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PubMedDate not supplied

Knowledge of malaria, risk perception, and compliance with prophylaxis and personal and environmental preventive measures in travelers exiting Zimbabwe from Harare and Victoria Falls International airport.

BACKGROUND: Travel associated malaria is a major health risk for visitors to malaria endemic destinations. To examine the knowledge of malaria prevention, risk perception, current prophylactic behavior, and compliance with chemoprophylaxis and personal and environmental protection measures we conducted a study in a cohort of travelers exiting Zimbabwe from two international airports during a peak malaria transmission period. METHODS: Data were collected by pretested self-administered questionnaires from 595 adults in the departure lounges of Harare and Victoria Falls International airports. Excluded were children and travelers from the African continent. A multilingual research assistant supervised data collection. RESULTS: The majority of travelers obtained health advice prior to travel. Patterns of protective behavior and compliance with prophylaxis were inconsistent with a high perception of malaria threat and good knowledge. About 23% of travelers failed to use chemoprophylaxis during their visit. In the group of travelers who used chemoprophylaxis, 18% were noncompliant. Fifteen drug combinations were in use. Full compliance with medication plus use of personal preventive measures always was estimated as 13%. Forgetfulness was the main cause of noncompliance, followed by deliberate omission due to side effects. Of 57 travelers who reported side effects from current medication, over half used mefloquine. CONCLUSIONS: There is a need to examine how people process personal risk and communications about risk. We must recognize the competition between precautionary measures against malaria and other life demands that are imposed by travel, especially in young long stay travelers and persons visiting primarily for business purposes. Mediating a protective response will also depend on judgments about the effectiveness of the action, strengthening travelers intentions toward adherence, and increasing efficacy perception by individuals and their peers. Conflicts in prophylactic recommendations need to be resolved. As ecotourism develops in Zimbabwe and other malaria regions, stakeholders in this rapidly growing industry must be made aware of the important role they can play in protecting clients from malaria.

Adult↗
PubMed2000

Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes.

OBJECTIVE: Self-monitoring of blood glucose (SMBG) is a cornerstone of diabetes care, but little is known about barriers to this self-care practice. RESEARCH DESIGN AND METHODS: This cross-sectional study examines SMBG practice patterns and barriers in 44,181 adults with pharmacologically treated diabetes from the Kaiser Permanente Northern California Region who responded to a health survey (83% response rate). The primary outcome is self-reported frequency of SMBG. RESULTS: Although most patients reported some level of SMBG monitoring, 60% of those with type 1 diabetes and 67% of those with type 2 diabetes reported practicing SMBG less frequently than recommended by the American Diabetes Association (three to four times daily for type 1 diabetes, and once daily for type 2 diabetes treated pharmacologically). Significant independent predictors of nonadherent practice of SMBG included longer time since diagnosis, less intensive therapy, male sex, age, belonging to an ethnic minority, having a lower education and neighborhood income, difficulty communicating in English, higher out-of-pocket costs for glucometer strips (especially for subjects with lower incomes), smoking, and excessive alcohol consumption. CONCLUSIONS: Considerable gaps persist between actual and recommended SMBG practices in this large managed care organization. A somewhat reduced SMBG frequency in subjects with linguistic barriers, some ethnic minorities, and subjects with lower education levels suggests the potential for targeted, culturally sensitive, multilingual health education. The somewhat lower frequency of SMBG among subjects paying higher out-of-pocket expenditures for strips suggests that removal of financial barriers by providing more comprehensive coverage for these costs may enhance adherence to recommendations for SMBG.

Adult↗
PubMed2004

Neuropsychological executive functions of adolescent sex offenders and nonsex offenders.

A growing body of research now suggests that a substantial number of criminal offenders display neuropsychological deficits, especially frontal-executive dysfunctions. The present study investigated the possibility of similar deficits by comparing the performance of 60 adolescent sex offenders court-ordered to a residential treatment facility with the performance of 60 nonsexual delinquent offenders matched on several pertinent sociodemographic characteristics and scores on four neuropsychological tests: (1) the Trail Making Test, (2) the Controlled Oral Word Association test of the Multilingual Aphasia Examination, (3) the Tower of London, and (4) the Wisconsin Card-sorting Test. Analysis indicated a pattern of frontal-executive dysfunction in a subset of both groups of offenders; this pattern has both theoretical and treatment implications.

Adolescent↗
PubMed2001

EQ-5D: a measure of health status from the EuroQol Group.

Established in 1987, the EuroQol Group initially comprised a network of international, multilingual and multidisciplinary researchers from seven centres in Finland, the Netherlands, Norway, Sweden and the UK. Nowadays, the Group comprises researchers from Canada, Denmark, Germany, Greece, Japan, New Zealand, Slovenia, Spain, the USA and Zimbabwe. The process of shared development and local experimentation resulted in EQ-5D, a generic measure of health status that provides a simple descriptive profile and a single index value that can be used in the clinical and economic evaluation of health care and in population health surveys. Currently, EQ-5D is being widely used in different countries by clinical researchers in a variety of clinical areas. EQ-5D is also being used by eight out of the first 10 of the top 50 pharmaceutical companies listed in the annual report of Pharma Business (November/December 1999). Furthermore, EQ-5D is one of the handful of measures recommended for use in cost-effectiveness analyses by the Washington Panel on Cost Effectiveness in Health and Medicine. EQ-5D has now been translated into most major languages with the EuroQol Group closely monitoring the process.

Europe↗
PubMed1996

Training to meet the needs of the communicatively impaired population of South Africa: a project of the University of the Witwatersrand.

At a time when South Africa is in the throes of transition, ideologies in the educational, medical, economic and social spheres are being redefined and redirected. The field of speech pathology and audiology is no exception. The Department of Speech Pathology and Audiology, University of the Witwatersrand has acknowledged an urgent need to address the requirements of a multilingual and multicultural South Africa and extend training beyond the white middle-class population. It is the responsibility of the training institutions to redirect the objectives of their curricula in order to meet these needs. This paper describes the changes introduced by the Department. These include teaching of community work principles and primary health care to the speech and hearing therapist, and the training of personnel for an alternative form of service, such as the community speech and hearing worker (CSHW) and the community-based rehabilitation worker (CBRW).

Community Health Services↗
PubMed1991

Language function following anterior temporal lobectomy.

The authors report the results of a prospective investigation that evaluated postoperative changes in language function after dominant (29 cases) or nondominant (35 cases) anterior temporal lobectomy for treatment of complex partial seizures. These patients received conservative resection of lateral temporal cortex but aggressive resection of medial temporal cortex. None of the patients underwent functional mapping of cortical language ability. All patients were assessed with a standardized aphasia battery (Multilingual Aphasia Examination) before and 6 months after surgery. Postoperatively, the dominant anterior temporal lobectomy group did not show any significant losses in language function compared to patients who underwent nondominant anterior temporal lobectomy. In addition, the dominant temporal lobectomy group showed significant postoperative improvement in complex receptive language comprehension compared to the nondominant group. These results suggest that patients with complex partial seizures of medial temporal lobe onset can undergo a conservative resection of lateral temporal cortex without language mapping. Such surgery carries little risk to language function and provides an excellent postoperative surgical outcome.

Adolescent↗
PubMed2006

The Functional Assessment of Cancer Therapy-Prostate (FACT-P) scales in men with prostate cancer: reliability and validity of the Korean version.

The Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire is a relevant, worldwide tool used for assessing the health-related quality of life in men with prostate cancer. The purpose of this study was to translate the FACT-P into Korean, to assess its reliability and validity, and to test its discriminative ability between the cancer patients and normal controls. The Korean version was developed via the FACT multilingual translation project. The translated questionnaire was self-administered to 70 prostate cancer patients and 70 age-matched controls. In evaluating its psychometric properties for cancer patients, internal consistency and test-retest reliability were used. Validity was estimated by using inter-subscale correlations and discriminant validity between cancer patients and controls. Cronbach's alpha coefficient for the individual subscales were 0.7 or greater (range 0.73 to 0.89), except for emotional well-being (0.61). The test-retest reliability showed high correlations (intraclass coefficients ranged from 0.72 to 0.93). Inter-subscale correlations demonstrated each subscale was unrelated, but moderate correlation was observed between social/family well-being and functional well-being subscales (r=0.56). The FACT-P scale could discriminate reliably between the cancer patients and controls in most subscales. In conclusion, the Korean version of the FACT-P is a reliable and valid questionnaire in patients with prostate cancer.

Aged↗
PubMed1985

Language skills of general practitioners in Sydney.

Nearly 50% of the general practitioners in nine representative local-government areas of Sydney spoke one of 27 languages other than English. The most common languages were Chinese dialects, Indian dialects, Italian, German and French. Bilingual and multilingual doctors tended to practise in local government areas with relatively large non-English-speaking populations. Nevertheless, some language groups would not have easy access to a general practitioner, particularly to a female doctor, who speaks their language.

Australia↗
PubMed1998

Electronic patient-physician communication: problems and promise.

A critical mass of Internet users will soon enable wide diffusion of electronic communication within medical practice. E-mail between physicians and patients offers important opportunities for better communication. Linking patients and physicians through e-mail may increase the involvement of patients in supervising and documenting their own health care, processes that may activate patients and contribute to improved health. These new linkages may have profound implications for the patient-physician relationship. Although the federal government proposes regulation of telemedicine technologies and medical software, communications technologies are evolving under less scrutiny. Unless these technologies are implemented with substantial forethought, they may disturb delicate balances in the patient-physician relationship, widen social disparities in health outcomes, and create barriers to access to health care. This paper seeks to identify the promise and pitfalls of electronic patient-physician communication before such technology becomes widely distributed. A research agenda is proposed that would provide data that are useful for careful shaping of the communications infrastructure. The paper addresses the need to 1) define appropriate use of the various modes of patient-physician communication, 2) ensure the security and confidentiality of patient information, 3) create user interfaces that guide patients in effective use of the technology, 4) proactively assess medicolegal liability, and 5) ensure access to the technology by a multicultural, multilingual population with varying degrees of literacy.

Communication↗
PubMed1993

A model for coding and multiaxial classification examplified.

A model of a coding and classification scheme is examplified in the domain of clinical laboratory sciences. It is for a multilingual thesaurus based on coded elementary concepts used to form coded composites or aggregates of preferred terms. These are for transmission over alphabet and language barriers.

Clinical Laboratory Information Systems↗
PubMed1997

MERMAID 1996--report on the implementation of a European Project on "medical emergency aid through telematics".

MERMAID is a project that intends to provide multilingual medical emergency services to seaborne vessels around the world. MERMAID uses two-way transmission of live images in marine medical teleconsultation, greatly improving services that up to now depended on short-wave and VHF radio alone. Transmission of high resolution still pictures is also possible, so that the teleconsulting physician may closely (visually) examine his patient, along with transmission of biological signals and patient anamnesis details. Telemedical interventions are critically dependent on local paramedics. Merchant marine officers are trained in first-aid procedures and basic medical transactions. In practice, however, this training is often inadequate. For this reason MERMAID uses a multimedia medical guide that covers the absolutely necessary basics to handle medical emergencies and common medical problems on board. This application is based on the WHO "Medical guide for ships" and EU Council Directive 92/29. The delivery of medical and mental health care to distant populations has never been easy. In addition, the progress of technology has widened the disparity between the quality of care available to the urban citizen and that available to the rural or remote location resident. The only viable solution to the problem seems to come from telecommunications technologies. Indeed, ISDN is the first widely available public network that supports integrated services and can serve as a reliable backbone for telemedical services. Communications satellites provide a means of expanding ISDN network to geographically remote locations. Against this background, MERMAID combines mobile satellite technologies, VSAT technologies and ISDN protocols in order to realise a Global Telemedicine System that is reliable, exhibits, continuity, is seamlessly connected, has low cost and is downward compatible.

Computer Communication Networks↗
PubMed1997

Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) will be considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) will be tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Emergency Medical Services↗
PubMed1997

Galen-In-Use: an EU Project applied to the development of a new national coding system for surgical procedures: NCAM.

GALEN has developed a language independent common reference model based on a medically oriented ontology and practical tools and techniques for managing healthcare terminology including natural language processing. GALEN-IN-USE is the current phase which applied the modelling and the tools to the development or the updating of coding systems for surgical procedures in different national coding centre co-operating within the European Federation of Coding Centre (EFCC) to create a multilingual knowledge repository for multicultural Europe. NCAM (Nomenclature Commune des Actes Médicaux) is the new French multipurpose coding system for surgical procedures. The labels are processed from the intermediate dissections to the Grail representation and the natural language generation by the electronically related Medical Informatics research centres network of Saint Etienne, Manchester, Geneva and Nijmegen. The national coding centre is able to retrieve the initial labels with different categories of concepts, to compare the professional language proposed by expert clinicians to the French generated controlled vocabulary and to finalize the linguistic labels of the coding system in relation with the meanings of the conceptual system structure.

Electronic Data Processing↗
PubMed1989

Mutual aid in remote areas: addressing the obstacles.

Mutual aid is a powerful tool for individual and group change and an excellent means of promoting mental and physical health. This article examines the main factors that may hinder the development of self-help groups (SHGs) in rural and remote areas, specifically the Sudbury-Manitoulin region of Northern Ontario. It considers several issues common to rural areas, such as population distribution, geographic isolation, lack and inaccessibility of human and material resources, and local factors such as multiculturalism and multilingualism. One of the strategies considered for overcoming these obstacles is a model for a community mutual-aid organization based on a computerized network of mutual-aid services (central organization with regional units). The originality of the model lies in the recognition of computer technology and telecommunications as promising solutions to the problems of geographic, social and cultural isolation faced by remote and rural communities, solutions that may play a part in fully developing the potential for mutual aid in this type of community.

Community Mental Health Services↗
PubMed1998

A convincing case for the provision of telemedicine services to ocean going vessels: the MERMAID paradigm.

MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental state each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Emergency Medical Services↗
PubMed1999

Differences in knowledge of hepatitis B among Vietnamese, African-American, Hispanic, and white adolescents in Worcester, Massachusetts.

OBJECTIVE: To assess the level of knowledge about hepatitis B of Vietnamese adolescents, a group at high risk for hepatitis B, and compare it to the knowledge of adolescents of other races and ethnicities. METHODS: A sample of 2816 adolescents was surveyed in 1993 in 2 middle schools and 2 high schools in Worcester, Massachusetts, using a self-administered multilingual questionnaire. RESULTS: Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver (35.6% vs 22.6%). However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection (13.7% vs 32. 8%). Independent predictors of this knowledge were: white race; older age; attending high school versus middle school; having been taught about hepatitis B in school; knowing the definition of hepatitis B; reporting better grades; having a family member with hepatitis B; and being more highly acculturated. CONCLUSIONS: Adolescent knowledge about risk of infection was low in this study. Attention should be directed at providing health education on hepatitis B to adolescents, particularly to Vietnamese. Health care providers, community health educators, and others engaged in the effort to control and eradicate hepatitis B should be sensitive to the unique educational and cultural needs of high-risk southeast Asian adolescent populations.

Adolescent↗
PubMed1999

The G8-global healthcare applications project (GHAP) - recommendations for the way into the information society

The Global Healthcare Applications Project has sought to demonstrate the potential of telematics in the field of medicine and healthcare and to promote joint approaches to issues such as the setting of standards. This has been done through 10 sub-projects covering a range of applications and issues: 1. Towards a global public health information network - Coordinator: Germany (Ulrich Laaser, ulaaser@mail.uni-bielefeld.de; URL: http://health.ibs.uni-bielefeld. de/i-jphe/database/documents/abstract/laaser-g7.htm(C45-60_laaser-g7. pdf) 2. Improving prevention, early detection, diagnosis and treatment of cancer. - Coordinator: France (Gerard Brugal, gerard. brugal@imag.fr; URL: http://pathconsult.imag.fr/G7/G7_index.html) 3. Improving prevention, diagnosis and treatment of major cardiovascular diseases. - Coordinator: Italy (Attilio Maseri, amaseri@rm.unicatt.it; URL: http://www.g7cardio.org) 4. International concerted action for collaboration in telemedicine. - Coordinator: Canada (Andre Lacroix, lacroixa@ere.umontreal.ca; URL: http:// www.g7sp4.org) 5. Enabling mechanisms for a global healthcare network, including Internet connectivity. - Coordinator: UK (Ray Rogers, r.rogers@mcmail.com; URL: http://www.ehto.be/sp5) 6. International harmonisation of the use of data cards in healthcare: Internet Connectivity Coordinator: USA (Elliot R. Siegel, siegel@nlm.nih.gov; URL: http://www.nlm.nih.gov/) - Smart Cards and information exchange security in health care Joint Coordinators: France, European Commission, Italy and Germany (Jacques Sauret, jacques.sauret@sante.gouv.fr and G8-HC@sesam-vitale.fr; URL: http:/www.sesam-vitale.fr/Projects/Netlink-G7-En/) 7. Evidence and effectiveness. - Coordinator: Canada (Andrew Penn, andrew. penn@ualberta.ca; URL: http://www.medlib.com/spi/web.htm) 8. Multilingual anatomical digital database. - Coordinator: USA (Michael J. Ackermann; URL: http://www.nlm.nih.gov) 9. Medical image reference centre. - Coordinator: Japan (Eturo Kashiwagi,EK-WEY@mhw. go.jp; URL: http://www.medirec.ncc.go.jp) 10. Special Interactive TV and Multimedia Programmes for Professionals and Public in Dentistry and International Online Academy for Dentistry and Oral Medicine. - Coordinator: Germany (Alexander Ammann, ammann@quinline.com; URL: http://quinline.globaldent.com) - Further information: http://www. bmgesundheit.de

Journal Article↗
PubMed2000

Utilising multimedia for training merchant mariners as paramedics.

MERMAID is a telemedicine project with global reach and a 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model is not limited to medical diagnostics but it encompasses all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications are considered while the full range of network choices is explored in terms of the cost/performance tradeoffs inherent to them and the developmental stage each of these options occupies in its life cycle. MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialty care best suited to each particular case. Finally, the development of programme modules for training and education of the seafarers in the use of the MERMAID medical communications system is given top priority as such modules constitute the firmest basis for the promotion of proper practice of telemedicine at sea.

Commerce↗