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PubMed2005

Sun protection in renal transplant recipients: urgent need for education.

BACKGROUND: Renal transplant recipients (RTR) are considered as a high-risk group of skin cancer development. OBJECTIVE: The aim of the present studywas to find out the knowledge about the harmfulness of sunlight and the methods of sun protection among RTR. MATERIAL AND METHODS: 151 RTR (91 males and 60 females) were surveyed using a specially designed questionnaire. RESULTS: The knowledge about the danger of sunlight exposure among RTR appeared to be very unsatisfactory. Only 40.4% of patients knew that the development of skin cancer is connected with the exposure to sunlight. Moreover, only 68.2% of investigated individuals considered RTR as a high-risk group of skin cancer development. Although 74.8% of patients were informed about the necessity of sun protection, only 11.3% could explain what the number of the SPF (sun protection factor) means. Females significantly more often knew that RTR are especially predisposed to the development of skin cancers (p = 0.0001) and significantly more frequently could explain what the SPF number means (p = 0.006). 72.8% of RTR (females significantly more often, p = 0.02) made efforts to avoid sunlight irradiation. However, only 5.3% of the examined patients routinely used creams with SPF (females significantly more often, p < 0.0001). More than a half of the patients (62.3%) did not apply any sun protection. CONCLUSIONS: The present study revealed the urgent necessity of education concerning the harmfulness of sunlight and the methods of sun protection among RTR. Moreover, it is postulated that every patient should be routinely examined by a dermatologist in a dedicated transplant patient clinic.

Adult↗
PubMed1990

Community-based study of neurological disorders in rural central Ethiopia.

Between 1986 and 1988 a door-to-door survey was conducted on a stable rural population of 60,820 in central Ethiopia. Trained lay health workers made a complete census and identified cases with symptoms and signs of neurological disorders, using specially designed questionnaires which, in a previous pilot study, were found to have a sensitivity of 91% and specificity of 85%. Neurological disorders in the rural population were epilepsy, postpoliomyelitis paralysis, mental retardation, peripheral neuropathy (mainly due to leprosy), and deaf-mutism with prevalence rates (cases/100,000 population) of 520, 240, 170, 150 and 130, respectively. The prevalence rates of the other less common neurological disorders were 62 for hemiparesis (15 of which were for cerebrovascular accidents), 20 for cerebral palsy, 16 for optic atrophy, 12 for perceptive deafness, 10 for tropical spastic paraparesis, 7 for Parkinson's disease and 5 for motor neuron disease, ataxia and chorea/athetosis. Among related non-neurological conditions, blindness, locomotor disability and deafness were predominant. The significance and role of such a neuroepidemiological study in laying the strategies for the prevention of neurological disorders and rehabilitation of patients are discussed in the context of a developing country.

Adolescent↗
PubMed1992

A large-scale study of epilepsy in Ecuador: methodological aspects.

The methodology is presented of a large-scale study of epilepsy carried out in a highland area in northern Ecuador, South America, covering a population of 72,121 people; The study was carried out in two phases, the first, a cross-sectional phase, consisted of a house-to-house survey of all persons in this population, screening for epileptic seizures using a specially designed questionnaire. Possible cases identified in screening were assessed in a cascade diagnostic procedure applied by general doctors and neurologists. Its objectives were: to establish a comprehensive epidemiological profile of epileptic seizures; to describe the clinical phenomenology of this condition in the community; to validate methods for diagnosis and classification of epileptic seizures by a non-specialised team; and to ascertain the community's knowledge, attitudes and practices regarding epilepsy. A sample was selected in this phase in order to study the social aspects of epilepsy in this community. The second phase, which was longitudinal, assessed the ability of non-specialist care in the treatment of epilepsy. It consisted of a prospective clinical trial of antiepileptic therapy in untreated patients using two standard anti-epileptic drugs. Patients were followed for 12 months by a multidisciplinary team consisting of a primary health worker, rural doctor, neurologist, anthropologist, and psychologist. Standardised, reproducible instruments and methods were used. This study was carried out through co-operation between the medical profession, political agencies and the pharmaceutical industry, at an international level. We consider this a model for further large-scale studies of this type.

Adolescent↗
PubMed1995

Assessment of cardiovascular risk factors in menopausal Argentinian women.

The cardiovascular risk factor profile was assessed in a population sample consisting of 60 nonmenopausal (control) and 100 menopausal women from different cities in Buenos Aires Province, Argentina. Each subject was individually interviewed and asked to complete a specially designed questionnaire aimed at identifying cardiovascular risk factors. A clinical general and gynecological examination including blood pressure and anthropometric measurements as well as a Papanicolaou smear were performed. The most prevalent risk factor in the menopausal group was low physical activity (87% of the subjects), followed by nervous complaints (67%), obesity (64%), familial antecedents of cardiovascular disease (CVD; 38%) and hypertension (33%). Other risk factors assessed showed a level of prevalence below 10%. In the control group, a tobacco smoking habit was the CVD risk factor with the highest prevalence (47%). Nervous complaints also showed a high prevalence (48%). Most menopausal patients (77%) had a cardiovascular risk index (RI) level between 1.5 and 4.0, whereas 17% of these subjects had an RI greater than 4.0 (high-risk patients). The present study reveals that, in the studied community, the menopause is associated with increased levels of both estrogen-dependent and psychosocial risk factors for CVD.

Adult↗
PubMed2003

Infection and the risk of spontaneous cervical artery dissection: a case-control study.

BACKGROUND AND PURPOSE: Several constitutional and environmental risk factors may be involved in the occurrence of spontaneous cervical artery dissection (SCAD). This work explored the association between recent infection and SCAD in an hospital-based case-control study. METHODS: Forty-seven patients with SCAD and 52 with ischemic stroke from another cause were prospectively and consecutively recruited by 2 neurology departments. A specially designed questionnaire was used to assess the history of an acute infection that could have occurred within a month before the vascular event. RESULTS: Acute infection was more frequent in patients with SCAD (31.9%) than in control subjects (13.5%) (crude odds ratio, 3.0; 95% confidence interval, 1.1 to 8.2; P=0.032). This association was stronger in patients with multiple (odds ratio, 6.4) than single artery (odds ratio, 2.1) dissection. CONCLUSIONS: Recent infection is a risk factor and could be a trigger for SCAD.

Acute Disease↗
PubMed1996

Acute infection as a risk factor for ischemic stroke.

BACKGROUND AND PURPOSE: Prior studies have demonstrated that infections might precipitate ischemic strokes (IS), but the role of infection as a risk factor remains unclear. We conducted a case-control study to investigate this issue. METHODS: Consecutive patients (n = 182) with acute IS were examined within 48 hours after admission to our center. A history of acute infections within 2 months before the IS was assessed by means of a specially designed questionnaire that was also given to a control group consisting of 194 consecutive patients who were seen in our outpatient clinic and had suffered IS at least 6 months previously. RESULTS: The prevalence of acute infection in the study group was significantly higher (44/182 = 24.2%) than in the control group (19/194 = 9.7%; odds ratio, 2.93; 95% confidence interval, 1.64 to 5.26; P = .0002) and infection occurred mostly within 1 week before the IS (41/44). Neither the severity of the IS nor the type of the infection was significantly different in patients and control subjects. CONCLUSIONS: Acute infections of different types constitute a risk factor for IS, particularly within 1 week of the event. However, the severity of the stroke is not related to this factor.

Acute Disease↗
PubMed2006

Long-term visual acuity and its predictors after surgery for congenital cataract: findings of the British congenital cataract study.

PURPOSE: To report long-term postoperative visual acuity in a nationally representative group of children with congenital/infantile cataract and to investigate the factors associated with poor vision. METHODS: All children aged less than 16 years in the United Kingdom who had newly diagnosed congenital/infantile cataract in a 12-month period during 1995-1996 (the British Congenital/infantile Cataract Study) were traced through their managing ophthalmologists. Outcome data were collected at least 6 years after diagnosis, by using specifically designed questionnaires. Ordinal regression analysis identified factors associated with postoperative acuity. RESULTS: Of 153 children who had surgery, complete data were available in 122 (85%). Median age at follow-up was 7 and 6.91 years, respectively, for bilateral and unilateral disease. Median age at surgery was 4.57 months in bilateral and 2.99 months in unilateral cases, with 40% and 45%, respectively, of children operated on by 3 months. Median (range) postoperative acuity was 6/18 (6/5, no perception of light) in bilateral and 6/60 (6/5, no perception of light) in unilateral disease. Poor compliance with occlusion was the factor most strongly associated with poorer acuity in both unilateral and bilateral disease: the odds of worse vision in unilateral cataract were 7.92 times greater with <50% versus 100% compliance (95% CI 1.68-37.26). In bilateral disease, odds of worse vision were reduced with each month of decreasing age at surgery (0.98, 95% CI 0.94-0.99), but increased by the presence of additional medical conditions (3.53, 95% CI 1.08-11.44) and the presence of postoperative ocular complications (2.94, 95% CI 1.38-6.51). CONCLUSIONS: These findings support a secular improvement in postoperative acuity in bilateral, and to a lesser extent, unilateral disease. Nevertheless early detection of congenital cataract through effective newborn screening and improving concordance with occlusion both remain priorities. Further improvements in outcomes in unilateral disease are necessary before parents can be advised universally that treatment will achieve a functionally useful "spare" eye.

Cataract↗
PubMed1989

Psychiatric resident dismissal: a national survey of training programs.

The authors report on a nationwide survey of psychiatric residency training directors who responded to a questionnaire designed to elicit information on the magnitude of the problem of unacceptable performance by residents. One hundred six program directors reported on 5,591 internship or residency positions from 1981 to 1985. A total of 184 residents (3.3%) were prematurely terminated or persuaded to resign; departmental deliberations were held on an additional 139 residents (2.5%). Reasons for dismissal and indications during the selection process that a trainee might prove problematic are discussed. A provocative finding was that 37% of terminated residents were accepted into other psychiatry training programs.

Career Choice↗
PubMed1991

A survey of Canadian psychiatric residents regarding resident-educator sexual contact.

BACKGROUND AND METHOD: A survey of all Canadian psychiatric residents was undertaken to ascertain the prevalence of resident-educator sexual contact in training programs, the residents' feelings about this contact, their knowledge of the ethical standards of the profession, and the extent of the information they had been given about this subject. An investigator-designed questionnaire was circulated to all psychiatric residents in Canada through the directors of postgraduate training programs. To ensure confidentiality, the residents returned their questionnaires directly to the investigators. RESULTS: Of the 314 respondents, 4.1% (N = 6) of the female residents and 1.2% (N = 2) of the male residents reported sexual involvements with their educators. Although the majority of these eight residents had positive or neutral feelings about the contact, 37.5% (N = 3) of the involved residents had mixed feelings. The residents' education concerning resident-educator sexual contact was strikingly sparse. CONCLUSIONS: This study highlights the need for inclusion of this tissue in residency programs.

Adult↗
PubMed1993

Obsessions in obsessive-compulsive disorder with and without Gilles de la Tourette's syndrome.

OBJECTIVE AND METHOD: Although obsessive-compulsive disorder commonly occurs in many patients with Gilles de la Tourette's syndrome, little is known about the obsessions and compulsions of Tourette's syndrome and whether they differ from those seen in pure obsessive-compulsive disorder. The authors prospectively studied 10 subjects with obsessive-compulsive disorder and 15 subjects with obsessive-compulsive disorder and comorbid Tourette's syndrome by using the Yale-Brown Obsessive Compulsive Scale, the Leyton Obsessional Inventory, and a new questionnaire designed to emphasize the differences in symptoms between these two groups. RESULTS: Subjects with comorbid obsessive-compulsive disorder and Tourette's syndrome had significantly more violent, sexual, and symmetrical obsessions and more touching, blinking, counting, and self-damaging compulsions. The group with obsessive-compulsive disorder alone had more obsessions concerning dirt or germs and more cleaning compulsions. The subjects who had both disorders reported that their compulsions arose spontaneously, whereas the subjects with obsessive-compulsive disorder alone reported that their compulsions were frequently preceded by cognitions. CONCLUSIONS: There are phenomenologic differences between obsessive-compulsive disorder and obsessive-compulsive disorder with comorbid Tourette's syndrome that may reflect differential involvement of neurochemical and neuroanatomic pathways.

Adult↗
PubMed1994

Ataque de nervios and panic disorder.

OBJECTIVE: Ataque de nervios ("attack of nerves") is an illness category used frequently by Hispanic individuals to describe one or more particular symptom complexes. A review of the literature on ataque suggested some overlap with panic disorder. This study investigated the overlap with panic disorder as well as other DSM-III-R axis I disorders. METHOD: Hispanic subjects seeking treatment at an anxiety disorders clinic (N = 156) were assessed with a specially designed questionnaire for self-report of ataque de nervios and panic symptoms and with structured or semistructured psychiatric interviews for axis I disorders. RESULTS: Seventy percent of the subjects reported at least one ataque de nervios; 80% of these were female, whereas 57% of the group without these attacks were female. There were no differences in DSM-III-R diagnoses between the groups with and without ataque de nervios. Ataque was frequently associated with one or more anxiety and affective disorders, including panic disorder, generalized anxiety disorder, recurrent major depression, and anxiety not otherwise specified. Of the 45 subjects with both ataque de nervios and primary panic disorder, 80% appeared to have labeled panic disorder as ataque. Ataque de nervios was associated with panic symptoms even in subjects without panic disorder, but the self-reporting of ataque conveyed additional clinical information about the subjects with panic disorder. Ataque de nervios was similar in frequency and symptoms among subjects of Dominican and Puerto Rican origin. CONCLUSIONS: Ataque de nervios overlaps with panic disorder but is a more inclusive construct. Further study of its interrelation with axis I disorders is needed.

Adult↗
PubMed1991

Semen-loss syndrome: a comparison between Sri Lanka and Japan.

In some cultures semen loss is associated with illness, anxiety, and loss of energy and power. Thirty-five nonpsychotic patients attending a psychiatric clinic in Sri Lanka during one month, attributed their complaints of sexual dysfunction, lethargy, thinness, and miscellaneous aches and pains to semen loss resulting from masturbation or nocturnal emissions. Similar complaints are rare among psychiatric patients in Japan. A survey questionnaire designed to measure negative attitudes and beliefs regarding semen loss was used to measure such attitudes in a patient population and a general university population in Sri Lanka and Japan. The survey disclosed that unlike in Japan, people in Sri Lanka consider semen loss to be detrimental to mental and physical health. Attitudes regarding semen loss were the most negative in the patient population. These results indicate the possibility that culturally held negative attitudes and beliefs may contribute to the high incidence of semen-loss complaints in Sri Lanka, and suggest that attitudes and beliefs may play a role in the way patients express psychopathological symptoms in different societies.

Adult↗
PubMed1985

Homophobia among physicians and nurses: an empirical study.

In a large urban teaching hospital treating many patients with AIDS, 37 medical house officers and 91 registered nurses completed a questionnaire designed to measure attitudes about homosexuality. Mean scores for both physicians and nurses fell in the low-grade homophobic range. No significant differences were found between scores for doctors and nurses, but women respondents were significantly more homophobic than men. Respondents who had a friend or relative who was homosexual were less homophobic than those who did not. Nearly 10 percent of respondents agreed with the statement that homosexuals who contract AIDS are getting what they deserve. The authors consider this to be an alarming statistic and conclude from the findings that homophobia is higher than desirable in this group of health professionals.

Acquired Immunodeficiency Syndrome↗
PubMed1989

AIDS anxiety among health care professionals.

House staff physicians and nurses at a major New York City teaching hospital completed a 79-item questionnaire designed to assess AIDS anxiety, fear of contagion, and personal attitudes about homosexuality. Sixty-three percent of respondents were skeptical of or did not believe assurances by experts that health care workers who observe safety guidelines are at minimal risk of contracting AIDS from patients. Respondents from minority groups were significantly less trusting of experts' reassurances of their safety and were more uncomfortable working with homosexual patients. Twenty-six percent of all respondents feared that they would become victims of AIDS if they continued their present work, yet 97 percent expressed a firm commitment to caring for AIDS patients throughout their illness and the dying process. The author suggests that AIDS training and educational programs for health care professionals should consider their cultural background and psychosocial needs.

Academic Medical Centers↗
PubMed1991

A survey of hospitals in New York State treating psychiatric patients with chemical abuse disorders.

Eighty-eight of 143 hospitals in New York State providing psychiatric inpatient treatment responded to a mailed questionnaire designed to determine the size of three subgroups of chemical abusers--alcohol abusers, drug abusers, and polychemical abusers--among inpatients with psychiatric diagnoses, as well as the availability of services for these patients. Data for New York City and its metropolitan area were analyzed separately. In 1987 almost one-third of psychiatric admissions both in and outside the metropolitan area had comorbid chemical abuse disorders. Seventy-five percent of patients in the metropolitan area with comorbid chemical abuse had a drug abuse disorder; in rural areas 88 percent of patients with chemical abuse disorders abused alcohol. Both hospital- and community-based aftercare services, especially in the metropolitan area, were less available to psychiatric patients with chemical abuse than to patients without these disorders.

Aftercare↗
PubMed1987

Behavioral, psychosocial, and academic correlates of marijuana usage in adolescence. A study of a cohort under treatment.

In 1985 approximately 120,000 American high school seniors smoked marijuana daily. We interviewed 35 middle-class, cannabis-dependent adolescents with a mean age of 16 years who were patients in a drug treatment program. The patients also completed a lengthy self-assessment questionnaire designed to elicit information on drug-related problems. Our results show that family harmony, school attendance, and school achievement deteriorated once these young people began to use marijuana at least 4 days a week. The following behaviors were noted: remaining away from home without permission or parental knowledge for at least 7 consecutive days (29%), a D or F grade average on the last report card before they entered the drug treatment program (43%), involvement in a motor vehicle accident when the driver was under the influence of marijuana (26%), suicide attempts (20%), and convincing a "marijuana-naive" younger sibling to smoke the drug (20%). Despite such seemingly apparent signs of possible drug use by these 35 adolescents, a mean time of 12 months elapsed before parents suspected their children of marijuana abuse. In many cases mental health professionals consulted by a number of the children when they were using drugs were likewise unaware of the marijuana abuse.

Adolescent↗
PubMedDate not supplied

Learning disabilities as functions of familial learning problems and developmental problems.

A family history of learning problems as provided on a specially designed questionnaire by maternal report was examined in families of 101 children with learning disabilities and 171 children without disabilities. Diagnoses of learning disabilities followed the U.S. Office of Education definition. Students were selected from the Special School District of St. Louis County and the Pattonville School District. A life history of developmental risk factors in the child subject was also examined in the same two groups. Learning disabilities were found to be strongly familial. In principle, the definition of learning disabilities excluded from the study children with problems attributable to child rearing, emotional, or motivational factors. The report of a family history of learning problems is therefore interpreted as consistent with, although not unequivocally supportive of, genetic factors as determinants. Among developmental factors, only male gender proved to have a significant association with learning disabilities.

Adolescent↗
PubMed1990

Mainstreaming modification preferences of parents of elementary-age children with learning disabilities.

One hundred twenty-nine parents of children with learning disabilities responded to a questionnaire designed to solicit information on the types of modifications deemed most facilitative of parents' acceptance of full-time mainstreaming. Responses indicated that parents' participation in the mainstreaming process was an important factor in successful integration of children with learning disabilities. Parents' preferences for mainstreaming modifications differed from their current options, and they were supportive of full-time mainstreaming for their children, contingent upon implementation of their mainstreaming-related recommendations. Results are discussed relative to mainstreaming and proposed educational reforms.

Attitude↗

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