Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mail Distribution”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed2004

Situation analysis of prenatal diagnosis technology utilization in China: current situation, main issues, and policy implications.

OBJECTIVES: The purpose of this study is to describe the situation with the distribution and utilization of prenatal diagnosis technology in China, to identify some important barriers to prenatal diagnosis use, and to suggest changes to improve the present situation. METHODS: The study uses cross-sectional surveys to capture quantitative data from both providers and consumers. Qualitative information based on focus group discussions is also presented. RESULTS: A mail survey of the provincial Bureaus of Health (BOHs) reveals that sixteen provincial prenatal diagnosis centers and twelve city level centers were accredited by the BOHs by July of 2001. These centers were located in thirteen provinces, of thirty in all of China. Of 147 selected institutions surveyed separately, 90.5 percent offer ultrasound examination, 72.1 percent provide pathogen tests (mainly Toxoplasma, rubella virus, cytomegalovirus, and herpes simplex or TORCH), 57.1 percent do biochemical tests, 21.8 percent have genetic counseling, 13.6 percent do karyotype testing, 7.5 percent do enzymology testing, and 5.4 percent carry out molecular genetic testing. Chromosome diseases, congenital diseases, and several gene diseases are the target diseases. According to qualitative data, macromanagement for prenatal diagnosis, supplier provision of tests, and population demand are the main influences on prenatal diagnosis use. CONCLUSIONS: From the quantitative and qualitative analysis, it is clear that the technology of prenatal diagnosis is not diffusing well throughout China and is apparently not appropriately used. The situation of prenatal diagnosis has implications for policy-makers, including identification of priorities, regulation of prenatal diagnosis, strategic planning, development of guidelines based on health technology assessment, and consumer orientation.

China↗
PubMed1999

A managed care organization's attempt to increase influenza and pneumococcal immunizations for older adults in an acute care setting.

OBJECTIVE: Among the high risk groups for complications from influenza and pneumococcal disease, individuals aged 65 and older hospitalized within the previous year represent the group at highest risk. Studies have demonstrated that targeting hospitalized patients aged 65 and older for immunization before hospital discharge can be successful. This study addressed the efficacy of such a program within a managed care organization to immunize this highest risk group. DESIGN: A cross-sectional study. SETTING: Oxford Health Plans, a major managed care organization in New York serving a large Medicare population. PARTICIPANTS: A total of 106 Primary Care Physicians caring for 153 patients aged 65 and older, who were hospitalized in one of 10 high volume hospitals during October and November of 1996. Nine of these facilities were located in New York and one was in New Jersey. INTERVENTION: Patients aged 65 and older admitted to any of the 10 hospitals were identified daily. A fax was sent to each patient's primary care physician explaining the program and requesting that he/she administer influenza and/or pneumococcal vaccine to his/her patient before hospital discharge. Literature references citing past successful programs were included in the fax. MEASUREMENTS: Measurements included medical record documentation of influenza and pneumococcal immunization, both ordered and given, for the individual member before discharge; patient age; sex; and primary and secondary diagnoses. Physicians were sent follow-up questionnaires to determine reasons for not vaccinating. RESULTS: A total of 206 patients were admitted during the eligible time period. One hundred fifty-three hospitalized patients (average age = 74 years) participated. The median length of stay among this study population was 5 days (range, 1-63 days). The distribution of the median length of stay for the 25th and 75th percentiles was 3 and 9 days. The rate for influenza and pneumococcal immunization, both ordered and given, before hospital discharge was 1.96% for the influenza vaccine (n = 3) and .65% for the pneumococcal vaccine (n = 1), respectively. Results of a follow-up survey mailed to all physicians (n = 106) with eligible members in the study indicated that the most frequent reasons for not vaccinating included: patients were vaccinated before admission, patients were not stable enough to be vaccinated before discharge, and the acute care setting is not appropriate for vaccination. Response rate of 58% (n = 61) was achieved with an initial mailing and one follow-up telephone call to all previous nonresponders. Some physician survey responses do not correlate with data obtained from retrospective patients' claims analysis. CONCLUSION: Well-coordinated and timely attempts to encourage primary care physicians to immunize patients 65 years and older before hospital discharge were unsuccessful in our study. Rather than working with physicians, it may be that managed care organizations should work directly with hospitals to implement influenza and pneumococcal immunization programs.

Aged↗
PubMed1991

National survey of state psychiatric hospital pharmacies.

The results of a winter 1990 nationwide mail survey of pharmaceutical services provided in state psychiatric hospitals are reported and discussed. The survey universe consisted of all 207 state psychiatric hospitals registered by the American Hospital Association. Private and federal and other government-operated psychiatric hospitals were not included. Questionnaires were mailed to the director of pharmacy at each institution. Two questionnaires were not deliverable. There were 117 usable replies, for a net response rate of 57.1%. Compared with community hospitals, state psychiatric hospitals had pharmacy departments that were open fewer hours per week, occupied more floor space, were less likely to have a complete unit dose distribution system and i.v. admixture program, had lower inventory turnover rates, and had fewer full-time positions. About 28% of the respondents employed pharmacists who spent at least two thirds of their time providing clinical services. Differences in the provision of pharmaceutical services between state psychiatric hospitals and community hospitals may be due in part to the fact that most of the former are long-term-care institutions rendering a specific class of therapies.

Formularies, Hospital as Topic↗
PubMed1999

[Factors for the onset of and the exacerbation of tuberculosis. 6. Recent socio-medical characteristics of tuberculosis and their perspectives in Japan].

In the late 1970s the decline of TB incidence rate has begun to slow down among both elderly population and younger one. This phenomenon mostly owed the reactivation of dormant M. tuberculosis infection among the elderly people and small TB outbreaks in the younger generation. The micro-epidemics among adolescent and young adults have been reported since 1980. The latest data showed the TB incidence in 1997 was 33.9 per 100,000 population, increased from 33.7 per 100,000 in 1996. To explain the situation above, several sociomedical factors were discussed as follow: (1) Age distribution of TB: The highest peak of newly registered TB patients shifted to the elder age cohorts and was the age group between 65 and 74 years in 1997, contrasting small peaks observed in 20-29 years age group remained unchanged. (2) Characteristics of infection route: Overall incidence rates of smear positive TB cases slightly increased in 1980s and leveled off thereafter. However, the number of smear positive cases among persons elder than 70 years old sharply increased, 1,779, 3,744, 5,728, in 1977, 1987 and 1997, respectively. Several papers showed that about one quarter of TB patients was diagnosed as TB while being treated for diseases other than TB. This may have contributed to the current TB infection. (3) Delay in case-finding: Patient's delay in symptomatic smear positive cases, especially among male patients in 30-54 age group, has been increased during last 10 years. This may also contribute to the current TB issue to the younger people. (4) TB problems in the cities: TB incidence rate in a certain area of some big cities was much higher than the other areas and the regional difference became magnificent due to serial socioeconomic problems of vulnerable population there. (5) Notification of TB: One study using mailed questionnaires showed that only 76 percent of medical doctors knew the TB notification system under the TB control law. It concluded that contact tracing would become more important issue in case-finding and the 100 percent of TB notification in medical institutions would be indispensable.

Adolescent↗
PubMed1998

Long-term results of polyglactin mesh for the prevention of incisional hernias in obese patients.

The aim of this study was to compare prospectively the incidence of incisional hernia in two groups of patients operated on for morbid obesity, with or without intraperitoneal polyglactin mesh. From October 1990 to September 1993, a total of 288 patients were randomly assigned to the two groups. There were 144 patients in the mesh group and 144 in the no-mesh group. Altogether 240 patients (83%) were reviewed personally, 45 (16%) were interviewed by phone (n = 39) or mail (n = 6), and 3 (1%) were inaccessible for follow-up since discharge from the hospital. The mean follow-up period was 29.8 months (range 0-67 months). A total of 33 incisional hernias were observed in the mesh group and 41 in the no-mesh group. There was no significant difference in the distribution of herniation time between the two groups (p = 0.43). The two main predictive factors of herniation were age and weight. In conclusion, the use of an intraperitoneal polyglactin mesh does not prevent postoperative incisional hernias in obese patients.

Adult↗
PubMed1994

Some useful statistical properties of position-weight matrices.

Position-weight matrices (or profiles) are simple mathematical objects traditionally used to capture the information about local sequence patterns (or motifs) characteristic of a given structure or function. Although weight matrices can lead to fast database scanning algorithms their usage has been limited, due to the lack of a reliable method to assess the statistical significance of the matching scores. In this article I first review 3 different computation scheme for designing weight matrices from a block-alignment of any (small or large) number of sequences. I then show that, for patterns spanning 10 positions or more, the best scores expected from matching random sequences are distributed according to the extreme value (Gumbel) distribution. The threshold of statistical significance assessed from this distribution perfectly delineate the range of scores characterizing "true positive" sequences (biological significant matches). This result allows weight matrices to be used to scan an entire protein database for patterns in a highly sensitive way. MODEST (MOtif DEsign and Search Tools), a suite of programs in Unix/C, implements these statistical improvements and is available upon E-mail request (jmc@ncbi.nlm.nih.gov).

Amino Acid Sequence↗
PubMed2005

Mail surveys resulted in more reports of substance use than telephone surveys.

OBJECTIVE: To determine to what extent the substance-use information obtained in surveys is affected by method of data collection. STUDY DESIGN AND SETTING: Questions on the use of alcohol and drugs were administered to samples of Minnesota adults assigned to one of two conditions to test the effect of mode of administration (mail and telephone); 816 persons completed the survey, roughly one half by mail and one half by telephone. RESULTS: Those interviewed by telephone revealed more heavy use of alcohol, but the mail sample includes disproportionate numbers of respondents from demographic groups that exhibit less use. Controlling for these differences across modes, as well as the differential use of listed telephone numbers and addresses, reduces the effect of mode on one measure of heavy alcohol use to nonsignificance but yields significant effects of mode on others. Specifically, those in the mail condition reported higher levels of illicit drug use in the last year, alcohol use in the last month, and heavy alcohol use in the last 2 weeks. CONCLUSIONS: The greater, and arguably more accurate, reporting of substance use, coupled with potential cost savings, suggests that researchers should consider using mail surveys for investigating substance use.

Alcohol-Related Disorders↗
PubMed1997

Results of a national survey on ethics education in general surgery residency programs.

BACKGROUND: Medical ethics is a required part of the curriculum in all medical schools in the United States, and an essential component of the educational guidelines for most postgraduate residency programs. Currently, general surgery does not specify ethics education in its essential curriculum for surgical training. This study was designed to determine the existing educational activities in ethics for residents in general surgery, as well as to characterize the attitudes of surgical educators about the role of ethics teaching in residency training. METHODS: An 80-item questionnaire was mailed to the program directors of all accredited general surgery residencies in the United States. They were requested to provide information about their teaching activities in ethics, their resources for ethics instruction, and their attitudes about the importance of education in clinical ethics for surgical residents. RESULTS: The survey had a 71% response rate with a representative distribution of programs based on size, geographic location, and community versus university affiliation. Fifty-six programs (28%) offered no formal ethics education, 94 (48%) held one teaching event in ethics, and 48 (24%) conducted two or more activities. The format for instruction in ethics included grand rounds (50%), resident conferences (41%), and ethics rounds (9%). Residencies with a faculty surgeon having expertise or special interest in ethics had a greater number of ethics teaching activities (P <0.05), whereas programs with a hospital ethicist were more likely to provide ethics rounds (P <0.01). A standardized curriculum in ethics was favored by 85% of respondents with critical content in end-of-life decisions, managing ethical conflict, and informed consent. The majority of program directors were opposed to (50%) or undecided (20%) about inclusion of ethics questions on the American Board of Surgery Inservice Training Examination (ABSITE) and Qualifying Examination in General Surgery. CONCLUSIONS: The majority of program directors of general surgery residencies support the teaching of clinical ethics and favor a standardized curriculum. However, most residencies in general surgery do not include ethics instruction as part of their on-going, regular educational schedule.

Attitude of Health Personnel↗
PubMed2001

Receiving a positive HIV test result: the experience of patients in Europe.

OBJECTIVE: To describe HIV-infected people's experience of the HIV test procedure in Europe. METHODS: Between August 1996 and September 1997, anonymous self-administered questionnaires were distributed to HIV-infected people in 11 European countries. RESULTS: A total of 1366 people completed the questionnaire (50% response rate). Of these, 194 (16%) had more than five negative HIV tests before being diagnosed as HIV positive, 179 (14%) were tested without consent and 192 (15%) were informed about the HIV positive test result by mail or by telephone. Of the 963 people who received a positive test result during a consultation, 247 (26%) reported that this visit lasted less than 10 min, 336 (35%) between 10 and 20 min, and 289 (30%) more than 20 min. Over half the total respondents (591, 54%) felt they did not receive adequate support when they were informed about being HIV positive, with 249 (19%) experiencing feelings of rejection. People who were diagnosed as HIV positive after 1994 reported more frequently receiving adequate support, information and understanding when the positive test result was revealed compared with those diagnosed before 1990. CONCLUSION: A large number of our study participants did not endorse the way HIV tests were conducted and positive test results revealed. Although there was an improvement over time in the way HIV tests were conducted, they often did not conform to international guidelines.

AIDS Serodiagnosis↗
PubMed2002

Validity and reproducibility of a physical activity questionnaire in women.

PURPOSE: To determine the validity and reproducibility of a self-administered physical activity questionnaire that assesses the frequency, intensity, and duration of recreational, household, and occupational activity in women. METHODS: The questionnaire was administered by mail twice to 131 participants 1 yr apart. During this interval, participants completed four 1-wk activity logs corresponding to different seasons throughout the year. RESULTS: The intraclass correlation coefficients used to measure reproducibility were 0.82 for total activity, 0.79 for moderate activity, 0.86 for vigorous activity, 0.80 for recreational activity, and 0.73 for household activity. The distribution of activity scores was similar between the questionnaires and the average of the four logs, indicating the participants' ability to incorporate seasonal variation into their recall on a questionnaire. The correlations between the questionnaire-based activity scores and log-based activity scores, indicating validity, were 0.26 for total activity, 0.15 for moderate activity, and 0.52 for vigorous activity. Women younger than age 50 tended to have higher validity scores than women aged 50 yr and older (r = 0.31 vs r = 0.19, respectively, for total activity). CONCLUSION: These data indicate that this physical activity questionnaire is reproducible and provides a useful measure of current activity, particularly vigorous activity, over a 1-yr period.

Adult↗
PubMed2006

Development of content-valid technical skill assessment instruments for athletic taping skills.

BACKGROUND AND PURPOSE: The content validity of technical skill assessment instruments (TSAI) for the skills of athletic taping has not been reported. The purpose of this paper is to outline and present the process of content validation for nine TSAIs for athletic taping. Local and national validators were selected from Canadian Athletic Therapists' Association (CATA)-accredited athletic therapy (AT) programs to serve as content validators. METHODS: The process of content validation began with the creation of a detailed task analysis via mail and simple validation by local validators. Subsequently, the detailed task analysis was committee validated by a group of 10 validators from across Canada. Validators judged the importance and difficulty of each item, and a face-to-face committee-validator meeting established consensus on the majority of checklist items. Through a modified Ebel procedure, frequency distribution was used in the formation of the final TSAIs. RESULTS: Initial consensus for pre-taping assessment and technical skill performance items was low. Upon committee discussion and lack of agreement, the decision to remove pretaping assessment items was made. Initial results of importance and difficulty for athletic taping technical skills were low prior to the committee meeting. Results of importance and difficulty improved substantially following the face-to-face committee-validators meeting. Consensus on fail points improved from initial to final committee validation. CONCLUSION: The process of simple and committee validation can be seen as effective methods to establish the content validity of instruments used for the evaluation of athletic taping.

Alberta↗
PubMedDate not supplied

Transplant patients' perceptions about effective preoperative teaching.

With the increasing number of heart transplants being performed, transplant programs are continually evaluating and revising their programs. The resulting expanded knowledge base is then presented to transplant candidates through preoperative teaching. Often in the design of preoperative teaching programs, nurses use information they believe will be helpful to the patient. Frequently, the patient's needs are not identified and incorporated into the preoperative teaching. The purpose of this descriptive study was to determine what information transplant patients perceived as being helpful in their postoperative recovery. The method for this study involved designing a close-ended questionnaire that elicited responses from participants regarding preoperative teaching needs in the following categories: preoperative, perioperative, immediate postoperative, immunosuppressive drugs, endomyocardial biopsy, rejection, infection, and other. A five-point Likert-type scale was used to rank responses from extremely helpful to not helpful. Questionnaires were mailed to 20 surviving transplant patients who had undergone surgery between October 1982 and August 1985 at a large midwestern hospital that specializes in the treatment of the cardiovascular patient. Seventy percent (14) of the questionnaires were returned to the investigator. Two questionnaires were not used because of incomplete responses. Statistical analysis of the data included frequency distributions and point biserial correlation of the independent variables. Ninety percent of respondents perceived their overall preoperative teaching to be adequate. From these results, it appears that the areas most helpful to participants include information in the following areas: immunosuppressive drugs, rejection, biopsy, and infection. Information perceived as less helpful to participants included explanation of chest tubes and urinary catheters as used in the immediate postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

Navicular disease in the horse: risk factors, radiographic changes, and response to therapy.

In a retrospective study, 74 horses met defined historical and clinical features indicative of navicular disease. Most of the affected horses were 4 to 9 years old. Males had a greater risk of navicular disease than females, geldings had a greater risk than stallions, and Quarter Horses had a greater risk than other breeds. Diagnostic radiographic changes were found in 42 of 70 horses examined. The distribution of diagnostic radiographic changes between the right and left fron feet was equal. There was no correlation between the finding of diagnostic radiographic changes and the horse's response to therapy or the type of work for which the horse had been used. A questionnaire regarding the current status of the horses in the study was mailed, and 51 replies were received. Of the 38 horses that were alive at least 6 months after treatment and for which the current status was known, 9 were sound at the time of follow-up (from 7 to 91 months after treatment). Three of these horses had been treated medically, 4 surgically, 1 by corrective shoeing, and 1 not treated. No advantage for medical or surgical therapy was demonstrated. The poor response to therapy in this group of horses suggests that the prognosis for horses with navicular disease should be guarded, and that the probability of a return to a prelameness capacity for work is slight.

Animals↗
PubMed1995

Utilization of expert consultants by poison centers in the United States.

A survey was mailed to 103 poison centers in the US during March 1990 to characterize the use of outside experts for patient-specific problems; 69 centers responded. Outside experts were utilized by 64 centers (93%) with contact being made < 3 times monthly by 58% of the respondents. There were 84 different types of experts utilized with near equal distribution of medical and non-medical specialties. A minority (18%) of the centers had organized a committee of experts and only 7% of the centers compensate outside experts. There was no association between the utilization of experts and characteristics of a poison center, such as receipt of state funding, funding level or certification. With the variety of practices in utilizing experts, poison centers may wish to review their approaches to the use of outside consultants.

Consultants↗
PubMed1997

The Michigan equine monitoring system. I. Design, implementation and population estimates.

The Michigan equine monitoring system (MEMS) was designed and implemented in the State of Michigan, starting in 1991. The program was designed systematically to track the State's equine population, its health, and its economic implications to the equine industry. The MEMS was designed as a two-phase program. Phase I (the population and economic survey; the subject of this paper) was designed to provide new and statistically valid information describing the size, composition, location and economic characteristics of the Michigan equine industry. A standardized questionnaire was used to collect data via mail, telephone and personal interviews. Of the 3000 randomly selected list-frame samples, 2800 (93%) participated. However, 650 of these had no equids. There were 129,932 equids reported compared with 160,000 in 1984. The American Quarter Horse, Standardbred and Arabian breeds were the most numerous. Detailed results, including the size of equine operations/herds, uses, geographical distribution and the financial structure of the industry, are presented. A detailed account of the strategies used in designing and implementing the system is provided.

Animal Husbandry↗
PubMed2000

The effect of societal changes on drunkenness trends in early adolescence.

Increased adolescent drunkenness in Finland has called for research to explore the background of this development. This study seeks to find out to what extent the societal level changes have contributed to the increased drunkenness among 14 year olds in Finland from 1981 to 1997. The data set is drawn from a nationally representative bi-annual mail study, the Adolescent Health and Lifestyle Survey, conducted since 1981 (N = 792-2533, response rate 77-90% per year). Logistic regression analysis was used to study the effect of several background factors on the drunkenness prevalence trend. Family structure, parental education, residence urbanization, weekly allowance and timing of biological maturation were associated with drunkenness. Changes within the distribution of these factors, especially in increased weekly allowance and earlier timing of biological maturation, appeared to account for a considerable part of the increased drunkenness from 1981 to 1997. The findings suggest that increased adolescent drunkenness is significantly associated with societal changes outside the scope of health and alcohol policies.

Adolescent↗
PubMed1990

[Informatics in the School of Medicine of the University of Chile. II. The school network and access to data bases].

Projects on informatics at the School of Medicine of the University of Chile are being brought about in accordance with both its institutional goals and present trends in technology. Prominent among the latter are the widespread distribution of autonomous processing power represented by low-cost computers and the ease of communication at local and worldwide levels. Our main project has been the design and start of a computer network that integrates the School's Departments and the geographically dispersed teaching hospitals. The principal services provided by the network are local and international electronic mail, access to data bases, and emulation of mainframe terminals (eg, to run remotely a mainframe's statistics software). Automated bibliographic search has been made available both through remote access to Medline data base and through local usage of compact disc (CD-ROM) versions. Since our network is open, it should become a forceful mean of assisting and integrating the biomedical community throughout the country.

CD-ROM↗
PubMed1998

[Electronic forum of Revista de neurología: 'Internet, Medicine and Neuroglia'].

INTRODUCTION: In recent years Internet has drastically transformed the world of telecommunications. Questions about whether Internet and the global communication accessibility may be considered as a fundamental aspect in the medicine of today and tomorrow have been brought up. OBJECTIVE: Discuss current and future applications of Internet to the field of Medicine and Neurology. METHODS: Bibliographical review based on Medline and standard Web search engines. Forum sessions performed through Internet by means of Web-Chat. Forum coordination entirely performed by electronic mail. RESULTS: There are several opinions regarding the influence of Internet on Medicine and Neurology. Currently, the communication and collaboration between teams is improving. It allows scientific publications on-line, improves continuous remote training and facilitates information to patients. New applications like telemedicine need more development. CONCLUSIONS: Currently, Internet represents an efficient tool for collaboration, training and distribution of information in the field of Medicine and Neurology.

Humans↗