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PubMed2001

Attitudes to oral care among caregivers in Japanese nursing homes.

OBJECTIVES: The purpose of this study is to investigate oral care practice and awareness of it among caregivers in Japanese nursing homes. METHODS: Caregivers were surveyed by means of a self-administered questionnaire designed to elicit the following information: awareness of oral care, its importance, the burden involved in oral care, and systematization of oral care. RESULTS: The results showed that most caregivers are adequately informed of the importance of oral care, but are inadequately educated in oral care and have little training in systematic oral care. CONCLUSION: The importance of providing appropriate and systematic oral care training must be stressed among caregivers along with the need to develop equipment to simplify and support oral care.

Adult↗
PubMedDate not supplied

[Epidemiology of mental disorders in Spain: methods and participation in the ESEMeD-Spain project].

INTRODUCTION: The ESEMeD-Spain study is part of a European project on the epidemiology of mental disorders, which is also part of a World Health Organization initiative called World Mental Health Surveys. The main objectives of the study are to estimate the prevalence of mental disorders in Spain; to analyze their association with sociodemographic variables and predisposing and protective factors; to evaluate their impact on the quality of life; and to describe and evaluate the health care received by people with mental disorders. METHODS: A representative sample of the noninstitutionalized Spanish population older than 18 years is interviewed. Sample size is 5,500 people. The instrument used in the interviews is the Composite International Diagnostic Interview (CIDI), a questionnaire designed to be used by lay interviewers that allows the diagnosis of psychiatric disorders. Strict quality control of field work has been established. Furthermore, approximately 200 subjects are re-interviewed by a psychiatrist using the Structured Clinical Interview for DSM-IV (SCID) and several questionnaires to measure clinical severity. RESULTS: Field work started in September 2001 and finished in November 2002. Up to Ap ril 2002, more than 4,300 people have been interviewed. Preliminary response rate has been 68.7%. Comparison of the age and gender of the study sample with the general Spanish population shows high representativeness. CONCLUSIONS: The ESEMeD-Spain project will produce un - precedented scientific information about the epidemiology of mental disorders in Spain.

Adult↗
PubMed1987

Canadian undergraduate medical education: family physician involvement.

A questionnaire designed to determine the nature and extent of family physicians' involvement in Canadian undergraduate medical education was sent in the fall of 1985 to the person in each department of family medicine in the 16 Canadian medical schools who was responsible for the undergraduate program. The questionnaires were followed up by visits to each school. The findings revealed that approximately 1200 family physicians were teaching 7400 Canadian medical students. There was considerable variation in the total curriculum time devoted to family medicine and in the content of and support for an undergraduate curriculum in family medicine across the country. In order to achieve nationally acceptable standards and greater continuity between undergraduate and postgraduate training, the College of Family Physicians of Canada and the Association of Canadian Medical Colleges should develop objectives and program requirements.

Canada↗
PubMed1994

Case finding in the elderly: a postal questionnaire.

AIMS: To evaluate a postal questionnaire designed to identify elderly persons in need of geriatric evaluation and intervention in the community. METHODS: A sample of elderly persons, over 75 years, was randomly selected from the age-sex register of four general practices in the Auckland area. All respondents filled out postal questionnaires and a blinded assessment was made in their own homes using validated geriatric assessment tools (the reference test). Objective evaluations were compared to self report questionnaire results and sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: Sixty-four persons aged 75-93 were evaluated. Thirty-nine subjects (61%) answered the questionnaire in a way which indicated they had one or more unmet needs. Reference test evaluations showed that 23 persons (36%) had problems in one or more areas. Sensitivity for the questionnaire was 0.78 (18/23 correctly identified) and specificity was 0.49. Positive and negative predictive values were 46% and 80% respectively. CONCLUSIONS: A postal questionnaire may be a useful adjunct to health surveillance of the elderly in general practice in New Zealand.

Aged↗
PubMed1997

The impact of advanced trauma life support course on graduates with a non-surgical medical background.

The aim of this study was to assess advanced trauma life support (ATLS) and combat trauma life support (CTLS) skills implementation among general practising physicians, its perceived utility in their routine daily practice as well as in their potential army combat assignments. One hundred and ten physicians, graduates of ATLS and CTLS courses, from the subspecialties of geriatrics, psychiatry and family medicine, were surveyed by telephone, to answer a specially designed questionnaire. The response rate was 82%. Professional distribution was: 6.6% geriatrics; 46.7% family physicians; and 46.7% psychaitrists. The number of trauma events treated by these physicians in their post-course practise was: geriatrics-three; family physicians-30; psychiatrists-18. We believe that a properly designed ATLS course, executed and applied to general practitioners, can be highly beneficial to trauma victims.

Adult↗
PubMed2002

Mild iodine deficiency in a sample of New Zealand schoolchildren.

OBJECTIVE: To assess the iodine status of New Zealand schoolchildren. DESIGN: A proportionate to population size school-based cluster survey was used to randomly select children from two cities. The indicators used to assess iodine status were urinary iodine, as determined in a casual urine sample, and thyroid volume, as measured by ultrasonography. A qualitative food frequency questionnaire designed to ascertain frequency of consumption over the previous 3 months of foods or food groups that are good sources of dietary iodine, including iodized salt, was administered to each child. SETTING: Dunedin and Wellington, New Zealand. PARTICIPANTS: Three-hundred children aged 8-10 y from 30 schools. RESULTS: The median urinary iodine concentration of the children was 6.6 micro g/dl (interquartile range, 4.5-9.1). The percentage of children who had urinary iodine levels less than 5 micro g/dl was 31.4 (95% confidence interval (CI), 24.2-38.6). Comparison of thyroid volume with 2001 World Health Organization age/sex-specific and age/BSA-specific cut-off values resulted in a goitre prevalence of 11.3% (95% CI, 7.6-15.1) and 12.0% (95% CI, 7.9-16.1), respectively. Almost 30% of the children's caregivers did not use iodized salt in cooking and 51% of the children did not use iodized salt at the table. CONCLUSIONS: Mild iodine deficiency was found in this sample of children. Iodized table salt may no longer be making a significant contribution to the iodine intakes of New Zealand children.

Child↗
PubMed1993

Fluvoxamine: an open pilot study in moderately obese female patients suffering from atypical eating disorders and episodes of bingeing.

The results of a small pilot study using Fluvoxamine (Faverin) in the treatment of non-vomiting bingeing female patients and women with bulimia nervosa is presented. Ten non-vomiting subjects and six with bulimia nervosa were treated on an open basis with Fluvoxamine 100-200 mg daily. Assessment was made using established questionnaires for severity of eating disorder and abnormality of mood. Five non-vomiting patients and three with bulimia nervosa completed the study. Non-vomiters showed a significant weight loss; a significant reduction in number of binges; a significant reduction in the scores on the BITE and the EAT; and a significant reduction in anxiety. Those with bulimia nervosa had a significant reduction in hunger and a reduction in depression which tended towards significance. Firm conclusions cannot be drawn from this study as it is an open pilot study of a small number of women. However, the results indicate that Fluvoxamine may have a role in the treatment of eating disorders where bingeing is a prominent symptom and that further research would be valuable. Comments are also made on the usefulness of various questionnaires designed to assess eating disorders.

Adolescent↗
PubMed2004

Add-on melatonin improves quality of life in epileptic children on valproate monotherapy: a randomized, double-blind, placebo-controlled trial.

This randomized, double-blind, placebo-controlled study in epileptic children aged 3-12 years evaluated the effects of add-on melatonin administration on the quality of life of these children on sodium valproate (VPA) monotherapy using a parental questionnaire. Quality of Life in Childhood Epilepsy is a questionnaire designed to assess a variety of age-relevant domains such as physical function, emotional well-being, cognitive function, social function, behavior, and general health. Of the 31 patients, 16 randomly received add-on melatonin (MEL), whereas 15 received add-on placebo (P). The questionnaire had good internal consistency reliability, because for most of the multi-item scales Cronbach's alpha reliability exceeded 0.5 (range: 0.59-0.94). To our knowledge, this is the first study assessing quality of life in epileptic children with add-on melatonin administration in the form of a randomized, double-blind, placebo-controlled trial. The study suggests a potential use of melatonin as an adjunct to antiepileptic therapy due to its diverse spectrum of action as an antioxidant, neuroprotector, and free radical scavenger, thus offering the advantage of reducing oxidant stress and subsequent damage. The beneficial effects of melatonin on sleep, its wide safety window, and its ability to cross the blood-brain barrier have the potential to improve quality of life in pediatric epilepsy.

Anticonvulsants↗
PubMed1990

The arthritis impact measurement scales: an anglicized version to assess the outcome of British patients with rheumatoid arthritis.

The Arthritis Impact Measurement Scales (AIMS) is an American questionnaire designed to measure the health status of patients with arthritis. Its suitability for use with British patients with rheumatoid arthritis (RA) has been tested. A study on 30 patients high-lighted the need to anglicize the terminology and spelling. A further 30 patients found the modified questionnaire easier to complete than the original. The concurrent validity of this modified AIMS was then tested on 59 patients by comparison with two widely accepted standards. Physical function and pain scales were tested against the Stanford Health Assessment Questionnaire (HAQ). Because the HAQ has no psychological component, psychological status was compared with the Hospital Anxiety and Depression Scale (HAD). Results showed a good correlation between the scales and it is concluded that the modified version of the AIMS may be used with confidence in British patients with RA.

Adult↗
PubMed2006

Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study.

BACKGROUND: Late presentation of patients at advanced stages when little or no benefit can be derived from any form of therapy is the hallmark of breast cancer in Nigerian women. Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in populations of the developing countries that hitherto enjoyed low incidence of the disease. Worried by this prevailing situation and with recent data suggesting that health behavior may be influenced by level of awareness about breast cancer, a cross-sectional study was designed to assess the knowledge, attitude and practices of community-dwelling women in Nigeria towards breast cancer. METHODS: One thousand community-dwelling women from a semi-urban neighborhood in Nigeria were recruited for the study in January and February 2000 using interviewer-administered questionnaires designed to elicit sociodemographic information and knowledge, attitude and practices of these women towards breast cancer. Data analysis was carried out using Statistical Analysis Software (SAS) version 8.2. RESULTS: Study participants had poor knowledge of breast cancer. Mean knowledge score was 42.3% and only 214 participants (21.4%) knew that breast cancer presents commonly as a painless breast lump. Practice of breast self examination (BSE) was low; only 432 participants (43.2%) admitted to carrying out the procedure in the past year. Only 91 study participants (9.1%) had clinical breast examination (CBE) in the past year. Women with higher level of education (X2 = 80.66, p < 0.0001) and those employed in professional jobs (X2 = 47.11, p < 0.0001) were significantly more knowledgeable about breast cancer. Participants with higher level of education were 3.6 times more likely to practice BSE (Odds ratio [OR] = 3.56, 95% Confidence interval [CI] 2.58-4.92). CONCLUSION: The results of this study suggest that community-dwelling women in Nigeria have poor knowledge of breast cancer and minority practice BSE and CBE. In addition, education appears to be the major determinant of level of knowledge and health behavior among the study participants. We recommend the establishment and sustenance of institutional framework and policy guidelines that will enhance adequate and urgent dissemination of information about breast cancer to all women in Nigeria.

Journal Article↗
PubMed2006

Prevalence of depressive symptoms among patients with chronic cough.

STUDY OBJECTIVES: Cough is the most common complaint for which patients in the United States seek medical attention. Although the significant effect of cough on quality of life has been reported, the association of chronic cough with depressive symptomatology has not previously been investigated. DESIGN: Prospective, nonrandomized evaluation. SETTING: Outpatient department of academic medical center. PATIENTS: Representative sample of patients presenting to a specialty center seeking evaluation and treatment of chronic cough. INTERVENTIONS: Participants completed the Center for Epidemiologic Studies Depression Scale (CES-D), a 20-item self-report questionnaire designed to measure depressive symptomatology and risk for clinical depression, on initial evaluation and again after 3 months. Patients also provided subjective cough scores reflecting the severity of their cough. MEASUREMENTS AND RESULTS: Of 100 patients undergoing initial evaluation, 53% scored positive (>/= 16) on the CES-D. Mean CES-D score was 18.3 +/- 13.2 (+/- SD). Among 81 subjects followed up at 3 months, mean CES-D score fell to 7.4 +/- 10.4, and subjective cough score decreased from 10 to 4.9 +/- 3.1. There was a statistically significant improvement in both cough and depression scores after 3 months (p < 0.001). Improvement in cough score correlated significantly with improvement in depression score (p = 0.003; Spearman rho = 0.323). CONCLUSION: Depressive symptomatology is very common in patients with chronic cough. Physicians and other caregivers must be aware of the significant risk of clinical depression in this patient population.

Adult↗
PubMed1993

[Acceptability, reliability and validity of the Corney and Clare social problems questionnaire].

OBJECTIVE: To evaluate the acceptability, reliability and concurrent validity of the CORNEY and CLARE self-administered social problems questionnaire. DESIGN: Reliability was studied by a test-retest (24 hours). Validity (concordance) was studied through comparison with a standard social adaptation interview. SETTING: Primary Health Care. PATIENTS: Consecutive patients attached to a long-treatment nursing station and 4 medical clinics. MEASUREMENTS AND MAIN RESULTS: The questionnaire consisted of 33 items and evaluated 9 areas of social functioning. In each area, the items covered 2 types of evaluation: problems in objective circumstances or in functioning and level of satisfaction. There were no significant difficulties in the questionnaire's administration. In the test-retest evaluation, there was adequate concordance of the average scores of the items evaluating difficulties and problems. This was not the case for the average scores of the items which evaluated satisfaction. The validity of 28 of the questionnaire's 33 items was examined. A moderate concordance level was found for 11 items on the questionnaire. An average score taken from these items provided a sufficient measurement of tendency regarding the overall seriousness of the subjects' social problems. CONCLUSIONS: The results do not favour the use of this questionnaire as a substitute for standard interviews in the evaluation of specific social problems, but do support the use of part of it in order to obtain a valid tendency measurement.

Adolescent↗
PubMed1998

Two measures of physical activity as predictors of bone mass in a young cohort.

OBJECTIVE: To compare the association of two measures of physical activity with bone mass in healthy children and young adults, as part of a larger study on bone mineral acquisition in youth. DESIGN: Cross-sectional observation study. SETTING: General community, outpatient study. PARTICIPANTS: Subjects included 103 non-Hispanic white female (n = 54) and male (n = 49) healthy volunteers aged 9 to 25 years. MAIN OUTCOME MEASURES: Self-reported physical activity was measured by a 3-day activity diary of all activities and a questionnaire designed to capture recreational activities throughout the year. Activity was expressed as hours per week of weight-bearing and non-weight-bearing activity. Bone mass at the hip, spine, and whole body was measured by dual x-ray absorptiometry. RESULTS: The activity measures were not well correlated with each other. In males, weight-bearing and non-weight-bearing activity reported in 3-day diaries was positively associated with bone mass at the hip, spine, and whole body (p < 0.05). Among females, only weight-bearing activity measured by the yearly questionnaires was significantly positively associated with bone mass (p < 0.05). In males and females, weight-bearing activity was more highly correlated with bone mineral than was non-weight-bearing activity. In addition, the associations between activity and bone mass varied by skeletal site. CONCLUSIONS: The association between physical activity and bone mass varied both in direction and in significance depending on the physical activity instrument used. Gender differences were observed in the associations between specific activity instruments, type of activity (weight-bearing and non-weight-bearing), and bone mass at different skeletal sites. Variability associated with the two physical activity measures may contribute to discrepant findings in this study and in the literature.

Adolescent↗
PubMed1999

The Westdoc Internet Questionnaire--a survey of the use of "on-line" resources by West Lothian general practitioners.

OBJECTIVE: To investigate the extent to which a representative sample of Scottish GPs used on-line resources for medical applications and their attitudes to various aspects of the technology at a time just prior to the introduction of the Scottish Office Computers offering Internet access to the majority of Scottish practices. DESIGN: Questionnaire survey. SETTING: "Out of hours" GP emergency service cooperative. SUBJECTS: All the (106) GP principals in practice in the Scottish District of West Lothian in June 1997. Locums and Registrars were excluded. RESULTS: There was an 87% response rate. Nineteen (21%) respondents used the Internet once a month or more, 12(13%) used it to communicate with colleagues by e-mail and 4(4%) with patients. Only 8% found it useful for medical purposes though more than half thought it would be a significant part of practice in five years time. Younger GPs were more likely to use the Internet. Many users expressed concern about reliability of the information and the ease with which it could be applied. CONCLUSION: By identifying a mismatch between levels of Internet use and the perceived potential of this new technology this study points to the need for training initiatives. It also forms a benchmark against which the uptake of Internet technology by GPs can be measured in years to come.

Adult↗
PubMed2005

Reliability and validity of the Norwegian translation of the Seattle Angina Questionnaire following myocardial infarction.

The aim of this study was to validate the Norwegian version of the Seattle Angina Questionnaire (SAQ), a self-administered 19-item questionnaire designed to assess health-related quality of life in patients with chest pain or coronary artery disease. In 885 patients with prior myocardial infarction (MI), we abstracted clinical data from the patients' medical records. Two to three years after the MI, we mailed a self-administered questionnaire including the SAQ, the Short Form 36 (SF-36), and questions about current medication, to the 548 patients still alive. The response rate was 74%. Internal consistency reliability of the SAQ, assessed with Cronbach's alpha, ranged 0.75-0.92. Test-retest reliability, tested with an intraclass correlation coefficient, ranged 0.29-0.84. The pattern of association between similar and dissimilar scales of the SAQ and SF-36 mainly supported the construct validity of the SAQ. Four of the five SAQ scales discriminated between patients with different medication regimens as a proxy for severity of angina pectoris. We conclude that the Norwegian version of the SAQ showed acceptable reliability and cross-sectional validity following MI, with properties in line with the original US version.

Aged↗
PubMed2005

Management of lower limb lymphoedema in the United Kingdom.

OBJECTIVE: Many investigations and treatments exist for lower limb lymphoedema. We undertook a survey on the management of this condition by vascular surgeons and the resources available for its treatment in the UK. DESIGN: A questionnaire was designed to assess the management of lymphoedema. MATERIALS AND METHOD: A postal questionnaire was sent to all members of the The Vascular Society of Great Britain and Ireland. RESULTS: 251/440 (57%) consultant surgeons returned a completed questionnaire comprising 45.3% teaching hospital and 54.7% district general hospital (DGH) consultants. 77.9% of the consultants saw less than 10 patients annually with lymphoedema. The commonest causes of lymphoedema were primary lymphoedema (99.3%) and malignancy (37.1%). Lipoedema, a cause of limb swelling was only seen or recognised by 46.2% of the consultants. The commonest investigations performed were a duplex scan, lymphoscintigram, full blood count and urea and electrolytes. The common methods of confirming lymphoedema were either by lymphoscintigram (54.5%) or from a diagnosis of exclusion (33.7%). Lymphoedema physiotherapy was available only to 53.8% of the consultants. Surgery was performed by 10.5% of consultants. 73.4% of the consultants believed that lymphoedema is managed inadequately and 72.9% believed that resources are insufficient in the UK for this condition. CONCLUSION: In the UK the majority of vascular consultants see less than 10 patients annually with lymphoedema. Very few patients undergo confirmation of this diagnosis with non-invasive investigation and very few consultants perform surgery. Management of this condition is perceived by the consultants to be poor, with a lack of resources and particular shortage of lymphoedema physiotherapists. Centralisation of these services may be a way of improving this condition.

Diagnosis, Differential↗
PubMed2002

Availability of resources of diabetic care in primary health care settings in Aseer region, Saudi Arabia.

OBJECTIVE: The objective of this study is to evaluate the availability of resources of diabetes care in primary health care settings in Aseer region, Southwest, Kingdom of Saudi Arabia. METHODS: This study was conducted during September 2001 by distributing a questionnaire to all technical directors of primary health care centers (PHCCs) in Aseer region. The questionnaire, designed by the authors, contained 6 sections that dealt with the necessary structures of diabetic care in the region in addition to the data base of PHCC such as served population, distance from the hospital, and total working physicians and nurses at the PHCC. The data from the questionnaire was entered and analyzed using Statistical Package for Social Sciences. RESULTS: Two hundred and forty-two PHCC technical directors responded to the questionnaire. Total served population by PHCC was 970,306 individuals. Total working physicians were 391 and nurses were 902. Diabetics represented 2.7% of the total served population. More than 90% of PHCCs have diabetic files, registers, appointment system and protocol for diagnosis and treatment of diabetes. Oral hypoglycemic agents were always available at 55% of PHCCs while metformin was not available at 52% of PHCCs. Diabetic identification cards were available in 80.4% of PHCCs while the health education means were less available, except for health education programs was available at 97.5% of PHCCs. At least, 40% of PHCCs were provided financially or by different means of health education through community health committees. CONCLUSION: This study revealed that resource items for diabetic care are inadequate in particular drugs and laboratory facilities. Establishment of a diabetes committee in Aseer region is a priority in order to manage such shortages and to plan, supervise and coordinate the diabetic care in the region.

Diabetes Mellitus↗
PubMed1996

Practitioner-patient communication software: an aid in the prescription of dental prostheses.

A questionnaire designed for psychometric evaluation was used to develop communication software that helps us understand patients' expectations of their prostheses. This enables the practitioner to select and suggest the type of prosthesis that best responds to the hopes, as well as the needs, of patients. At the end of the treatment process, the practitioner is able to ascertain whether the patient's expectations have indeed been met. With this software, we can also compare various types of prostheses based on evaluation by patients as well as conduct multi-center studies.

Communication↗