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PubMed1984

Current clinical practices in the assessment of velopharyngeal closure.

A questionnaire designed to survey methods of assessing velopharyngeal closure and the extent of training and experience in velopharyngeal assessment was distributed to 256 randomly selected American Cleft Palate Association members. There was a 50% response rate and 94% of those responding were associated with cleft palate teams. Findings included the following: (1) the respondents rely primarily upon the use of listener judgments of spontaneous speech samples, phonological analysis, and lateral view cine/videofluoroscopy; (2) the majority spend thirty minutes or less on an average diagnostic evaluation of velopharyngeal competency; and (3) 45% feel that they are inadequately trained in assessment of velopharyngeal closure.

Cleft Palate↗
PubMed2000

Validation of the side effect and life satisfaction (SEALS) inventory.

Diminished quality of life (QOL) is a common feature of epilepsy. It is generally more severe among patients with poor seizure control but prevalent, to a clinically significant degree, even among those whose seizures are well controlled. People with epilepsy frequently report diminished socialization, negative self image, feelings of stigmatization, reduced earnings potential, and diminished hope and ambition. Problems with antiepileptic drug (AED) therapy are common, and AED therapy is recognized as an important determinant of health-related quality of life (HRQOL). A clinically efficient psychometric instrument is needed to measure its impact. The Side Effect and Life Satisfaction (SEALS) inventory is a 38-item, patient-completed questionnaire designed to measure satisfaction with AED therapy. We tested its construct validity in comparison with three widely used psychometric instruments of similar design, the Profile of Mood States (POMS), the Hospital Anxiety and Depression (HAD) scale, and the Medical Outcomes Study-Cognitive Functioning (MOS-COG) scale. All four instruments were completed by 307 epilepsy patients. A matrix of Pearson's correlations was produced for the SEALS inventory and the comparative instruments. A statistically significant correlation was found for each planned comparison. We conclude that the SEALS inventory is a valid psychometric instrument, well suited for use in clinical investigations of AED therapy and in the practical, long-term management of epilepsy.

Adolescent↗
PubMed2005

Preventing hepatitis C: what do positive injectors do?

The majority of hepatitis C prevention research among injectors is concerned with preventing initial exposure to the virus. Given that the prevalence of hepatitis C among injectors is between 50 and 60 per cent, one aim should be to prevent further transmission of the virus from infected to non-infected injectors. The major aim of this study was to investigate the risk management strategies hepatitis C positive injectors might take to prevent further transmission of the virus. A total of 111 hepatitis C positive injectors were recruited and interviewed with a questionnaire designed to gather information regarding current and past injecting behaviours and risk reduction options outlined in response to a series of injecting vignettes. The responses indicated that the majority of respondents recognised the risks associated with the various injecting scenarios and could describe actions by which they could reduce those risks. However, the examination of reported options revealed that while some of these would indeed eliminate the risk of further transmission others would be less effective because they either relied on unproven methods of removing viral material from used needle and syringes or the user assumed that other injectors had knowledge equivalent to that of the respondent.

Adult↗
PubMed1981

A brief life-graft technique for work with geriatric patients.

Patients aged over 60 or older from the practice of a private physician (n = 32) and from a geriatric outpatient clinic (n = 132) responded to a questionnaire designed to assess perceived present and future health, treatment expectations, and general future projection. Of interest was the extent to which present health, as measured by a brief life-graft technique, might be predictive of perceptions in these other areas. Results from two samples were consistent in suggesting that present health ratings were related to anticipated future health, general future projection, and certain treatment expectations. However, expectations of when benefits from treatment would begin, and of the probable duration of treatment, were not predicted in either sample. The life-graft technique seems useful for practitioners' interactions with older patients and for understanding these patients' extended view of their health.

Aged↗
PubMed1999

Assessing the prevalence and determinants of unwanted pregnancy and induced abortion in Nigeria.

This study was conducted to determine the prevalence and sociodemographic determinants of unwanted pregnancy and induced abortion in the Jos and Ife local government areas of Nigeria. A total of 1,516 randomly selected women aged 15-45 responded to a pretested structured questionnaire designed to elicit information concerning previous unwanted pregnancies and induced abortions in a value-free manner. Nearly 20 percent of the women reported having had an unwanted pregnancy. Of these, 58 percent reported that they had successfully terminated the pregnancies; 32 percent continued the pregnancies; and nearly 9 percent stated that they had attempted termination but failed. Overall, the prevalence of self-reports of induced abortion was 11 percent. The results reveal that information can be obtained on abortion in areas with restrictive abortion policies if an indirect interviewing approach is used.

Abortion, Induced↗
PubMed1998

Are clinical measurements of uncomfortable loudness levels a valid indicator of real-world auditory discomfort?

A recent study revealed that most patients were wearing National Health Service hearing aids that were capable of exceeding their uncomfortable loudness level (ULL) measured clinically (Munro et al., 1996). However, there is little evidence to show that these clinical measurements are a valid indicator of real-world auditory discomfort. The aim of this study was to investigate the relationship between ULL and real-world discomfort. The study involved 20 adult subjects, aged 41-92 years, who had been fitted monaurally with an NHS hearing aid. ULLs were measured using a probe-tube microphone situated close to the eardrum. Individual real ear to coupler differences were added to the SSPL90 in order to predict the maximum power output (MPO) of the hearing aid at the eardrum. Subjects completed a questionnaire designed to rate the loudness of different environmental sounds. The results show that the more the MPO value exceeded the ULL value, the more likely it was that the subjects reported loudness tolerance problems to environmental sounds of long duration. There was a statistically significant correlation between the ULL and discomfort ratings for sounds of longer duration, such as traffic and wind noise; but not for shorter-duration sounds, such as door banging. Subjects did not express real-world auditory discomfort when the MPO value matched the ULL value. These findings support the argument for setting hearing-aid MPO close to ULL.

Adult↗
PubMed2004

Exploring the psychological and somatic impact of identity theft.

Identity theft is a new and growing form of white-collar crime. This exploratory study examined the psychological and somatic impact of identity theft and coping methods utilized by victims. Thirty-seven victims of identity theft participated in regional victim focus groups. Participants completed a victim impact questionnaire designed by the authors and the Brief Symptom Inventory-18 (BSI-18). The majority of participants expressed an increase in maladaptive psychological and somatic symptoms post victimization. Results on the BSI indicated that identity theft victims with unresolved cases, in contrast to those with resolved cases, were more likely to have clinically elevated scores when compared with a normative sample. Relatively similar coping mechanisms were utilized across victims. The results from this study suggest that victims of identity theft do have increased psychological and physical distress, and for those whose cases remain unresolved, distress is maintained over time.

Adaptation, Psychological↗
PubMed2004

[The "Compli'Asthme" therapeutic observation survey on good use of inhaled drugs for asthma: perception by general practitioners].

A cross sectional survey was conducted in 2000 in coordination with the CHIESI medical representatives among 1758 French physicians caring for patients with persistent asthma (80% general practitioners, 20% specialists). This "Compli'Asthme" survey was based on a self-administered questionnaire designed to learn more about the physicians' experience with good use of inhaled drugs and to collect information on therapeutic observance, corticophobia, and use of prescribed inhalers. Poor observance was noted as an important problem by 58-85% of the participants. Most of the problems were related to inability to use the inhaler properly (children, elderly subjects) or to patients forgetting to take their medications (adults, parents). For 58% of the participating physicians, corticophobia is frequent. The patients are worried about the anabolizing effect, secondary effects, and dependence. When there is a potential problem with corticophobia, physicians generally question the patients and provide explanations to achieve good observance. Patient preference is taken into consideration by 86% of the physicians prescribing inhalation devices; 90% demonstrate use of the device at the first prescription and 68% make repeated demonstrations at subsequent consultations. For 56-87% of the physicians, poor therapeutic observance, corticophobia, and poor use of the inhaler can be detected and corrected. Patient education is an important element for 77% of the physicians for improving observance and achieving good use of the inhaler. When poor observance and poor use of the inhaler occur, the physicians responding to this questionnaire applied the currently recommended guidelines.

Administration, Inhalation↗
PubMed1991

Survey of cardiac pacing in Canada.

UNLABELLED: The status of cardiac pacing in Canada in 1989 was determined from data provided by 62 of 128 physicians surveyed (48% response) and four major manufacturer/distributors. A questionnaire designed for the IXth World Symposium on Cardiac Pacing was used. DEMOGRAPHICS: There were five implant hospitals per million population, 65% community based and 35% university affiliated; 63% of implanters were surgeons. There were 279 new implants and 46 replacement procedures per million population. INDICATIONS: Sinus node disorders accounted for 44.6% of implants, atrioventricular block 43.2% (fixed 24.4%, intermittent 12.0%, incomplete 6.8%), tachycardias 2.9%, drug-induced bradycardia 3.1%, and other (including automatic implantable cardioverter defibrillators) 6.2%. TECHNOLOGY: Single chamber units were implanted in 78.6% of patients, and dual chamber in 22.7%, and 19.5% of the total were rate-adaptive. Unipolar leads were used in 57.1% of atrial and 53.2% of ventricular insertions; 40.4% of atrial and 5.8% of ventricular leads were active fixation. The pervenous sheath introducer technique was used in 64.9% of lead insertions. PERIOPERATIVE: Major complications occurred in 2.6% of single and 6.8% of dual chamber primary implants, but mortality was less than 0.1%; 8.4% of replacements were unanticipated; there was no known death from malfunction. Mean hospital stay was 2.7 days for primary implants and 1.4 days for replacement/revisions. CONCLUSIONS: Comparison with prior surveys (1979, 1981, 1985) reveals: increased physician response to the survey questionnaire; relatively stable electrocardiographic indications for implant; a modest increase of new implants per million; continued decrease in replacements; an increase in dual chamber and rate-adaptive pacing; and increased use of active fixation and bipolar electrodes in both atrium and ventricle.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Patient perceptions of factors that affect adherence to dietary regimens for diabetes mellitus.

The purpose of this study was to identify how selected factors influence patient use of diet regimens for diabetes and to determine the effect of demographic characteristics. A survey was conducted using a 75-item questionnaire designed to collect responses from people with non-insulin-dependent diabetes mellitus. Frequency distributions and chi-square analyses were performed on the survey data. Five significant relationships were identified: (1) age and emotions, (2) age and schedule, (3) gender and emotions, (4) use of a diet plan and being told why to control diet, and (5) use of a diet plan and return for follow-up education. Dietitians need to consider demographic characteristics to tailor education sessions and to focus on improving communication with patients to increase their understanding of diabetes. This study showed that increased education promoted increased adherence to dietary recommendations.

Adult↗
PubMed1998

Evaluation of medical locum tenens.

The medical and educational literature reveals no helpful material on applying quality assurance principles to the evaluation of medical locums tenens. The present preliminary study describes the development and analysis of a questionnaire designed to indicate measures of competence in locums and satisfaction by those who supervise them. The sample consisted of 53 doctors recruited from overseas by a single locums agency. No similar studies have been reported and further research would elucidate whether locums who have trained overseas and those trained in Australia are regarded as equally acceptable and competent. Very high scores confirm the perceived skills and knowledge of the locums to be excellent. An overall rating above 4.5 out of 5 and the fact that 41 of 53 doctors had ratings entirely in the 4-5 range indicates that these locums have received excellent acceptance and are regarded as competent.

Australia↗
PubMed1993

A comparison of mail and telephone interview strategies for mental health surveys.

The high cost of mental health surveys of the general population has sparked interest in less costly research methods. Two low-cost mental health survey strategies (mail and telephone) were compared in terms of cost, response rate and quality of data obtained. A total of 1,074 persons agreed to participate in the study as a sample, one-half by telephone and the other half by mail. They completed the Diagnostic Interview Schedule Self-Administered, a questionnaire designed to be self-administered, which was used to assess specific mental disorders and to evaluate risk factors. In addition, 239 respondents who were selected according to the presence or absence of specific diagnoses were reinterviewed face-to-face using the Diagnostic Interview Schedule as an external criterion. The telephone method yielded a better response rate (15% higher) and better control over answers (for example, less missing data). The mail strategy was less expensive and appeared to yield data of slightly better quality, particularly for respondents suffering from anxiety disorders.

Adolescent↗
PubMed1999

Use of topical ascorbic acid and its effects on photodamaged skin topography.

OBJECTIVE: To determine the efficacy of topical ascorbic acid application in treating mild to moderate photodamage of facial skin using an objective, computer-assisted image analysis of skin surface topography and subjective clinical, photographic, and patient self-appraisal questionnaires. DESIGN: A 3-month, randomized, double-blind, vehicle-controlled study. SETTING: Facial plastic surgery private practice. PATIENTS: Nineteen evaluable volunteer sample patients aged between 36 and 72 years with Fitzpatrick skin types I, II, and III who were in good physical and mental health with mild to moderately photodamaged facial skin were considered for analysis. INTERVENTION: Coded, unmarked medications were randomly assigned to the left and right sides of each subject's face, one containing the active agent, topical ascorbic acid (Cellex-C high-potency serum; Cellex-C International, Toronto, Ontario), the other, the vehicle serum (Cellex-C International). Three drops (0.5 mL) of each formulation were applied daily to the randomly assigned hemifaces over the 3-month study period. Treatment assignments were not disclosed to subjects, clinicians, or personnel involved in analyzing skin replicas. MAIN OUTCOME MEASURES: Specific clinical parameters were evaluated and graded on a 0- to 9-point scale (0, none; 1-3, mild; 4-6, moderate; and 7-9, severe). Reference photographs were used to standardize grading criteria. Overall investigator scores were compared with baseline and graded as excellent (much improved), good (improved), fair (slightly improved), no change, or worse. Patient self-appraisal questionnaires rated the degree of improvement (much improved, improved, slightly improved, no change, or worse) and reported adverse effects (burning, stinging, redness, peeling, dryness, discoloration, itching, and rash). Standard photographs were taken at baseline, including anteroposterior and left and right oblique views to facilitate subsequent clinical evaluations, and at the end of therapy for comparison. Optical profilometry analysis was performed on the skin surface replicas of the lateral canthal (crow's feet) region, comparing baseline to end-of-study specimens. Using this computer-based system, the resulting image was digitally analyzed, and numeric values were assigned to reflect surface features. The parameters obtained included Rz, Ra, and shadows. These values provided objective data that document pretreatment and posttreatment texture changes proportional to the degree of wrinkling, roughness, and other surface irregularities. RESULTS: Optical profilometry image analysis demonstrated a statistically significant 73.7% improvement in the Ra and shadows north-south facial axis values with active treatment greater than vehicle control, as well as a trend for improvement in the Rz north-south facial axis parameter, showing a 68.4% greater improvement of active treatment vs vehicle control. Clinical assessment demonstrated significant improvement with active treatment greater than control for fine wrinkling, tactile roughness, coarse rhytids, skin laxity/tone, sallowness/yellowing, and overall features. Patient questionnaire results demonstrated statistically significant improvement overall, active treatment 84.2% greater than control. Photographic assessment demonstrated significant improvement, active treatment 57.9% greater than control. CONCLUSIONS: A 3-month daily regimen of topical ascorbic acid provided objective and subjective improvement in photodamaged facial skin. Skin replica optical profilometry is an objective method for quantification of the skin surface texture changes.

Administration, Topical↗
PubMed2006

Mentoring Cambodian and Lao health professionals in tobacco control leadership and research skills.

DESIGN: The aim of the programme was to ultimately affect public health practice and policy in the Kingdom of Cambodia and Lao People's Democratic Republic (Lao PDR) by training key health professionals to conduct tobacco control research. SETTING: Encouraged by the World Health Organization's Framework Convention on Tobacco Control, a global partnership formed to build effective leadership to develop and guide national tobacco control agendas. The partners were the Ministries of Health (Cambodia and Lao PDR), non-government organisations (Adventist Development and Relief Agency in Cambodia and Laos) and an academic institution (Loma Linda University, Loma Linda, California, USA). SUBJECTS: 16 health professionals, 10 from Cambodia and 6 from Lao PDR, were selected by local advisory committees to enter a two-year, intensive tobacco research graduate certificate and research training programme. INTERVENTION: We developed a "Global Tobacco Control Methods" (GTCM) 28 unit certificate programme that was offered in five sessions from September 2003 to September 2005 at the National Institute of Public Health, Phnom Penh, Cambodia. As part of their coursework, the 16 trainees actively participated in the development and implementation of two research projects. In the first project, "Healthy Doc Healthy Patient" (HDHP), trainees adapted an existing, self-administered questionnaire designed to assess health practices and beliefs of medical students in Cambodia and Lao PDR. The second project involved the design of a national prevalence of tobacco use and health beliefs study in Cambodia using a multi-stage, cluster sample method. Trainees were sponsored to attend and present at international tobacco control conferences to enhance their awareness of the tobacco epidemic. RESULTS: As of September 2005, 14 trainees (8 from Cambodia and 6 from Lao PDR) completed the courses in the GTCM certificate programme. The HDHP study sampled four medical school classes (years 3, 4, 5 and 6) in both Cambodia (n = 330, 71.1% response rate) and Lao PDR (n = 386, 87.3% response rate). As part of the Cambodian adult tobacco prevalence study in Cambodia, 13,988 adults (ages > or = 18 years) were interviewed from all 22 provinces during the summer of 2005. Over the two years, more than half of the trainees participated substantially in local and regional tobacco control and research activities. Programme challenges included the trainees' limited English language and computer proficiency skills, both of which improved during the two years. CONCLUSIONS: With the successful completion of the certificate programme, the remaining two years of the grant will be used to prepare the trainees for positions of leadership within their Ministries of Health and other agencies to implement effective tobacco control policies based on locally-derived research findings.

Cambodia↗
PubMed2001

Assessing service quality in paediatric audiology and early deaf education.

Quality monitoring and assurance is a key aspect of evidence-based service provision in health and education. Part I of the present paper summarizes the results from a survey in which performance of health-based paediatric audiology services in the UK was assessed against existing good practice guidelines (NDCS, 1994, 1996). The results of the survey indicated varied levels of provision, with guidelines commonly not followed. Part II of the paper reports the detailed development of two short questionnaires designed to provide scores (out of 100) reflecting aspects of service quality in paediatric audiology services and in early deaf education services. The results from the use of the two indices (the Paediatric Audiology Service Index (PASI) and the Deaf Education Early Service Index (DEESI)) are presented along with data from some component questions. Although some services are functioning close to guideline levels of service, the overall distribution of scores is such as to raise serious concerns about the variability of quality and the consequent inequity of provision for children with permanent hearing loss and their families in both health and education services.

Age Factors↗
PubMed1978

Computer analysis of allergic histories taken by questionnaire.

We report the development of a detailed allergy questionnaire designed so that the answers can be typed into a mini-computer. Computer programmes have been written to file and to retrieve these answers, and to print a summary which is then 'weighed', so as to produce a clinical atopy score which is then further broken down into indoor and outdoor scores. In a pilot survey of ninety patients, their clinical atopy scores and immunoglobulin E (IgE) profiles have been compared, and additional computer programmes have been written which will (a) assess if a more detailed IgE investigations is warranted, and (b) suggest which allergens, if any, are likely to be responsible for the patients' symptoms.

Adult↗
PubMed1995

Retrospective and prospective psychological and physical health as a function of negative affect and attributional style.

Subjects completed questionnaires designed to assess (a) attributions along internal-external, stable-unstable, and global-specific dimensions subsequent to undersirable events; (b) negative affect; and (c) retrospective psychological and physical health. Subjects then kept weekly records, for 12 weeks, of their visits to doctors and days of illness (prospective physical health) and days they experienced emotional problems (prospective psychological health). Multiple regression analyses that used negative affect and attributional variables as predictors showed that negative affect was the best predictor of retrospective health and that global attributions were the best predictors of prospective health. Analysis of the comparative predictive value of the internal, stable, and global attributions revealed that global attributions were the most significant predictors of retrospective and prospective health.

Adult↗
PubMed1995

Prescribing authority: an examination of Ohio pharmacists' opinions.

This study was conducted to determine the opinions of Ohio pharmacists about possible implementation of prescribing authority for pharmacists in the state. Questionnaires designed to determine pharmacists' opinions were mailed to a random sample of Ohio Pharmacists Association members. The overall net response rate was 44%. A majority of respondents preferred dependent prescribing authority under physician supervision. Respondents favored charging a fee for prescribing, although they did not expect the fee to be large enough to increase income substantially. A majority agreed that pharmacists should pass a qualifying exam and receive formal training to prescribe medications. A large number of respondents agreed that prescribing authority will lead to greater use of generic drugs and lower health care costs. For prescribing authority to succeed, it is suggested that appropriate protocols be developed in consideration of state requirements.

Attitude of Health Personnel↗