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PubMed2005

[Orthodontic treatment need: the IOTN, or Index of Orthodontic Treatment Need (part 2)].

IOTN is an index of orthodontic treatment need that has been devised on the basis of the available evidences of the deleterious effects of malocclusion on the aesthetic and health of the dentition. It has two components i.e. an aesthetic component and a dental health component. This index is widely used in epidemiological research and by third party payment for determination of those patients who should benefit from public funding.

Dental Arch↗
PubMedDate not supplied

Nursing informatics needs assessment. Are distance programs needed?

Nursing informatics is a small but growing specialty area in nursing. The authors describe the results of a needs assessment designed to determine interest in a distance-based master's degree and certificate program in nursing informatics. Information was also collected on computer and Internet proficiency for a large sample of BSN graduates. Results suggest that there is an interest in informatics, although somewhat less than was found previously. Respondents indicated that a knowledge of nursing informatics could provide additional career opportunities and that there was a general lack of programs available.

Adult↗
PubMed1997

Respite-care needs--met and unmet: assessment of needs for children with disability.

The study aimed to ascertain the current use of respite-care services by families with children with a learning and/or a physical disability in a South London, UK, health authority, to estimate the type and extent of the unmet need, and to set standards for the provision of such services. Over 1200 families were sent an 11-page questionnaire. The results indicated that the child's level of dependency and the presence of behaviour and communication problems led to significantly higher levels of experienced stress among carers. This was also associated with a significantly greater use of respite care except by families of children with behavioural problems. The results showed that respite care was generally perceived as an inadequate service, though 88% of respondents had no knowledge of the existence of respite-care services. Recommendations are made in relation to information provision, choice, and flexibility for carers and for quality standards in general.

Adolescent↗
PubMed1982

Levels of analysis and levels of need: cultural factors and the assessment of need for alcoholism treatment services in an urban community.

This is a case study in techniques for combining qualitative and quantitative data in local community service needs assessments. Problems in available administrative statistics when applied to local communities are illustrated and discussed. Supplementation of epidemiologic estimates and utilization statistics with ethnographic, historical, and sample survey data is shown.

Alcoholism↗
PubMed2006

Social support needs of families adopting special needs children.

A grounded theory begins to explain parental practices in seeking social support. Interviews with 20 parents who had adopted children with special needs and 5 health care providers indicated that parents lacked awareness of available resources; preferred informal support systems; sought help only when "failing" to solve problems; and perceived that health care providers lacked knowledge of adoption issues, family dynamics, and common health issues. Parents preferred informal to formal supports, and felt upset when formal supports were judged ineffective or non-existent.

Adolescent↗
PubMed1999

[Possibility of discharge and need for rehabilitation of psychiatric patients hospitalized for one year or more in Japan: a preliminary report. Committee on Rehabilitation Affairs, Subcommittee of Survey on Rehabilitation Need].

A total of 19,342 psychiatric patients staying in a total of 143 hospitals in Japan for one year or more entered in this study in order to determine the possibility of discharge (POD) and the need for rehabilitation. Those who were assessed by the psychiatrist in charge to have POD provided community support was assured accounted for 32.5%. As for the levels of daily life functions measured with the GAF score, those assessed to have POD showed the maximum frequency between scores 51 and 60, while the others, who were not considered suitable for discharge, showed the maximum frequency between scores 21 and 30. On the other hand, the control group, consisting of subjects with psychiatric disabilities and living in the community while using day care or rehabilitation facilities, showed the maximum frequency of GAF scores between 51 and 60. Two-thirds of the study subjects were older than fifty, while in the control group those aged between 30 and 49 accounted for 49.0%, thus indicating that the residents of mental hospitals tend to be older. More than 60% of the study subjects had been staying in hospital for five years or more. Those without their own home accounted for about 60%.

Adult↗
PubMedDate not supplied

Health care needs, user needs and socioeconomic conditions.

The key factors in the correlation between health care needs, demand and supply of health services in Italy are analyzed. Some organizational and managerial problems of the Italian health service are stressed. In particular, demographic and epidemiological changes occurred in the Italian population and in the hospital supply system are deal with. The growing gap between central, northen and southern Italy is described in terms of health indicators and expenses. Worries on the fact that the present system is not logically and consistently organized to be able to calmly face the challenges of the future, are expressed.

Demography↗
PubMed1980

Needs for precise measures of acuity. Equipment to meet these needs.

The equipment described provides precise, reliable measures of acuity from normal to the lowest measurable and meets all recommendations of the NAS-NRC Working Group 39 of the Committee on Vision. Special features of the equipment are as follows: (1) It is a valuable component of a complete clinical eye examination. (2) Because it measures very low acuities, it is excellent for use in low-vision clinics. (3) It meets the demanding requirements of collaborative research studies in which acuity is the primary measure of the effects of therapy. These studies involve tests at repeated intervals under conditions that can be duplicated in a number of examining centers. The adoption of one standard method of measuring acuity for these diverse needs would aid in establishing a sound, generally understood foundation for this basic measure of visual function.

Eye Diseases↗
PubMed2005

Biosensors for marine applications. We all need the sea, but does the sea need biosensors?

The aim of the paper is to explain the rationale behind marine biosensor applications, give an overview of measurement strategies currently employed, summarise some of the relevant available biosensor technology as well as instrumentation requirements for marine sensors and attempt a forward look at what the future might hold in terms of needs and developments. Application areas considered are eutrophication, organism detection, food safety, pollutants, trace metals and ecotoxicology. The drivers for many of these studies are discussed and the policy environment for current and future measurements is outlined.

Biosensing Techniques↗
PubMed2006

Future of high pressure liquid chromatography: do we need porosity or do we need pressure?

Making a theoretical study supported by experiments of the kinetic advantages of increased inlet pressures versus increased external porosity using impedance plots of analysis time versus required plate number, it is found that both approaches more or less have the same effect on the kinetic performance. The need to change a given system to one with an increased inlet pressure or with an increased external porosity can best be assessed from the optimal plate number (N(opt)) of the system. When the pursued application requires a plate number that is larger than N(opt), any increase in inlet pressure and external porosity is beneficial. When the required plate number is smaller than N(opt), any increase in inlet pressure and external porosity should preferentially be accompanied by an overall reduction of the feature sizes of the support. The degree to which this feature size reduction can be realized in practice will to a large extent determine which of the two approaches will be the dominant system of the future.

Chromatography, High Pressure Liquid↗
PubMed1994

Bombesin suppresses need-free and need-induced salt intake in rats.

The researchers performed experiments to evaluate whether the effects of bombesin are selective for the satiation of ingestive behaviors related to energy balance or if ingestive behaviors associated with sodium balance are also suppressed by bombesin. Injections of 4 and 8 micrograms/kg bombesin reliably reduced need-free and sodium deficiency-induced NaCl intake in male rats. The effects of bombesin on the sodium-deficiency-induced change in taste reactivity was assessed. Injections of 4 micrograms/kg and 8 micrograms/kg bombesin had no effect on the sodium deficiency-induced shift in taste reactivity. These data indicate that bombesin suppresses NaCl intake and that bombesin does not appear to interact with gustatory sensibility in exerting its behavior-controlling action.

Animals↗
PubMed2005

[Criteria for assessing the need for rehabilitation and for sanctioning refund claims -- Würzburg rating scale for sociomedical expertising on the need for rehabilitation and on the justification of refund demands on statutory insurance].

The essential criteria governing the assessment of the need for rehabilitation must be reviewed before making a sociomedical decision on claims to the German Statutory Pension Insurance (GRV) for refunding expenditure on rehabilitation. For an objective view of such a sociomedical decision, one must specify more clearly the fundamental assessment criteria. The study presented here was based on an exploratory analysis using a specific rating scale (the "Würzburg Checklist") for the various aspects of necessary rehabilitation according to sociomedical assessment of the medical records and medical examination of the patient. The aim of such an analysis is to pinpoint the various necessary decisions one by one before arriving at a final sociomedical expertise enabling the insurance body to decide to meet the cost of rehabilitating a particular patient. Three Bavarian Statutory Sickness Insurance bodies conducted medical random checks by selecting a sample of applicants with musculo-skeletal disease (n = 483) and examining the medical records and the results of a personal examination of the applicant by the medical expert. Completion of the rating scale was done after the experts had made their decision. The rating was subsequently repeated by the clinicians when the patient was admitted to the rehabilitation hospital. Although there were significant differences between these three groups of physicians in the evaluation of the applicants in respect of requirement criteria, it was not possible to identify any particular tendency to a verdict. Assessing the criteria according to the records is limited to some extent. Factor analysis yields five subscales in the rating list with good internal consistency: overall impediment, forecasting the ability to being motivated for rehabilitation, professional efficiency rating, psychosocial stress, risk factors. These subscales, while fairly consistent, are discriminatively valid in respect of rehabilitation recommendations by the sociomedical experts. The results of this survey are a first approach to the development of a practically relevant structural tool for sociomedical assessment.

Adult↗
PubMed2005

HIV testing of pregnant women--what is needed to protect positive women's needs and rights?

With increased availability of antiretroviral therapy, there is an escalating global trend to test all pregnant women for HIV in order to stop perinatal transmission. However, insufficient consideration is given to the impact this may have on the lives of these women and their families. Many women feel pressured into HIV testing during pregnancy, do not receive adequate pre-test counselling or do not give truly informed consent. Some women who test positive experience significantly more discrimination from their partners, families and community members than HIV-positive men do. As a consequence, large numbers of women diagnosed during pregnancy do not tell their husband their status because they fear blame, abandonment or abuse, including physical assault. Women who do disclose their HIV status may face dramatic negative repercussions on their own and their children's wellbeing. Consequently, it is unfair to test women during pregnancy solely or mainly to help prevent perinatal transmission if there are no available support services to protect the women's rights, enable them to live healthy after an HIV-positive diagnosis and engage them in the policies and programmes that affect women's lives. We need to create a climate that encourages HIV testing before pregnancy so that women can make informed reproductive choices. Men must be brought into the testing process through couple counselling before pregnancy and scaling up of voluntary counselling and testing programmes outside the antenatal care setting. In addition, people living with HIV have unique expertise and are very effective as peer counsellors. They have been under-utilised in the health care sector to provide support to newly-diagnosed people and to help eliminate AIDS-related shame and stigma.

Anti-HIV Agents↗
PubMed2004

The number needed to treat needs an associated odds estimation.

BACKGROUND: The number needed to treat (NNT) is a practically useful indicator that represents how many patients must be treated to prevent one adverse event when provided with a new intervention instead of the standard one. The NNT associates the net-benefit of an experimental treatment with the number of patients, or the size of trials, expecting one outcome of success. The NNT, however, also suggests that we assume an implicit execution of independent Bernouilli trials--as it were, the hypothetical NNT trials--independently repeated the same number of times as the value of NNT and with the same occurrence-probability of success as the value of absolute risk reduction. These independent Bernouilli trials, of course, have some probabilities of failure. Most decision-makers in practice would be more interested in how much the hypothetical NNT trials can achieve 'success/failure' with 'how many' patients, or the 'odds' of success versus failure, rather than 'one' outcome of success as the mean value. METHODS: We investigated the properties of hypothetical NNT trials. A binomial distribution was employed to develop formulae for estimating the odds of success versus failure to gain net-benefit in the NNT-associated trials. RESULTS: Most of the estimates of odds expected by the new intervention are between three and 1.72, converging to e-1 as the NNT increases. CONCLUSION: When basing decisions on an NNT, clinicians and public health specialists should take account of the odds of achieving the theoretical NNT.

Data Interpretation, Statistical↗
PubMed1999

Information needs in a changing health care system: capitation and the need for a population-oriented view.

Information systems needed for managing the health care of populations under at-risk (capitation) contracts must be designed differently than those used in fee-for-service practice. Under capitation, providers must deliver health care to enrollees with financial resources that are fixed in advance. Therefore, the information systems they use must enable them to understand the health status of health plan enrollees and how health care is provided. These systems should facilitate the detection of underservice and of inadequate quality of health care as well as overuse of health care resources. They should permit clinical-epidemiologic and statistical analysis; facilitate disease management and the adoption of preventive programs, and lend themselves to use by planners, group leaders, and practicing physicians.

Ambulatory Care Information Systems↗
PubMed2006

Number-needed-to-treat (NNT)--needs treatment with care.

The "number-needed-to-treat" (NNT) was introduced about 15 years ago and has gained widespread use. It has been claimed to be "easy to understand" and gives "intuitive meaning". When used to measure the effectiveness of interventions targeting chronic disease processes e.g. atherosclerosis and osteoporosis, NNT (as well as relative and absolute risk reduction) does not capture the crucial time component, a fact that has important consequences: NNT varies over time, it may not mean that adverse events (fractures, myocardial infarctions etc.) are avoided, but simply that they are postponed. Finally, empirical studies indicate that lay people and doctors misunderstand NNT. We recommend that NNT be used with considerable care. There is probably no single effect measure that is able to convey all necessary information.

Drug Therapy↗
PubMedDate not supplied

Preventing dental disease for people with special needs: the need for practical preventive protocols for use in community settings.

People with disabilities have more dental disease, more missing teeth, and more difficulty receiving dental care than other members of the general population. Because of the deinstitutionalization movement during the later 20th century, many formerly institutionalized people now reside in community settings, which lack oral health services. Even individuals who were not institutionalized have barriers to oral health services. These realities underscore the importance of preventing dental disease in people with special needs by establishing preventive dental disease protocols.

Adolescent↗