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PubMed2005

Assessment of the training needs of Kentucky public health educators.

A survey to identify the training needs of Kentucky public health educators was conducted during the spring of 2001. Questionnaire items assessed respondents' job title, years of experience in public health education, percentage of work time doing public health education, and educational background. Respondents were asked to rate their perceived level of mastery of 50 public health educator competencies and skills, desire for additional training in each of the competencies and skills, and preferred format for training. Surveys were mailed to 699 health department employees across the commonwealth. A total of 366 questionnaires were completed and returned. Results provide a descriptive profile of Kentucky public health educators and pinpoint competency deficiencies. Grant writing, budgeting, evaluation, managing controversy, and multicultural understanding were identified most frequently as competencies in which more training was needed. An overview of survey results and recommendations regarding the training of Kentucky public health educators is provided.

Adult↗
PubMedDate not supplied

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students.

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.

Adolescent↗
PubMed2004

Factors that influence doctors' participation in clinical research.

BACKGROUND: Although clinical investigators are regarded as an endangered species, no systematic investigation of the factors that influence doctor participation in clinical research has previously been performed. AIM: The objective of this study was to evaluate the influences of selected aspects of medical education, specialty selection and practice type upon current involvement in clinical research. METHODS: Data were obtained by a mail survey of 428 graduates from the 1985-95 classes of the Penn State College of Medicine. RESULTS: Among the 34% (n = 145) of doctors who were currently participating in clinical research, there was a higher rate of participation among those in medical and surgical specialties versus those in primary care or hospital-based specialties. Of those participating in clinical research, 46% (n = 65) had sought external funds for their research, and 82% (n = 51) of that group had been awarded funds. Those who had been awarded funds as the percentage of their time involved in clinical research increased were more likely to report that research carried out in medical school had positively influenced their current involvement in clinical research (P = 0.004). The gender distribution among both this latter funded group and the larger group of 145 who were participating in clinical research was 72% men and 28% women, whereas the gender distribution among all respondents was 60% men and 40% women. The 283 individuals who were not participating in clinical research cited financial, family, career plan and practice philosophy as reasons for not doing so. CONCLUSION: The authors conclude that participation in medical research as a medical student may be under-recognised as a determinant of future involvement in clinical research and that the gender disparity of young doctors entering clinical research must be addressed.

Attitude of Health Personnel↗
PubMed2002

Blood transfusion, alcohol use, and anthropometric risk factors for rheumatoid arthritis in older women.

OBJECTIVE: To evaluate whether blood transfusion, alcohol use, or anthropometric characteristics are risk factors for rheumatoid arthritis (RA) in older women. METHODS: These factors were evaluated in a prospective cohort study that was initiated in 1986, and included 31,336 women aged 55-69 years without a history of RA. Risk factor data were self-reported using a mailed questionnaire. Through 1997, 158 cases of RA meeting at least 4 of 7 American College of Rheumatology criteria were identified and validated by medical record review. The relative risk (RR) and 95% confidence interval (CI) were used as the measure of association, and were adjusted for the potential confounding effects of age, marital status, smoking history, age at menopause, and use of estrogen replacement therapy. RESULTS: History of blood transfusion was inversely associated with RA (multivariate RR = 0.72; 95% CI 0.48-1.08), and this association was stronger for rheumatoid factor (RF) positive disease (RR = 0.59; 95% CI 0.35-1.00). There were no associations for use of medications for hyper- or hypothyroidism or adult onset diabetes. Anthropometric factors (height, weight, body mass index, body fat distribution), leisure time physical activity, and alcohol use were not associated with risk of RA. CONCLUSION: A history of blood transfusion was inversely associated with RA, particularly RF positive RA. Anthropometric factors, physical activity, and alcohol use did not influence the risk of RA in this cohort of older women.

Aged↗
PubMed1986

Burnout experienced by recent pharmacy graduates of Mercer University.

The degree of burnout experienced by graduates of the Mercer University Southern School of Pharmacy from 1973 to 1983 was studied. Questionnaires were mailed to 1000 alumni, representing 850 Bachelor of Science (B.S.) and 150 Doctor of Pharmacy (Pharm.D.) graduates. Three components of burnout--emotional exhaustion, depersonalization, and personal achievement--were measured using the Maslach Burnout Inventory to determine relationships between burnout and primary work setting, primary work activity, and type of degree (Pharm.D. or B.S.). The response rate was 41%. The respondents experienced a moderate degree of burnout. Those pharmacists working primarily in community chain store settings reported greater levels of burnout than those working in hospital or institutional pharmacies, independent community pharmacies, academia, and home health care. Respondents who performed primarily nondistributive duties (direct patient care, drug information, teaching or research, and management or administration) experienced lower levels of burnout than those involved primarily in drug distribution. Pharmacists holding the Pharm.D. degree were involved to a greater extent in nondistributive positions and experienced a lower degree of burnout than the pharmacists holding a B.S. degree only. Pharmacists in nondistributive roles appear to be less affected by burnout than pharmacists performing traditional distributive activities.

Burnout, Professional↗
PubMed1996

The PDBFINDER database: a summary of PDB, DSSP and HSSP information with added value.

MOTIVATION: The Protein Data Bank currently contains more than 4700 protein coordinate sets. It is often desirable to make a selection from these files based on a criterion like R-factor, experimental method, length of the amino acid sequence, or the number of homologous sequences in SWISSPROT. Doing this using the distributed form of the Protein Data Bank can be a tedious task, because (1) this requires reading one file for every single entry, and (2) not all of the information is present in a consistent computer readable way in all of the entries. RESULTS: The PDBFINDER database provides an easy to interpret file containing summary information about all Protein Data Bank files. Summary information from the DSSP (Definition of Secondary Structure of Proteins) and HSSP (Homology derived Secondary Structure of Proteins) databases is also included. Furthermore, where essential data were missing from the Protein Data Bank file, this information has been retrieved from the original literature. AVAILABILITY: The latest version of the PDBFINDER database can be downloaded by anonymous ftp from swift.embl-heidelberg.de, directory:/pdbfinder. CONTACT: E-mail address hooft@embl-heidelberg.de.

Amino Acid Sequence↗
PubMed2000

Twinship and risk of postmenopausal breast cancer.

BACKGROUND: Intrauterine exposure to high levels of endogenous estrogens has been hypothesized to increase the risk of breast cancer. Because estrogens and other pregnancy hormones are substantially elevated in twin pregnancies, and possibly more so in dizygotic twin pregnancies, we evaluated the association between aspects of twin membership (i.e., belonging to a twin pair) and the risk of breast cancer. METHODS: In a cohort of 29 197 postmenopausal Iowa women with no prior diagnosis of cancer (except for nonmelanoma skin cancer), breast cancer risk factors were determined by use of a mailed questionnaire in 1986 (baseline); twin membership, sex of the twin, and zygosity were determined by use of a follow-up questionnaire in 1992. RESULTS: Within the cohort, 1.8% (n = 538) of the women reported being a twin; of these, 24% (n = 130) were monozygotic twins, 63% (n = 337) were dizygotic twins, and 13% (n = 71) did not know their zygosity. From 1986 through 1996, 1230 breast cancers in the cohort were ascertained by linkage to the Iowa Cancer Registry. Compared with singletons, women who belonged to a twin pair were at elevated risk of breast cancer (multivariate-adjusted risk ratio [RR] = 1.72; 95% confidence interval [CI] = 1.22-2.42), with adjustment for educational level, family history of breast cancer, height, body mass index, body fat distribution, age at menarche, age at first live birth, use of hormone replacement therapy, and alcohol use. Multivariate-adjusted risk was elevated (in comparison with singletons) if the sex of the other twin was female (RR = 1.82; 95% CI = 1.20-2.75); however, this risk was limited to female dizygotic twins (RR = 2.14; 95% CI = 1. 21-3.79), since no excess risk was evident for monozygotic twins (RR = 1.04; 95% CI = 0.43-2.50). The risk to women with a male twin was also elevated (RR = 1.49; 95% CI = 0.80-2.78) in comparison with singletons, but this estimate was not statistically significant. CONCLUSIONS: This cohort study lends further support to the theory that there are important intrauterine influences on carcinogenesis of the breast.

Aged↗
PubMed1998

Prosthesis evaluation questionnaire for persons with lower limb amputations: assessing prosthesis-related quality of life.

OBJECTIVE: To develop a self-report questionnaire for persons with lower limb amputations who use a prosthesis. The resulting scales were intended to be suitable to evaluate the prosthesis and life with the prosthesis. The conceptual framework was health-related quality of life. DESIGN: Multiple steps of scale development, terminating with test-retest of the Prosthesis Evaluation Questionnaire (PEQ) by mail. SOURCE OF SAMPLE: Records from two Seattle hospitals. PATIENTS: Ninety-two patients with lower limb amputations who varied by age, reason for amputation, years since amputation, and amputation level. MAIN OUTCOME MEASURES: The 10 scales used were 4 prosthesis function scales (Usefulness, Residual Limb Health, Appearance, and Sounds), 2 mobility scales (Ambulation and Transfers), 3 psychosocial scales (Perceived Responses, Frustration, and Social Burden), and 1 Well-being scale. Validation measures were the Medical Outcomes Study Short Form-36, the Social Interaction subscale from the Sickness Impact Profile, and the Profile of Mood States-short form. RESULTS: Nine PEQ scales demonstrated high internal consistency. All met test-retest criteria for comparing group results. Validity was described based on methods used to gather original items, distribution of scores, and comparison of scores with criterion variables. CONCLUSIONS: The PEQ scales displayed good psychometric properties. Future work will assess responsiveness of PEQ scales to changes in prosthetic components. We conclude that they will be useful in evaluation of prosthetic care.

Activities of Daily Living↗
PubMed2004

ICPC Multilingual Collaboratory: a Web- and Unicode-based system for distributed editing/translating/viewing of the multilingual International Classification of Primary Care.

The International Classification of Primary Care (ICPC) is a clinical classification containing 726 clinical concepts, available in over 20 languages, augmented by links to ICD-10 concepts. It is employed in clinical information systems in several European countries, Israel, Japan, and Australia. In translating ICPC, it has been challenging to manage the flow of multilingual information, maintain its quality, and optimize its portability, particularly in light of the numerous character encodings used to represent its content. The ICPC Multilingual Collaboratory (IMC) is a World Wide Web-based environment, created to allow the viewing, maintenance, and translation of ICPC content by a dispersed international editorial staff. Based upon open-source software, it represents ICPC content using the Unicode standard for character encoding. The system implements three interfaces to ICPC data: 1) a password-protected editorial interface which instantiates a hierarchical authority model and communication channels for review and control of content, including a means of up-loading new candidate translations; 2) an openly accessible read-only interface, with e-mail access to the editors (providing another level of content review); and, 3) a management interface for the system administrator. The completed system powerfully demonstrates the ability of the World Wide Web, open-source software, and Unicode to expedite and simplify international multilingual collaboration, even in a world in which Unicode support is incomplete on existing computing platforms.

Female↗
PubMed2006

Cancer prevention trials and primary care physicians: factors associated with recommending trial enrollment.

BACKGROUND: To explore the willingness of primary care providers (PCPs) to encourage enrollment of patients into cancer prevention trials. METHODS: A self-administered survey was mailed to a random sample of PCPs in three geographic regions. Physicians were asked questions about their knowledge and attitudes towards cancer prevention trials. We presented a clinical vignette of a woman at high risk for breast cancer and asked if they would encourage her enrollment into a breast cancer chemoprevention trial (yes/no). Each survey included one of 16 possible clinical vignettes where patient characteristics (age, race socioeconomic status, physical mobility and co-morbidity) varied dichotomously. Bivariate analyses and logistic models were used to examine the independent effects of patient and physician characteristics on physician decisions. RESULTS: Two hundred and sixty-six surveys (50% response) were analyzed. The mean age of respondents was 48; 54% were White, 35% Asian and 5% Black. By design physicians were evenly distributed by gender, specialty and geographic location. Overall, 53% would encourage enrollment into a breast cancer chemoprevention trial. Significant predictors of a recommendation to enroll were: geographic location in California or Georgia, younger vignette patient and anticipating an increase in patient trust after recommending enrollment. CONCLUSION: PCPs are less likely to encourage elderly patients to enroll into cancer chemoprevention trials. Decisions differ based on geographic location and perceived trust in the patient-provider relationship. To achieve successful enrollment, trial investigators must continue to educate PCPs and ensure a strong PCP-patient relationship is maintained.

Aged↗
PubMed2000

Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction.

STATEMENT OF PROBLEM: Little is known about the importance of published fabrication standards in determining the outcome of treatment with mandibular distal extension removable partial dentures in patients of community practices. PURPOSE: This study describes mandibular partial dentures worn by patients from King County, Wash., and examines the validity of standards of design and fabrication by relating the standards to measures of clinical acceptability and patient satisfaction. MATERIAL AND METHODS: Eighty-two people treated in private dental practices who responded to a mail survey about satisfaction with a partial denture were examined. Eight standards of fabrication, overall clinical acceptability of the prosthesis, and tissue health were evaluated clinically. Patient satisfaction was assessed by questionnaire. Associations between variables were assessed by contingency tables and odds ratios. RESULTS: Half the prostheses met 4 or fewer of the 8 standards, and these were responsible for nearly all the displacement of tissue by the framework. Forty-three percent of the dentures (35/82) were rated clinically acceptable. Of the remaining dentures, 38 could be made acceptable by modifications. The remaining 9 dentures needed replacement. Sixty-three percent of the patients examined were satisfied with the dentures. There was a relationship between tissue health and the fabrication standards related to rest form, base extension, stress distribution, and framework fit. This study found no relation between tissue health and other design or fabrication features. None of the standards were found to be related to patient satisfaction. CONCLUSION: This study found partial support for the validity of design/fabrication standards for removable partial dentures. The most important standards are rest form, base extension, and stress distribution. The standards appear to be unrelated to patient satisfaction.

Dental Stress Analysis↗
PubMed2006

Communication technology in trauma centers: a national survey.

The relationship between information and communication technology (ICT) and trauma work coordination has long been recognized. The purpose of the study was to investigate the type and frequency of use of various ICTs to activate and organize trauma teams in level I/II trauma centers. In a cross-sectional survey, questionnaires were mailed to trauma directors and clinicians in 457 trauma centers in the United States. Responses were received from 254 directors and 767 clinicians. Communication with pre-hospital care providers was conducted predominantly via shortwave radio (67.3%). The primary communication methods used to reach trauma surgeons were manual (56.7%) and computerized group page (36.6%). Computerized group page (53.7%) and regular telephone (49.8%) were cited as the most advantageous devices; e-mail (52.3%) and dry erase whiteboard (52.1%) were selected as the least advantageous. Attending surgeons preferred less overhead paging and more cellular phone communication than did emergency medicine physicians and nurses. Cellular phones have become an important part of hospital-field communication. In high-volume trauma centers, there is a need for more accurate methods of communicating with field personnel and among hospital care providers.

Analysis of Variance↗
PubMed2003

An experimental study of women's internet personal ads.

Personal ads are a potentially rich source of information on relationships, particularly mating strategies. Most research on personal ads has been limited to content analyses of naturally occurring ads. In this study, four "female seeking male" ads were placed on two large Internet bulletin boards specializing in such ads. The four ads, differing primarily in a few key words representing the manipulated independent variable, garnered over 500 e-mail responses in 6 weeks. Contrary to prior research and to our prediction, the most popular ad was one in which the woman described herself as "financially independent...successful [and] ambitious:" producing over 50% more responses than the next most popular ad, one in which the woman described herself as "lovely...very attractive and slim." A content analysis of responses to the ads revealed that information provided varied as a function of the ad they were answering.

Adult↗
PubMed1995

Monitoring electrocardiographic changes: results of a national survey.

This article describes the electrocardiographic (ECG) monitoring practices of a national sample of nurses caring for patients who have suffered an acute myocardial infarction (AMI). Of specific interest were lead section practices, diagnosis of infarct evolution, and use of right precordial leads. Two populations were randomly sampled in an attempt to minimize sampling bias. Of the 2,549 mailed surveys, 882 were returned (34.8% response rate) from 48 states. Lead II was used most commonly (66.3%) with a single-channel system. Lead II plus V1 (or MCL1) was selected most often (62.4%) with dual-channel systems. Few (20%) respondents reported "always" modifying lead selection based on location of AMI; selected most often (62.4%) with only 43.3% correctly identified classic ischemia, injury, and infarction. Right precordial leads are used infrequently in practice.

Chi-Square Distribution↗
PubMed1997

Gender and age differences in attitudes to dental pain and dental control.

In the literature, it is usual to find women and younger subjects reporting higher levels of dental anxiety than men and older subjects. Fear of pain was found to be the most important predictor of dental anxiety and issues of control were also related to such anxiety. Therefore, it was predicted that gender and age differences would be reflected in attitudes to pain and control. Subjects were randomly selected from the voters' list in metropolitan Toronto and mailed a questionnaire with a request for cooperation in a study of their thoughts, feelings, and behaviour regarding dental treatment. The questionnaire included demographic data, measures of dental anxiety and painful experiences as well as the Pain Anxiety Symptoms Scale and the Iowa Dental Control Index. The results supported the main predictions. In addition, attitudes to pain and control were found to be complex phenomena with characteristic gender differences.

Adolescent↗
PubMed2002

Questionnaire color and response rates to mailed surveys. A randomized trial and a meta-analysis.

The authors conducted a randomized trial in Geneva, Switzerland, to assess whether response rates to a mailed survey could be increased by printing the questionnaire on green paper. The authors also conducted a meta-analysis of 10 experimental studies that tested the effect of colored questionnaires on response rates. The randomized trial showed no effect (relative risk of responding [RR] = 1.00). The meta-analysis showed that mailing questionnaires on pink paper increased response rates by 12% (RR = 1.12, 95% confidence interval = 1.01 to 1.25, p = 0.04). Other colors had no statistically significant effect (blue: RR = 1.03, p = 0.49; green: RR = 1.02, p = 0.23; yellow: RR = 0.96, p = 0.30). Overall, using colored instead of white paper had no effect (RR = 1.02, p = 0.17). Thus, printing questionnaires on colored paper does not substantially increase response rates in surveys, except for pink paper.

Adult↗
PubMed2004

Factors associated with colorectal cancer screening among the US urban Japanese population.

OBJECTIVES: The author examined the prevalence and predictors of colorectal cancer screening among the urban Japanese population of the United States. METHODS: A sample of Japanese residents of major US metropolitan areas completed a self-administered mailed survey. RESULTS: Physician recommendation, acculturation, and perceived psychological costs were consistent predictors of screening for colorectal cancer. Gender and marital status were related to screening via fecal occult blood testing; age, susceptibility, and health insurance were related to sigmoidoscopy/colonoscopy screening. CONCLUSIONS: Colorectal cancer screening among the urban Japanese population could be increased with interventions seeking to promote physician recommendations for screening, alleviate perceived psychological costs among patients, and improve physician-patient communication.

Acculturation↗
PubMed2000

Incidence of childhood type 1 (insulin dependent) diabetes mellitus in northeastern Thailand.

The incidence of type 1 (insulin dependent) diabetes mellitus in children under 15 years from northeastern Thailand was reported. Data of new cases from 1991 to 1995 were collected retrospectively by a mail survey from 257 government hospitals in the northeastern part of Thailand. The incidence rate of type 1 (insulin dependent) diabetes mellitus was 0.3/100,000 (95% confidence interval [CI] = 0.24-0.38). The incidence rate in girls was 2 fold that of boys. More than half of the cases were diagnosed between the ages of 10 and 14. These data indicated that incidence of childhood type 1 diabetes mellitus in Thailand is one of the lowest in the world.

Adolescent↗