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PubMedDate not supplied

Telephone counseling for population-based smoking cessation.

OBJECTIVES: To examine the options for use, efficiency, and effectiveness for structuring a population-based telephone smoking-cessation service. METHODS: Callers (n=632) to a 1-800 number were randomized in a 2 (50-minute counseling with 2/6 calls) x 2 (pamphlet/booklet) design with print only control. RESULTS: Six-month use of the service was 0.6% of adult smokers. Service promotion cost 31.02 dollars/person. Telephone counseling resulted in higher continued abstinence (5%) than did print only (1%), P<.05. Amount of print and calls did not increase cessation. Six calls resulted in lower completion rates than 2 (22% vs 56%, P<.05). CONCLUSIONS: For planning, consider 1% use, low-cost promotion, pamphlet, 50-minute initial counseling plus 2 follow-ups, and minimize call-attempts.

Adolescent↗
PubMed1993

Nurse-assisted counseling for smokers in primary care.

OBJECTIVE: Physician-delivered advice to stop smoking is effective, but time demands often reduce the number of smokers who receive assistance. We evaluated three nurse-assisted interventions designed to minimize physician burden and increase counseling in primary care settings. DESIGN: Randomized controlled trial with a 12-month follow-up. SETTING: Internal medicine and family practice offices in a health maintenance organization. PARTICIPANTS: Smokers (n = 3161) who were patients of participating physicians or other medical care providers (n = 60). INTERVENTION: Medical care providers delivered a 30-second stop-smoking prompt to 2707 smokers and referred them to an on-site nurse smoking counselor. The nurse randomly provided a two-page pamphlet (advice control) or one of three nurse-assisted interventions: 1) self-quit training; 2) referral to a group cessation program; or 3) a combination of self-quit training and referral. Each nurse-delivered intervention included a 10-minute video, written materials, and a follow-up phone call. RESULTS: Physicians delivered brief advice to 86% of identified smokers during the 1-year program. The proportion of participants reporting abstinence after both 3 and 12 months of follow-up nearly doubled (P = 0.01) for the nurse-assisted self-quit (7.1%), group-referral (7.6%), and combination (6.9%) interventions, compared to brief physician advice alone (3.9%) (P < 0.05). Saliva cotinine tests confirmed these effects (P < 0.004), although quit rates were lower (3.4%, 4.7%, 4.3%, and 2.3%, respectively) because roughly one half of quitters chose not to provide a saliva sample and were counted as smokers. CONCLUSION: Involving nurses in counseling smokers reduces physician burden, makes counseling more likely, and significantly increases cessation rates compared with brief physician advice alone.

Adult↗
PubMed1998

Communication of risks: organization of a methylmercury campaign in the Cree communities of James Bay, Northern Quebec, Canada.

In the James Bay region of Canada, with the advent of extensive hydroelectric development, methylmercury contamination of fish has become a serious problem, having a direct impact on the Cree way of living. In 1982, the Cree Board of Health and Social Services of James Bay implemented a methylmercury exposure surveillance program in all Cree communities. Since that time, it has developed several educational tools on methylmercury contamination, including posters, pamphlets, and a video. In 1993 and 1994, Cree leaders, Community Health Representatives, medical staff, and other selected band members were consulted to identify the needs of the population regarding information on mercury. All questions and comments were listed, and a summary was sent to those consulted to double check the type of information required by the population. This led to the preparation of a brochure on mercury in a question and answer format, as well as creation of posters. The brochure and the posters were published in French, English and Cree and distributed in each community. A radio message was broadcast in all communities, and individual and group meetings were also held. Cree involvement in the mercury information program has been essential to its success.

Animals↗
PubMed1990

A survey of physicians' uses/opinions regarding nutrition education resources.

Since physicians are one of the public's main sources of nutrition information, a study was conducted to investigate physicians' sources of nutrition knowledge, patient education resources, and opinions about potential nutrition services. A questionnaire was mailed to a random sample of family physicians. The response rate was 53% (n = 255). Fifty-three per cent of respondents ranked their personal knowledge and training as their most frequent source of nutrition information. The most widely reported sources of patient education resources were Health and Welfare Canada and industry. Physicians ranked resources from Health and Welfare Canada as highest for quality characteristics, and industry information as lowest. Pamphlets were ranked as the most/very useful patient service (70%), and physician reimbursement as the most useful physician service (59%). One-quarter of physicians asked for patient information on heart disease. The results of this study suggest physician reimbursement for nutrition education needs to be addressed by health insurance plans if physicians are to be expected to provide nutrition intervention. Further nutrition training for physicians should be conducted through medical education, continuing education and medical journals.

Alberta↗
PubMedDate not supplied

Benchmark matrix and guide: Part I. Headquarters Air Force Logistics Command, Wright-Patterson Air Force Base, OH.

The President's Award for Quality and Productivity Improvement is the highest recognition of improvements in quality and productivity in the federal government and is equivalent to the Malcolm Baldrige Award. It is awarded to agencies, or major components of agencies, that have implemented total quality management (TQM) in an exemplary manner resulting in high quality products and services, and effective use of taxpayers' dollars. On May 23, 1991, Headquarters Air Force Logistics Command at Wright-Patterson Air Force Base was notified that it had won this prestigious award. This first article of a three-part series was authored by a special working group within Headquarters Air Force Logistics Command that was tasked with developing a benchmarking system to measure progress in implementing total quality management (TQM). The tasking was in support of the near-term vision initiative to develop a guideline pamphlet for measurement. This benchmark matrix should be used periodically to identify those categories that need additional emphasis, but it should be seen as a self-assessment tool only. The intent was to provide a method of measuring behaviorally oriented activity that can be documented or observed. Real process improvement can begin only when a process cna be understood and measured. Benchmarking is a viable means to do this and should be used in combination with other TQM methodology.

Outcome and Process Assessment, Health Care↗
PubMed1985

Word-of-mouth communications in health care marketing.

Word-of-mouth (WOM) advertising can be an important communications tool, since it addresses the right target--the decision maker, contains the needed information, and occurs at the right time. An effective WOM communications program will use a marketing survey to identify decision makers and measure their degree of preference for the provider to determine which decision makers can be influenced. A survey also should be used to discover the most significant information sources. To involve those sources in a WOM communications effort requires that they be satisfied with their provider and that they be convinced the provider is the best choice for the person who has requested the recommendation. To increase the likelihood that sources will be informed about a specific provider, pamphlets or other materials can be distributed to assist them. Other forms of encouragement include patient surveys and employee bonuses. An institution's WOM program should also be consistent with its other communications efforts. Messages must be compatible with the themes of advertising and publicity campaigns.

Advertising↗
PubMed1986

Recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and infant; availability of final recommendations--FDA. Notice.

Food and Drug Administration (FDA) is announcing the availability of final recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and breastfeeding infant. The final recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), include the agency's rationale for the recommendations as well as the endorsement of the recommendations by several professional organizations. The final recommendations are being published in a pamphlet that is being made available to interested persons.

Embryo, Mammalian↗
PubMed1982

Updating of National Service and U.S. Government Life Insurance regulations: Veterans Administration. Final regulations.

The Veterans Administration is amending its regulations relating to insurance matters to (1) permit a Veterans Administration physician's assistant to conduct certain physical examinations that are required for insurance purposes, (2) reflect that the law permits the conversion or exchange of National Service Life Insurance policies to insurance on a modified life plan with reduction at 70, (3) update certain Agency insurance service personnel job titles, and (4) update insurance information pamphlet and policy form references. In addition, certain terms are being changed to eliminate gender reference in those regulations which are being amended. These changes result from a review of the Agency's insurance regulations.

Insurance, Life↗
PubMed1999

Worksite cholesterol and nutrition: an intervention project in Colorado.

The study purpose was to determine whether group intervention or an individual self help program proved to be more effective at lowering heart disease risk factors among employees in different worksites. Eight worksites and 502 employees in the Denver metropolitan area were selected for the project, with four randomized to Usual Care and four to the Special Intervention. Most worksites had < 200 employees. Employees were randomly assigned to either a control group receiving usual nutrition education or one of two special intervention groups in which employees selected to attend group nutrition education classes or complete an individual self paced nutrition education program. Results indicated that offering a choice of methods for the special nutrition education intervention was valuable, and both approaches modified behavior and certain physiological outcomes. Results suggested that enhanced nutrition education efforts in worksites may be effective and will realize greater benefits than a pamphlet or brief discussion following a worksite screening.

Adolescent↗
PubMed1999

[Development of 18F-FDG ([F-18]-2-fluoro-2-deoxy-D-glucose) injection for imaging of tumor reflecting glucose metabolism--results of preclinical studies].

Fluorine-18-2-fluoro-2-deoxy-D-glucose (18F-FDG) injection was prepared by a modification of a method originally developed by Hamacher et al. The dosage form is the injectable solution (2 ml) containing 185 MBq of 18F-FDG at a calibration time. Preclinical studies of the agent were performed. Its radiochemical purity is more than 95% and expiration time is 4 hours after the calibration time at ambient temperature. No toxicity was observed with up to 200 mg/kg and 100 mg/kg of non-radioactive FDG intravenously injected to rats and dogs in single-dose toxicity tests, respectively. Biodistribution studies demonstrated that the radioactivity was mainly distributed into brain (3.0 to 3.3% I.D./Organ at 30 minutes) and heart (4.2 to 5.8% I.D./Organ at 1 to 3 hours) after intravenous injection of the agent to normal rats. In a tumor transplanted mouse model (colon 26), tumor uptake was 10.9 +/- 3.5% I.D./g at 1 hr after intravenous injection of the agent, the radioactivity was retained until 3 hours. The radiation absorbed dose was estimated according to the MIRD Pamphlet based on the biodistribution data both in humans reported by Mejia et al. and rats described in this report. The radiation absorbed dose was not higher than those of commercially available radiopharmaceuticals. In conclusion, the 18F-FDG injection is expected to be useful for further clinical application.

Animals↗
PubMed1999

HIV/STD: the women to blame? Knowledge and attitudes among STD clinic attendees in the second decade of HIV/AIDS.

We aimed to determine the knowledge and attitudes towards HIV/STDs among women attending an STD clinic by interviewing 520 randomly selected women. Nearly all had heard of HIV/AIDS/STDs, with posters, pamphlets and the radio being the main source of their information. The years of schooling was the only predictive factor of knowing a preventive measure of HIV. Two-thirds thought they were at risk of contracting HIV from their regular partner. Knowledge of the sexual habits of their male partners was low with 260 (50%) of the women distrusting their partner. Only 52 (10%) of respondents admitted to sex in exchange for gifts or money. In the event of a positive HIV test result, the perceived partner response would be to blame the woman for introducing the infection into the relationship. After a positive HIV test result, only 3.5% would resort to using condoms while another 3.7% would try to pass on the disease to other people. The quality of their knowledge of the transmission of HIV was low in spite of the fact that most respondents have heard of HIV/AIDS/STDs. Violence against women was expected in relation to a positive test result. There is a need for better educative effort on the modes of transmission and prevention of HIV, also in 'low risk' populations.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Pilot study to improve health outcomes for medication-induced headache sufferers.

The objectives of this prospective cohort study were to identify and encourage individuals with symptoms consistent with medication-induced headache (MIH) to seek medical help, and to determine the health outcomes of these patients. All community pharmacists (approximately 150) on Newfoundland's Avalon Peninsula were provided with continuing education material on MIH and were asked to display a poster inviting individuals taking analgesics more than two days a week for headache to speak to their pharmacist. Pharmacists were asked to provide a patient information pamphlet to individuals with medication use and symptoms consistent with MIH, to request them to contact a study nurse and to log the number of potential MIH patients encountered. The study nurse supervised the completion of headache and quality of life questionnaires, and advised the subjects to seek help from their family physicians. Forty-six pharmacists returned logs identifying 142 potential MIH subjects: 21 contacted the study nurse, 17 completed the questionnaires and 11 were classified as MIH sufferers. MIH sufferers reported a reduction in headache frequency (P<0.02) and analgesic consumption (P<0.05) when re-interviewed after three months. A health care team approach can improve health outcomes for some MIH sufferers. Further work to evaluate strategies to encourage chronic headache sufferers to seek help is required.

Headache↗
PubMed1999

Reducing surgery in management of spontaneous abortions. Family physicians can make a difference.

OBJECTIVE: To test the effectiveness of physician and patient education in reducing the rate of surgery in management of spontaneous abortions in family practice. DESIGN: A before-after intervention trial. SETTING: Urban and suburban family doctors' practices in greater Vancouver, BC. PARTICIPANTS: Family practice patients (56 physicians contributed 417 patients) who had spontaneous abortions between June 1997 and August 1998. INTERVENTIONS: Seminars for doctors and educational pamphlets for patients. MAIN OUTCOME MEASURES: Rate of surgeries, and rates of referrals and complications. RESULTS: In the 2 years before the intervention, the rate of surgery was 45.8% (n = 299); after, it was 32.2% (n = 118). No transfusions were required. Before the intervention, 17% of women had hemorrhages; after, 13%. Rates of infection were 3.7% and 0.8%, respectively. Rates of referral to gynecologists were 54.0% and 40.2%, respectively. CONCLUSIONS: Patients of family doctors who attended seminars and agreed to join the study had significantly reduced rates of surgery after spontaneous abortions. Rates of referral for these patients were also lower, and there was no increase in complications.

Abortion, Spontaneous↗
PubMed1999

[A strategic family medicine model for controlling borderline and mild arterial hypertension].

OBJECTIVE: To research on the relationship of the patient and his/her family as a non-pharmacological factor for blood hypertension. To determine whether a hyposodic, hypocaloric, hypofat, and hypocholesterolemic diet decreases the blood tension. To determine whether physical exercises in the patient and his/her family help to reduce the hypertension. To observe whether the psychological therapy of muscles relaxation helps to reduce the hypertension. To evaluate in the sample of families, the experience of each member, as well as their suggestions and complaints about the programme. To design the strategic model to control the blood tension by ambulatory means. DESIGN: Controlled intervention study, descriptive, non-randomized, prospective. PLACEMENT: Primary care. PATIENTS AND OTHER PARTICIPANTS: Study group of 10 patients, 10 wives, and 12 children, and control group of 10 patients excluding family members. INTERVENTIONS: With both groups (study and control) there were meetings every 15 days for 6 months according to an established schedule. In the meetings there were given talks, pamphlets, physical exercises, muscles relaxation therapy, all about blood hypertension. There were questionnaires before and after each activity. MEASURING AND MAIN RESULTS: In both groups (study and control) there was a statistically significant (t < 0.01) reduction in the weight. The blood systolic tension decreased in both positions, seated and standing, in the study group (difference statistically significant) but not so in the control group, although there was a non-significant difference (decrease of 1.5 mmHg) in the seated position. The diastolic tension decreased significantly in the study group both in seated and standing positions, not so in the control group. CONCLUSIONS: The study sample showed that systolic tension seated and standing had a statistically significant reduction in the study group but not so in the control group. The weight had statistically significant reduction in both study and control groups. Total cholesterol had statistically significant decrease in the study group but not in the control group. HDL-C had statistically significant reduction in the study group; in the control group there was a decrease but not statistically significant. The triglycerides did not decrease statistically significant in any of the groups (study and control).

Adult↗
PubMed1999

A cytologic study of oral mucosal cell alterations in smokeless tobacco users and efficacy of a related cessation program.

PURPOSE: The primary objective of the study was to determine if oral tissue changes, as documented by cytologic study and reported to the smokeless tobacco user, provide incentive to discontinue use of smokeless tobacco products. METHOD: Smokeless tobacco users who presented for treatment in the University of Arkansas for Medical Sciences dental hygiene clinic served as the 10 subjects of this one-year study. Calibrated dental hygiene faculty collected cellular specimens from the oral mucosa of subjects at the site of smokeless tobacco placement and a clear site as control. Specimens were collected by a moistened tongue blade scrape, then fixed, stained, and diagnosed by faculty in the department of pathology. Subjects participated in a cessation program: a standardized session in which results of the cytologic findings and risks of smokeless tobacco usage were discussed, using visuals and pamphlets. The subjects, with the exception of the last, were contacted at three- and six-month intervals to determine their compliance with cessation recommendations. RESULTS: Three of the 10 subjects displayed significant tissue changes; these subjects discontinued smokeless tobacco use. The cytologic studies of the other seven subjects revealed only various amount of hyperkeratosis. CONCLUSION: Cytologic assessment and results may be a valuable component of a smokeless tobacco cessation program. This area merits further research.

Adult↗
PubMed2000

S values for radionuclides localized within the skeleton.

UNLABELLED: Calculations of radiation absorbed dose to the active marrow are important to radionuclide therapies such as radioimmunotherapy and bone pain palliation. In diagnostic nuclear medicine, calculations of the effective dose for radiopharmaceutical procedures also require the assessment of radiation dose to the skeletal endosteum. We have previously reported the development of 2 3-dimensional electron transport models for assessing absorbed fractions to both marrow and endosteum in trabecular and cortical bone, respectively. Here, we extend these calculations to the assignment of radionuclide S values. METHODS: Data published in International Commission on Radiological Protection Publication 70 were used to develop tables of masses for total marrow space, active and inactive marrow, endosteum, and bone matrix within 22 skeletal sites in the adult. Using our site-specific tissue masses, along with electron absorbed fractions given by our 3-dimensional transport models, radionuclide S values (electron and beta particle components only) were subsequently calculated using the MIRD schema for 32P, 33P, 89Sr, 90Sr, 90Y, 117mSn, 153Sm, 169Er, 177Lu, and 186Re. Specific consideration was given to the trabecular active marrow as both a source and a target region. RESULTS: Site-specific radionuclide S values are reported for 22 skeletal sites, for 9 source-target tissue combinations within trabecular bone, and for 6 source-target tissue combinations within cortical bone. Skeletal-averaged S values are also provided. CONCLUSION: A fully documented model is presented for the adult for use in radionuclide dosimetry of the skeleton. The model is based on both the latest international recommendations for skeletal tissue masses and results from three-dimensional electron transport calculations within the skeleton. Comparisons are additionally made against the radionuclide S values published in MIRD Pamphlet No. 11 and those calculated using the MIRDOSE2 and MIRDOSE3 computer codes. Differences in these datasets vary with the source-target combination considered and may be attributed to 1 of 3 causes: (a) assumptions on reference target masses, (b) transport models used to assign absorbed fractions, and (c) implicit assumptions made in considering the trabecular active marrow as both a source and a target tissue.

Adult↗
PubMed1999

How many pregnant women in Christchurch are using folic acid supplements in early pregnancy?

AIMS: To determine the proportion of pregnant women in Christchurch using folic acid supplements in early pregnancy. To evaluate the level of current knowledge relating to folic acid amongst pregnant women. To determine the main sources from which this information was gained. METHODS: A short questionnaire was administered to 191 pregnant women in Christchurch during antenatal visits with their lead maternity carer. The survey contained questions relating to knowledge about folic acid and use together with sources of information regarding folic acid. Obstetric and demographic details were also collected. RESULTS: The response rate was 95.5%. Ninety-one per cent (174/191) of participants had heard of folic acid and, of these, 63% knew that folic acid reduces the risk of spina bifida. Of the 191 participants in the study, 118(62%) took folic acid supplements at some stage of their pregnancy, however, only 33(17%) had taken periconceptual folic acid supplements. Of the 44% of all women in the study with a planned pregnancy, only 35% had taken folic acid supplements periconceptually. Of those women with an unplanned pregnancy (55%), only 2.8% had taken a folic acid supplement periconceptually. The main sources of advice for women relating to folic acid were general practitioners (48%) or media advertising, either in the form of a magazine, or health pamphlet or television promotion (20%). CONCLUSIONS: The results of this study indicate that the level of knowledge amongst women of child-bearing age relating to folic acid is relatively high compared with other countries. Despite this high level of knowledge, only a small percentage of women are actually consuming a folic acid supplement during the recommended periconceptual period due in part to the high proportion of unplanned pregnancies. These results emphasize the need for an effective public health strategy to ensure that all women of child-bearing age have access to an adequate folic acid intake.

Female↗