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PubMed1999

Universal modular glottiscope system: the evolution of a century of design and technique for direct laryngoscopy.

Since Kirstein introduced formal direct examination (autoscopy) of the glottis in 1895, a great number of laryngoscopes have been produced to view the vocal folds; however, none have had universal appeal. The primary goals for the designs have been to optimize exposure and to facilitate instrumentation of the glottis. An analysis of more than 50 laryngoscopes was done to assess key design characteristics that would ideally be present in a laryngoscope for optimally viewing the musculomembranous vocal folds. The Pro/Engineer and Pro/Mechanica computer programs were used to model the universal modular glottiscope. This new laryngoscope comprises a plurality of specially designed examining tubes that are bivalved proximally to improve utilization of hand instrumentation, and form a single tube distally to achieve internal distention of the supraglottal tissues. The distal lumen has an arcuate isosceles-triangular conformation to optimally expose the glottis. The base of the tube is detachable for the difficult intubation or the placement of bronchoscopes. The examining tubes vary in size and dimension to accommodate the diversity of human anatomy. The tubes are easily attachable to and detachable from an ergodynamically designed universal handle that can be joined to fulcrum laryngoscope holders or suspension gallows. The universal modular glottiscope evolved from the selective integration of optimal 20th-century design modifications of Kirstein's original autoscope. This new laryngoscope is ideally suited for phonomicrosurgery as well as for difficult intubation.

History, 20th Century↗
PubMed1999

Gender differences in health-related practices among university students in northeast Thailand.

The study aims at appraising gender differences in health-related practices, and health behaviour among university students of the Khon Kaen University, northeast Thailand, using a self-administered questionnaire. Of 539 university students, there were 155 males, 384 females, with mean ages 19.7 (+/- 1.2) and 19.6 (+/- 1.1) years, respectively. Persistent health problems were not significantly different between male and female students (12.9% vs. 15.4%). An average body mass index (BMI) was significantly different between male and female students (20.2 +/- 2.1 vs. 19.8 +/- 2.1). Female students reported positive health habits, in terms of drinking, smoking, sun protection, tooth brushing, fruit consumption, conscious efforts to avoid fat and cholesterol, over men, while regular exercise and safety belt use were more likely practised among male students. Using ANOVA and pairwise multiple comparisons, female students demonstrated better health eating habits than men (p = 0.0001). Coronary heart disease preventive habits between the medical and nonmedical faculty was greater for female students than for male students (p = 0.0006 for gender; p = 0.0001 for faculty). Health behaviour (combination of health eating habits, deliberate nutritional practices and coronary heart diseases preventive behaviour) was found to be better practised among women than men (p = 0.0001). These findings, therefore, should focus attention on university students as a target group for health education.

Adolescent↗
PubMed1995

Suicide in Oxford University students, 1976-1990.

BACKGROUND: The aim was to determine the extent, characteristics and timing of suicide in Oxford University students. METHOD: Students who died from suicide or undetermined cause between October 1976 and September 1990 were identified through University records and individual colleges. Information about each student was sought from coroners, college staff, general practitioners and hospital case notes. RESULTS: There were 21 suicides (16 men and 5 women) and one open verdict (female). The observed number of suicides (O) was greater than the number expected (E = 11.09) on the basis of mortality statistics for England and Wales (O/E = 1.89; 95% CI 1.17 to 2.90). When deaths due to undetermined cause were included, however, the difference between O and E (17.03) was much reduced (O/E = 1.29; 95% CI 0.81 to 1.95). There was no evidence of an association with the Finals examination but two-thirds of the students had been worried about academic achievement or their courses. Nearly half appeared to have had a psychiatric disorder (mostly depression). CONCLUSIONS: The much publicised apparent excess of Oxford University student suicides may be partly artefactual. Measures for preventing student suicides include careful induction upon arrival at university, means of alleviating academic stress and worries, and readily available and closely associated student counselling and psychiatric services.

Cause of Death↗
PubMed2006

Audit of pregnancies complicated by diabetes from one center five years apart with selective versus universal screening.

The article compares the effect of selective and universal screening on detection rate and outcomes of pregnancies complicated by diabetes mellitus (DM) in a multiethnic population. The method used was to review the pregnancy and delivery of two 18-month periods, 5 years apart. In the year 1996-1997 when selective screening was used 315 (5.7%) of 5506 delivered women had diabetes during pregnancy. The rates of diabetes in the different ethnic groups were: UAE (4.4%), Peninsula Arabs (4.0%), Chami Arabs (4.5%), North African Arabs (6.7%), Indian subcontinent (7.5%), and Somalis and Sudanese (9.7%). The rate of diabetes among the different ethnic groups for the year 2001-2002 when screening was universal but diagnosis made by the same criteria were 590 (9.7%) of 6232 delivered women, UAE (9.2%), Peninsula Arabs (8.4%), Chami Arabs (8.2%), North African Arabs (9.6%), Indian Subcontinent (11.0%), Somalis and Sudanese (11.3%). The outcome indicators and their rates in the years 1996-1997 and 2001-2002 were respectively: gestational diabetes, 86.3%, 89.0%; requirement of insulin treatment, 74.3% 82.5%; vaginal delivery, 68.2%, 75.3%; cesarean section, 30.3%, 19.8%; macrosomia, 22.2%, 6.7%; intrauterine fetal death, 2.9%, 1.1%; and preterm delivery, 22.5%, 17.5%. This article confirms the influence of ethnic background on the prevalence of gestational diabetes in a multiethnic and multicultural society. Over a period of 5 years, there was a 66.7% increase in the incidence of gestational diabetes, which was probably due to a combination of increased detection by change in screening policy and an increase in the incidence of gestational diabetes. The indicators of disease severity and control, such as insulin requirement, rates of abdominal delivery, macrosomia, and structural congenital malformations, were significantly better in a cohort identified by universal screening compared with that identified by selective screening. Universal screening seems to be a more appropriate strategy for screening in this environment.

Diabetes Complications↗
PubMed1979

The universality of generalized personality statements.

Researchers for three decades have assumed that generalized personality statements are nearly universally valid. In this study, undergraduate students indicated whether generalized personality statements were "true" or "false" as applied to themselves; then these same students and a group of graduate students estimated the percentage of college students who would answer each generalized statement "true." Only 7 of the 12 commonly-used, generalized personality statements were found to be nearly universally valid among the undergraduates; the other 5 were answered "true" by fewer than two-thirds of the undergraduates. Both groups undergraduates and graduate students were very accurate in estimating the percentage of students who would respond "true" to each statement. Thus, many supposed generalized statements are not nearly universally valid, and students are cognizant of the degree of universality of generalized statements. Results of prior research based on inappropriate assumptions about generalized statements must be viewed cautiously.

Journal Article↗
PubMed1997

Single payers and multiple lists: must everyone get the same coverage in a universal health plan?

In spite of recent political setbacks for the movement toward universal health insurance, considerable support remains for the idea. Among those supporting such plans, most assume that a universal insurance system, especially if it is a single-payer system, would offer a single list of basic covered services. This paper challenges that assumption and argues for the availability of multiple lists of services in a universal insurance system. The claim is made that multiple lists will be both more efficient and more fair. Any single list will fund some services that are quite attractive to some people, but only marginally attractive to others. Thus any single-list plan will fund some services that produce only marginal benefit for the resources used. Moreover, since some people will hold values quite compatible with the single list and others will hold values leading to preferences for unfunded services, some people will get much more benefit from any single list than other people will. Fairness and efficiency require providing an entitlement to universal access to health insurance that could be purchased by typical consumers for a fixed price of perhaps $3500. By permitting everyone to pick their preferred list of services available at that price, each person will efficiently use his or her entitlement while getting more equal opportunity for benefits.

Abortion, Induced↗
PubMed2004

Analytical validation of the tag-it high-throughput microsphere-based universal array genotyping platform: application to the multiplex detection of a panel of thrombophilia-associated single-nucleotide polymorphisms.

BACKGROUND: We have developed a novel, microsphere-based universal array platform referred to as the Tag-It platform. This platform is suitable for high-throughput clinical genotyping applications and was used for multiplex analysis of a panel of thrombophilia-associated single-nucleotide polymorphisms (SNPs). METHODS: Genomic DNA from 132 patients was amplified by multiplex PCR using 6 primer sets, followed by multiplex allele-specific primer extension using 12 universally tagged genotyping primers. The products were then sorted on the Tag-It array and detected by use of the Luminex xMAP system. Genotypes were also determined by sequencing. RESULTS: Empirical validation of the universal array showed that the highest nonspecific signal was 3.7% of the specific signal. Patient genotypes showed 100% concordance with direct DNA sequencing data for 736 SNP determinations. CONCLUSIONS: The Tag-It microsphere-based universal array platform is a highly accurate, multiplexed, high-throughput SNP-detection platform.

Genotype↗
PubMed1993

Preventive therapy for the patient with both universal indication and contraindication for isoniazid.

BACKGROUND: The delphi method of decision making was used to address an unusual clinical case in which various aspects of the case required opposing management strategies. METHODS: A panel of 30 pulmonary experts was surveyed repeatedly until a convergence of treatment approaches was reached for a patient who was considered to have both a universal indication for and a universal contraindication against prevention therapy. Participants were asked to evaluate the appropriateness of proposed treatments on a scale from 1 to 9, with 1 being extremely inappropriate, 5 being equivocal, and 9 being extremely appropriate. The delphi survey data responses were compared using measures of central tendency (ie, the mean and median) and measures of variability (ie, the standard deviation and interquartile range). RESULTS: Although no treatment was wholeheartedly supported by the experts, analysis of the three-round delphi survey responses resulted in two possible treatments: rifampin, 600 mg daily, for four months, or no treatment with close observation. Interestingly, the experts working in a non-university setting favored the rifampin treatment, and those working in a university setting favored no treatment with close observation. CONCLUSIONS: The delphi method has the potential to be used for clinical decision making.

Adult↗
PubMedDate not supplied

[University-trained nurses in Mexico: an assessment of educational atrition and labor wastage].

OBJECTIVE: To estimate and analyze the rate of wastage among university-trained nurses during their training period and in the labour market. MATERIAL AND METHODS: Wastage at the training stage was estimated using data from ANUIES for the 1978-2002 period. We used the 2000 Population and Household Census database to estimate job market wastage. Concepts and formulas were defined for the valuation of both areas. RESULTS: The Rate of Education Wastage (TDE) for the generation cohort finishing in the year 2002 reached 252 per 1000, far below the 1987 rate, which was 555 per 1000. Regarding the job market, 55.2% of the total graduates who finished university studies and carried out post-graduate studies in nursing, now perform paid activities in the field of nursing, 15.4% work in activities different from their original training, and 16.2% are dedicated to household duties. The Global Rate of Labor Wastage (TGDL, per its abbreviation in Spanish) is 410 per 1000 thousand who obtained a degree in nursing at the university. CONCLUSIONS: There is an important degree of wastage in the population holding a university nursing degree, both in the training and in the job market areas, an unacceptable situation that calls for immediate action by incumbent institutions.

Education, Nursing↗
PubMed1997

[Evolution of the demand for the undergraduate nursing course at the Federal University of San Carlos].

This study analyzes the evolution of demand for the nursing undergraduate course of Federal University of São Carlos (UFSCar), from the first entrance examination in 1977 to 1996. The economic crises and the crises in health social programs affected significantly the demand for this entrance examination which declined abruptly 1980. During 1990, the demand for this nursing program was two candidates per chair, the lowest level since its foundation in 1977. From 1991, the recovery of the Brazilian economy associated with a change in the health care system were responsible for the increasing in the demand of nursing professionals. In 1990 the entrance examination started to be done by another institution (FUVEST, one state foundation responsible for this examination). The FUVEST was already responsible for the entrance examination for two others são Paulo State Universities. Starting in 1990 the candidates could compete simultaneously for the nursing program at the three universities through the same entrance examination. The UFSCar always was the last option for the candidates among those universities. However, the candidate demand for that program at UFSCar, as the first option, increased to six candidates per chair in 1995 with a small decrease in 1996 (4, 6 candidates/chair). During 1982 and 1986, respectively three and six chairs, out of 30 offered by UFSCar, were not taken, this number increased to 15 during 1990. This great decrease in the interest for this nursing program, during 1990 could be attributed to three factors: First, the decrease in the candidate numbers that applied for this examination (around 2/1). Second, the degree of difficulty of the examination requirement. Third, the bureaucratic procedures that the candidates had to fulfill, after being approved, to get enrolled in the program.

Brazil↗
PubMed2002

Toward a universal standard: comparing two methods for standardizing spotted microarray data.

DNA microarray technology has allowed the transcriptome to be studied to a depth that was inconceivable only 10 years ago. Until recently these studies were isolated because, without a universal standard, the results from experiment to experiment and laboratory to laboratory were not directly comparable. For human microarrays, this problem has been addressed by numerous methods, but only two are truly universal. The first method uses genomic DNA as a standard for comparison since it is, by definition, complete and universally available. The second method employs a highly representative total RNA pool such as the one currently available from Stratagene. To determine the advantages and disadvantages of both methods, they were directly compared by hybridization to the University of Texas Southwestern Medical Center's 4000- or 10800-member human cDNA array, using typical microarray techniques. The labeled analytes were 2 microg normal human genomic DNA labeled by nick translation or 20 microg total RNA pool labeled by reverse transcription. The resulting data were then background-subtracted, analyzed, and the number of spots above a background threshold was compared in each sample. Using the McNemar test and a Yate's correction with one degree of freedom, the samples were statistically identical with chi2 = 3.72.

DNA↗
PubMed2006

Median and ulnar neuropathies in university guitarists.

STUDY DESIGN: Descriptive study. OBJECTIVES: To determine the presence of median and ulnar neuropathies in both upper extremities of university guitarists. BACKGROUND: Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Guitarists and plucked-string musicians are at risk for entrapment neuropathies in the upper extremities and are prone to mild neurologic deficits. METHODS AND MEASURES: Twenty-four volunteer male and female guitarists (age range, 18-26 years) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Individuals were excluded if they were pregnant or had a history of recent upper extremity or neck injury. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. RESULTS: Six subjects had positive findings on provocative testing of the median and ulnar nerves. Otherwise, these guitarists had normal upper extremity neural and musculoskeletal function based on the history and physical examinations. When comparing the subjects' nerve conduction study values with a chart of normal nerve conduction studies values, 2 subjects had prolonged distal motor latencies (DMLs) of the left median nerve of 4.3 and 4.7 milliseconds (normal, < 4.2 milliseconds). Prolonged DMLs are compatible with median neuropathy at or distal to the wrist. Otherwise, all electrophysiological variables were within normal limits for motor, sensory, and F-wave (central) values. However, comparison studies of median and ulnar motor latencies in the same hand demonstrated prolonged differences of greater than 1.0 milliseconds that affected the median nerve in 2 additional subjects, and identified contralateral limb involvement in a subject with a prolonged distal latency. The other 20 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities. CONCLUSIONS: In this descriptive study of a population of 24 university guitarists, 4 musicians (17%) were found to have electrophysiologic evidence of median neuropathy at or distal to the wrist or carpal tunnel syndrome. Ulnar nerve electrophysiological function was within normal limits for all subjects examined.

Adolescent↗
PubMed2000

Universal neonatal hearing screening--parental attitudes and concern.

This study addresses parental attitudes and concern in relation to universal neonatal hearing screening by otoacoustic emissions (OAE) testing. The parents of 87 children who had participated during the first year of the universal neonatal hearing screening programme at University Hospital, Linköping, Sweden were included in the study. These children were all tested during this period and later cared for at three well-baby clinics (part of their primary healthcare). A questionnaire was given to the parents during routine medical check-ups at the well-baby clinics when the infants were 5-6 months of age. Ninety-five per cent of parents stated that they had a positive attitude towards neonatal hearing screening, 1% were ambivalent and 4% were negative about it. The parents wanted early detection of hearing loss and the possibility of early intervention. It was also found that screening did not disturb the children. A few parents were anxious due to repeated testing of their children. The information provided in connection with the test was found to be sufficient by 77% of parents, whereas 11% of parents had negative comments about it (e.g. they wanted more information about the otoacoustic emissions technique). The general attitude among parents towards universal neonatal hearing screening was very positive in that they felt reassured by it. The risk of disturbing the parent-child relationship by early screening seems to be small, and could be further minimized by improved information and rapid and effective follow-up.

Attitude to Health↗
PubMed1998

Evaluation of universal preenrichment broth for the recovery of foodborne pathogens from milk and cheese.

The use of universal preenrichment broth for the recovery of verotoxigenic Escherichia coli, Salmonella spp., and Listeria monocytogenes from milk and cheese was examined. Universal preenrichment broth supported the growth of low inoculum levels (10 cfu/ml) of these organisms in pure cultures and in mixed cultures containing higher levels of other pathogens or bacterial flora from raw milk. This medium also supported the recovery and growth of heat-injured Salmonella spp., L. monocytogenes, and verotoxigenic E. coli at inoculum levels of 10(2) cfu/ml to yield cell levels of 10(8) cfu/ml in pure cultures and at least 10(5) cfu/ml in the presence of high levels of known competitive pathogens or microflora of cheese samples after 24 h of incubation. Universal preenrichment broth performed better than Listeria enrichment broth in supporting the recovery and growth of heat-injured L. monocytogenes and equally as well as buffered peptone water or trypticase soy broth in supporting the growth of uninjured L. monocytogenes, Salmonella spp., and verotoxigenic E. coli. Coenrichment of these pathogens in universal preenrichment broth reduced the quantity of milk or cheese samples that were required for analysis and also reduced the cost and labor involved in preparing and processing separate preenrichment media.

Animals↗
PubMed2002

Reduction in the hepatitis B related burden of disease--measuring the success of universal immunisation programs.

There is collective evidence from countries of both low and high endemicity that administration of hepatitis B vaccination at birth saves lives and reduces the burden of disease from acute and chronic infection. However, a discussion on the cost-effectiveness of vaccination for HBV is beyond the scope of this article. In Australia, longer term follow-up of HBV disease burden is required following the more recent introduction of routine and universal infant vaccination. Universal vaccination for HBV at birth can be seen as a 'safety-net' against infection at a very young age. However, it is estimated that the effect of universal infant vaccination will not be evident for at least another 15 years in Australia. The obstacles to vaccination with HBV, which have historically included fears that the vaccine may be linked to multiple sclerosis, should be put to rest, and concerns about the thiomersal content allayed by communicating the current availability of thiomersal-free vaccines to all providers and parents or care-givers. Furthermore, ongoing adverse events surveillance should be in place to detect any rare adverse events which may be related to the vaccine. Currently, more than one half of the world's infants are still not being immunised for HBV, and the need for a global initiative for universal infant hepatitis B vaccination is apparent. This is especially true for countries with high prevalence, and the costing issues and logistics of such an initiative still remain to be addressed. In addition, there is a need to address the implementation of guidelines for screening and vaccination of families who have immigrated to Australia from countries with a high prevalence of hepatitis B.

Australia↗
PubMed2003

[Symptoms, depression, and coping behaviors of university students].

PURPOSE: The purpose of this study was to examine the relationship among subjective symptoms, depression, and stress coping behavior of university students. METHOD: The survey was carried out on a convenience sample of 298 university students. The questionnaire consisted of each scale for symptoms, depression, and stress coping behaviors. Data analysis procedure included the factor analysis for stress coping behaviors, and the correlation analysis describing a relationship among symptoms, depression, and stress coping behaviors. RESULT: There were significant correlations between depression and the three types of symptoms : general, psychological, and somatic symptom. Subjects using the negative-emotional-response coping and the self-control coping showed a more severe depression, and those using the problem-solving reappraisal coping and the positive-emotional-response coping showed a milder depression. Subjects using the negative-emotional-response coping complained of all 3 types of symptoms severely, and those using the positive-emotional-response coping complained of general symptoms mildly. Of five stress coping methods, the negative-emotional-response and the positive-emotional-response coping methods were related to both symptoms and depression significantly. CONCLUSION: This study suggests that the emotional-oriented coping method has more important role for university student's depression and their subjective symptoms than the problem-oriented coping or social supports seeking coping. Further study needs to be conducted to help students effective coping mechanism for good mental health. Also it is necessary for university students to recognize that their symptoms are associated with depression.

English Abstract↗
PubMedDate not supplied

Specialisation patterns of medical graduates, University of Malawi College of Medicine, Blantyre.

OBJECTIVE: To describe specialization patterns of medical graduates of the University of Malawi College of Medicine. DESIGN: Cross sectional study. SUBJECTS: Medical graduates of the University of Malawi College of Medicine. SETTING: University of Malawi College of Medicine. MAIN OUTCOME MEASURES: Speciality choices, sources of funding for training, employer at time of graduate studies and country where specialist training obtained. RESULTS: Between 1991 and 2000, 60 (35.5%) of the 169 graduates of the College of Medicine of the University of Malawi have obtained or are in specialist training, 38/60 (63.3%) with training institutions either in the United States or the United Kingdom, 10 (16.7%) had gone to South Africa, 8% Kenya, 5% to the Republic of China (Taiwan) and 3.3% to Uganda. Other countries are; Uganda, Australia and Finland. The preferred specialties were; Public Health 17 (28.8%), Internal Medicine 12 (20%) and Paediatrics 10 (16.7%). Most of the funding was provided by agencies/institutions in the USA and UK. At the time of their training fellowship, 33 (55%) of the candidates were employed by the College of Medicine, 24 (40%) by the public service and the rest, three (5%) by other institutions. CONCLUSIONS: Most Malawian medical graduates are obtaining their specialty training overseas funded mostly by institutions/agencies in the UK and USA. There is need to explore ways on how training could be provided regionally. Malawi and her neighbours must develop post graduate speciality training locally and regionally.

Career Choice↗
PubMed2004

Dietary selenium and copper intake by resident undergraduate students of the University of Ghana.

OBJECTIVES: To determine and evaluate dietary intake of selenium and copper by resident undergraduate students of the University of Ghana. DESIGN: Prospective/comparative study. SETTING: The university of Ghana, Legon, Accra. SUBJECT: One hundred and fifty undergraduate resident students in five out of seven halls of residence of the University of Ghana. MAIN OUTCOME MEASURES: Pre-tested structure questionnaires were administered to informed students to obtain personal data, intake of selenium, copper and/or multimineral supplements and foods consumed as well as frequency of consumption. A twenty four hour food intake on two non-consecutive days, were used to determine food intake. Selenium and copper levels in the foods identified were determined using Atomic Absorption Spectrophotometer (AAS) and compared to the respective RDAs to assess intake adequacy/inadequacy. RESULTS: None of the students interviewed took in selenium or copper supplements, although 2% took in multi-mineral supplements, which contained insignificant levels of selenium and/or copper. In the case of copper, 7.3% (11/150) met 75-100% of the RDA, while 1.3% (2/150) met the RDA in the case of selenium. As many as 15.3% (23/150; in the case of copper) and 83% (123/150; in the case of selenium) did not meet the required intakes. However, 77% (116/150) had excess intake of copper while 15.7% (25/150) took excess selenium. CONCLUSION: Due to the importance of these micronutrients and in the face of poor nutritional status, as judged by the few that met the required RDAs as well as excess, there is a need to carry out blood analyses to determine whether the dietary pattern has been translated systemically. If indicated, the University authorities must consider mounting nutritional education to ensure that those deficient take in the required levels while those consuming excess are made to cut down on their intakes, since both deficient and excess status have physiological consequences.

Adult↗