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[A cohort study of patients with chronic pathology who frequently consult: the results of corrective health measures].

The results from a cohort of frequent consulters with chronic diseases that were followed up for 20 years were evaluated according to morbidity and use of health services; these indicators were compared in two subgroups, not randomly selected, defined on whether any type of health intervention was carried out or not. Although the intervention group consulted more times, this difference disappeared when the comparison was stratified for the number of chronic diseases; in addition, there were no differences in the mean number of prescriptions between both groups. It is concluded that the effects of social factors should receive a greater attention; effort should be focused in approaches not exclusively based on health care, as these only partially explain the morbidity and use of health services by frequent consulters.

Age Factors↗

Accuracy and precision of joint space width measurements in standard and macroradiographs of osteoarthritic knees.

OBJECTIVES: To improve the reproducibility and accuracy of joint space width (JSW) measurement as an assessment of cartilage loss in patients with osteoarthritis (OA) of the knee by determining how precision and accuracy of JSW measurement were altered by a computerised method of measurement, correction for radiographic magnification, radiography of the knee in the standing semiflexed view, and high definition macroradiography of the knee in the semiflexed view--taking JSW measurements from standard radiographs of OA knees in the extended view as the standard for comparison. METHODS: Twenty five OA and 10 nonarthritic knees were radiographed in the extended view and minimum JSW was measured manually. Conventional and x5 macroradiographs were taken in the semiflexed view. All radiographs were taken twice on the same day and repeated two weeks later. Automated computerised measurement of minimum JSW was obtained from digitally stored images of all radiographs. RESULTS: For medial compartment JSW measurements, computerised was more accurate than manual, correction for radiographic magnification improved precision and accuracy, measurements in the semiflexed view were more precise and accurate, and macroradiography increased measurement precision. For the lateral compartment JSW measurements, correction for radiographic magnification improved precision and accuracy, and the semiflexed view improved precision only. CONCLUSIONS: Protocols defining radiographic and mensural procedures are essential for quality control of knee radiography in the semiflexed view to permit accurate and reproducible measurement of JSW. Macroradiography provides greater precision of JSW measurement.

Adult↗

Automation of the social interaction test by a video-tracking system: behavioural effects of repeated phencyclidine treatment.

The social interaction test is a valuable behavioural model for testing anxiolytic and neuroleptic drugs. The test quantifies the level of social behaviour between pairs of rats and it is usually based on manual analysis of behaviour. Advances in computer technology have made it possible to track the movements of pairs of rats in an arena, and the present paper describes the automation of the social interaction test by the commercial video-tracking programme, the EthoVision system. The ability of the automated system to correctly measure the social behaviour of rats is demonstrated by determining a dose-response relationship in the social interaction test for phencyclidine, a psychotomimetic drug that reduces social behaviour between pairs of rats. These data are subsequently analysed by the manual and automated data-acquisition methods and the results are compared. The study shows that the automated data-acquisition method best describes the behavioural effects of phencyclidine in the social interaction test by the locomotor activity of the rats, how much time the rats spend in different sections of the testing arena, and the level of social behaviour. Correlation analysis of the results from the manual and automated data-acquisition methods shows that the social behaviour measured by the automated system corresponds correctly to the social behaviour measured by the manual analysis. The present study has shown that the automated data-acquisition method can quantify locomotor activity, how rats use a testing arena and the level of social behaviour between rats in the social interaction test. The system cannot distinguish between social and aggressive behaviours, and therefore the rats should be tested in an unfamiliar arena to reduce territorial behaviour. Taking this limitation into consideration, the social interaction test can be automated by this computer-based video-tracking system and can be used as a routine test for quantifying the effects of drugs on the social behaviour of rats.

Aggression↗

Behavioural change phases of different stakeholders involved in the implementation process of ergonomics measures in bricklaying.

The objective of this qualitative study was to assess whether a hypothesised sequential order of behavioural change phases would be fulfilled in different groups of stakeholders involved at the start of a process to implement ergonomic [corrected] measures in bricklaying teams. The measures include trestles, bricklaying scaffolds, mast climbing work platforms [corrected] and cranes. The behavioural change phases were: (1) being aware of measures, (2) understanding measures, (3) wanting measures, (4) intention to buy or hire measures, (5) ability to use measures, (6) using measures (experience), and (7) continuing to use measures. Structured interviews were conducted to examine the change phases in two groups of stakeholders (employers/work planners (n=11) [corrected] and foremen/bricklayers (n=9) [corrected] from nine companies) thought to be relevant in the decision to adopt and use the ergonomic [corrected] measures. The results show that the fulfilled behavioural change phases differ between individual stakeholders, groups of stakeholders, companies and also between ergonomic measures. The hypothesised order of fulfilled consecutive behavioural change phases for individual stakeholders has not been confirmed by this study. The relationship between [corrected] fulfilled and unfulfilled change phases by each stakeholder (group) and actual use of each ergonomic measure requires further study, so as to improve the selection of suitable implementation strategies [corrected]

Adult↗

The predictive validity of a neuropsychological screening measure.

This study examined the efficacy of a neuropsychological screening measure in discriminating between neurologically impaired and nonimpaired subjects. It also examined the ability of this screening measure correctly to classify impaired subjects according to right and left hemisphere involvement. The results showed that some 96% of subjects could be correctly classified as impaired or nonimpaired. The measure was also found correctly to identify the hemisphere involved in 95% of the impaired cases. The value and limitations of neuropsychological screening instruments was discussed in terms of portability and ease of administration.

Adult↗

A survey of health care practitioners' knowledge of the QT interval.

OBJECTIVE: To assess health care practitioners' ability to correctly measure the QT interval, and to identify factors and medications that may increase the risk of QT-interval prolongation and torsades de pointes. DESIGN: A cross-sectional analysis of a survey administered between April 2002 and March 2003. PARTICIPANTS AND SETTING: Health care practitioners attending Grand Rounds Conferences at 6 academic institutions in the United States in internal medicine and psychiatry and at 6 community hospitals in the same geographical areas as the academic institutions. INTERVENTION: Anonymous, self-administered questionnaire that included 20 questions on the QT interval. MEASUREMENTS AND MAIN RESULTS: Of approximately 826 attendees, 517 (63%) completed the survey. Of about 608 attendees of internal medicine conferences, 371 (61%) responded, and of about 208 attendees of psychiatry conferences, 146 (67%) responded. Of a total number of 20 questions, the median number of correct answers for the whole group was 10 (interquartile range 7-13). The median number of correct answers for internists was 12 (interquartile range 9-13), for psychiatrists 10 (interquartile range 7-13), and for other specialists 10 (interquartile range 5-13). Respondents who graduated between 1990 and 1999 and academicians performed significantly better overall than other respondents. Of the 517 respondents, 224 (43%) measured the QT interval correctly. Physicians in training and academicians were more likely to measure the QT interval correctly. CONCLUSION: The majority of health care practitioners cannot correctly measure the QT interval and cannot correctly identify factors and medications that can prolong the QT interval. Our findings suggest that greater attention to the QT interval is warranted to ensure safer use of QT prolonging medications.

Adult↗

A complex-difference phase-contrast technique for measurement of volume flow rates.

Magnetic resonance (MR) phase-difference methods work well for measuring volumetric flow rates when the vessel diameter is large compared with the in-plane voxel dimensions. For small vessels (eg, coronary arteries), partial-volume effects introduce substantial errors in the measured volume flow rate. To correctly measure flow rates through a voxel, both the fraction of the voxel containing moving spins and the phase shift imparted to those spins must be known. The authors propose a flow measurement method that combines information obtained with both the complex-difference and phase-difference processing techniques and thereby provides the fractional volume occupied by the moving spins and the phase of those spins. The complex-difference flow map method proposed results in improved accuracy of MR phase-contrast flow measurements in the presence of partial-volume effects.

Blood Flow Velocity↗