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PubMed2004

Trainee to trained: helping senior psychiatric trainees make the transition to consultant.

PURPOSE: To describe the contents and results of a series of annual fora for senior psychiatric trainees in New Zealand. These fora were designed to address a perceived gap in the training of psychiatrists in non-clinical skills. PROCEDURES: The contents of the fora are described, and qualitative and quantitative feedback from participants is reported, These data were gathered from participants for the purposes of quality improvement, using questionnaires designed for this setting. Issues addressed included participants' self-ratings of gains in knowledge, as well as their ratings of tutor effectiveness, the forum overall and the extent to which their needs were met. Qualitative feedback included suggestions for improvements and identification of key learning gains. MAIN FINDINGS: There was an increase in understanding in all topic areas as assessed by the participants. In addition, participants made unanticipated gains in confidence and their sense of empowerment. The opportunity to meet with peers and the increased sense of collegiality were valued. Suggestions for improvements were incorporated into fora held in successive years. PRINCIPAL CONCLUSIONS: Non-clinical skills can be taught successfully to senior trainees in a forum setting, which can also facilitate development of peer support and empowerment. More time for practice and discussion of how the teachers coped with challenging situations would improve the forum. It is recommended that such non-clinical skills also be incorporated into the teaching of senior trainees in the workplace.

Clinical Competence↗
PubMed2006

Dietary intake in relation to self-reported constipation among Japanese women aged 18-20 years.

OBJECTIVE: Information on modifiable lifestyle factors associated with constipation is limited, especially among non-Western populations. We examined associations between dietary intake and self-reported constipation in young Japanese women. DESIGN: Cross-sectional study. SUBJECTS: A total of 1,705 female Japanese dietetic students aged 18-20 years and free of current disease and current dietary counseling. METHODS: Dietary intake was estimated over a 1-month period with a validated, self-administered, diet history questionnaire, and lifestyle variables including self-reported constipation were assessed by a second questionnaire designed for this survey. RESULTS: A total of 436 women (26%) reported themselves to be 'constipated'. A multivariate odds ratio (OR) for women in the highest quartile of rice intake was 0.47 (95% confidence interval (CI): 0.33, 0.68) compared with the lowest. Additionally, women in the highest category of coffee intake had a multivariate OR of 0.67 (0.47, 0.94) compared with women in the lowest. Conversely, women in the highest quartile of confectionery intake had a multivariate OR of 1.54 (1.12, 2.13) compared with women in the lowest. Moreover, a multivariate OR for constipation for women in the highest quartile of Japanese and Chinese tea intake was 1.49 (1.09, 2.05) compared with women in the lowest. Neither total dietary fiber intake nor other lifestyle factors examined were associated with constipation. CONCLUSIONS: The consumption of rice and coffee was inversely associated with and that of confectioneries and Japanese and Chinese tea was positively associated with a prevalence of self-reported constipation.

Adolescent↗
PubMed2002

A survey of pharmacists' opinions and practices related to the sale of cigarettes in pharmacies-revisited.

The objective of the study was to follow-up on important findings from a 1996 statewide survey of Indiana pharmacists regarding their opinions and practices related to the sale of cigarettes in pharmacies. More specifically, this study was designed to (1) collect 2001 state-wide data concerning the percentage of Indiana pharmacies selling cigarettes and to learn what pharmacists think about the sale of cigarettes in their stores; (2) compare these findings with results from a 1996 study; and collect new information on (3) whether a cigarette selling policy in pharmacies in which pharmacists are employed differs from their professional and personal values; (4) pharmacists' opinions related to state-wide initiatives on tobacco control in Indiana; and (5) the level of involvement with smoking cessation activities by community pharmacists. A 1996 survey instrument of Indiana pharmacists opinions and practices related to the sale of cigarettes in pharmacies served as the basis for questionnaire design. In addition, 11 new items were added to assess the three new objectives of the study. This questionnaire was administered to half of the 1,280 pharmacies in Indiana. Collected data were analyzed by using descriptive and inferential statistical methods. Findings reveal that independent pharmacies had significantly reduced their sale of cigarettes from 1996 while there was no significant change among retail chain pharmacies. Additionally, significantly more pharmacists in 2001 believed that pharmacies should not sell cigarettes compared to five years ago. Also, more than three-fourths of pharmacists who worked in pharmacies that sold cigarettes felt it differed from their professional values. When it came to pharmacists involvement in tobacco control activities, results were mixed. This study found that the majority of pharmacists do not ask their patients about their smoking habits. In addition, an overwhelming majority of Indiana pharmacists were unfamiliar with a number of state public health programs/resources on smoking preven- tion and cessation. Nevertheless, it was very encouraging that nearly three-fourths of the pharmacies offer counseling programs for smokers who want to quit and more than one-half believed that increasing the state excise tax on cigarettes would be effective on tobacco control in Indiana.

Adult↗
PubMed2002

Dietary exposures and oral precancerous lesions in Srikakulam District, Andhra Pradesh, India.

OBJECTIVE: To test the effect of dietary nutrients on oral precancerous lesions in a reverse-smoking (i.e. smoking with the glowing end inside the mouth) population in South India. DESIGN: Case-control. Cases with precancerous lesions were matched to an equal number of lesion-free controls matched on age (+/- 5 years), sex and village. All subjects used tobacco in some form. Dietary data were obtained using an interviewer-administered food-frequency questionnaire, designed for use in this population. All interviews were conducted blinded to the disease status of the subject. Data were analysed using logistic regression. SETTING: Nineteen rural villages in Srikakulam District, Andhra Pradesh. SUBJECTS: From a survey of 6007 tobacco users, 485 (79% women) were found to have precancerous, mostly palatal, lesions (cases), and 487 lesion-free subjects were selected as controls. RESULTS: All eligible subjects consented to participate and nearly all (> 99%) had complete data for analyses. Reverse smoking was the most common form of tobacco use among cases (81.9%) and controls (73.5%), and reverse smokers were 5.19 times more likely than chewers to have these lesions (95% confidence interval = 1.35, 19.9). After controlling for relevant covariates, including the type of tobacco use, protective linear effects were observed for zinc (70% reduction across the interquartile range, P < 0.002), calcium (34% reduction, P < 0.002), fibre (30% reduction, P < 0.009), riboflavin (22% reduction, P < 0.03) and iron (17% reduction, P < 0.05). CONCLUSIONS: Several dietary nutrients appear to protect against oral precancerous lesions that are strongly associated with reverse smoking. The results of this study indicate scope for targeting dietary factors in preventing oral cancer, which should be coupled with aggressive anti-tobacco use efforts.

Calcium, Dietary↗
PubMed1990

Pediatricians' attitudes concerning motherhood during residency.

Because half of pediatric residents are women, pregnancy is increasingly common among pediatric house staff. We hypothesized that the heavy work load of pregnant pediatric residents is tolerated because those who have experienced a residency themselves underestimate the strain of residency compared with other work. A questionnaire, designed to survey pediatricians' attitudes concerning the effects of employment on the fetus, mother, and newborn infant, was produced in two formats, which were identical except that one concerned residents, while the other concerned women employed full-time in other jobs. Each type of questionnaire was sent to 1000 randomly selected members of the American Academy of Pediatrics. Respondents in both groups shared many attitudes concerning the effects of maternal employment. Certain subgroups (eg, males, those married to spouses not employed, and those women not pregnant in residency) judged employment as more harmful in general. Contrary to the original hypothesis, however, all subgroups consistently judged residency as more deleterious than other work. Training programs need to adopt humane strategies to integrate motherhood with residency.

Attitude of Health Personnel↗
PubMed2004

Emotional functioning in adolescent anorexia nervosa patients--a controlled study.

OBJECTIVE: In this study, emotional functioning of adolescent anorexia nervosa patients was compared with two control groups; another internalizing psychiatric outpatient group and a healthy control group. METHODS: Forty-eight anorexia nervosa patients (AN), 21 other psychiatric outpatients with depressive and/or anxiety disorders (PSYCH) and 48 healthy controls (HC) completed a battery of tasks and questionnaires designed to measure different aspects of emotional functioning. Cognitive (parallel) tasks were administered to control for differences of a cognitive nature. RESULTS: The AN and the PSYCH groups had clear deficits in emotional functioning compared to the HC group. Considering the data from the alexithymia questionnaire, it was the AN group who scored significantly worse on emotional functioning when compared to the HC group. Considering the data from the emotional tasks, both psychiatric groups performed worse than the HC group in their processing of visual emotional information and the PSYCH group had more difficulty in memorizing responses to auditory emotional stimuli than the AN and HC group. Furthermore, the PSYCH group processed auditory emotional information more slowly than the HC group. No differences between the three groups were found on the non-emotional, cognitive tasks. CONCLUSION: Both the AN and PSYCH patients show deficits in their processing of emotional information and details are discussed.

Adolescent↗
PubMed1993

Use of a bilingual medical history questionnaire in the emergency department.

STUDY OBJECTIVE: To demonstrate that a complete and rapid clinical history can be obtained using a self-administered, bilingual questionnaire. DESIGN: A post-test experimental design was used to evaluate time spent obtaining the history and information completeness for the two groups. SETTING: Urban county emergency department. PARTICIPANTS: All patients were non-English-speaking Hispanic women who presented with gynecologic complaints. METHODS: Fifty-five patients completed a history questionnaire in Spanish on a form that displayed their responses in English on the carbon copy. In the control group, a history was obtained using a bilingual interpreter. RESULTS: Average completion time was significantly less (t = 14.38; P < .0001) for the experimental group (chi 2 = 5.67 minutes; SD, 1.89) than for controls (chi 2 = 14.58 minutes; SD, 4.19). There was no statistical difference in review criteria for documentation between groups. CONCLUSION: Using a bilingual questionnaire to obtain a clinical history results in more rapid patient evaluation without affecting the quality of information obtained.

Adult↗
PubMedDate not supplied

The Family Stress and Coping Interview for families of individuals with developmental disabilities: a lifespan perspective on family adjustment.

BACKGROUND: The present study investigated the psychometric properties of the Family Stress and Coping Interview (FSCI), a questionnaire designed to quantitatively and qualitatively examine the experiences of parents of children with developmental disabilities (DDs). METHODS: The participants consisted of 106 primary caregivers of 106 individuals with DDs from centres in Eastern, Central and North-western Ontario, Canada. The participants completed a demographic questionnaire, the FSCI, and the Vineland Adaptive Behaviour Scales. RESULTS: The results of this study indicate that the FSCI has adequate reliability (i.e. internal consistency and long-term stability) and validity (i.e. independent item ratings and discriminant validity). CONCLUSIONS: The results of this study support the use of the FSCI as a measure of family stress in research and practice.

Adaptation, Psychological↗
PubMed1999

Consumer collaboration, patient-defined outcomes and the preparation of Cochrane Reviews.

OBJECTIVES: To identify the extent to which the Cochrane Collaboration involves consumers (patients, carers, patient and non-patient members of patient/consumer organizations) as members of Cochrane Review Groups (CRGs); to explore the emphasis CRGs place on identifying and collecting information on outcomes identified by patients as being important indicators of quality and effectiveness of treatment and care ('patient-defined outcomes'). METHOD: A postal questionnaire designed by The College of Health, a UK patient organization, was sent in January 1998 to all CRGs registered with the Cochrane Collaboration on 1 January 1998 (n = 42). RESULTS AND CONCLUSIONS: Replies were received from 35 CRGs, a response rate of 83% and 33 questionnaires (79%) were completed. The survey revealed that CRGs varied in the extent to which they had recruited consumer members: almost one third of respondents said their CRG did not have any consumer members. There was also no apparent consensus across CRGs on the importance attached to identifying and collecting information on patient-defined outcomes or on integrating such information into their activities. It is hoped that differences between CRGs may inform discussions as to whether and how the Cochrane Collaboration might address the issue of patient-defined outcomes in the future.

Journal Article↗
PubMed2005

Characterization of a population of monozygotic twins with asthma.

BACKGROUND: Asthma is a complex inflammatory lung disease that results from allergic and nonallergic environmental exposures in genetically susceptible individuals. The interrelationship and impact of environmental and genetic determinants on the development of asthma is still unclear. Monozygotic twins (MZT) have been considered a potentially useful population to investigate the role of genetic and environmental factors on asthma because of their identical genetic background, similar childhood environmental exposures, and expected high concordance rate for asthma. METHODS: A detailed questionnaire designed to obtain demographic information, medical history/severity of asthma, and environmental exposures was distributed to 43 pairs of MZT pairs where one or both probands had a history of asthma. All twin pairs were clinically evaluated for atopy by skin testing. Asthma was assessed by questionnaire, baseline spirometry, disease severity, airway reactivity, and medication scores. RESULTS: Based on a history of physician-diagnosed asthma, disease severity, airway reactivity, and medication scores, 22 MZT pairs were identified as concordant (C) for asthma while 21 MZT pairs were discordant (D) for asthma. Those MZT-C for asthma were on average older and more often female. Adjusted odds ratios for age and gender revealed that MZT-C for asthma had a 2.3 greater likelihood of childhood tobacco exposure and a 1.8 greater likelihood of early exposure to a pet compared to MZT-D pairs. In addition, MZT-C for asthma had a 2.4 greater likelihood of being full term vs. premature at birth. None of these odds ratios were statistically significant due to a small sample size. However, a trend for a greater likelihood of earlier environmental exposures was observed for MZT-C asthma pairs. Among MZT-D probands, a history of asthma in one proband was supported by a lower FEV1 and higher airway reactivity, disease severity, asthma symptom, and medication scores compared to the nonasthma proband. There was significant intrapair heterogeneity among MZT-C and MZT-D probands in their positive skin test responses to specific aeroallergens. CONCLUSION: Cross-sectional evaluation of larger MZT populations where one or both proband has asthma with a long-term prospective follow-up may be a feasible way for identifying the impact of environmental determinants as independent risk factors for the development of asthma.

Adolescent↗
PubMed2002

Reproducibility of a self-administered lifetime physical activity questionnaire among female college alumnae.

Recent epidemiologic evidence suggests that lifetime physical activity is an important factor in the development of many chronic diseases. The authors assessed the reproducibility of a self-administered physical activity questionnaire designed to assess the duration, frequency, and intensity of lifetime household and recreational activities. The study was conducted among 134 female college alumnae from two colleges in western Massachusetts who were aged 39-65 years in 1998. A modified version of the Historical Leisure Activity Questionnaire was used to assess physical activity over four prior age periods (menarche to 21 years and 22-34, 35-50, and 51-65 years). The questionnaire was administered to participants by mail twice 1 year apart. The intraclass correlation coefficients used to measure reproducibility were 0.82 for total lifetime physical activity, 0.80 for lifetime moderate-intensity activities, 0.86 for lifetime vigorous-intensity activities, 0.87 for lifetime recreational activities, and 0.78 for lifetime household activities. Correlations were 0.73 for total activity during the earliest prior age period (menarche to 21 years), 0.70 for ages 22-34 years, 0.78 for ages 35-50 years, and 0.83 for ages 51-65 years. These data indicate that this physical activity questionnaire is reproducible and provides a useful measure of average lifetime activity.

Adult↗
PubMed1988

Student nurse perception of the staff nurse role.

A survey was undertaken to identify the developing perception of the staff nurse role by student nurses in two health districts of one regional health authority using a questionnaire specially developed for the survey. A sample of 190 was selected from student nurses, staff nurses and sisters, working within those areas used for general nurse teaching at the two districts. The results indicate that first-year student nurses hold perceptions of the importance of the functions of the staff nurse role which are significantly different from the staff nurse whilst second-year students respond in the same way as staff nurses. Third-year student nurses hold a perception of the staff nurse role which does not differ significantly from that held by staff nurses except for the clinical function. Questions relating to performing within these functions were less easily interpreted. The results do not demonstrate a sequential developing perception of the staff nurse role, rather a change over the first year with some areas of performance remaining different throughout the years of training. Possible reasons for these differences are advanced. Difficulties in generalizing the results due to the limitations of the data obtained, questionnaire design and the locations for the study, are identified.

Humans↗
PubMed1990

Alcoholics' attitudes toward and experiences with disulfiram.

We studied 345 alcoholic inpatients utilizing a 43-item questionnaire designed to assess these patients' attitudes toward and experiences with disulfiram. A surprisingly high number of patients who had received disulfiram drank ethanol while taking or within 1 week of stopping disulfiram and experienced a disulfiram ethanol reaction. This finding and others derived from the questionnaire are reported, and the potential implications of the findings are discussed.

Adult↗
PubMed2001

The development and evaluation of a programme to teach cultural diversity to medical undergraduate students.

UNLABELLED: This paper describes the design (of process and content), implementation and evaluation of a component of the Human Diversity Module developed to teach cultural diversity to undergraduate medical students. The objectives of the teaching were to enable students to gain factual and practical information about other cultures and also for them to examine their own attitudes. METHOD: Students completed a questionnaire, designed in a previous study, at two stages; the first before the component on cultural diversity had been delivered and the second after the sessions on cultural diversity. The time interval between stages 1 and 2 was 1 week. The cultural diversity component was developed using a range of sources. RESULTS: Out of 181 students, 140 (77.3%) completed the questionnaire at both stages. There were a number of statistically significant findings, which indicate that the teaching enabled the session objectives to be successfully met. The findings include statistically significant changes that reflect more "positive" attitudes about cultures coming together and about specific cultures. CONCLUSION: The study indicates that attitudes changed over the period of teaching. There is, however, scope for further development of measures to enable attitudinal shifts to be evaluated.

Attitude↗
PubMedDate not supplied

Evaluation of a community-based intervention to promote physical activity in youth: lessons from Active Winners.

PURPOSE: To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. DESIGN: Quasi-experimental. SETTING: Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. SUBJECTS: Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. INTERVENTION: The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. MEASURES: Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior. The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. RESULTS: There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. CONCLUSIONS: The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

Child↗
PubMed1986

Brief psychosocial screening in outpatient pediatric practice.

The Pediatric Symptom Checklist (PSC) is a brief screening questionnaire designed to help pediatricians in busy office practice select children who are likely to have psychosocial difficulties and thus could benefit from further evaluation. We report two preliminary validation studies that indicate that PSC correlates well with the Childhood Behavior Checklist, a longer, well-validated questionnaire, and most children referred for psychiatric evaluation score above the PSC cutoff score. Developing a valid and practical psychosocial screening procedure for office practice is methodologically difficult but highly relevant to clinical practice.

Child↗
PubMed1982

Evaluation of a self-administered dietary questionnaire for use in a cohort study.

A self-administered diet questionnaire designed for use in a cohort study has been assessed in comparison with a detailed quantitative diet history previously used in and validated for case-control studies. One hundred fifty-eight women aged 40 to 59 were asked to complete the self-administered questionnaire and 123 returned it by mail. Of these women, 50 were interviewed at home using the detailed diet history. Estimates of intake of major nutrients other than fat and fatty acids are comparable from the two methods although in general, estimated intake from the self-administered questionnaire was higher than the diet history. The difference in intake of fat and fatty acids was largely but not completely accounted for by differences in amounts of added fat recorded. It is concluded that when applied to large numbers of women in a cohort study, the self-administered questionnaire is feasible to administer and will be sufficiently accurate in estimating nutrient intake as compared to estimates from a detailed, interview-type diet history.

Adult↗
PubMed2001

A CNS-managed diabetes foot-care clinic: a descriptive survey of characteristics and foot-care behaviors of the patient population.

Lower extremity lesions are the primary cause of hospitalization for people with diabetes, resulting in enormous personal and financial costs. This study used a survey designed to describe the characteristics and foot-care behaviors of people with diabetes who attended a clinical nurse specialist managed foot-care clinic. Forty-eight patients who received care at the participating foot-care clinic completed a 21-item multiple-choice questionnaire designed to determine the presence of foot pathology and foot-care behaviors. Most of the patients were between 65 and 74 years of age, had concurrent illnesses, and had four or more primary care visits per year. Although 69% had existing foot pathology, only 44% reported inspecting their feet daily and only 54% reported that their primary care provider examined their feet on each visit. Twenty-five percent reported going barefoot sometimes and eight percent would either treat a foot lesion themselves or wait for it to get better.

Adult↗