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PubMed1999

Dental hygienists' knowledge of menopause and its potential oral manifestations.

PURPOSE: The purpose of this study was to assess dental hygienists' general knowledge of menopause and its possible oral manifestations. Demographic descriptors, including education level, course work, and menopausal status, were examined to determine their influence on knowledge levels. METHOD: A 27-item, self-administered survey was mailed to a random sample of Connecticut dental hygienists. Frequency distributions and inferential statistics (ANOVA, t-test) were used for data analysis. RESULTS: Fifty-four percent of respondents scored 75 percent or higher in general knowledge about menopause. Seven percent scored the same about its oral effects. Educational level and dental hygiene college curricula influenced the oral effect scores. Dental hygienists with bachelor degrees exhibited more knowledge than those with certificate/associate degrees. Those who had taken a college course on the oral effects of menopause had more knowledge than those who had not. CONCLUSION: The findings suggest that dental hygienists need more education about menopause and its related oral conditions. Those with additional knowledge might be more able to provide comprehensive care to menopausal and post-menopausal dental patients. Future research using larger sample sizes may enhance the education of dental hygienists in this area.

Analysis of Variance↗
PubMedDate not supplied

Antibiotic prophylaxis for children with sickle cell disease: a survey of pediatric dentistry residency program directors and pediatric hematologists.

PURPOSES: The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. METHODS: A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. RESULTS: Surveys were returned by 60% (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51% of pediatric hematologists at the meeting (N=72/140). At least 50% of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71%, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38% (N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62% of pediatric hematologists (N=36/58) recommended amoxicillin. (P<.05). CONCLUSIONS: There is a lack of consensus on the appropriate use of antibiotic prophylaxis in SCD children undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

Anemia, Sickle Cell↗
PubMed1990

Options for the disposal of unwanted donations.

Donations of biomedical books and journals frequently duplicate the holdings of a receiving library. A decision must then be made concerning the distribution of the material to other libraries that may need it. What options are available to the librarian? Are many volumes of valuable material destroyed each year because libraries lack the necessary staff, space, or money to distribute donated materials? Are libraries restricted in choice of methods for distribution or unaware of available options? A survey questionnaire was mailed to 150 health sciences libraries in the spring of 1988 to determine the various methods used to dispose of unwanted gift materials. A total of 113 responses was received (75% return rate). This paper reports the results and discusses some of the creative methods used by receiving libraries to place unneeded materials. Statistical comparisons are included for the methods used by academic, hospital, and other types of health sciences libraries.

Book Collecting↗
PubMedDate not supplied

Obstetrics in family medicine: effects on physician work load, income, and age of practice population.

A survey of active members of the American Academy of Family Physicians was conducted to determine the effect of the practice of obstetrics by family physicians on patient age distribution, physician work load, and physician income. A questionnaire was mailed to 800 randomly selected physicians; the survey response rate was 60.4%. Almost 20% of all respondents had never provided obstetrical care of any type. Another 40% had provided obstetrics previously but had discontinued this service, while the remaining 40% currently provided obstetrical care. Physicians who provided obstetrical services reported a significantly higher mean proportion of children and a significantly lower proportion of middle-aged and elderly adults in their patient panels than did physicians who do not provide obstetrics. Those physicians who had never offered obstetrics saw approximately the same number of patients and worked approximately the same number of hours as did those who provided low-risk, routine obstetrics; however, the former group reported a significantly higher average annual income than did the latter group.

Adolescent↗
PubMed1979

The recent trend in breast-feeding.

This study presents results of surveys conducted on a continuous basis over a period of years to determine the trend in the incidence of breast-feeding. Questionnaires were mailed to large samples of mothers, representative of the national distribution of births, asking them what type of milk they fed their infants over a period of time. Demographic characteristics of mothers who breast-fed were also obtained. From 1955 to 1971, there was a progressive decline in breast-feeding, followed by a resurgence in its incidence through 1978. Not only are more mothers breast-feeding, more are continuing to do so for a longer period of time throughout the months of their infants' most rapid growth and high nutritional requirements. It is also apparent that the increased incidence of breast-feeding has not been limited to higher income, better educated mothers. From 1971 to 1978, the incidence at two months postpartum more than doubled among mothers in lower-income families. The incidence of breast-feeding almost tripled among mothers whose education did not extend beyond elementary or high school and among those attending public clinics.

Animals↗
PubMed1981

1980 update: the recent trend in breast-feeding.

This study presents results of surveys conducted on a continuous basis over a period of years to determine the trend in the incidence of breast-feeding. Questionnaires were mailed to large samples of mothers, representative of the national distribution of births, asking them what type of milk they fed their infants over a period of time. Demographic characteristics of mothers who breast-fed were also obtained. From 1955 to 1971, there was a progressive decline in breast-feeding, followed by a resurgence of its incidence through 1979. Not only are more mothers breast-feeding, more are continuing to do so for a longer period of time throughout the months of their infants' most rapid growth and high nutritional requirements. It is also apparent that the increased incidence of breast-feeding has not been limited to higher income, better educated mothers.

Bottle Feeding↗
PubMedDate not supplied

The effect of a career planning workshop on graduate dental hygienists.

Purpose. The purpose of this study was to determine the effects of a career planning workshop on the career satisfaction, decisions, and plans of graduate dental hygienists. Method. A workshop was designed to teach graduate dental hygienists a systematic process for analyzing their needs and opportunities and making informed, realistic, and satisfying career decisions. This workshop incorporated vocational testing, interpretation by a professional counselor, lecture/discussion, small group interaction, and an accompanying manual of career planning resources and exercises. Sixty-nine dental hygienists attended a two-day workshop in fall 1990. Participants completed data collection instruments consisting of 42-item pre-assessment and 40-item follow-up questionnaires designed by the authors. Sixty-three completed the pre-workshop questionnaire. Fifty-four participants responded to the follow-up questionnaire mailed six months after the workshop. Data analyses included frequency distributions, percentages, means, and standard deviations. Paired t-tests and chi-square statistics were also calculated. Results. Findings from the pre-workshop questionnaire indicated that over 76% of participants had considered leaving their present position and 70% had considered leaving the profession. The six-month follow-up questionnaire revealed that four participants had changed dental hygiene employers and two had left the profession to pursue different careers. Forty-four percent reported that their feelings toward dental hygiene as a career had become more positive since attending the workshop. Pre-workshop to six-month follow-up responses indicated increased mean satisfaction in amount of challenge, compensation/rewards, and overall career satisfaction. Conclusions. The results of this study indicated that career planning workshops, in combination with other methods, are a useful strategy for helping dental hygienists maintain satisfaction, and have the potential to promote career longevity in the dental hygiene profession.

Adult↗
PubMed1996

Chronic disease, functional health status, and demographics: a multi-dimensional approach to risk adjustment.

OBJECTIVE: The goal of this study was to develop unbiased risk-assessment models to be used for paying health plans on the basis of enrollee health status and use propensity. We explored the risk structure of adult employed HMO members using self-reported morbidities, functional status, perceived health status, and demographic characteristics. DATA SOURCES/STUDY SETTING: Data were collected on a random sample of members of a large, federally qualified, prepaid group practice, hospital-based HMO located in the Pacific Northwest. STUDY DESIGN: Multivariate linear nonparametric techniques were used to estimate risk weights on demographic, morbidity, and health status factors at the individual level. The dependent variable was annual real total health plan expense for covered services for the year following the survey. Repeated random split-sample validation techniques minimized outlier influences and avoided inappropriate distributional assumptions required by parametric techniques. DATA COLLECTION/EXTRACTION METHODS: A mail questionnaire containing an abbreviated medical history and the RAND-36 Health Survey was administered to a 5 percent sample of adult subscribers and their spouses in 1990 and 1991, with an overall 44 percent response rate. Utilization data were extracted from HMO automated information systems. Annual expenses were computed by weighting all utilization elements by standard unit costs for the HMO. PRINCIPAL FINDINGS: Prevalence of such major chronic diseases as heart disease, diabetes, depression, and asthma improve prediction of future medical expense; functional health status and morbidities are each better than simple demographic factors alone; functional and perceived health status as well as demographic characteristics and diagnoses together yield the best prediction performance and reduce opportunities for selection bias. We also found evidence of important interaction effects between functional/perceived health status scales and disease classes. CONCLUSIONS: Self-reported morbidities and functional health status are useful risk measures for adults. Risk-assessment research should focus on combining clinical information with social survey techniques to capitalize on the strengths of both approaches. Disease-specific functional health status scales should be developed and tested to capture the most information for prediction.

Adult↗
PubMed1997

Primary care physicians' recognition of and attitudes toward domestic violence.

PURPOSE: Physicians fail to identify the majority of domestic violence victims, even though they are often the first and only individuals to whom a victim may present. The present study was designed to assess primary care physicians' recognition of and attitudes toward domestic violence. METHOD: Of the 148 primary care physicians in three midwestern counties, all the women and a random sample of the men were included in the survey, for a total of 83. A seven-page questionnaire was developed that contained items about demographics and practice characteristics, and questions about the following aspects of domestic violence: knowledge, attitudes, importance, and prevalence in practice; attitudes toward responsibility; current practices and protocols used; level of education and domestic violence received; and opinions on how best to distribute information and/or education concerning domestic violence. The questionnaire was mailed in 1994. Follow-up was conducted through phone calls, remailings, and visits to the physicians' offices. Responses were examined using chi-square tests and two-tailed t-tests. RESULTS: The response rate was 63% (52 of 83); 53% of those responding were family physicians and 47% were general internists; 34% were women. Although all of the physicians agreed that finding and treating domestic violence is important, less than half agreed that domestic violence was a significant problem in their patient populations. Almost 96% of the physicians believed that more should be done to educate physicians about domestic violence, and 94% agreed that domestic violence should be included in a doctor's professional medical training; yet nearly half said they would not participate in a domestic violence forum. Even though 41% noted that they had received some type of formal education about domestic violence, 57% felt that their medical education had inadequately prepared them to deal with domestic violence, and less than 25% reported that they had been trained to diagnose domestic violence. The family physicians and the female physicians had received more education about domestic violence and were more comfortable addressing domestic-violence situations. The older physicians were less comfortable addressing domestic violence and were less likely to agree that education about domestic violence should be a part of medical training. CONCLUSION: Interventions by the medical community to increase physician awareness of domestic violence and available treatment resources are necessary, and domestic-violence information should be included in formal medical curricula.

Attitude of Health Personnel↗
PubMed2005

Head and neck cancer patient and family member interest in and use of E-mail to communicate with clinicians.

BACKGROUND: E-mail is actively discussed as a promising method for clinical communication, but little study of patient and family preferences regarding its use has been done. This study aimed to describe patients' and family members' interest in and use of E-mail with their surgeons and nurses after head and neck cancer surgery. METHODS: Surveys were distributed to patients and family members attending postoperative clinic visits. Seventy-four patients and 35 caregivers completed the surveys. RESULTS: Although one in three patients expressed interest in E-mailing their clinicians, only 9.5% reported actually doing so. Symptom management and prescription refills were the most common issues addressed by E-mail. Few family members expressed any interest in using E-mail. CONCLUSIONS: The findings suggest that E-mail communication between patients with head and neck cancer or their family members with surgeons and nurses is not common. Interest in using E-mail tends to be stronger among patients than family members.

Attitude to Computers↗
PubMed2005

Successfully recruiting a multicultural population: the DASH-Sodium experience.

Recruiting practices employed by the four clinical centers participating in the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial were examined to assess the most successful method of obtaining participants and to describe pertinent learning experiences gained as a result of the trial. The primary recruitment strategies employed by each center were mass mailing brochures (direct, coupon packs, or other) and mass media (advertisements in newspapers, radio, and television spots). Of 412 randomized participants, 265 (64%) were from mass distribution of brochures, 62 (15%) mass media, and 85 (21%) were prior study participants, referred by word-of-mouth, or reported coming from screening events and presentations. Although the most successful method of recruitment was mass mailing brochures, three times as many brochures were distributed to obtain similar success as in the initial DASH trial.

Adult↗
PubMed1999

A survey of the ethnic and racial distribution in orthopedic residency programs in the United States.

This study examined the racial and ethnic composition of orthopedic training programs in the United States. A questionnaire was mailed in January 1995 to chairpersons at 159 orthopedic programs in the United States. Eighty-nine (56%) responses were received. The distribution of orthopedic residents and fellows was as follows: white non-Hispanic, 84.2%; Asian, 6.6%; African American, 3.6%; Native American, 2.2%; Puerto Rican, 1.2%; Mexican American, 0.8%; and other Hispanic, 1%. African Americans and Hispanics were under-represented in orthopedic training programs compared with their numbers in the general population. The percentage of residents in these two minority groups also were below goals established by the Council on Graduate Medical Education and the US Government's Healthy People 2000 report. In contrast, Native Americans and Asians were overrepresented. If racial balance is to be achieved in orthopedics, new incentives must be created to encourage more African Americans and Hispanics to enter orthopedic residency training programs.

Black or African American↗
PubMed1994

A nationwide survey on the occurrence of Vogt-Koyanagi-Harada disease in Japan.

A nationwide survey was carried out to estimate the frequency and distribution of Vogt-Koyanagi-Harada disease in Japan. A questionnaire was mailed to the Departments of Ophthalmology in hospitals with 200 or more beds. Responses were received from 489 out of 1,077 institutions, or 45.5%. The annual prevalence was estimated to be 15.5 per million and the incidence was 6.5 per million, based on the number of reported cases and the response rate per prefecture. It was estimated that 1,800 patients were treated for this disease annually and that there were about 800 new cases each year. Geographical distribution showed no special characteristics such as those seen with Behçet's disease. The results of the analysis of 1,833 reported cases showed that females were slightly more often affected than males. For both male and female patients, the age distribution on the first visit showed a peak in the fifth decade and a median age of 42.3 years.

Adolescent↗
PubMed2005

Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension. ETECUM-HTA study.

OBJECTIVE: To study the efficacy of telephone and mail intervention in therapeutic compliance among patients with mild to moderate hypertension. DESIGN: A prospective controlled multicenter clinical trial. SETTING: Eighty-five primary care centers in Spain, with a duration of 6 months. PATIENTS: A total of 636 patients with newly diagnosed or uncontrolled hypertension were included. Interventions. The patients were randomized and distributed between the following groups: (i) control (CG) - under routine clinical management; (ii) mail intervention (MIG) - received a mailed message reinforcing compliance and reminding of the visits (15 days, 2 and 4 months); (iii) telephone intervention (TIG) - received a telephone call at 15 days, then at 7 and 15 weeks. MAIN OUTCOME MEASURE: Five visits were scheduled, with the measurement of blood pressure and counting of tablets. Compliers were defined as subjects showing 80-110% drug consumption. Calculations were made of mean percentage compliance (MPC) and compliers, mean blood pressure and percentage controlled subjects. RESULTS: Five hundred and thirty-eight patients completed the study (261 males); 85.5% were compliers (CI = 82.5-88.5; n = 460). The MPC was 95.1+/-19.6% (CI = 93.28-96.92). The CG consisted of 182 individuals, MIG = 172 and TIG = 184. Compliers represented 69.2% of the CG (CI 62.5-75.9%), 91.3% (CI = 87.1-95.5) of the MIG (p = 0.0001) and 96.2% of the TIG (CI 93.5-98.9%); the final MPC was 89.6%+/-15 in CG, 96.6%+/-12 in MIG and 99.1+/-26.8 in TIG (p = 0.0001). The percentage of controlled subjects was 47.2% in CG (CI = 40-54.4), 61.3% in MIG (CI = 54.1-68.5%) and 63.3% in TIG (CI = 56.4-70.2%) (p<0.05). CONCLUSIONS: TIG and MIG are effective measures for improving patient compliance in hypertension.

Adolescent↗
PubMed1995

The impact of mailing fecal occult blood test kits on return rate in a community cancer screening center.

PURPOSE/OBJECTIVES: To describe how mailing fecal occult blood test (FOBT) kits prior to office appointments rather than distributing the kits at office visits affects the return rate of completed tests and to describe the demographic characteristics of those who returned the tests and those who did not. DESIGN: Retrospective chart review. SETTING: An urban, community hospital cancer screening program. SAMPLE: 631 people; 382 returned the FOBTs; 128 did not return the tests; 121 refused all colorectal screening including fecal occult blood testing. METHODS: Charts were reviewed and abstracted using a form; data were entered and analyzed using descriptive statistics. MAIN RESEARCH VARIABLES: Completion and return of the FOBT and FOBT results. FINDINGS: The return rate when the FOBT was mailed prior to appointments was 85% compared to 32% for patients who received test kits in the office. Of those who completed the test, 80% also underwent digital rectal examinations and 26% underwent flexible sigmoidoscopies. Nine people demonstrated positive FOBT results, but no colorectal cancers were detected. CONCLUSIONS: In this retrospective chart review, mailing FOBT kits prior to office appointments appeared to be related to increased return rates. IMPLICATIONS FOR NURSING PRACTICE: Findings are preliminary in nature, but nurses must consider various methods of distributing FOBTs in order to increase return rates.

Aged↗
PubMed2007

Assessment of potassium iodide (KI) distribution program among communities within the emergency planning zones (EPZ) of two nuclear power plants.

The primary objective of this study was to evaluate a joint state and local government-sponsored potassium iodide (KI) distribution program in New Jersey. This program is part of a radiological emergency response system for residents living within the Emergency Planning Zones (EPZs) of nuclear power facilities. KI pills and an informational fact sheet were distributed locally at six different public clinics in the summer of 2002. In this study, a mailed survey was developed, pilot tested, and sent to the general public to assess knowledge about KI use. The survey consisted of two groups of people, those who attended a KI distribution clinic and those that did not attend a clinic. There was a statistically significant difference in knowledge among the two groups of survey respondents regarding KI prophylaxis, with a mean of 46% of survey questions answered correctly by those who attended a clinic vs. 15% by those who did not attend. Certain questions were problematic for the public to answer correctly and included potential low compliance with government instructions for taking KI, confusion regarding where the public can obtain KI pills during an emergency, and the lack of awareness on the proper use of KI for children, pregnant women, and persons over the age of 40 y. Additional outreach in these specific areas is warranted. This study also found that there was a highly variable geographic pattern of homes that have a supply of KI pills, with some areas having 60% of the households supplied with pills from the clinic while other areas had as low as 1% of the homes supplied with KI pills.

Adult↗
PubMedDate not supplied

Incontinence after prostatectomy: coping with incontinence after prostate cancer surgery.

PURPOSE/OBJECTIVES: To describe the nature of postprostatectomy urinary incontinence, determine how men manage postsurgery urinary incontinence, identify men's perceptions of adequacy of preoperative counseling, and identify men's expectations regarding the probability of postsurgery incontinence. DESIGN: Survey. SETTING: United States. SAMPLE: Members of US TOO International, who experienced urinary incontinence after surgery. METHODS: Copies of the survey (N = 370) were mailed to all chapters of US TOO International, a prostate cancer support group, for distribution to members. A letter of invitation also was posted on the US TOO International Web site and in the monthly newsletter. Men who desired to complete the survey (N = 130) called the researcher's office, and a copy of the survey and a stamped return envelope was mailed to them. Surveys returned to the researchers from June 1998 to January 1999 were included in the analyses. MAIN RESEARCH VARIABLES: Urinary incontinence, management of urinary incontinence, and coping. FINDINGS: 166 men returned surveys. The majority was Caucasian (95%) and married (83%). The median age was 67 years, 87% of the men rated their health as good or excellent, and 114 men (69%) reported becoming incontinent after surgery. Most men experienced stress incontinence symptoms. The majority (89 of 111 men) reported that they were told preoperatively that urinary incontinence was a possible complication. Overall, regardless of length of time since surgery, men (74%) thought that incontinence was an important problem to resolve. Men used containment devices such as pads, special undergarments, and even sanitary napkins as management strategies. The majority of men (54%) used pelvic muscle exercises, especially those who were fewer than two years postsurgery (72%). CONCLUSIONS: Urinary incontinence is a prevalent postoperative complication for men, even up to five years after surgery, and a source of great distress for some. Men reported stress and urge incontinence symptoms and used an array of strategies to contain their urine. Finding effective treatments for postprostatectomy urinary incontinence and receiving adequate information before surgery is important to these men. IMPLICATIONS FOR NURSING: As the number of men who undergo surgical treatment for prostate cancer increases, nurses need to be equipped with the necessary knowledge and information to answer preoperative concerns and provide effective strategies for managing postoperative urinary incontinence.

Adaptation, Psychological↗