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PubMed1997

Alcoholism in a geriatric outpatient clinic of São Paulo-Brazil.

Alcohol abuse and dependence are an increasing health problem among the elderly, but there is only scanty information about their prevalence and associated risk factors in developing countries. The authors set out to evaluate the prevalence and associated clinical/demographic features of alcoholism in a sample of male elderly subjects attending a Geriatric Primary Health Outpatient Clinic in a State University Hospital in the City of São Paulo-Brazil. Three hundred four patients were assessed with the Brazilian version of the Michigan Alcoholism Screening Test and a semistructured questionnaire designed to investigate associated features. Lifetime alcoholism was present in 15.1% of the sample, although only 4.3% were active drinkers. Patients classified as "cases" were younger than their nonalcoholic counterparts (70.61 vs. 73.31), and there was a mild, though not significant, excess of Blacks and Mulattos among the former (32.6% vs. 15.9%). Cases were also more likely to rely on their family for financial support (59.0% vs. 43.5%) and to acknowledge a positive family history of alcoholism (51.4% vs. 31.2%). Alcohol abuse or dependence was further associated with heavy smoking (58.7% vs. 44.0%). The authors concluded that alcoholism in this Brazilian elderly sample was likely to be associated with an earlier age at onset of medical problems, financial dependence, Black/Mulatto race, smoking, and positive family history of alcohol abuse/dependence. The authors suggest that the use of standardized methods of assessment of alcoholism in general medical settings may increase the detection of cases and contribute to improved health measures for the management of these patients.

Aged↗
PubMed2006

[Detection of anti-Lassa antibodies in the Western Forest area of the Ivory Coast].

Lassa fever is an African viral hemorrhagic fever (VHF) known to be endemic in a number of West African countries including Nigeria, Sierra Leone, Liberia and Guinea. Despite having common borders with Liberia and Guinea, Côte d'Ivoire has never reported any cases of Lassa fever. In March 2000, as part of a research project on VHF--mainly yellow fever, Lassa fever and Ebola fever--in Guinea and Cote d'Ivoire, an exploratory survey was conducted to assess knowledge about VHF and immunological status against Lassa virus among forest workers in the Duekoue and Guiglo regions. One hundred and sixty-three male forest workers were interviewed using a questionnaire designed to assess risk factors for VHF exposure and personal medical history over the last 12 months. Detection of IgG antibodies against Lassa virus was performed by immunofluorescence assay with Lassa virus antigens from the Josiah and Las/AV strains. The overall prevalence of IgG antibodies was 26% (42/161). Among the Lassa IgG positive subjects, 38.5% were loggers including 20% that were positive at a serum dilution of 1/40 and 46.7% were national park workers or forest rangers including 69% that were positive at a dilution of 1/40 and more. Forty-one percent of subjects had heard of VHF including 14% who attributed it to animals and 2% who attributed it to plants. Contact with rodents was frequent and more than 50% of subjects had either eaten or skinned rodents. Although the prevalence of anti-Lassa IgG antibodies seemed high in the study population, no conclusion can be about level of exposure to Lassa virus.

Adult↗
PubMedDate not supplied

Drug compliance among hypertensive patients in Port Harcourt, Nigeria.

BACKGROUND: Hypertension contributes significantly to cardiovascular morbidity and mortality. Adequate blood pressure control would therefore reduce cardiovascular morbidity and mortality, however adequate blood pressure control requires good treatment compliance. METHODS: One hundred consecutive patients aged 30-79 years attending the cardiac clinic of the medical out-patients clinic of the University of Port Harcourt Teaching Hospital were directly questioned about compliance with their antihypertensive drugs and results entered into the questionnaire designed for the study. RESULTS: Compliance was good in sixty percent (60%) of respondents, fair in twenty nine percent (29%) and poor in eleven percent (11%). Compliance was also found to be good in sixty-seven percent (67%) of patients with tertiary education, good in forty one percent (41%) of those with primary education. Compliance was good in seventy four percent (74%) of those taking one drug, good in only thirty three percent (33%) of those taking four drugs. Patients taking single daily dose drugs had good compliance in seventy percent (70%), twice daily dosing had good compliance in fifty five percent (55%) and among those taking thrice daily dosage, compliance was good in only seventeen percent (17%). CONCLUSION: The study shows that good compliance with anti-hypertensive therapy is best achieved with monotherapy given as single dosage. It also shows the role of education in the level of compliance.

Adult↗
PubMed1993

The milk-mucus belief: sensory analysis comparing cow's milk and a soy placebo.

A questionnaire designed to measure the "milk mucus effect" was based on sensations and symptoms after drinking milk reported in interviews with 169 individuals, 70 of whom held the belief that milk produces mucus. This was used to measure responses in a randomized, double-blind trial of a flavoured UHT cow's milk drink, compared with a similarly flavoured and constituted UHT soy milk drink. The soy placebo was indistinguishable from cow's milk in a pretest of 185 individuals. Of 14 milk-mucus effect indicator variables, three showed significant increases after consumption of 300 ml of the test drink. These were "coating/lining over the mouth, throat or tongue" (39% increase), "need to swallow a lot" (31% increase) and "saliva thicker, harder to swallow than before" (42% increase). However, these increases occurred in both milk and placebo groups. It is concluded that the effect measured is not specific to cow's milk, but can be duplicated by a non-cow's milk drink with similar sensory characteristics.

Animals↗
PubMed1999

Support for the availability of prenatal testing for neurological and psychiatric conditions in the psychiatric community.

Faculty and residents of the University of Michigan Department of Psychiatry, members of the Alliance for the Mentally Ill (AMI), and university students were surveyed to elicit attitudes toward the availability of prenatal testing and genetic therapy or enhancement for early- and late-onset psychiatric diseases compared to neurological disorders and human traits. They were asked to complete a written questionnaire designed to assess their opinions as to whether prenatal testing and genetic therapy or enhancement should be applied to 16 selected "disease" phenotypes or human traits: eight early- and late-onset psychiatric conditions, four neurological disorders, and four human traits. Twenty-two percent returned the written survey. The majority of all respondents supported the availability of prenatal testing for well-defined, serious psychiatric or neurological phenotypes and found testing for human traits less desirable. The percentages of respondents supporting availability of testing increased if in utero curative gene therapy was available. Response to the survey differed on the basis of gender and age, as well as personal versus professional familiarity with the condition. The results of this pilot study suggest that a majority of the population, including psychiatrists, will support the public availability of prenatal diagnosis for serious psychiatric or neurological phenotypes, even if no in utero curative therapy is available. Support for testing for human traits was not strongly endorsed.

Adult↗
PubMedDate not supplied

Self-reported HIV and AIDS experience, practices, and knowledge of Pennsylvania family physicians.

BACKGROUND: Patients with disease caused by the human immunodeficiency virus (HIV), while still more commonly treated in urban settings, are being seen in nonurban areas in numbers rapidly outstripping the local availability of specialists with expertise in HIV or acquired immunodeficiency syndrome (AIDS). METHODS: A questionnaire designed to measure self-assessed experience, practices, and knowledge regarding basic aspects of HIV was mailed in 1989 to the 2177 members of the Pennsylvania Academy of Family Physicians. RESULTS: The response rate was 72 percent. Approximately 95 percent of physicians surveyed had been asked questions by patients about AIDS, 30 percent had a patient with a confirmed positive blood test, and 27 percent had a patient with symptomatic HIV disease in their practice. CONCLUSIONS: Although most family physicians indicated that they were comfortable in recognizing persons at risk, counseling, and using tests to diagnose HIV and AIDS, more than one-half reported practice patterns at variance with published guidelines. Respondents were most uncomfortable with their knowledge and skills regarding legal issues, state and community resources, and caring for patients with AIDS. Continuing medical education courses at local hospitals and written materials were the two methods of AIDS education most likely to be used by respondents.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Purchasing infant shoes: attitudes of parents, pediatricians, and store managers.

Questionnaires designed to collect data about the purchase of shoes for normal infants were completed by 104 parents in a university ambulatory unit, 127 practicing pediatricians, and 36 shoe store managers. Infants received their first pair of walking shoes at an average age of 8.1 months (range: 4 to 12 months) and at an average cost of $14.56 (range: $2 to $43). Most of these shoes had laces (95%), high tops (87%), hard soles (74%), and special arch supports (50%). Of the 104 children, 73 had shoes before they were walking (average cost: $13.21) and 35 wore walking shoes before they were even standing (average cost: $12.68). Parents obtained much more information about shoes from friends and relatives than from physicians. Those parents who obtained most of their information from salespersons spent the most for shoes. The average cost of shoes recommended by store managers was $18.74. Although 77% of pediatricians felt that inexpensive canvas sneakers are adequate, only 28% of the salespersons and 37% of the parents believed that wearing sneakers is healthy.

Attitude↗
PubMed2005

Psychological distress of patients undergoing intensified conditioning with radioimmunotherapy prior to allogeneic stem cell transplantation.

This is a pilot study comparing the emotional distress of patients receiving an intensified conditioning regimen (radioimmunotherapy=RIT) with patients receiving conventional conditioning for allogeneic stem cell transplantation. In total, 53 patients (18 received RIT) were given two questionnaires designed to measure emotional distress (HADS, POMS) before starting conditioning (t1) and at discharge (t2). During the in-patient period, patients answered questions daily relating to physical distress, psychological distress, and how they were "coping with the situation". At t2, the transplant team assessed the manner in which the patients were coping. The data displayed no relevant differences with regard to emotional distress between the two groups, both at t1 and t2. For both groups, anxiety and vigor decreased and fatigue increased between t1 and t2. On average, perceived distress was higher for those patients being treated with RIT during the in-patient time, but the differences between both groups were significant only regarding physical distress during the recovery period. No difference was found for the transplant team's assessment. We hypothesize that an intensified conditioning regimen with RIT per se has only a small distressing effect on the patients' psyche during their stay at the hospital. Differences between both groups probably result from independent factors such as, for example, the patients' pre-existing health conditions.

Adult↗
PubMed2004

Exploring the links between depression, integrity, and hope in the elderly.

OBJECTIVE: To explore the links between depression, integrity, and hope in the elderly. METHOD: For this pilot study, we recruited a voluntary sample of cognitively intact elderly patients receiving psychiatric care (n = 35). Recruitment sources included an inpatient geriatric psychiatry unit (n = 14), a geriatric psychiatry day program (n = 6), and an outpatient geriatric psychiatry service (n = 15). Participants completed a questionnaire designed to measure depression, acording to the Geriatric Depression Scale Short Form (GDSSF); integrity, according to the Sense of Coherence Scale-Short Form (SOC-13); and hope, according to the Hope Differential-Short (HDS) and the Hope Numerical Rating Scale (Hope-NRS). The HDS consists of 3 separate subscales: Personal Spirit, Risk, and Authentic Caring. We analyzed the data, using descriptive statistics, t tests, and Pearson correlations. RESULTS: Patients with no depression (n = 17) showed a greater sense of coherence (SOC) (P < 0.01), higher levels of hope (Hope-NRS, P < 0.05), enhanced Personal Spirit (HDS subscale, P < 0.05), and greater risk taking (HDS subscale, P < 0.01) than did patients with depression (n = 18). The 2 variables that correlated most highly with depression were SOC (r = -0.65, P < 0.01) and Risk (HDS subscale, r = -0.62, P < 0.01). CONCLUSIONS: These findings suggest that depression, integrity, and hope are highly interrelated in the elderly population and may influence mastery of the developmental tasks of aging. Further research is warranted to better understand these complex experiences in late life.

Aged↗
PubMed1991

Substance use among senior medical students. A survey of 23 medical schools.

Senior students at 23 regionally distributed medical schools received an anonymous questionnaire designed to examine current and prior use of tobacco, alcohol, and nine other drugs. The overall response rate was 67% (N = 2046). Substance use prevalence rates during the 30 days preceding the survey included alcohol, 87.5%; marijuana, 10.0%; cigarettes, 10.0%; cocaine, 2.8%; tranquilizers, 2.3%; opiates other than heroin, 1.1%; psychedelics other than LSD (lysergic acid diethylamide), 0.6%; amphetamines, 0.3%; barbiturates, 0.2%; LSD, 0.1%; and heroin, 0.0%. Compared with national, age-related comparison groups, senior medical students reported less use of all substances during the past 30 days and the past 12 months, except for alcohol, tranquilizers, and psychedelics other than LSD. Substantial new drug use after entry into medical school was reported only for tranquilizers. Seven students (0.2%) admitted to current dependence on a substance other than tobacco, four of these implicating marijuana. Thirty-three students (1.6%) believed that they currently needed help for substance abuse. Only 25.7% were aware of any policy on substance abuse at their own school.

Adult↗
PubMed2004

Prevalence of Hymenoptera venom allergy and its immunological markers current in adults in Poland.

BACKGROUND: The prevalence of insect venom allergy is still being assessed. The aim of our study was to estimate, on the basis of an interviewer-administered questionnaire survey, the frequency of post-sting allergic reactions and venom sensitization. MATERIAL/METHODS: The study was performed within the framework of the ECRHS. A random sampling of 3000 persons was selected from among 68,000 persons living in the area of Wrocław, Poland. Of the 2050 persons responding to a mailed screening questionnaire, 169 were randomly selected to complete a questionnaire designed only for insect allergy detection. Venom skin test and sIgE assessment were performed on 146 and 132 patients, respectively. RESULTS: Allergic post-sting symptoms were found in 20.7% of surveyed patients. Large local reactions (LLs) occurred in 11.8% and systemic reactions (SYSs) in 8.9% of the study population. SYS was most often manifested by urticaria (4.7%). The frequencies of SYS II, III and IV were 1.8%, 1.8%, and 0.6%, respectively. Only LLs were more frequent in subjects with other allergic diseases (p=0.03). The presence of positive skin tests and/or sIgE in serum were 42.8% of subjects with LL, 53.3% with SYS, and 17.1% of "asymptomatic" patients. No significant differences were found between these groups regarding venom skin test results and sIgE serum concentrations. Occurrence of sIgE to bee venom was frequently associated with the presence of sIgE to timothy grass. CONCLUSIONS: Insect venom allergy and asymptomatic venom sensitization in adults are common in Poland. Only some venom allergy cases are IgE dependent.

Adult↗
PubMed1999

The influence of social class, strain and social support on symptoms of anxiety and depression in mothers of toddlers.

BACKGROUND: The aim of the study was to identify risk and protective factors for anxiety and depression among mothers of toddlers. METHODS: A population-based sample of 921 Norwegian mothers with 18-month-old children completed a questionnaire designed to examine the impact of socioeconomic and demographic factors, somatic health problems, negative life events, chronic strain and social support on symptoms of anxiety and depression (HSCL-25). RESULTS: There was a moderate aversive effect of negative life events and chronic strain and a moderate protective effect of social support on the symptom level, but no interaction effects were found between the risk and protective factors. Behaviour problems among the children clearly seemed to affect the mothers' symptom level. The symptom level varied with background factors like the mothers' education, employment status and age even after controlling for the effect of strain and social support. The largest effect of the background factors seemed to be indirect, however, mediated through their effect on the risk and protective factors. CONCLUSIONS: Although problems with the children's behaviour and child care arrangements were observed to have a strong impact on the mothers' symptom level, the frequencies of such problems appeared to be less dependent on socioeconomic conditions than did other types of strain.

Adult↗
PubMed2002

Relationships between cognitive and behavioral measures of executive function in children with brain disease.

This study addressed the clinical and construct validity of the Behavior Rating Inventory of Executive Function. (BRIEF: Gioia, Isquith, Guy, & Kenworthy, 2000), a questionnaire designed to tap behavioral aspects of executive functions in children. BRIEF profiles in early treated phenylketonuria (PKU; n=44), early treated hydrocephalus (n=45), frontal focal lesions (n=20) and controls (n=80) were examined. Clinical validity was supported through significant between-group comparisons, especially between the frontal focal lesion group and other groups. To examine construct validity, raw scores on cognitive executive function measures including the Contingency Naming Test (CNT), Rey Complex Figure (RCF), Tower of London (TOL), and Controlled Oral Word Association Test (COWAT), were correlated with BRIEF scale scores. Few significant correlations were found, indicating cognitive and behavioral measures appear to tap different constructs within the executive function domain. A dissociation was found between behavioral and cognitive impairments in the frontal as opposed to PKU and hydrocephalus groups. This is discussed in relation to underlying pathology, the cognitive measures used, and possible limitations in the BRIEF's usefulness for measuring behavioral executive dysfunction in groups only mildly affected by neurological compromise.

Adolescent↗
PubMed1987

Nurses' perceptions of inter- and intra-professional relationships: an analysis of support from nursing and physician colleagues in rural hospitals.

Nurses employed in ten rural hospitals in Canada completed questionnaires designed to examine their perceptions of the strength of the professional relationship which existed among nurses and between nurses and physicians. Four questions addressed the availability of nursing education programs and the attendance of nurses and physicians at such programs. Seven questions examined the nurses' perception of physician interest in nursing education and the encouragement received from their nursing colleagues to participate in learning activities and medical management decision making. Chi square analysis was undertaken to determine whether the colleagial relationships differed by hospital or medical staff characteristics. Forty percent of the nurses felt that the majority of of physicians were supportive of continuing nursing education. Sixty-three percent indicated their nursing colleagues encouraged them to attend educational programs. The results indicate that physician participation in nursing continuing education was greatest in communities with the fewest health resources (an acute hospital with fewer than 50 beds). In contrast, encouragement to participate in continuing nursing education was highest in settings where the hospital provided both acute and extended care services, had more patient admissions and a greater availability of educational programming.

Alberta↗
PubMed2002

Health-related quality of life after laparoscopic and open nephrectomy.

BACKGROUND: Postoperative recovery often is assessed with parameters (pain and return to work) susceptible to bias. This study sought objectively to compare postoperative health-related quality of life (HRQL) after laparoscopic and open nephrectomy with the Postoperative Recovery (PRS) (a validated questionnaire designed to assess pain), activities of daily living (ADL), and HRQL in postoperative patients. METHODS: Patients undergoing contemporaneous laparoscopic and open nephrectomy received the PRS pre- and postoperatively. The results were analyzed with analysis of covariance (ANCOV) and survival analysis. RESULTS: The 33 open nephrectomy and 38 laparoscopic patients in this study were comparable in age, gender, body mass index (BMI) and employment. Laparoscopic operative time was longer (p = 0.015), and the hospital stay was shorter (p<0.001). Laparoscopic patients had higher HRQL scores from postoperative days 3 to 365 (p<0.001), and they returned to preoperative HRQL faster (p<0.001). CONCLUSIONS: An objective HRQL instrument confirms that laparoscopic nephrectomy patients recover faster and with a higher HRQL than open surgery patients. The PRS can be modified for use after other abdominal procedures, and may prove useful for comparisons of other minimally invasive surgical techniques.

Activities of Daily Living↗
PubMed2004

The 3-metros study of drugs and crime in South Africa: findings and policy implications.

This study examined the drug-crime nexus by investigating the prevalence of recent drug use among persons arrested by the police. Data were gathered during August/September 2000 from 1050 adult arrestees in eight police stations in Cape Town, Durban, and Johannesburg (South Africa). Measures included urinalysis results for cannabis, methaqualone (Mandrax), opiates, cocaine, amphetamines, and benzodizepines, and a questionnaire designed to assess socioeconomic and demographic backgrounds of arrestees, history of prior arrests and imprisonment, current arrest information, profile of substance use, etc. Results of the study show high levels of drug use among arrestees, with 45% testing positive for at least one drug (mainly cannabis and Mandrax). A greater proportion of arrestees in Cape Town tested positive for drugs than in the other sites. Data were also analyzed in terms of gender, age, race, location (site and police station), and offense category. Persons arrested on charges of housebreaking or for drugs/alcohol offenses were particularly likely to test positive for drugs. Drug positive arrestees were more likely to have had a prior arrest. Among the conclusions of the study are that 1) strategies to reduce drug use and drug related crime must be area specific, 2) particular attention needs to focus on young offenders, 3) police need to be trained to recognize particular symptoms and to establish protocols on handling arrestees under the influence of drugs, and 4) diversion to treatment of drug using offenders deserves more consideration.

Adolescent↗
PubMed2004

[Evaluation of the medical orientation for the benzodiazepine side effects].

OBJECTIVES: Benzodiazepines are among the most prescribed drugs indicated as anxiolytics, hypnotics, myorrelaxants or antiepileptics. Their main side effects are: reduced psychomotor activities, interaction to other drugs, like alcohol, and the development of dependence. In the present study it was evaluated the quality of the medical directions given to patients about those side effects. METHODS: One hundred and twenty patients (39 men and 81 women), mean age of 48 years old, who visited pharmacies in Curitiba to buy prescribed benzodiazepines, were interviewed by an open or directive questionnaire designed to obtain the medical directions about benzodiazepines side effects. RESULTS: Directions about the three main benzodiazepines side effects were observed only in 13% of the patients, 27% had received at least two and 40% only one, while 19% reported no directions. It suggested that the medical orientation was precarious and its quality was not influenced by the patients' educational level, the kind of medical attendance or the specialty of the physician. The main orientation cited was "don't drink" (85%), followed by "don't drive or operate machines" (46%), while few orientations about the risk to develop dependence on benzodiazepines was observed (31%). CONCLUSION: This suggests that physicians were worried about the alcohol interaction risk, which can be dangerous for the patients. The high number of patients using benzodiazepines continuously for more than one year (61%), the unsuccessfully attempt to stop using BZD (94%) and the poor information about the duration of the treatment (22%) were all related to the low medical worry about dependence on benzodiazepines.

Adult↗
PubMed2004

A comparison of autogenous/reactive obsessions and worry in a nonclinical population: a test of the continuum hypothesis.

Employing the autogenous-reactive model of obsessions (Behaviour Research and Therapy 41 (2003) 11-29), this study sought to test a hypothesized continuum where reactive obsessions fall in between autogenous obsessions and worry with respect to several thought characteristics concerning content appraisal, perceived form, and thought triggers. Nonclinical undergraduate students (n=435) were administered an online packet of questionnaires designed to examine the three different types of thoughts. Main data analyses included only those displaying moderate levels of obsessions or worries (n=252). According to the most distressing thought, three different groups were formed and compared: autogenous obsession (n=34), reactive obsession (n=76), and worry (n=142). Results revealed that (a) relative to worry, autogenous obsessions were perceived as more bizarre, more unacceptable, more unrealistic, and less likely to occur; (b) autogenous obsessions were more likely to take the form of impulses, urges, or images, whereas worry was more likely to take the form of doubts, apprehensions, or thoughts; and (c) worry was more characterized by awareness and identifiability of thought triggers, with reactive obsessions through these comparisons falling in between. Moreover, reactive obsessions, relative to autogenous obsessions, were more strongly associated with both severity of worry and use of worrying as a thought control strategy. Our data suggest that the reactive subtype represents more worry-like obsessions compared to the autogenous subtype.

Adolescent↗