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PubMed1996

[Precautionary education against extracorporeal shock wave lithotripsy complication].

The purpose of precautionary education against Extracorporeal Shock Wave Lithotripsy complication in urinary system is to help patients build knowledge, trust, and collaboration. The methods of the education include 1) group education--reading pamphlet which we specially provide and receiving regular information, 2) individual education--giving advice prior to treatment and something special to the patient's needs. Educational content include drinking water, physical adjustment and postural drainage. Three years clinical practice showed that precautionary education could reduce unnecessary complication after Extracorporeal Shock Wave Lithotripsy and it needs further attention in this field.

Humans↗
PubMed1996

Health education for pregnancy care in Harare. A survey in seven primary health care clinics.

OBJECTIVE: The aim of this study was to evaluate how health education is currently practiced in the antenatal clinics in Harare and to make recommendations for its improvement. DESIGN: This was a descriptive study in which data was collected through subject interviews and by observations of antenatal clinics in progress. SETTINGS: Antenatal sessions at primary care clinics in Harare. SUBJECTS: 100 pregnant women and 65 midwives. MAIN OUTCOME MEASURE: The timing, frequency and methods used in health education and the attitude of the pregnant mothers and staff to health education. RESULTS: The results revealed that health education was given once in pregnancy, on the first visit only. The lecture was the most used teaching method. The lecture was full of distractions which affected the concentration of the audience. Midwives decided on the subject matter for health education without consultation with the expectant women. As a result many women could not follow the practical advice given to them. Midwives overestimated their use of other methods of health education. Both the staff and the pregnant women agreed that there should be greater use of written material for women to read at home with their spouses. CONCLUSION: The lecture is not the most appropriate method of health education during pregnancy and greater use should be made of other methods of communication such as the mass media and pamphlets.

Adult↗
PubMed1998

Cultural sensitivity and readability of breast and prostate printed cancer education materials targeting African Americans.

Cancer prevention materials such as pamphlets, booklets, and fact sheets play a significant role in reducing cancer disparities. Little is documented in the literature about the cultural sensitivity of materials targeting African Americans. The Cancer Prevention Materials and African Americans project was conducted to assess the cultural sensitivity and readability of printed cancer education materials targeting African Americans. Results showed current breast and cancer materials are not written at appropriate reading levels, and only 54% of the breast and 40% of the prostate cancer materials were found to be culturally sensitive. Even though the materials are being developed and disseminated in health fairs, physician offices, barber shops, and other locations, the materials are still not reflective of the African-American populations and do not consider literacy, visual, written messages, and format as factors in their utilization. Future studies should assess the appropriateness of materials for African Americans to promote and prevent cancer in African Americans.

Black or African American↗
PubMed1997

Innovative system to improve use of patient education materials.

OBJECTIVE: To evaluate a new storage system for patient education materials. DESIGN: Anonymous surveys before and after implementation of new storage system. SETTING: Family medicine residency teaching centre. PARTICIPANTS: All nurses, staff doctors, and first- and second-year residents in the unit. INTERVENTIONS: Implementation of a new storage system for patient education materials, orientation of all health professionals in the unit to the new system, and periodic distribution of patient education newsletters. MAIN OUTCOME MEASURES: Self-reported use of patient education materials. RESULTS: Response rates were 73% (30 of 41 health professionals) in 1990 and 86% (36 of 42) in 1992. Responses to the first survey on use of 20 categories of patient education materials showed materials were seldom used by most respondents. Back Care, Nutrition, Diabetes, VD/Birth Control, and Pregnancy categories were the most frequently used. In the second survey, more respondents reported using these five categories of pamphlets. Rates of use varied only slightly for the remaining 15 categories. CONCLUSIONS: Health professionals reported more frequent use of certain patient education materials following implementation of a new storage system.

Abstracting and Indexing↗
PubMed1989

Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization.

Physicians could help a large number of patients quit smoking by taking time to advise them about quitting, helping them plan a date to quit, giving them self-help materials, following up, and referring some to smoking cessation programs. To determine the attitudes and practices of internists concerning smoking cessation and selected preventive medical practices, we surveyed a random sample of internists in private practice and in a large health maintenance organization (Kaiser-Permanente Medical Group) in the San Francisco Bay area. Overall, internists consider counseling about smoking to be at least as worthwhile as many other practices, such as screening for breast cancer, and more worthwhile than periodic physical examinations. Despite these beliefs, 57% to 65% of internists reported that they spend two minutes or less counseling smokers during new patient visits. Many internists never use recommended strategies for counseling about smoking: 33% to 44% never help patients plan dates to quit, 68% to 75% never make follow-up appointments with patients primarily about smoking, and 27% to 48% never give smokers self-help pamphlets about quitting. Although they believe that counseling about smoking is worthwhile, internists are not doing as much as they could to help their patients quit.

Attitude of Health Personnel↗
PubMed2000

Barriers to care for patients with neurologic disease in rural Zambia.

The awesome burden of treatable yet untreated neurologic disease in the developing world presents a humanitarian crisis to those of us with neurologic expertise from more privileged situations. Although increased economic resources are critically needed, a shortage of personnel to care for these patients is as great a problem. It is neither feasible nor desirable to propose training neurologists to work in these regions. However, COs could be selected to receive additional training and return to their home regions to serve as resources for referrals and as community educators. Such a training program would not require massive financial commitments. A handful of dedicated neurologists could conceivably accomplish this in 6- to 8-week training sessions. Ideally, educational materials, such as posters and pamphlets in both English and the native language of the various regions, would be provided at no cost. Existing textbooks in neurology are written for physicians and often focus on diagnostic evaluations and therapies far beyond the services available in developing countries. A text for practical use by COs and community health workers that discusses the application of available medicines and therapies for common neurologic problems would be invaluable. Similar books exist that address general medical and obstetrical problems (for example, Where There Is No Doctor: A Village Health Care Handbook). Where There Is No Neurologist could be developed as a primary teaching tool and a valuable reference for COs with neurologic expertise. Neuroscience researchers, clinical neurologists, and neurology residents from industrialized countries have much to offer and to gain by working in the Third World. Research to monitor the incidence and resource utilization of emerging problems such as stroke is needed to influence public policy. The economic burden and lost productivity caused by neurologic disease in this part of the world has not been appreciated or explored. Disease beyond the scope of Western experience manifests daily in places like Chikankata. Entities such as tabes neurosyphilis, which previous generations of neurologists used as the basis for their training, still abound in Zambia. Much personal satisfaction can be gained in providing care to this vulnerable and underserved population.

Adult↗
PubMed2002

Patient education and informed consent in head and neck surgery.

OBJECTIVE: To examine the effects of an educational intervention, in the form of printed material, on patient knowledge and recall of possible risks from parotidectomy or thyroidectomy. DESIGN: Prospective, randomized, controlled study conducted during a 9-month period. SETTING: Head and neck surgery clinic of an academic tertiary care hospital. PATIENTS: One hundred twenty-five consecutive patients older than 16 years who were undergoing thyroidectomy or parotidectomy at the head and neck surgery clinic were recruited. Four patients were excluded from analysis because their follow-up interview was not within the required limits. INTERVENTION: At the preoperative visit during the routine consent process, both groups received a verbally delivered checklist of risks specific for the surgery to be performed. The intervention group was also given a pamphlet with written information accompanied by illustrations. MAIN OUTCOME MEASURES: The effectiveness of the educational intervention was determined by comparing the average rate of risk recall between the intervention and control groups. The effects of age, sex, level of education, and time between the consent and recall interviews on recall rate were also assessed. RESULTS: The overall risk recall rate for both procedures was 39.1%. The recall rate of the intervention group was 50.3% compared with 29.5% for the control group (P<.001). CONCLUSIONS: The intervention consistently improved risk recall for all patients regardless of age, sex, and level of education. Patients' ability to recall potential risks was significantly increased by an educational intervention; all patients would benefit from this intervention.

Adolescent↗
PubMed2001

Counseling smoking parents of young children: comparison of pediatricians and family physicians.

BACKGROUND: Secondhand smoke is a major cause of morbidity in young children, and exposure to smoking parents is the principal source. Physician visits for young children present an opportunity to effect behavioral change among smoking parents. OBJECTIVE: To survey pediatricians and family physicians in their knowledge and practice of smoking cessation counseling with parents. DESIGN: Cross-sectional mail survey. SETTING: Urban California. PARTICIPANTS: Pediatricians and family physicians in urban areas of California, younger than 65 years, practicing in an ambulatory setting, and randomly selected from the American Medical Association Physician Masterfile. MAIN OUTCOME MEASURES: Reported frequency of asking about tobacco use, using cessation counseling techniques with smokers, and perceived barriers to providing cessation services. RESULTS: Of the 1000 mailed surveys, 899 were eligible and 499 (56% response rate) were returned and completed. A higher proportion of pediatricians compared with family physicians were women (44% vs 29%; P<.01) and nonwhite (44% vs 32%; P =.01). Family physicians compared with pediatricians were more likely to report referring a parent to a smoking cessation program (41% vs 30%), giving pamphlets on smoking cessation (40% vs 28%), asking for a quit date (41% vs 18%), scheduling a follow-up visit to discuss quitting (27% vs 5%), and recommending nicotine replacement therapy (41% vs 13%) (for each comparison, P<.001). Pediatricians were more likely to report recording in the medical record smoking by a parent as a problem for the child (65% vs 48%; P<.001), but a higher proportion of pediatricians perceived that parents would ignore the advice (39% vs 24%; P<.001) and lacked interest in quitting smoking (45% vs 27%; P<.001). Pediatricians were more likely to agree that they lacked smoking cessation counseling skills (26% vs 7%; P<.001). Multivariate models showed that pediatricians were less likely to report performing 5 of 14 smoking cessation techniques in at least 50% of smoking parents. CONCLUSIONS: Pediatricians appear to lack training to implement smoking cessation counseling with smoking parents. Physicians in private practice are less likely to counsel smoking parents. Educational interventions for pediatricians are needed to decrease secondhand smoke exposure for young children.

Adult↗
PubMed2001

A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care.

BACKGROUND: Effectiveness studies have tested interventions to improve quality of care for depression in primary care, but none, to our knowledge, have been completed for panic disorder (PD) in this setting. This study sought to test the clinical effectiveness of PD pharmacotherapy embedded in a disease management framework of "collaborative care" (CC). METHODS: One hundred fifteen patients with PD from 3 primary care clinics were randomized to CC or "usual care" (UC). Patients in CC (n = 57) received educational videotapes and pamphlets; pharmacotherapy with the selective serotonin reuptake inhibitor paroxetine; 2 psychiatrist visits and 2 telephone calls in the first 8 weeks; and up to 5 telephone calls between 3 and 12 months' follow-up. Usual care patients (n = 58) were treated by their primary care physician. Telephone assessments of panic, anxiety sensitivity, depression, and disability variables were performed at 3, 6, 9, and 12 months' follow-up. Adequacy of pharmacotherapy was assessed with an algorithm based on a review of efficacy studies. RESULTS: Patients in CC were more likely to receive adequate (type, dose, duration) medication and more likely to adhere to this medication at 3 and 6 months. Random regression analyses showed that CC patients improved significantly more over time compared with UC patients on anxiety, depression, and disability measures, with the greatest effects at 3 and 6 months. CONCLUSIONS: Compared with UC, CC interventions significantly improved both quality of care and clinical and functional outcomes in primary care PD patients. Clinical differences were greatest in the first 6 months, corresponding to the greater quality of care and the greater intensity of intervention.

Adult↗
PubMed2004

A low-carbohydrate diet in overweight patients undergoing stable statin therapy raises high-density lipoprotein and lowers triglycerides substantially.

BACKGROUND: A low-carbohydrate diet remains controversial, especially in patients with arteriosclerotic heart disease. HYPOTHESIS: This study was undertaken to evaluate the effect of a low-carbohydrate diet on the lipid levels in obese patients with known arteriosclerotic heart disease on chronic statin therapy. METHODS: Thirty-eight overweight patients with angiographically documented arteriosclerotic heart disease were followed in a private cardiology practice setting. All patients were undergoing stable statin therapy. Patients received a 15-min consultation and a 4-page pamphlet explaining a low-carbohydrate diet; no other diet instruction was given. Patients were followed weekly for 2 weeks, then monthly for 3 months, then every third month. A fasting finger stick lipid panel (cholesterol, high-density and low-density lipoprotein [HDL/ LDL], triglycerides, and glucose) was obtained with each visit and patients were weighed in street clothes. RESULTS: The 38 patients were followed for a average of 11.8 months (range 6-22 months). Average body mass index declined from 33.5 kg/m2 before to 27.9 kg/m2 at the end of the study. Weight loss averaged 31 lbs (range 16-107 lbs). Triglyceride levels were lowered by 29.5%, HDL raised by 17.6%, and cholesterol decreased by 8.4%. The cholesterol/ HDL ratio changed from 5.31 to 3.78 and LDL cholesterol decreased by 5%. CONCLUSION: The addition of a low-carbohydrate diet for overweight patients with known coronary artery disease undergoing stable statin therapy causes significant weight loss and a favorable change in the lipid panel.

Adult↗
PubMedDate not supplied

Keeping current: ten important information resources to help rehabilitation nurses.

Rehabilitation nurses have a professional responsibility to provide the most current and informed client care possible. As a result, they must keep up with the emerging healthcare delivery system of the 21st century. This article describes how nurses can get access to and use 10 information resources--namely, journals, books, pamphlets, indexes and on-line databases, conferences, continuing education, professional organizations, standards of practice of interest to nurses in rehabilitation nursing, and networking.

Computer Communication Networks↗
PubMed2006

A decision aid to assist in adjuvant therapy choices for breast cancer.

BACKGROUND: Decision aids are tools that help patients make specific and deliberative choices among options. This study was a group randomized controlled trial of a novel decision aid to help patients with breast cancer make adjuvant therapy (AT) decisions. METHODS: Fourteen oncology practices (n=58 physicians) were randomized to receive the decision aid or a control pamphlet. Complete data were obtained from 405 patient-oncologist pairs. Eligible patients had stage I-III disease and had completed their primary treatment. The decision aid is a simple to use computer program, titled Adjuvant!, that provides estimates of outcome with and without AT. Graphical representations of outcome are shared with patients. Consultations were audiotaped, patients interviewed, and physicians completed a self-administered survey. RESULTS: In a multivariable model, the 54 patients (13.3%) who took no AT were more likely to have received the decision aid (p=0.02). A differential effect of the Adjuvant! Decision Guide was noted between node negative and positive patients. It was stated by 86.2% of patients that the decision aid was influential when making their treatment decision. Over 95% of patients reported that the Adjuvant Decision Guide was easy to understand and 75% of physicians believed that it helped them understand their patient's treatment preferences and 81.4% reported the information as useful for themselves. CONCLUSIONS: This study showed that a decision aid made a difference in the choice of whether or not to take AT. The decision aid allowed patients and physicians to consider the benefits of AT in an easy to understand format. Treatment decisions were more individualized for patients in the intervention than in the control group. The use of the decision aid was acceptable to both patients and physicians.

Adult↗
PubMed2005

Video preparation for breast cancer treatment planning: results of a randomized clinical trial.

This paper reports results of a randomized controlled trial of a preparatory videotape to reduce distress and increase preparedness among 79 recently diagnosed breast cancer patients. Patients were randomly assigned to view a 19-min video developed for this study, or to a written pamphlet control condition. The video included physician interviews, doctor-patient interaction, and a description of a typical patient's experience at the clinic. Baseline measures included demographic characteristics, history of mental health treatment, personality, and distress (depression, anxiety, helplessness). Outcome measures included distress, quality of life, patient satisfaction, readiness to ask questions of doctor, and participation in the appointment. Results showed that among minority patients, those in the video condition were more satisfied with the overall clinic appointment. Among unmarried patients, those in the video condition tended to have lower distress. Among patients with a history of mental health treatment, those in the video condition tended to have higher quality of life. Among patients working at least half time, those in the video condition were more prepared to ask questions of their doctors. Results suggest that video preparation of cancer patients can be effective, and may be most likely to benefit patients who are vulnerable or underserved.

Aged↗
PubMed1995

Survey of New Jersey schools and day care centers for lead in plumbing solder. Identification of lead solder and prevention of exposure to drinking water contaminated with lead from plumbing solder.

Levels of lead in drinking water can be high enough to pose a potential health threat to very young children, primarily from the use of lead solder for indoor plumbing. In February 1987, New Jersey banned lead solder for use in the installation or repair of drinking water plumbing systems. However, because lead solder continued to be available for purchase in the state, New Jersey Department of Health staff sought to (i) determine the extent to which schools and day care centers were in compliance with the ban, and (ii) determine the effectiveness of a solder analysis test kit commonly used by plumbing inspectors in the field. Samples of solder were collected from 53 day care centers and 37 schools known to have been constructed or renovated after the ban took effect. Samples from 24% of those facilities constructed or renovated just after the lead ban (1987-1988) tested positive for lead content. However, for those facilities constructed or renovated in later years (1989-1992), there was a decline in the percentage of samples that tested positive for lead content. For this period of time, 13% of the samples tested positive for lead. In total, more than 10% of facilities with new plumbing installed between 1987 and 1992 had solder samples that tested positive for lead. A lead in solder test kit commonly used by inspectors proved to be an effective screening tool for the field. The New Jersey Department of Health recommends continued enforcement of the lead solder ban through inspection and encouragement of behaviors that minimize consumption of potentially lead-contaminated drinking water. In order to assess patterns of water use, staff at the day care centers were asked to complete a questionnaire. Sixty-seven percent of the respondents reported that they "always" use water from the cold tap when preparing drinks or food for the children. In addition, 57% reported that they always first flush the tap before using the water for drinking or food purposes. Posters and pamphlets developed by the department and containing recommendations for how to minimize consumption of lead-contaminated drinking water were also provided.

Day Care, Medical↗
PubMed1994

Pharmacokinetics and radiation dose of oxygen-15 labelled butanol in rCBF studies in humans.

In this positron emission tomography (PET) study in humans we determined the pharmacokinetics and radiation dose of oxygen-15 labelled butanol, a recently introduced tracer for regional cerebral blood flow (rCBF). This report includes a description of the automated preparation of 15O-butanol which allows repetitive activation studies, each 15 min apart. Dynamic rCBF studies were extended by prolonged measurements up to 15 min after injection over different organs such as brain, liver, kidneys and bladder. All measurements were done with a whole-body PET camera PC4096-15WB. Based on the pharmacokinetic data in 13 subjects the radiation doses to single organs were calculated according to MIRD pamphlet No. 11 and the effective dose defined by ICRP 60 as an indicator of radiation dose to the total body. The liver received the highest radiation dose of about 2.2 mGy per 1500 MBq of injected 15O-butanol, which is the typical amount of administered tracer in one rCBF measurement. The dose to the kidneys was 1.6 mGy, to the stomach 0.8 mGy, and to the brain 0.16 mGy. The effective dose was 0.54 mGy, which was similar to that of H2(15)O, but lower than the effective dose from C15O2 in amounts typically applied in human rCBF studies.

Adult↗
PubMed1986

Felix A. Theilhaber--pioneer sexologist.

Felix A. Theilhaber, a physician, was born in Germany in 1884 and died in Israel in 1956. He was a pioneer sexologist, demographer, and sportsman and an early Zionist. Theilhaber was an original thinker and a prolific writer. He fought courageously against the pervasive reactionary and antisocial attitudes in the Germany of his time and campaigned actively, in his public addresses, books, pamphlets, and papers, for sexual reform, especially for liberalization of abortion and legalization of contraception. He founded the Society for Sexual Reform (Gesex) in 1913 and was cofounder and sexologic adviser of one of the first birth control and sex advisory clinics in Berlin (1930), operating under the patronage of the Gesex. In 1925, he founded the Coalition for Reform of the (Germany) Criminal Law, and in 1928, the periodical Sexual Hygiene. Among 20 books authored by Theilhaber are The Decline of the German Jews (1911), Das Sterile Berlin (1913), and Goethe, Sexus and Eros (1929). After his emigration to Israel in 1935, he continued his writings and later founded a Health Insurance Company in Tel Aviv, acting as its medical director. He has left a great legacy for sexology.

Abortion, Legal↗
PubMed1978

[Insurance system. Prevention from viewpoint of the insurer].

The purpose of an insurance must not be restricted to the payment of claims to those insured persons who suffered a loss, for loss prevention is much preferable to claim settlement. A whole range of different institutions and measures has been established by the Swiss insurers, in which many insurance branches participate. The loss preventing activities can be listed as follows:--Activities of the fire insurers to prevent and fight fires. This is the prevailing duty of the Consulting Agency for Fire Prevention (BfB) as well as the Fire Prevention Service for Industry and Trade (BVD).--Activities of the accident insurers to prevent accidents. The fight against accidents, mostly traffic accidents, in sports and at home is the foremost task of the Swiss Council for the Prevention of Accidents (BfU), an institution created by the Conference of Accident Insurance Managers (UDK) and the Swiss National Accident Insurance Fund (SUVA).--The Health Service in life insurance, after all the periodical medical examinations and consultations granted by many insurers to their insured persons, as well as the pamphlets aiming at health education published by several Companies and finally institutions and measures to promote fitness, e.g. VITA-Parcours.

Accident Prevention↗
PubMed1996

Experimental evaluation of a modular approach to mobilizing antitobacco influences of peers and parents.

The experimental evaluation of two components of a community intervention to prevent adolescent tobacco use are described. Youth antitobacco activities (e.g., peer quizzes, sidewalk art, poster and T-shirt giveaways, etc.) and family communications activities (pamphlets to parents and student quizzes of parents) were evaluated in two time-series experiments, each of which was conducted in two experimental and one control community. Students in Grades 6 and 8 and their parents were assessed in a series of four phone surveys in the first experiment and six phone surveys in the second. Implementation of the youth antitobacco and family communications activities led to significantly greater exposure of young people to antitobacco information. They led to increases in parent and youth knowledge about tobacco use and more negative attitudes toward tobacco. In Experiment 2, youths in intervention communities had significantly lower rated intentions to smoke. The findings suggest the value of a modular approach to community interventions for influencing the social context relevant to the onset of adolescent tobacco use.

Adolescent↗