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PubMed2001

The surgical morbidity and mortality meeting as an educational tool.

PURPOSE: This study aimed at evaluating the educational value of the morbidity mortality meeting and benefits obtained from it so as to implement changes that can improve it. METHODS: Surgeons (n = 13) at a university hospital responded anonymously to a questionnaire which was structured to monitor the educational activity of the morbidity mortality meeting. They indicated their perceptions on a five-point scale (very poor, poor, fair, good and very good). Depending on the results of the first questionnaire, these changes were made: 1) Standardisation of the notice of the Meeting 2) Organization of the meeting 3) Review of the literature on the specific problems encountered. The participants were not aware of the results of the first questionnaire. Nine weeks later, the same questionnaire was repeated (n=12). Mann-Whitney test was used to compare the ratings of the two questionnaires. RESULTS: The attributes which showed significant improvement between the first and second questionnaires were a) organization (p = 0.004; (median (range) 3 (2-5) compared with 5 (3-5)) b) knowledge is up-to-date (p < 0.005; (median (range) 3 (2-4) compared with 4 (3-5)), c) discussion related to the problem (0.01; (median (range) 3 (1-4) compared with 4 (3-5)) and d) notice of the meeting (p < 0.026; (median (range) 3 (2-4) compared with 4 (2-5)). CONCLUSIONS: This study showed that specific actions can improve the educational quality of the morbidity mortality meeting.

General Surgery↗
PubMed1992

[Care for women: where and how].

OBJECTIVE: To analyse the demand for family planning, gynecological cancer tests and pregnancy supervision in an area with no public resources devoted specifically to these questions. To evaluate users' level of satisfaction and their readiness or otherwise to be visited at the Health Centre (HC), with a view to planning out a specific programme. DESIGN: Descriptive study. SITE. Health Centre at Castelldefels. (Barcelona). PATIENTS AND OTHER PARTICIPANTS: Random stratified sample of 595 women over 14, living within the centre's catchment area. The age distribution was selected in line with the town's population pyramid. MAIN MEASUREMENTS AND RESULTS: We undertook a self-administered, anonymous survey of 437 women. 4.9% of those sexually active between the ages of 14 and 20 and 13.2% of women aged between 21 and 45 use no contraceptive method. The greater attendance at private rather than public centres for contraception (73% as against 23.8/1000 p less than 0.001) and for regular check-ups (63.8% as against 32.1/1000 p less than 0.001) was notable. But for pregnancy care it was the other way round (29.3% as against 61.2/1000 p less than 0.001). 64.1% have regular check-ups; 48.8% annually. A higher level of satisfaction is shown by women seen at private (95.2%) than at public centres (75.1/1000 p = 0.0159). 68.9% would use a special care services for women if offered by the HC. CONCLUSIONS: Existing services offer scant cover to sections of the population more at risk and tend to make everything a medical problem. The public centres give little user-satisfaction. The Primary Care teams could cover these deficiencies with their services and would be welcome by the public.

Adolescent↗
PubMed2004

[Child sexual abuse: a study among 892 female students of a medical school].

OBJECTIVE: This study was designed to ascertain the prevalence of child sexual abuse (CSA) among female students of a medical school and to explore the impact of CSA on the mental health and health related risk behaviors of the victims being sexually abused and to provide useful reference for CSA prevention. METHODS: A cross-sectional survey was carried out among 892 female students from a medical school by anonymous self-administered questionnaire during Oct. 2002. The questionnaire used for this study mainly included (1) general demographic information; (2) sexual experiences; (3) 12 forms of CSA. In this study, cases of CSA were defined as those who answered positively to one or more of the 12 questions relating to childhood sexual experiences (including non-physical contact CSA and physical contact CSA) occurring before age 16 with a person when a child did not want to. (4) Center for Epidemiologic Studies (CES)-Depression Scale; (5) Self Esteem Scale; (6) Risk Behaviors; (7) Health status' self-evaluation. Survey procedures were designed to protect students' privacy by allowing anonymous and voluntary participation. Students were seated separately, completed the self-administered questionnaire in their classrooms during a regular class period. Respondents were encouraged to participate in this survey, but given the sensitive nature of the subject, they could skip portion of the questionnaire if they were not comfortable with the questions. The completed questionnaires were sealed in envelopes by students themselves (the envelope was distributed with questionnaire at the same time), and then collected together. Data were analysed by using the Statistical Package for the Social Sciences software. Frequency, percentage, Chi-square test and t-test of statistics were used to analyze the CSA prevalence and explore the influence of CSA on mental health of students. RESULTS: Among 892 female students, 25.6% reported having experienced CSA (any one of 12 forms non-physical contact and physical contact CSA) before the age of 16 years. The median age at first episode was 12 years. Comparing the rates of CSA of female students in different parents' education level, between one-child in a family and more than one-child in a family, among rural area, county and city, there were no significant differences. Compared to the students who had not experienced CSA, the students who had experienced CSA reported higher levels of depression (CES-D score 18.78 vs. 16.68, t = 2.81, P = 0.005), lower levels of health status self-evaluation (score 3.53 vs. 3.78, t = 2.94, P = 0.003); higher proportion of subjects who reported drinking alcohol and having ever smoked during the past 30 days (drinking 32.7% vs. 22.9%, chi(2) = 8.51, P = 0.004; smoking 8.8% vs. 4.4%, chi(2) = 6.17, P = 0.013); a higher percentage engaged in sexual intercourse (19.3% vs. 5.9%, chi(2) = 33.48, P = 0.000); ever seriously considered attempting suicide (23.7% vs. 15.4%, chi(2) = 8.09, P = 0.004), making a plan about how would attempt suicide (17.9% vs. 9.7%, chi(2) = 10.62, P = 0.001), being threatened or injured by someone with a weapon such as a knife, or club on school property (3.5% vs. 1.1%, chi(2) = 6.17, P = 0.013), being involved in physical fight (16.7% vs. 5.6%, chi(2) = 27.05, P = 0.000) during the 12 months preceding the survey. CONCLUSIONS: The results further showed that the CSA of girls in our country is not uncommon, as reported before in our country and in the other countries and is associated with poor mental health and risky behaviors. The findings highlight the urgent need for the further research into CSA epidemiological characteristics, health services for the victims abused sexually, sexual abuse prevention programs in schools and the general community in China.

Adolescent↗
PubMed1993

Contemporary issues in the treatment of alcohol dependence.

Alcoholism treatment has certainly come of age since its inception with the founding of Alcoholics Anonymous in 1935. Although AA is a "fellowship" and is not considered "treatment" per se, the growth and proliferation of professional treatment programs has spawned a significant new sector in the health care industry, with a corresponding rise in health care cost. Because the social cost due to the destructiveness of alcoholism is enormous, however, treatment appears to be a cost beneficial investment for society, both in terms of dollars expended and in terms of the lessening of human misery. Inpatient and outpatient programs appear to be effective, but simplistic comparisons are to be avoided because their populations are frequently much different, with patients with poor prognosis indicators showing up more frequently in inpatient settings. Although outpatient treatment is undeniably cheaper initially, appreciable long-term savings may not be realized because of the greater tendency for recidivism in outpatient-treated groups. Taken as a whole, studies of treatment outcome and cost effectiveness support the view that contemporary alcoholism treatment should provide multiple levels of care, with appropriate matching of patients, depending on severity and various demographic factors. This matching may be difficult to realize in actual practice because of the wide variability among alcoholic patients. Although some patient-treatment matching criteria are now in use by insurance carriers and treatment providers, the long-term efficacy of these criteria have not been tested adequately. In the end, it may evolve that the best determinant of assignment to a particular treatment level or modality might best be done by a responsible clinician exercising good judgment based on experience and training. Appropriate legal and financial accountability for this decision should be based on standards of reasonableness, consistent with criteria used in the treatment of other medical and surgical conditions. The alcoholism clinician is performing a valuable service to humanity and to society. Social policies should support this effort by making available appropriate facilities and programs for treatment, and by promoting access through destigmatization and favorable payment and reimbursement systems.

Aftercare↗
PubMed2006

Adolescents' knowledge of and attitudes toward Minnesota laws concerning adolescent medical care.

BACKGROUND: Healthcare delivery to adolescents involves consent to care, confidentiality, and reimbursement in attendance to patients' medical problems. State laws address the medical care of minors with respect to privacy and autonomy. This study was conducted to determine adolescents' knowledge and attitudes toward the laws in their state, Minnesota, that influence their medical care. This information may guide health care providers in their education of adolescent patients, as well as advise future legislation on the healthcare of minors. METHODS: Written questionnaires were administered to 636 9(th) through 12(th) grade students in required classes at the three public high schools in Rochester, MN, providing a representative sample of approximately fifty participants from each of the four grades. Results from the sixteen-question, anonymous survey were compiled to calculate an overall median knowledge score. Median scores were also reported by individual question, policy category, gender, grade, and socioeconomic status. Adolescent opinion was scored on a system in which +1 signified a "good law," 0 "neither a good nor bad law," and -1 a "bad law." These opinion scores were used to determine adolescents' attitudes by category as well as an overall positive, negative, or neutral opinion toward the laws. RESULTS: 594(93.4%) students returned surveys. Adolescents obtained a median score of 31.3% (range, 0-100%) correct on a knowledge test. Opinion score was positive, with a median of + 0.38. 81.1% of adolescents reported that the laws in the survey had no effect on their lives. CONCLUSIONS: These results indicate that adolescents are not knowledgeable of Minnesota laws regarding their medical care. Overall opinion of the existing laws is positive, particularly of those laws that protect minor consent. Most adolescents feel that these laws have not affected their lives. Low knowledge and a lack of a sense of impact from these laws indicate a need for clinicians to educate patients and their families about the legal aspects of adolescent medical care. These results are particularly relevant at a time when changes to current minor health care legislation are under consideration.

Adolescent↗
PubMed1992

Partner notification as a tool for research in HIV epidemiology: behaviour change, transmission risk and incidence trends.

OBJECTIVE: To assess whether routinely collected data from partner notification for HIV infection could be used to study HIV epidemiology. The issues addressed were measures of contact patterns and behaviour change, variables influencing transmission risks, and indications of HIV incidence. DESIGN: We collected anonymous questionnaire data from all partner notifications performed from seropositive patients diagnosed in Sweden between 1 January 1989 and 30 June 1990. METHOD: A structured questionnaire was completed by the physician or counsellor interviewing newly diagnosed seropositive patients and counselling their reported partners. The questions focused on temporal and behavioural aspects of all contacts between index patients and partners. RESULTS: Questionnaires were completed for 365 of the 403 (91%) index patients diagnosed during the study period, for 350 of the 390 (90%) located partners, and for 274 of the 297 (92%) relationships where results of HIV testing were known for index patient and partner. Seropositive individuals diagnosed in 1989 or later reported less risk behaviour than those diagnosed earlier. Risk of transmission in sexual contact increased when the infectious partner developed symptoms of HIV infection. Anal intercourse was found to be approximately twice as infectious as vaginal, and transmission risk from a seropositive insertive partner approximately twice as high as from a receptive. The total HIV incidence in Sweden appears to be declining, as does the number of newly diagnosed infected homosexual men. CONCLUSION: Carefully collected data acquired from a partner notification programme are well suited to describe and follow the epidemiology of HIV infection.

Contact Tracing↗
PubMed1999

Australian doctors' beliefs and practice regarding Helicobacter pylori.

OBJECTIVE: To determine beliefs and behaviours of Australian doctors regarding Helicobacter pylori. DESIGN: Anonymous reply-paid postal survey mailed in December 1995 and again in March 1996. SUBJECTS: All members on the mailing lists of the Gastroenterological Society of Australia Endoscopy Section (n = 397) and the Australian Society of Infectious Diseases (n = 264; those without medical qualifications were asked not to reply), and 400 general practitioners (GPs) randomly selected from the Royal Australian College of General Practitioners. MAIN OUTCOME MEASURES: Differences between specialist groups in belief in a causative association between H. pylori and peptic disease and in use of eradication therapy and pre- and post-treatment testing for H. pylori. RESULTS: 92.6% of doctors believed H. pylori causes duodenal ulcer, with GPs significantly less likely to believe than gastroenterologists (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.00-0.81). In duodenal ulcer, 93.4% of doctors believed H. pylori eradication therapy should be given, but fewer (83.4%) claimed to give it "always or mostly", with GPs less likely to report giving it than gastroenterologists (OR, 0.06; 95% CI, 0.02-0.19). For non-ulcer dyspepsia, gastrointestinal surgeons were more likely than gastroenterologists to believe in a causative link with H. pylori (OR, 5.6; 95% CI, 3.0-10.7) and in a need for eradication therapy (OR, 3.6; 95% CI, 1.7-7.7). Most doctors (79.3%) believed in confirming the presence of H. pylori before eradication therapy in duodenal ulcer. Only 51.6% believed post-eradication testing necessary (45.5%), yet 79.1% reported performing it. CONCLUSIONS: Significant differences exist between specialist groups in beliefs and self-reported behaviours regarding H. pylori.

Adult↗
PubMed1999

Ethical issues in molecular pathology: paradigms in flux.

Recent advances in molecular pathology and molecular genetics have created new concerns about the use of human biologic materials in research. Since researchers now have the ability to extract and amplify DNA from minuscule archived samples, virtually any human tissue sample can potentially become the template for a test that provides information that may relate to the inherited genes of an individual. Researchers using human biologic materials should follow the 3 basic principles that have been defined for all ethical human subjects research: respect for persons, beneficence, and justice. Institutional Review Boards are responsible for providing review of the risks and benefits of research proposals to safeguard the rights and welfare of human subjects. Currently, there is considerable debate concerning the role of informed consent procedures and the Institutional Review Board oversight process in situations when researchers use human biologic materials that have been anonymized or coded. In 1999, the National Bioethics Advisory Commission is expected to make recommendations to President Clinton and the National Science and Technology Council that are expected to clarify the balance between respect for personal autonomy and the societal need to pursue biomedical research to improve the health and welfare of all individuals.

Ethics, Medical↗
PubMed1996

[Value of unipolar and bipolar recordings in radiofrequency ablation of accessory atrioventricular pathways].

The aim of the study was to compare the value of different modes of endocavitary recordings: unipolar alone, bipolar alone and the association of unipolar and bipolar recordings in radiofrequency ablation of accessory atrioventricular pathways. A retrospective analysis by three independent observers of 135 endocavitary recordings obtained immediately before radiofrequency application in 82 subjects who underwent radiofrequency ablation for symptomatic accessory atrioventricular pathways. In each case, the authors selected the "successful" record which corresponded to the final radiofrequency application and 0.1 or 2 records of "failures". Each initial recording being of 3 types (unipolar, bipolar and association of uni- and bipolar), a total of 390 anonymous and randomised recordings were analysed by the observers who determined whether the appearances indicated successful ablation. Univariate analysis of variants showed a correlation between success with the mode of recording (p = 0.03) and a left lateral position of the accessory pathways. In multivariate analysis, three variables remained correlated with successful ablation: the observer variable (p = 0.001), and two interactions observer - mode (p = 0.005) and observer-stability (p = 0.02). The benefits of the association of unipolar and bipolar recordings with respect to bipolar recording alone, seemed to be important in predicting failure. The results of tests of concordance in the group of failures were confirmatory: concordance between observers was only found between the unipolar mode alone and the association of unipolar and bipolar recordings. The results of this study suggest that the association of unipolar and bipolar endocavitary recordings may reduce the number of unnecessary application of radiofrequency energy by improved identification of recording showing failure.

Adult↗
PubMedDate not supplied

Faculty evaluations: diagnostic and therapeutic.

PURPOSE: An excellent teaching program is one that creates an atmosphere of mentorship, leadership, and professional development. The key to all of these may lie in the faculty evaluation. Currently, favorable faculty evaluations are often rewarded, whereas the more critical evaluations are downplayed and seldom used for faculty development. The purpose of this study is to investigate the efficacy of the faculty evaluation as a diagnostic tool to objectively identify individual strengths and weaknesses. Can such a tool then be used as a therapeutic modality to improve and enhance the faculty as a whole? METHODS: Fourth- and fifth-year surgical residents from 1 residency program were asked to collaboratively define 9 characteristics that make a surgical role model. They then anonymously evaluated each of the 44 teaching attendings on each of the 9 criteria. The results of the evaluations, which consisted of the overall mean scores and SD for each of the 9 criteria, the attending's score and SDs above or below the mean, as well as whether the residents considered them to be a Role Model, were sent to each faculty member as an intervention. Six months after the intervention, the residents evaluated the attendings using the same 9 criteria. Evaluations were collected and analyzed following the same procedure as 6 months prior. T-tests and p-values were calculated to determine any significant differences between the 2 data sets. RESULTS: Based on the results of the pre-intervention evaluations, we were able to delineate faculty members into 3 groups based on their Role Model score. Of the 10 faculty members with the lowest scores (defined as >1 SD below average), 7 improved after the intervention, 3 of them were statistically significant (2 with p < 0.05 and 1 with p < 0.10). In the middle group of 26 faculty members, 1 showed statistically significant improvement (p < 0.05). Interestingly, this was the faculty member with the lowest score in this group. Six faculty originally in the middle group improved to a score greater than 1 SD above average, defining them as a Role Model. The remaining 8 faculty members originally designated as Role Models showed no statistically significant changes in their scores after the intervention. After the intervention, the average score improved for all of the 9 criteria that make a faculty Role Model. Statistically significant improvements were seen in the categories of Provides Feedback (p < 0.05) and Didactic Teaching, Attendance at Didactic activities, and Stimulates Critical Thinking with the Use of Literature (all p < 0.10). CONCLUSIONS: (1) Faculty evaluations are a diagnostic tool with the ability to select out Role Models from the lower scoring groups. (2) After the intervention, the overall average score improved for all of the 9 criteria that make a Role Model, showing improvement of the faculty as a whole. (3) The therapeutic benefits of faculty evaluations were best seen in the faculty with the lowest scores.

Faculty, Medical↗
PubMed1996

[DNA prints instead of plantar prints in neonatal identification].

BACKGROUND: To check the possible usefulness in studying DNA in dried blood spots taken on filter paper blotters for newborn identification. It set out to establish: 1. The validity of the method for analysis; 2. The validity of all stored samples (such as those kept in clinical records); 3. Guarantee of non-intrusion in the genetic code; 4. Acceptable price and execution time. MATERIAL AND METHODS: Forty (40) anonymous 13-year-old samples of 20 subjects (2 per subject) were studied. DNA was extracted using Chelex resin and the STR ("small tandem repeat") of microsatellite DNA was studies using the "polimerase chain reaction method" (PCR). Three non coding DNA loci (CSF1PO, TPOX and THO1) were analyzed by Multiplex amplification. RESULTS: It was possible to type 39 samples, making it possible to match the 20 cases (one by exclusion). The complete procedure yielded the results within 24 hours in all cases. The estimated final cost was found to be a fifth of that conventional maternity/paternity tests. CONCLUSIONS: The study carried out made matching possible in all 20 cases (directly in 19 cases). It was not necessary to study DNA coding areas. The validity of the method for analyzing samples stored for 13 years without any special care was also demonstrated. The technic was fast, producing the results within 24 hours, and at reasonable cost.

DNA Fingerprinting↗
PubMed2005

Identification of molecular markers for aluminium tolerance in diploid oat through comparative mapping and QTL analysis.

The degree of aluminium tolerance varies widely across cereal species, with oats (Avena spp.) being among the most tolerant. The objective of this study was to identify molecular markers linked to aluminium tolerance in the diploid oat A. strigosa. Restriction fragment length polymorphism markers were tested in regions where comparative mapping indicated the potential for orthologous quantitative trait loci (QTL) for aluminium tolerance in other grass species. Amplified fragment length polymorphism (AFLP) and sequence-characterized amplified region (SCAR) markers were used to provide additional coverage of the genome. Four QTL were identified. The largest QTL explained 39% of the variation and is possibly orthologous to the major gene found in the Triticeae as well as Alm1 in maize and a minor gene in rice. A second QTL may be orthologous to the Alm2 gene in maize. Two other QTL were associated with anonymous markers. Together, these QTL accounted for 55% of the variation. A SCAR marker linked to the major QTL identified in this study could be used to introgress the aluminium tolerance trait from A. strigosa into cultivated oat germplasm.

Aluminum↗
PubMed1998

Viewing preferences, symptoms of psychological trauma, and violent behaviors among children who watch television.

OBJECTIVE: To examine the extent to which children's television-viewing practices are associated with symptoms of psychological trauma and aggressive behaviors. The following three hypotheses were tested: (1) children who report watching greater amounts of television per day will report higher levels of trauma symptoms than children who report lesser amounts of television viewing; (2) children who report watching greater amounts of television per day will report higher levels of violent behaviors than children who report watching lesser amounts of television per day; and (3) children who report a preference for action and fighting programs will report higher levels of violent behaviors than children who report a preference for other types of television programs. METHOD: The study used a survey design in which an anonymous self-report questionnaire was administered to students in grades 3 through 8 in 11 Ohio public schools during the 1995-1996 school year (N = 2,245). RESULTS: All three hypotheses were supported. CONCLUSION: Heavy television viewing by children may indicate the presence of problems such as depression, anxiety, and violent behaviors; such viewing should be screened for by psychiatrists and other mental health professionals working with children.

Aggression↗
PubMedDate not supplied

Depression prevalence in adolescents.

INTRODUCTION: This study aimed to know the prevalence of depressive manifestations in adolescents and the sociodemographic variables associated with them. METHOD DESIGN: observational, descriptive, cross-sectional study. LOCATION: three urban teaching centers. PARTICIPANTS: 389 students of obligatory secondary education from 12 to 16 years who answered the questionnaire freely and anonymously. MEASUREMENTS: Questionnaire of Depression for Children (CDS), self-applicable, validated in their Spanish adaptation for their individual and collective administration. Family APGAR questionnaire. Variables regarding sociodemographic, academic yield and presence of chronic illnesses circumstances. RESULTS: 10 children were excluded because they answered in an incomplete way. In the 379 study subjects, 39 had a score on the CDS in the depressive range (decatype > or = 8): 10.29 % (95 % CI: 7.2 %-13.3 %). In the bivariate analysis, we only found differences for the presentation of depressive symptoms in connection with the existence of family dysfunction diagnosed by the APGAR test: 24.4 % versus 6.1 % (p < 0.0001). In the logistic regression analysis, the model that best predicts the presence of one diagnosis of depression includes the family dysfunction variable, with an OR = 4.27 (95 % CI: 1.98- 9.21) for mild dysfunction and OR = 14.44 (95 % CI: 4.61- 45.17) for serious dysfunction, and sibling number with OR 0.56 (95 % CI: 0.33-0.93). CONCLUSIONS: Prevalence of depressive manifestations among adolescents is high, being more frequent in members of dysfunctional families, while a greater number of siblings would have a protective effect.

Adolescent↗
PubMed2005

Australian attitudes to DNA sample banks and genetic screening.

An exploration via an anonymous questionnaire of Australian public attitudes towards medical genetics and sample banking revealed the overwhelming majority views these developments with thoughtful confidence. Continued public education and awareness of these issues will allow the public to make informed decisions and enhance vigilance towards the sometimes misleading coverage in the press and media.

Adolescent↗
PubMed2006

Assessing the feasibility of harm reduction services for MSM: the late night breakfast buffet study.

BACKGROUND: Despite the leveling off in new HIV infections among men who have sex with men (MSM) in San Francisco, new evidence suggests that many recent HIV infections are linked with the use of Methamphetamine (MA). Among anonymous HIV testers in San Francisco, HIV incidence among MA users was 6.3% compared to 2.1% among non-MA users. Of particular concern for prevention programs are frequent users and HIV positive men who use MA. These MSM pose a particular challenge to HIV prevention efforts due to the need to reach them during very late night hours. METHODS: The purpose of the Late Night Breakfast Buffet (LNBB) was to determine the feasibility and uptake of harm reduction services by a late night population of MSM. The "buffet" of services included: needle exchange, harm reduction information, oral HIV testing, and urine based sexually transmitted infection (STI) testing accompanied by counseling and consent procedures. The study had two components: harm reduction outreach and a behavioral survey. For 4 months during 2004, we provided van-based harm reduction services in three neighborhoods in San Francisco from 1-5 a.m. for anyone out late at night. We also administered a behavioral risk and service utilization survey among MSM. RESULTS: We exchanged 2000 needles in 233 needle exchange visits, distributed 4500 condoms/lubricants and provided 21 HIV tests and 12 STI tests. Fifty-five MSM enrolled in the study component. The study population of MSM was characterized by low levels of income and education whose ages ranged from 18-55. Seventy-eight percent used MA in the last 3 months; almost 25% used MA every day in the same time frame. Of the 65% who ever injected, 97% injected MA and 13% injected it several times a day. MA and alcohol were strong influences in the majority of unprotected sexual encounters among both HIV negative and HIV positive MSM. CONCLUSION: We reached a disenfranchised population of MA-using MSM who are at risk for acquiring or transmitting HIV infection through multiple high risk behaviors, and we established the feasibility and acceptability of late night harm reduction for MSM and MSM who inject drugs.

Journal Article↗
PubMed2004

Predictors of smoking behavior of first year university students: questionnaire survey.

AIM: To assess the prevalence of smoking and sociodemographic factors related to smoking behavior of first year university students in Adana, Turkey. METHODS: The sample was selected from two faculties (Faculty of Engineering and Architecture and Faculty of Agriculture) using the method of simple cluster sampling, representing the university student population. The students filled out an anonymous questionnaire comprising 17 questions related to their sociodemographic characteristics and smoking behavior. The response rate was 73.5% (471 out of 640 students). RESULTS: The prevalence of daily smoking among the first year students was 21.4%, with the predominance of men (25.0%) over women (12.9%). Most students (89.1%) had positive expectations about quitting smoking in the next 5 years ("I will quit smoking", "I will decrease the number of cigarettes I smoke", and "I will continue to be a non-smoker"). The smoking behavior was significantly related to student's sex (p=0.026, Pearson's chi-square test), mother's education (p=0.029, Pearson's chi-square test), number of failed grades (p=0.011, ANOVA), student's monthly income (p<0.001, Pearson's chi-square test), and having friends who smoke (p<0.0001, Pearson's chi-square test). CONCLUSION: The main determinants of regular smoking behavior for university students in Turkey were male sex, low academic performance, having smoking friends, high level of income, and a mother with high education level. These findings call for making anti smoking policies more specific in regard to the targeted population.

Adult↗
PubMed2005

Patients' perception of military doctors in fracture clinics--does the wearing of uniform make a difference?

We performed a study during our Trauma Week when patients who were referred from the accident department with fractures were reviewed in our fracture clinic. During our Trauma Week, Mister Thomas, Consultant Orthopaedic and Trauma Surgeon or Surgeon Lieutenant Commander McLean, Specialist Registrar in Orthopaedic and Trauma Surgery reviewed a total of 93 patients in fracture clinic. All patients were given an anonymous questionnaire regarding their perceptions of their attending clinician, 77 were completed. Forty-nine questionnaires regarding Surgeon Lieutenant Commander McLean and 28 regarding Mister Thomas were available for analysis. During the Trauma Week all patients were seen in the same location in identical cubicles by either of the two clinicians, consultations were typically brief lasting about five minutes. Throughout the week the clinicians, one military and one civilian, wore differing attire. The military uniform comprised Royal Navy number four action working dress. The civilian attire comprised 'dog-robbers' (jacket, shirt with tie and smart trousers). The hypothesis tested was that the use of military uniform might alter patients' perceptions of their attending clinician. Our results appear to demonstrate that the attire of the attending clinician does not adversely influence patients' perceptions of their attending clinician.

Adolescent↗

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