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PubMed2007

Adaptation and evaluation of the National Cancer Institute's Diet History Questionnaire and nutrient database for Canadian populations.

BACKGROUND AND OBJECTIVE: Despite assumed similarities in Canadian and US dietary habits, some differences in food availability and nutrient fortification exist. Food-frequency questionnaires designed for the USA may therefore not provide the most accurate estimates of dietary intake in Canadian populations. Hence, we undertook to evaluate and modify the National Cancer Institute's Diet History Questionnaire (DHQ) and nutrient database. METHODS: Of the foods queried on the DHQ, those most likely to differ in nutrient composition were identified. Where possible these foods were matched to comparable foods in the Canadian Nutrient File. Nutrient values were examined and modified to reflect the Canadian content of minerals (calcium, iron, zinc) and vitamins (A, C, D, thiamin, riboflavin, niacin, B6, folate and B12). DHQs completed by 13 181 Alberta Cohort Study participants aged 35-69 years were analysed to estimate nutrient intakes using the original US and modified versions of the DHQ databases. Misclassification of intake for meeting the Dietary Reference Intake (DRI) was determined following analysis with the US nutrient database. RESULTS: Twenty-five per cent of 2411 foods deemed most likely to differ in nutrient profile were subsequently modified for folate, 11% for vitamin D, 10% for calcium and riboflavin, and between 7 and 10% for the remaining nutrients of interest. Misclassification with respect to meeting the DRI varied but was highest for folate (7%) and vitamin A (7%) among men, and for vitamin D (7%) among women over 50 years of age. CONCLUSION: Errors in nutrient intake estimates owing to differences in food fortification between the USA and Canada can be reduced in Canadian populations by using nutrient databases that reflect Canadian fortification practices.

Adult↗
PubMed2001

Relatives of hospitalized stroke patients: their needs for information, counselling and accessibility.

AIM OF THE STUDY: The purpose of this study is to explore the needs of stroke patients' relatives during the hospitalization period. BACKGROUND: In the Netherlands, the consequences of a stroke, and the needs of stroke patients and their relatives are becoming increasingly important. In hospital, however, nursing care is still focused on the patients. A previous qualitative study on the needs of relatives of stroke patients identified four categories of needs. This present study aims to test the results of the previous study in a larger setting and to identify the factors that influence the needs of the relatives. DESIGN/METHODS: This study uses a cross-sectional design. A questionnaire was designed for the purpose of data collection. This questionnaire was completed by 106 relatives of stroke patients admitted to the neurology wards of 19 Dutch hospitals (response rate 64%). The data were analysed using descriptive and multivariate analyses. RESULTS/FINDINGS: The findings of the study indicate that the needs of the relatives of stroke patients are best divided into three categories. These are the need for information, counselling (a combination of communication and support) and accessibility. In all cases, the most important need of the relatives of stroke patients is that their questions are answered honestly. The findings show a discrepancy between the importance of the needs and the degree to which these needs are met. Multivariate data analyses show that female relatives requested most information, whereas highly educated relatives needed less counselling. Satisfaction about the care provided is positively influenced by the period of hospitalization and negatively influenced by prior experiences of hospitalization.

Aged↗
PubMed2004

Reliability and validity of a food-frequency questionnaire for Chinese postmenopausal women.

OBJECTIVES: (1). To determine the reliability and validity of a food-frequency questionnaire (FFQ) for use in epidemiological research in postmenopausal women; and (2). to compare the volume estimation (VE) and weight estimation (WE) method of administration of this questionnaire. DESIGN: An initial list of foods was derived and modified after pre-testing in 22 subjects. Test-retest reliability was assessed in 21 subjects who had repeat administrations of the questionnaire 14 days apart (FFQ1, FFQ2). The validity of the FFQ was assessed by comparing nutrient intakes with those from a 4-day food record. SETTING: Chengdu, People's Republic of China. SUBJECTS: Twenty-two postmenopausal women (50-70 years) were recruited from The Second University Hospital, West China University of Medical Sciences, Chengdu and participated in the pre-test. Another 21 women (50-70 years) were randomly selected from the general population of all five districts of Chengdu and participated in the reliability and validity sub-studies. RESULTS: Energy, protein, carbohydrate, magnesium and sodium intakes in this sample were less than the Recommended Dietary Allowances (RDAs) for 45-70-year-old women in China. Intake of non-cooking fat was higher than the Chinese RDA. Pearson correlation coefficients and intra-class correlation coefficients (ICCs) for reliability of the VE FFQ ranged from 0.51 to 0.85 and from 0.51 to 0.81, respectively; for the WE FFQ, they ranged from 0.22 to 0.86 and from 0.21 to 0.81. Correlation coefficients and ICCs for validity of the WE FFQ ranged from 0.36 to 0.69 and from 0.34 to 0.57, respectively; corresponding values for the VE FFQ were -0.30 to 0.65 and -0.14 to 0.65. CONCLUSIONS: Both the VE and WE FFQs were reliable and valid except for sodium intake. The VE FFQ provided more valid estimates of nutrient intakes than did the WE FFQ.

Aged↗
PubMed1994

A cost-utility analysis of intensive therapy. II: Quality of life in survivors.

A questionnaire designed to assess changes in quality of life was sent to 56 survivors of critical illness one year after their admission to an intensive therapy unit. Forty-one patients completed the questionnaire, and for the majority, quality of life remained unchanged (n = 25). However significant decreases in quality of life were found in those patients who previously enjoyed a good quality of life or were admitted with respiratory problems. Survivors also recorded significant decreases in five aspects of their perceived quality of life (ability to think and remember, seeing family, their contribution to society, activities outside work and income). As part of a previous study, the costs incurred by each of these patients had been measured so that changes in quality of life detected in this study could be combined to the individual costs and expressed as cost per quality adjusted life year. The cost of intensive therapy for a patient surviving for one year after acute respiratory or cardiovascular disease was 2600 pounds. The total hospital cost per quality adjusted life year was estimated at 7500 pounds, which places intensive therapy at the higher end of health programme costs. If the costs of nonsurvivors are included in the cost per quality adjusted life year calculation, the cost of intensive care increases considerably.

Adult↗
PubMed2002

An introductory survey of helminth control practices in south africa and anthelmintic resistance on Thoroughbred stud farms in the Western Cape Province.

Fifty-one per cent of 110 questionnaires, designed for obtaining information on helminth control practices and management on Thoroughbred stud farms in South Africa, were completed by farmers during 2000. The number of horses per farm included in the questionnaire survey ranged from 15 to 410. Foals, yearlings and adult horses were treated with anthelmintics at a mean of 7.3 +/- 3.0, 6.6 +/- 2.7 and 5.3 +/- 2.3 times per year, respectively. An average of 3.4 different drugs were used annually, with ivermectin being used bymost farmers during 1997-2000. On 43% of farms the weights of horses were estimated by weigh band and 45% of farmers estimated visually, while both were used on 7% of farms and scales on the remaining 5%. Doses were based on average group weight on 50% ofthe farms and on individual weights on 46%. Forty-three per cent of farmers performed faecal egg count reduction tests (FECRT). Most farmers rotated horses between pastures and treated new horses at introduction. Faecal removal was practiced on 61% of farms and less than 50% of farmers used alternate grazing with ruminants. Faecal egg count reduction tests were done on 283 horses, using oxibendazole, ivermectin and moxidectin on 10,9 and 5 farms, respectively, in the Western Cape Province during 2001. While the efficacy of oxibendazole was estimated by FECRT to range from 0-88% and moxidectin from 99-100%, ivermectin resulted in a 100% reduction in egg counts. Only cyathostome larvae were recovered from post-treatment faecal cultures.

Animals↗
PubMed2000

Willingness to pay for new chemotherapy for advanced ovarian cancer.

AIMS: To investigate whether health care professionals had differing attitudes about cost and survival issues in regard to the treatment of advanced ovarian cancer. METHODS: A questionnaire designed for the study was mailed to hospital doctors, hospital nurses, Crown Health Enterprise (CHE) managers and health authority managers who were working in the same geographical area. A total of 391 questionnaires were mailed and 186 were completed reflecting an overall response rate of 47%. Replies were received from 46% of the health authority managers, 61% of the CHE managers, 59% of the doctors and 27% of nurses. RESULTS: Results indicated a threshold for how much individuals were willing to pay. Group differences were evident with the nurses and CHE managers willing to spend less than the other two groups. In addition, those with experience of cancer treatment were willing to spend less than those with no such experience. CONCLUSIONS: There are differences in attitudes to costs and benefits of treatment between individuals working in different areas of health care. Health sector workers value treatments which extend life expectancy without necessarily being curative.

Adult↗
PubMed2001

Life after cystectomy and orthotopic neobladder versus ileal conduit urinary diversion.

Patients frequently complain about changes in their everyday life after radical cystectomy and urinary diversion. The aim of this study was to compare subjective morbidity of ileal neobladder to the urethra versus ileal conduit urinary diversion and to elucidate its influence on quality of life. A total of 102 patients who underwent radical cystectomy due to a bladder malignancy were included in the study: 69 patients (67.6%) with an orthotopic neobladder and 33 patients (32.4%) with an ileal conduit. The compliance was 99% and mean follow-up was 37 months. All patients completed two retrospective quality-of-life questionnaires, namely the QLQ-C30 and a questionnaire developed at our institution to elucidate specific items regarding urinary diversion. The questioning was performed by a nonurologist. The results obtained from the validated (QLQ-C30) and our self-designed questionnaire clearly demonstrate that patients with an orthotopic neobladder better adapt to the new situation than patients with an ileal conduit. In addition, neobladder to the urethra improves quality of life due to a better self-confidence, better rehabilitation as well as restoration of leisure, professional, traveling, and social activities, and reduced risk of inadvertent loss of urine. For example, 74.6% of neobladder patients felt absolutely safe with the urinary diversion in contrast to 33.3% in the ileal conduit group. Only 1.5% of neobladder patients had wet clothes caused by urine leakage during day versus 48.5% of ileal conduit patients; 92.8% of neobladder patients felt not handicapped at all; and 87% felt not sickly or ill in contrast to 51.5% and 66.7% of ileal conduit patients, respectively. Moreover, 97% of our neobladder patients would recommend the same urinary diversion to a friend suffering from the same disease in contrast to only 36% of ileal conduit patients. The results obtained by this study demonstrate that quality of life is preserved in a higher degree after orthotopic neobladder than after ileal conduit urinary diversion.

Cystectomy↗
PubMed1986

Composition of cardioplegic solutions used in nine medical centers.

Eleven institutions that participated in the Coronary Artery Surgery Study (CASS) were surveyed to obtain information about the types of cardioplegic solutions used at these institutions. A short-answer questionnaire designed to obtain specific information about the composition and method of preparation of cardioplegic solutions was sent to each institution. Institutions that did not reply within four weeks were sent a second questionnaire. Nine institutions returned completed questionnaires. Four institutions used several different cardioplegic solutions, resulting in a total of 14 evaluable solutions. Six hospitals used a chemical-based cardioplegic solution, one used a blood-based solution, and two used a combination of blood and chemicals as a cardioplegic-solution base. Chloride and potassium were found in all 14 solutions, although the amounts varied widely. Dextrose was included in eight of the nine chemical-based solutions, and bicarbonate and sodium were each used in seven of the nine solutions. Centers using chemical-based cardioplegic solutions compounded them daily or froze them with a one-week expiration date; blood-based solutions had to be prepared daily. Although interinstitutional differences in dosage were evident, the cardioplegic solutions used in the institutions participating in the CASS had many similar components. Data on the composition of these solutions can be used as a guideline for developing a cardioplegic solution.

Academic Medical Centers↗
PubMed2003

Do radiologists want/need training in cardiopulmonary resuscitation? Results of an Internet questionnaire.

PURPOSE: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). MATERIAL AND METHODS: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. RESULTS: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 +/- 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. CONCLUSION: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological departments themselves should organize courses in order to cope with their specific situations.

Attitude of Health Personnel↗
PubMed1998

[Diet and risk of myocardial infarction. A case-control community-based study].

OBJECTIVE: To evaluate diet as a risk factor for myocardial infarction. DESIGN: Community based case-control study. SETTING: University Hospital, Oporto. PARTICIPANTS: First time consecutive cases of acute myocardial infarction (n = 100) and 198 community controls, older than 39 years and living in Oporto, were compared. METHODS: Data were collected by trained interviewers using a structured questionnaire designed to obtain information on socio-demographic, medical and behavioural aspects, emphasising the description of diet and food habits (using a semi-quantitative food frequency questionnaire). Controls were selected by random digit dialing with a participation rate of 70%. Odds ratios and 95% confidence intervals (CI) according to quartiles of nutrient ingestion were calculated using unconditional logistic regression. RESULTS: Female controls presented significantly higher mean intakes of protein, omega-3 fatty acids, fiber, cholesterol and vitamin C. Male controls had a significantly higher mean daily intake of fiber, vitamin C, vitamin E, and carotenes. After adjusting for age, sex, education, body mass index, ethanol, smoking and total energy intake, there was a protective effect of vitamin C (OR = 0.2, 95% CI: 0.1-0.6, for the 4th quartile), vitamin E (OR = 0.3, 95% CI: 0.1-0.9 for the 4th quartile) and total fiber (OR = 0.3, 95% CI: 0.1-0.9) for the 4th quartile). No significant effect was found for trans-fatty acids, but there was a higher risk with increased energy intake. CONCLUSIONS: This study showed that diet has an important independent effect on myocardial infarction, a protective independent role for anti-oxidant vitamin C and E was verified.

Adult↗
PubMed1993

Analysis of case-crossover designs.

The case-crossover design provides a means to study the effects of transient exposures on the risk of acute illness, for example, the effects of drinking alcohol on the immediate risk of a heart attack. Only cases are required by the design, since each case is effectively its own control; what a case was doing at the time of an acute event is compared with what the case would have been doing usually. Maclure has described an approach based on the Mantel-Haenszel method of analysis. It is shown here how the analysis of case-crossover designs can be achieved by a method of maximum likelihood. The method is quite general and, in principle, can be used to analyse the joint effects of many transient exposures. For binary exposures the Mantel-Haenszel approach is an approximate solution to the likelihood equations. In practice, case-crossover designs are limited by the information available on each case's 'usual' behaviour. Extracting such information requires in-depth questioning, but, in principle, it can be obtained. To do so requires careful questionnaire design. The approach is illustrated by analysis of 24 hour alcohol consumption and the risk of myocardial infarction. The problem with this analysis is how to estimate the probability of what a case would 'usually' have been doing from information on drinking frequency.

Adult↗
PubMed1996

Simulated disability exercises and their impact on attitudes toward persons with disabilities.

Two separate graduate rehabilitation counselling groups from a mid-south university either did or did not take part in a wheelchair sensitivity training pilot study designed to enhance their understanding as to what life might be like for persons who use a wheelchair. Twenty students were individually accompanied on a designated route across campus by a non-disabled graduate researcher. Eighteen other graduate students formed a control group and did not participate. Both groups completed a contextually different 14-item Likert type questionnaire designed to assess their perceptions of persons with physical disabilities based on either the sensitivity exercise or their experience in the rehabilitation programme. Results from this quasi-experimental study suggested that regardless of whether they participated in the sensitivity training, both groups perceived they would become better counsellors. t-Tests revealed significant differences in the two groups' responses to questions pertaining to daily frustrations experienced by persons with physical disabilities and a pre-occupation with how accessible places are. Other differences noted were that persons with physical disabilities must feel different from being stared at and must have a harder time in society. Implications of the utility and misuses of these one-time experiences are explored.

Activities of Daily Living↗
PubMed2004

Children's perceptions of their acoustic environment at school and at home.

This paper describes the results of a large-scale questionnaire survey that ascertained children's perceptions of their noise environment and the relationships of the children's perceptions to objective measures of noise. Precision, specificity, and consistency of responding was established through the use of convergent measures. Two thousand and thirty-six children completed a questionnaire designed to tap (a) their ability to discriminate different classroom listening conditions; (b) the noise sources heard at home and at school; and (c) their annoyance by these noise sources. Teachers completed a questionnaire about the classroom noise sources. Children were able to discriminate between situations with varying amounts and types of noise. A hierarchy of annoying sound sources for the children was established. External L(Amax) levels were a significant factor in reported annoyance, whereas external L(A90) and L(A99) levels were a significant factor in determining whether or not children hear sound sources. Objective noise measures (L(A90) and L(A99)) accounted for 45% of the variance in children's reporting of sounds in their school environment. The current study demonstrates that children can be sensitive judges of their noise environments and that the impact of different aspects of noise needs to be considered. Future work will need to specify the factors underlying the developmental changes and the physical and location dimensions that determine the school effects.

Adult↗
PubMed2000

[Control of a school outbreak of serogroup B meningococcal disease by chemoprophylaxis with azithromycin and ciprofloxacin].

OBJECTIVE: To assess the efficacy of azithromycin as a chemoprophylactic agent in meningococcal disease in pre-school aged children, and the safety of ciprofloxacin in children aged 6-16 years old. METHODS: After classic chemoprophylaxis with rifampicin failed to control a school outbreak of meningococcal disease in Cantabria (Spain), a second cycle of chemoprophylaxis was administered in the school. Azithromycin was administered in the nursery level (99 children, aged 3-5 years old) and ciprofloxacin was administered in the primary and secondary levels (795 children, aged 6-16 years old) and in the school's adult personnel (58 persons). The efficacy of chemoprophylaxis was studied through records of cases of meningococcal disease, the mandatory disease reporting system, and the school's absences. The safety of ciprofloxacin was studied using a questionnaire designed to determine the incidence of adverse osteoarticular effects, which was distributed to parents, school personnel and pediatricians within the school's area. RESULTS: The chemoprophylaxis administered controlled the outbreak. We collected 764 questionnaIres (response rate: 89.5 %). The incidence of arthralgia after ciprofloxacin was 0.9% in children and 3.3% in adults. All were mild and self-limiting without specific treatment, except in one patient (in the adult group) in whom arthralgia was present 1 month after prophylactic treatment. However, the arthralgia was so mild that the patient had not consulted her physician. Only three children had sought medical advice for arthralgia. Consequently, the incidence that would have been detected by the Spanish pharmacovigilance system would have been 0.4% in children and 0% in adults. CONCLUSIONS: Azithromycin was effective in controlling the outbreak in children aged between 3 and 5 years. Ciprofloxacin was safe and effective, with no serious or persistent osteoarticular effects in children. The incidence of arthralgia was lower in children than in adults.

Adolescent↗
PubMed2002

Using Rasch measurement to investigate the cross-form equivalence and clinical utility of Spanish and English versions of a diabetes questionnaire: a pilot study.

The purpose of this research was to use Rasch measurement to study the psychometric properties of data obtained from a newly developed Diabetes Questionnaire designed to measure diabetes knowledge, attitudes, and self-care. Specifically, a methodology using principles of Rasch measurement for investigating the cross-form equivalence of English and Spanish versions of the Diabetes Questionnaire was employed. A total of fifty diabetes patients responded to the questionnaire, with 26 participants completing the English version. Analyses detected problems with the attitude items. We attributed the scaling problems to the use of negatively worded items with participants having generally low educational backgrounds. Analysis of the knowledge and self-care items yielded unidimensional variables with clinically meaningful item hierarchies that may have relevance to treatment protocols. Furthermore, the knowledge and the self-care items from the two versions of the Diabetes Questionnaire met our criteria for establishing cross-form equivalence and thus allow quantitative comparisons of person measures across versions. Limitations of the study and suggested refinements of the Diabetes Questionnaire are discussed.

Black or African American↗
PubMed1996

[Behavior assessment in Alzheimer type dementia using the disruptive behavior questionnaire].

OBJECTIVES: We developed a disruptive behavior questionnaire designed for persons living close to the patient in order to assess behavior disorders in Alzheimer type dementia. METHODS: The study included 111 patients with criteria for diagnosis of Alzheimer type dementia. The questionnaire was used to assess the patients 15 days after withdrawal of psychotropic drugs. A partially-structured interview was also conducted by a psychiatrist in 20 cases. RESULTS: There was no relationship between the different behavior disorders and the mini-mental-state score or the social and cultural situation. Answers to the questionnaire and responses given during the interview were nearly identical. CONCLUSION: There has been little effort to assess behavior disorders compared with cognitive disorders in patients with Alzheimer type dementia. Behavior assessment should be an integral part of patient evaluation since cognitive and non-cognitive disorders are independent and certain therapeutics may be effective in behavior disorders.

Aged↗
PubMed1988

A partnership in health education between a neighborhood school and a community hospital.

This paper reports the results of a cooperative effort between a community teaching hospital and a neighborhood Intermediate School to promote health education in an urban setting. The liaison stemmed from the need to educate a large, multi-ethnic student population and, through it, the community. To this end, the administrative, teaching, and medical staffs of the school and hospital prepared a series of health education events designed to provide needed information. The subjects included: Mental Health, Urgent Care, Personal Hygiene, Nutrition, Eating Disorders, Substance Abuse, Teenage Sexuality, Depression, Suicide, and Family Relationships. This paper describes the results of a student questionnaire designed to measure the effectiveness of one of the programs and provide a venue for student suggestions. These suggestions were incorporated into subsequent programs. This cost-free partnership was one of six programs chosen as being outstanding in the field of education in New York City. It was the recipient of the Council of Supervisors and Administrators Education Program Award for 1987, New York City.

Health Education↗
PubMed1989

Vitamin C status and other nutritional indices in patients with stroke and other acute illnesses: a case-control study.

Sixty-three patients with acute thrombotic stroke were compared with 47 age and sex-matched patients admitted concurrently with acute ischaemic cardiac pain and a further 44 with acute noncardiovascular illnesses. Overall the stroke patients scored highest on a questionnaire designed to estimate mean daily intake of vitamin C before hospital admission. There were problems with this retrospective dietary assessment, however, and the diet scores of the 27 stroke patients able to answer the questionnaire themselves fell between those of the other two groups. There were no significant differences between the three patient groups in plasma ascorbic acid or uric acid levels, but plasma magnesium and albumin levels were higher in the stroke patients. These findings were similar for patients aged over and under 70 but intergroup differences in magnesium and albumin levels were more marked in the elderly. These results do not support the postulated inverse relationship between vitamin C status and the risk of stroke.

Acute Disease↗