott. "A Pilot Study Comparing the Use of Below-Knee and Above-Knee Graduated Stockings in Patients with Superficial Venous Incompetence." Phlebology: The Journal of Venous Disease 14, no. 1 (March 1999): 12–16. http://dx.doi.org/10.1177/026835559901400104.

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Objective: Investigation of the effects of high- and low-ankle-pressure, above- and below-knee compression stockings on the haemodynamics of normal and superficially incompetent venous systems. Design: Prospective duplex study of a normal group and a venous incompetence group randomised to high- or low-pressure stockings. Setting: Vascular services of a University Hospital. Subjects: Six subjects with normal venous haemodynamics (12 limbs) and 12 patients with superficial venous incompetence (20 limbs). Methods: Subjects wore below-knee and then above-knee stockings for 1 week each. Duplex scans were performed at the outset and end of the study and on fitting and after wearing each stocking type. Main outcome measures: Duplex-derived femoral and popliteal venous velocities were measured and indexed against the initial velocity. Results: Below-knee stockings produced only minor changes. Above-knee stockings produced increased velocities in normal subjects. Similar changes were only seen with higher-pressure stockings in patients with incompetence. Conclusion: Above-knee, high-ankle-pressure stockings produce increased deep venous flow velocities.

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McMullin, G. M., H. J. Scott, P. D. Coleridge Smith, and J. H. Scurr. "A Reassessment of the Role of Perforating Veins in Chronic Venous Insufficiency." Phlebology: The Journal of Venous Disease 5, no. 2 (June 1990): 85–94. http://dx.doi.org/10.1177/026835559000500204.

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Ambulatory venous hypertension is closely associated with the signs and symptoms of venous disease. It has been shown that reverse flow of blood in the superficial and deep veins is responsible. The pressure derangement caused by incompetence of perforating veins has not been established. The present study documents the pressure disturbances caused by incompetence in each of the three compartments of the venous system, the deep, the superficial and the perforating veins. In total 90 limbs of 49 patients with chronic venous insufficiency were examined and classified by duplex scanning and ascending venography. Ambulatory venous pressure measurements were performed on all 90 limbs and a venous sufficiency index (VSI) for each limb calculated from the percentage drop in pressure and refilling time. VSI was lowest in the group with deep vein incompetence (median 0.9, range 0–36.9), intermediate in the groups with superficial vein incompetence (median 7.6, range 0.4–59) and with incompetent perforating veins (median 14.6, range 0.4–35.7) and highest in the group with normal veins (median 41.7, range 3.5–87.5). The association of symptoms and VSI was also examined. The lower the VSI the more severe were the clinical symptoms and all ulcerated limbs had a VSI < 20. However a number of clinically normal limbs were also found to have low values of VSI.

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Marchese, Mariana, and Claudia Celerier. "The representation of mental health sufferers in administrative and legal discourse." Discourse & Society 28, no. 1 (December 4, 2016): 42–59. http://dx.doi.org/10.1177/0957926516676702.

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This article examines the records of mental incompetence cases filed at a court of the first instance in Buenos Aires Province, Argentina. Using a Critical Discourse Analysis framework and qualitative methods, we explore the ways in which mental health sufferers are represented. Applying Tone Theory and Appraisal Theory (attitude/judgement subsystem) to our data, we distinguish two discursive zones. In one of them, subjects are constructed with linguistic resources that amount to inscribed expressions of negative social judgement on their capacity. A discursive dichotomy is created whereby people are either competent or incompetent. In the other zone, these negative dichotomous judgements are largely softened by explicitly positive ones, without disappearing altogether. We suggest that mental incompetence, far from being a dichotomous concept, might be gradual.

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van Gent, WB, and CHA Wittens. "Influence of perforating vein surgery in patients with venous ulceration." Phlebology: The Journal of Venous Disease 30, no. 2 (December 19, 2013): 127–32. http://dx.doi.org/10.1177/0268355513517685.

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Objectives The exact role of perforating vein surgery is still unclear. The aim of this study is to analyze the influence of perforating vein surgery in patients with venous ulceration. Methods This study was part of a randomized controlled trial in which conservative and surgical treatment of venous ulceration was compared. It is a secondary analysis of prospectively gathered data. Ninety-seven active leg ulcers were surgically treated with a subfascial endoscopic perforating vein surgery (SEPS) procedure. Concomitant superficial venous incompetence was treated with flush saphenopopliteal ligation and/or saphenofemoral ligation and limited stripping of the great saphenous vein. All patients were also treated with ambulatory compression therapy. Ulcer healing and recurrences are described in detail. To measure the completeness of the SEPS procedure duplex ultrasonography was performed on each patient before and 6 weeks and 12 months after surgery. Also newly formed perforators after surgery were scored and their influence was analyzed. Results Analyses were performed on 94 ulcerated legs with a mean follow-up of 29 months. In all treated legs, only 45% all perforators were treated. In 55% one (29%) or more (26%) perforators were missed. Healing was not significantly influenced by the number of remaining incompetent perforating veins, but recurrence was significantly higher in patients who had incomplete SEPS procedure ( p = 0.007 log-rank). New incompetent perforating veins did not affect ulcer healing or recurrence. The plotted location of new perforators did not show a pattern. Deep vein incompetence and treatment of superficial venous incompetence had no significant influence on healing or recurrence rates in a complete or incomplete SEPS procedure. Conclusion In this series a well-performed SEPS procedure lowers the venous ulcer recurrence rate significantly, indicating the clinical importance of incompetent perforating veins in patients with an active venous ulcer.

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Schanzer, H., M. Skladany, and E. C. Peirce. "The Role of External Banding Valvuloplasty in the Surgical Management of Chronic Deep Venous Disease." Phlebology: The Journal of Venous Disease 9, no. 1 (March 1994): 8–12. http://dx.doi.org/10.1177/026835559400900103.

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Objective: Correction of venous reflux by perivalvular banding in patients suffering from chronic venous stasis secondary to primary valvular incompetence. Design: Prospective study in a group of patients with severe venous insufficiency. One patient (one extremity) was lost to follow-up. Setting: Tertiary care teaching hospital. Patients: Twelve patients (13 extremities) with severe or moderate venous insufficiency. Interventions: Correction of valvular incompetence by narrowing a valvular ring with an external band. Twenty-seven bands were fitted to incompetent valves of 13 extremities. Main outcome measures: Abolition of reflux and improvement of muscle pump measured by clinical, plethysmographic and venographic criteria. Results: Symptomatic improvement was found in 10 extremities (77%) and complete correction of reflux on venography in eight extremities (67%). Plethysmographically measured reflux improved in 6 extremities (50%) and muscle pump function improved in 7 extremities (58%). No correlation was found between plethysmographic and clinical or venographic outcome. Conclusion: Perivalvular banding can correct reflux and alleviate clinical symptoms of chronic venous stasis in patients with primary valvular incompetence. Selection of patients, valves to be corrected, necessary degree of valvular ring narrowing and need for additional interventions should be further investigated.

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Hobbs, J. T., and M. A. W. Vandendriessche. "Incompetence of the gastrocnemius vein." Phlebology: The Journal of Venous Disease 19, no. 2 (June 1, 2004): 57–64. http://dx.doi.org/10.1258/026835504323080317.

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The veins of the popliteal fossa are more complex than is generally realised. It is frequently taught that the short saphenous vein need only be divided deep to the popliteal fascia. However, the pattern and level of termination of the short saphenous vein shows wide variation. Sometimes, the short saphenous vein is normal and the pathology involves other veins. The 'vein of the popliteal fossa' may sometimes be present as a large tortuous varicosity and pierce the fascia to become superficial at the back of the knee. Incompetence of a gastrocnemius vein, usually the medial, may cause swelling and discomfort within the calf yet nothing is apparent. Awareness may be precipitated by attempting to wear tight fitting boots or trousers when the difference in calf circumference is recognised yet there is no ankle oedema. Next a venous flare or dilated venules appear over a perforator site, usually the mid-calf perforator, but sometimes the Boyd's perforator, filling the posterior arch tributary of the greater saphenous vein. Incompetence of a gastrocnemius vein is suggested by the history and clinical examination. Reflux is demonstrated by Doppler ultrasound and accurately localized by duplex ultrasound with colour-flow imaging. The anatomy is clearly visualized by venography.Large gastrocnemius veins are seen in athletes and ballerinas with well-developed calf muscles and such veins are physiological and should not be interrupted. It is imperative that reflux is demonstrated before surgical treatment is offered. Treatment involves ligating the incompetent gastrocnemius vein through a small incision over the popliteal fossa. If the mid-calf perforator is also incompetent it is divided deep to the fascia through a small vertical incision and the fascial defect closed. The distal short saphenous vein may be removed by partial stripping and any tributaries removed by phlebectomies using Oesch hooks. Strong below-knee stockings are worn for a month following this surgery.

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Nazarko, Linda. "Incontinence through incompetence." Nursing Standard 7, no. 32 (April 28, 1993): 52–53. http://dx.doi.org/10.7748/ns.7.32.52.s55.

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Jones, Miss A. C. "Smear test incompetence?" Nursing Standard 5, no. 18 (January 23, 1991): 40. http://dx.doi.org/10.7748/ns.5.18.40.s37.

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Akkawi, Nabil Maalikjy, Chiara Agosti, Barbara Borroni, Luca Rozzini, Mauro Magoni, Luigi A. Vignolo, and Alessandro Padovani. "Jugular Valve Incompetence." Journal of Ultrasound in Medicine 21, no. 7 (July 2002): 747–51. http://dx.doi.org/10.7863/jum.2002.21.7.747.

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Euchner, James A. "Innovations's “Skilled Incompetence”." Research-Technology Management 54, no. 5 (September 2011): 10–11. http://dx.doi.org/10.5437/08956308x5405002.

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Linsley Hood, J. L., S. K. Pal, and G. Gibbs. "Incompetence at work." Electronics and Power 31, no. 3 (1985): 199. http://dx.doi.org/10.1049/ep.1985.0144.

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Shprintzen, Robert J. "Evaluating Velopharyngeal Incompetence." Journal of Childhool Communication Disorders 10, no. 1 (May 1986): 51–66. http://dx.doi.org/10.1177/152574018601000105.

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Leskov, Sergei. "Lies and incompetence." Bulletin of the Atomic Scientists 49, no. 5 (June 1993): 13. http://dx.doi.org/10.1080/00963402.1993.11456352.

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Rogers, Richard, Emily V. Robinson, and Sarah A. Henry. "Feigned Adjudicative Incompetence." Assessment 24, no. 2 (July 28, 2016): 173–82. http://dx.doi.org/10.1177/1073191115605613.

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Psychological assessments are highly dependent on the forthrightness and sincere efforts of examinees. In particular, evaluations in forensic settings must consider whether feigning or other response styles are utilized to intentionally distort the clinical presentation. The current study examines the effectiveness of the Inventory of Legal Knowledge (ILK) at detecting feigned incompetency within a sample of jail detainees. As an ancillary goal, several scales of the Standardized Assessment of Miranda Abilities were included in the same within-subjects simulation design. Results of the total ILK score raised concerns regarding the mischaracterization of genuine offenders as “suggestive of feigning.” Pending cross-validation, however, a Revised ILK proved highly effective, using a floor effect detection strategy. Although intended for Miranda-specific abilities, several detection strategies on the Standardized Assessment of Miranda Abilities appeared to be very promising within a broadened context of feigned incompetency.

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Wattis, J. P. "Incompetence develops gradually." BMJ 310, no. 6994 (June 17, 1995): 1605. http://dx.doi.org/10.1136/bmj.310.6994.1605.

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