SEARCH · Search PubMed

Results for “Communication Methods, Total”

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.

SourceResearch connectionFrom yearThrough year

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

At least 919 records · Page 51Linked to original sources

PubMedDate not supplied

Cost of health services provided at a primary health centre.

BACKGROUND: Information on the cost of health services is essential for good planning and management and leads to an efficient use of resources. Very little information on this is available in India. We estimated the distribution of costs incurred on the Primary Health Centre, Chhainsa, Haryana by the type of service provided and their average unit costs. METHODS: We calculated the total costs incurred in running the primary health centre for one year using standard costing methods. This cost was apportioned under different heads on the basis of time and space utilization. The number of activities carried out, between April 1991 and March 1992, was obtained from the monthly reports of the centre maintained by the health assistant and supervised by the medical officer. RESULTS: The total cost incurred for one year was Rs 777,020 (US$ 24,250). Curative care accounted for 32% of the total costs followed by communicable disease control (17%), child care (17%), maternal care (11%) and family welfare (10%). An expenditure of Rs 24 was incurred on each outpatient. The cost of giving full primary immunization to a child was estimated at Rs 131, while Rs 127 was incurred on providing antenatal, natal and postnatal care to each pregnant woman. Tuberculosis-related activities in the community cost Rs 3 per head per year and malaria-related activities Rs 2 per head per year. The cost incurred annually on family welfare services to an eligible couple was Rs 19. CONCLUSIONS: Our findings suggest that the cost estimates from this primary health centre are comparable with the estimates from other developing countries. These cost estimates may be used to determine user fees by health agencies or for premiums for community health insurance schemes.

Capital Expenditures↗

PubMed1996

Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions.

OBJECTIVE: To evaluate the effect of cartoon illustrations on patient comprehension of and compliance with ED release instructions. METHODS: A prospective, randomized, controlled study of consecutive patients who presented to the ED of a community teaching hospital with lacerations necessitating wound repair during a three-month study period. At ED release, the patients were randomly assigned to receive wound care instructions with or without cartoon illustrations. Three days later, the patients were followed up by telephone. A blinded investigator asked a series of questions designed to test the patient's recall of, understanding of, and compliance with wound care instructions. RESULTS: A total of 234 patients were successfully contacted by telephone; 105 (45%) had been given ED release instructions with cartoons, 129 (55%), without cartoons. There was no significant difference in age, gender, level of education, or satisfaction with the ED visit between the two groups. The patients given cartoon instructions were more likely to have read the instructions (98% vs 79%, p < 0.001), were more likely to answer all wound care questions correctly (46% vs 6%, p < 0.001), and were more compliant with daily wound care (77% vs 54%, p < 0.01). Subset analysis of those patients who had less than a high school education (n = 57) demonstrated even larger differences between the two treatment groups in terms of comprehension of and compliance with ED release instructions. CONCLUSION: Cartoon illustrations are an effective strategy for conveying information and may improve patient compliance with ED release instructions.

Adolescent↗

PubMed1997

Olfactory dysfunction for pyridine and dementia progression in Alzheimer disease.

OBJECTIVE: To investigate whether odor detection sensitivity for pyridine, suggested by previous research not to be affected, is impaired in Alzheimer disease (AD) and whether an association exists between odor threshold and both degree of dementia and rate of dementia progression in AD. METHOD: The method of constant stimuli was used to determine odor thresholds for pyridine in 18 patients with AD (Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria) and 16 healthy elderly control subjects. All participants were carefully examined with medical and neuropsychological tests. RESULTS: Six patients with AD but none of the controls were anosmic (total olfactory loss) to pyridine, and the 12 nonanosmic patients had significantly higher detection thresholds (50% probability for detection, 323 parts per billion [ppb]) than did the controls (50% probability for detection, 105 ppb). In addition, an association was found between odor threshold and both degree of dementia and rate of dementia progression in AD. CONCLUSIONS: In contrast to previous findings, our results provide evidence that odor sensitivity in AD is impaired for pyridine. Odor sensitivity, in addition to other suggested predictors of progression rate, may be of interest for defining subgroups of AD or for clinical prognostic judgments of single patients.

Aged↗

PubMed1995

Combined use of the esophageal-tracheal Combitube with a colorimetric carbon dioxide detector for emergency intubation/ventilation.

OBJECTIVE: The esophageal-tracheal Combitube (Sheridan, Inc., Argyle, NY) is a unique double lumen tube that has been introduced as an emergency intubation device. Since it is placed blindly, proper use requires determination of which lumen can be successfully used for ventilation. The Easycap (Nellcor, Inc., Pleasanton, CA) is a colorimetric carbon dioxide detector that reacts with exhaled gas to indicate proper tracheal tube location. The purpose of this study was to determine if the Easycap can be used to identify which Combitube lumen is patent to the trachea after blind placement in dogs. METHODS AND RESULTS: The study was conducted using 8 anesthetized dogs. In each of 15 blind insertions of the Combitube, the Easycap device responded appropriately by changing color from purple to yellow when connected to the lumen communicating with the trachea. When the Easycap device was connected to the alternate lumen, no color change was appropriately observed in 9 out of 15 cases (60%) after 6 breaths; in 4 of the remaining 6 (87%, total), no color change was noted after 12 breaths. In the 2 remaining cases, the color change indicated the need of further verification of the tube location. In separate experiments, 10 direct tracheal and esophageal insertions of the Combitube were correctly verified by the appropriate Easycap color change. CONCLUSIONS: Our results suggest that the Easycap device may be useful with the Combitube, although human data are required.

Animals↗

PubMed2004

[Satisfaction of geriatric patients with their pain therapy. Wish and reality].

AIM: The goal of this study was to determine the level of satisfaction of geriatric patients with their pain therapy, their wishes for improved treatment, and possible influencing factors. METHODS: From April to November 2002, all patients able to communicate ( n=1432) were included in the study if they had reported pain in the previous 7 days or were taking regular analgesic medication without specifying pain. RESULTS: Of the geriatric patients reporting from home, 36.4% were not satisfied with their pain therapy up to that time, and 25.4% of surgical patients were dissatisfied as were 28.5% of patients treated in other departments. A total of 93.3% desired better pain treatment. Independent predictors for dissatisfaction with their therapy or wish for improvement were increasing pain intensity, frequent concomitant complaints in addition to pain, and the objectively perceived everyday competence. CONCLUSION: This study supports the observation that competent pain therapy is necessary and that there is room for improvement in geriatric facilities. Measuring pain intensity, posing questions pertaining to satisfaction with pain therapy, and determining whether patients desire better pain treatment are all indispensable for optimal care. Pain therapy should equally address reduction of pain intensity and management of other complaints.

Aged↗

PubMed2003

Parents' expectations regarding their children's eye care: interview results.

PURPOSE: To determine a relevant set of concerns that parents express as expectations regarding their children's eye care. DESIGN: Qualitative, cross-sectional, pilot study. METHODS: A total of 48 interviews were conducted with parents of pediatric ophthalmology patients at Duke University Eye Center and the McGovern Davidson Children's Health Center at Duke University to elicit parents' expectations regarding their children's eye care. Interviews were audiotaped, transcribed, and coded for parent expectations. RESULTS: Content analysis of transcripts from the 48 interviews yielded 35 different expectation areas for eye care, which were further classified into six groups: (1) Communication, (2) Interpersonal Manner, (3) Doctor's Skill, (4) Examination and Testing, (5) Logistics, and (6) Other. The six expectation areas most frequently identified by parents as the single "most important" expectation were the following: (1) Clinical Competence, (2) Interaction with Child, (3) Education/Training, (4) Explanation in Clear Language, (5) Information about Diagnosis, and (6) Personal Connection. CONCLUSIONS: Parents of pediatric ophthalmology patients expressed expectation areas in the Communication group more frequently than any other group. However, when asked to identify their single most important expectation area, more than half of parents identified Clinical Competence.

Child↗

PubMed1998

[Pneumocysts juxta-articular to the ilial bone and the sacral bone].

PURPOSE: The purpose of the study was to detect and safely diagnose pneumatocysts by means of computed tomography. METHODS: From September 1995 to May 1996 computed tomography of the pelvis was performed in six patients for various indications. A slice thickness of 8 mm was employed for all studies. One patient had undergone surgery for hyperparathyroidism nine years previously. Attenuation values within the coincidentally diagnosed pneumatocysts were obtained. RESULTS: We found a total of 14 pneumatocysts juxtaarticular to the sacroiliac joint. Three patients demonstrated a bilateral intraarticular vacuum phenomenon, yet a joint communication was not found. The lesions did not coincide with inflammation, tumour or trauma. CONCLUSION: Pneumatocysts are benign bone lesions associated with arthrotic changes of the sacroiliac joint. Computed tomography is the modality of choice for the diagnosis of pneumatocysts.

Aged↗

PubMed2006

Post-acute service utilisation and parental satisfaction with health care services after mild traumatic brain injury in children and adolescents.

The objectives of this study were to describe and analyse the current aftercare practise following define TBI in four German cities. A retrospective, cross-sectional design was chosen in order to investigate the research questions. Methods and procedures included a questionnaire mailed to parents whose children were admitted with TBI to one of seven collaborating hospitals. A total of 564 parents participated in the study. The results indicate that aftercare services were rarely utilised. Furthermore, it was found that the behaviour of the physician in charge had a great impact on parental satisfaction with healthcare services. In conclusion, the findings described in this article underline the need to improve communication between acute and post-acute services.

Adolescent↗

PubMed2004

Monitoring the functional health status of stroke patients: the value of the Stroke-Adapted Sickness Impact Profile-30.

PURPOSE: To further validate the Stroke-Adapted Sickness Impact Profile-30 (SA-SIP30) and to determine its responsiveness in a stroke rehabilitation population. METHOD: Data of 122 communicative stroke patients (mean age 57 years), selected for an inpatient rehabilitation programme, were available. All had suffered different types of stroke. Six months and one year post-stroke, the patients completed the SIP68 plus nine stroke-specific questions from the SIP136, enabling us to derive the SA-SIP30 from the questionnaire. We determined internal consistency, construct and clinical validity and responsiveness of the SA-SIP30. Total, physical and psychosocial dimension scores were calculated. RESULTS: Internal consistency was moderate to good (alpha>0.68) and correlation between the SIP68 and the SA-SIP30 was high (r>0.85), indicating good construct validity for total score and both dimension scores. Clinical validity assessment showed that total and psychosocial dimensions scores were significantly higher for patients with a cortical infarction compared to respectively subarachnoid haemorrhage and subcortical infarction (p<0.05). Effect sizes for the SA-SIP30 were moderate (between 0.56 and 0.65). CONCLUSIONS: The SA-SIP30 proved valid and responsive in our stroke rehabilitation population. The major advantages of the SA-SIP30 are the lesser number of items and, therefore, the shorter completion time and the fact that it is a stroke-specific scale to determine health-related functional status.

Female↗

PubMed2004

Underfunding of stroke research: a Europe-wide problem.

BACKGROUND AND PURPOSE: Previous studies in the United States and the United Kingdom have shown that stroke research is underfunded compared with coronary heart disease (CHD) and cancer research despite the high clinical and financial burden of stroke. We aimed to determine whether underfunding of stroke research is a Europe-wide problem. METHODS: Data for the financial year 2000 to 2001 were collected from 9 different European countries. Information on stroke, CHD, and cancer research funding awarded by disease-specific charities and nondisease-specific charity or government- funded organizations was obtained from annual reports, web sites, and by direct communication with organizations. RESULTS: There was marked and consistent underfunding of stroke research in all the countries studied. Stroke funding as a percentage of the total funding for stroke, CHD, and cancer was uniformly low, ranging from 2% to 11%. Funding for stroke was less than funding for cancer, usually by a factor of > or =10. In every country except Turkey, funding for stroke research was less than that for CHD. CONCLUSIONS: This study confirms that stroke research is grossly underfunded, compared with CHD and cancer, throughout Europe. Similar data have been obtained from the United States suggesting that relative underfunding of stroke research is likely to be a worldwide phenomenon.

Biomedical Research↗

PubMed1978

Dimensions of assertiveness: factors underlying the college self-expression scale.

A total of 447 Israeli students, both males and females, from four educational institutions were administered the College Self-expression Scale, a measure of assertiveness. The obtained responses were factor analyzed using the principal axis solution and the varimax rotation method. The results showed four main factors which included 43 of the 50 items of the original scale. These factors were identified as the willingness to take risks in interpersonal interactions, the ability to communicate feelings, setting rules and rectifying injustices, and the presence or absence of a tendency to invoke a self-punitive attitude. The findings were interpreted as adding support to the validity of the scale as a measure of assertiveness.

Adolescent↗

PubMed2006

[A Hebrew version of the FLACC scale: measurement of pain in non-verbal children].

BACKGROUND: The Israeli Ministry of Health requires that every patient have their pain routinely and systematically measured when there are treated in any of the country's medical institutions. Measurement guides treatment and enables follow-up of pain over time. Self-assessment of pain is the gold standard. Measurement is standardized by using scales representing intensity from "no pain" to "unbearable pain". Three-year-olds can assess their own pain, but younger children, or those who are non-verbal due to a medical procedure, cannot. Scales for this population rely on behavioral and physiological parameters, with assessment conducted by caretakers. Of the scales reviewed by the authors, the "FLACC" was chosen as appropriate for routine use due to its brevity and simplicity. AIMS: Translation and establishment of reliability and validity of the Hebrew version of the FLACC. METHODS: Subjects included 53 children aged 2 months to 8 years, who could not communicate verbally. Observations were conducted in the post-anesthesia care unit and the Intensive Care Unit. The FLACC was translated by the translation-back-translation technique. Inter-rater reliability was tested by two independent observers, and validity was assessed before and after provision of intravenous morphine or ketorolac. RESULTS: Inter-rater reliability was high for the total FLACC score (r = 0.94, p < 0.001), as well as for the separate items (kappa 0.5-0.85). The FLACC was considered valid, as the change in scores paralleled the known pharmacological effect of the medications. CONCLUSIONS: The Hebrew version of the FLACC was found reliable and valid for caretakers to use with children who cannot communicate verbally.

Child↗

PubMed2006

Independent prescribing by pharmacists: a study of the awareness, views and attitudes of Scottish community pharmacists.

AIMS: To investigate community pharmacists' awareness, views and attitudes relating to independent prescribing by community pharmacists and their perceptions of competence and training needs for the management of some common conditions. SETTING: Community pharmacies in Scotland. METHOD: A pre-piloted postal questionnaire was mailed to 500 randomly selected community pharmacies in Scotland for completion by the 'main pharmacist'. MAIN OUTCOME MEASURES: Scottish community pharmacists' awareness, views and attitudes towards independent prescribing by community pharmacists; perceived competence and training needs in relation to diagnosis and treatment of conditions in four therapeutic areas; perceptions about patient accessibility to medicines and safety of independent prescribing by community pharmacists; and attitudes towards becoming an independent prescriber. The items regarding perceptions and attitudes were subjected to Principal Components Analysis (PCA) to identify the domains. Univariate analysis was performed on individual items in the questionnaire against total scores on the identified domains; significant variables in univariate analysis were further analysed in linear regression models. RESULTS: A response rate of 43.4% (217/500) was achieved. Despite expressing confidence in their abilities to become independent prescribers and feeling competent in diagnosing and treating those conditions listed in the questionnaire, clinical training prior to implementation of independent prescribing was regarded important by 211 (97.7%) respondents, while 191 (88.4%) regarded clinical training in drugs used for treating the conditions to be important. Gaining improved patient consultation skills and ability to communicate prescribing actions to GP practices were regarded to be important by 125 (57.9%) and 172 (80.0%), respectively. In PCA, three domains--confidence in independent prescribing, satisfaction with the current methods of supply, and requirements for the process of independent prescribing were identified. Practising more hours per week as a pharmacist (p = 0.01), supplementary prescribing training (p = 0.02), and involvement in Scottish Executive pharmaceutical care model schemes (p = 0.02), were found to be associated with greater 'confidence in independent prescribing'. CONCLUSION: High awareness of independent prescribing and perceived competence in diagnosing and selecting appropriate drugs for treating many common conditions were identified. Prescribing training with emphasis on evidence-based medicine, generic issues of prescribing and diagnostic and consultation skills is warranted before independent prescribing is undertaken by community pharmacists.

Attitude of Health Personnel↗

PubMed2003

Statistical process control as a tool for research and healthcare improvement.

Improvement of health care requires making changes in processes of care and service delivery. Although process performance is measured to determine if these changes are having the desired beneficial effects, this analysis is complicated by the existence of natural variation-that is, repeated measurements naturally yield different values and, even if nothing was done, a subsequent measurement might seem to indicate a better or worse performance. Traditional statistical analysis methods account for natural variation but require aggregation of measurements over time, which can delay decision making. Statistical process control (SPC) is a branch of statistics that combines rigorous time series analysis methods with graphical presentation of data, often yielding insights into the data more quickly and in a way more understandable to lay decision makers. SPC and its primary tool-the control chart-provide researchers and practitioners with a method of better understanding and communicating data from healthcare improvement efforts. This paper provides an overview of SPC and several practical examples of the healthcare applications of control charts.

Decision Making, Organizational↗

PubMed2001

Expression of connexin 37, 40, and 43 mRNA and protein in renal preglomerular arterioles.

Gap junctions allow direct intercellular coupling between many cells including those in the vascular wall. Studies of connexin expression in cells of the microcirculatory system are very few in number. However, cell-to-cell communication between cells of the arteriolar wall may be particularly important in microcirculatory control. We investigated the expression of connexins 43, 40, and 37 (Cx43, Cx40, Cx37) mRNA and proteins in primary cultures of smooth muscle cells (SMC) from rat renal preglomerular arterioles and in the aortic cell line A7r5. Furthermore protein expression in preglomerular arterioles in frozen sections was evaluated. SMC were isolated from kidneys using an iron oxide sieve method and explant technique. Total RNA from these cultures was tested by RT-PCR analysis for the expression of the three connexins mRNA. Using immunofluorescence we examined whether the expression pattern of connexin protein in the cell culture and frozen sections corresponded to the mRNA expression. The data show that A7r5 and preglomerular SMC express mRNA for Cx37 in addition to Cx43 and Cx40. In A7r5 cells the mRNA for Cx43, Cx40, and Cx37 are translated to protein, whereas cultured preglomerular SMC and the media of afferent arterioles in frozen sections only showed Cx40 immunoreactivity.

Animals↗

PubMed2000

Prevalence and predictors of low sexual assertiveness

Background: Personal beliefs about sexual attitudes and rights likely affect reproductive health behaviors. We examined the prevalence and predictors of low sexual assertiveness (SA) among sexually active females across three age groups (14-17 yo, 18-21 yo, and 22-26 yo).Methods: 904 white, black, and Mexican-American females presenting at community-based family planning clinics in Southeast Texas between April 1997 and February 1998 completed an anonymous self-report questionnaire that assessed demographic and reproductive characteristics, dating behaviors, mental health measures and occurrence of physical and sexual assault. Subjects also completed a sexual assertiveness scale that assessed one's right to make various reproductive health decisions and sexual communications to partners. A total SA score was obtained by summing the 13 items; scores were then dichotomized so those scoring in the lowest quartile could be compared to the others. Data were analyzed using chi-square and logistic regression stratified by age group (244 aged 14-17; 392 aged 18-21; and 268 aged 22-26).Results: 27% of subjects aged 14-17, 22% aged 18-21, and 17% aged 22-26 were identified as having low SA. For 14-17 years olds, logistic regression analyses revealed that those with low SA as compared to adequate SA were significantly more likely to be Mexican American (OR = 4.8) or black (OR = 3.1) than white, to have hand </= 1 dating partner in the last 12 months (OR = 1.8), and to report inconsistent birth control in last 12 months (OR = 2.0). Among 18-21 years olds, low (SA) was related to reporting forced sexual contact in the last 12 months (OR = 5.2), moderate-to-severe depressive symptoms (OR = 3. 0), no history of physical abuse (OR = 2.5), believing that your partner is monogomous (OR = 2.6), married or living with a male partner (OR = 2.1), </= 3 lifetime sexual partners (OR = 1.8), not using alcohol before sex (OR = 1.8), and gravidity >/= 1 (OR = 1.8). Among 22-26 years olds, low SA was associated with gravidity >/= 1 (OR = 2.8), being a high school dropout (OR = 2.1), and inconsistent birth control use in the last 12 months (OR = 1.9).Conclusions: These data suggest that 1 in 4 sexually active women report low SA and for two age groups these attitudes are associated with inconsistent contraception. Among 18-21 years olds, low SA is also associated with forced sexual contact and depressive symptoms. Thus, efforts to prevent unintended pregnancy and unwanted sexual contact may be more effective if individual levels of SA are taken into account.

Journal Article↗

PubMed2004

Quantitative proteomic analysis of sokotrasterol sulfate-stimulated primary human endothelial cells.

The endothelium forms a continuous monolayer at the interface between blood and tissue and contributes significantly to the sensing and transducing of signals between blood and tissue. New blood vessel formation, or angiogenesis, is initiated by the activation of endothelial cells and is an important process required for various pathological and physiological situations. This study used cleavable isotope-coded affinity tag reagents combined with mass spectrometry to investigate the molecular basis of a recently discovered angiogenesis-promoting steroid, sokotrasterol sulfate. Changes in the relative abundances of over 1000 proteins within human endothelial cells treated with sokotrasterol sulfate and vehicle-treated cells were identified and quantitated using this technique. A method that examines the entire ensemble of quantitative measurements was developed to identify proteins that showed a statistically significant change in relative abundance resulting from treatment with sokotrasterol sulfate. A total of 93 proteins was significantly up-regulated, and 37 were down-regulated in response to sokotrasterol sulfate stimulation of endothelial cells. Among the up-regulated proteins, several were identified that are novel to endothelial cells and are likely involved in cell communication and morphogenesis. These findings are consistent with a role for sokotrasterol sulfate in endothelial sprouting.

Cations↗

PubMed2006

Training multiprofessional trauma teams in Norwegian hospitals using simple and low cost local simulations.

CONTEXT & OBJECTIVE: Norwegian hospitals' trauma teams are seldom exposed to severely injured patients. We developed and implemented a one-day multi-professional training course for hospital trauma teams in order to improve communication, cooperation and leadership. METHODS: Training courses were held in 28 Norwegian hospitals with learning objectives: improved team work, common understanding of treatment priorities and principles, communication skills, and threats to efficient communication. Two trauma teams in each hospital had two consecutive simulations in their hospital's own emergency room, as part of the course. Simulation was based on real cases, with a low-fidelity mannequin as patient. Participants completed questionnaires before and after the training course. RESULTS: A total of 2,860 trauma team members participated in the courses, of which 1,237 took part in the simulation. Independent of hospital size, the participants reported leadership and communication to be major obstacles during their last real trauma team participation. Immediately after the training, all participants reported highly fulfilled educational expectations and a high perception of learning, and taking part in the practical simulation improved the evaluation. Nurses scored their outcome significantly higher than physicians. Participants from minor hospitals reported as great a benefit from the training as personnel from major hospitals. CONCLUSIONS: Local team training is a feasible approach and team simulation offers an excellent opportunity to practise demanding and infrequent challenges. The simulation format makes it possible to integrate training on interpersonal skills as well as communication and leadership under stress. Continued requests for such training in Norway support this conclusion.

Cooperative Behavior↗